After hearing legal and actuarial analysis, the board gave staff direction to continue pursuing membership in a regional SCALE pooled insurance plan with a target effective date of Jan. 1, 2028, contingent on resolving whether Department of Commerce rules allow the proposed weighted‑voting governance structure.

Staff warned commissioners that a 2024 law to transition Medicaid non‑emergency medical transportation (NEMT) to state control has timeline and operational risks; Scott County has already removed the service from its budget and counties have asked state agencies for guidance on continuity and reimbursement.