Region 5 Systems, APACE present annual reports; Region seeks more crisis bed days and separate interlocal agreements

Region 5 Systems and APACE presented annual reports to the York County Board of Commissioners on May 13, outlining service activity in York County, funding pressures and proposed changes to crisis bed access.

The presentations matter because local match dollars and regional coordination fund crisis response, behavioral-health navigation and developmental disability services that county residents rely on for emergency and ongoing care.

Matt Kasek, CEO of APACE, told the commissioners APACE is the state’s largest provider of developmental disability services and serves 37 people in York County. "We support about 710 shared living providers," Kasek said, and he described a shift in state policy that is increasing vocational and day services while reducing residential offers.

Patrick Kreifels, regional administrator with Region 5 Systems Behavioral Health Authority, said Region 5 covers 16 counties and described the agency’s funding and service mix. "Statutorily, all the counties are required to match the behavioral health services that the state of Nebraska contributes," Kreifels said. He told commissioners Region 5 reduced the additional county match request by 38% through internal efficiencies and that Lancaster County supplies about 67% of the region’s budget.

Kreifels reported system use in York County: 29 crisis responses and 18 emergency protective custody (EPC) placements in fiscal year 2023–24, and 384 behavioral‑health encounters overall. He said Region 5 funds navigation services, rental assistance for eligible low‑income residents and a range of crisis supports for people not covered by Medicaid.

Both presenters said governance documents were updated. Kasek said APACE’s board adopted updated bylaws and an updated interlocal agreement that separates Region 5 services from Region 5 Systems governance. "We adopted new bylaws," Kasek said, and asked the county to sign the revised interlocal agreement when it is circulated.

Kreifels described a pilot to expand EPC bed access starting July 1 if hospitals agree: Region 5 plans to contract with Mary Lanning Health Services for York, Polk and Thayer counties and with Fremont Hospital for Butler and Saunders counties to add 368 bed days to the system. "We're gonna contract with Mary Lanning instead of using the single point of entry, which will increase bed access days," Kreifels said. He framed the move as a one‑year pilot and said law enforcement, hospitals and county attorneys were consulted.

Kreifels also noted LB454, a bill in the Nebraska Legislature, had passed committee and advanced to select file; he said the bill would remove a public‑bidding requirement for some behavioral‑health contracts and allow documentary‑stamp tax funds to be used for substance‑use housing. "LB454 ... got out of committee," he said, and reported it had favorable support on general file.

No formal county action was recorded at the May 13 meeting to adopt Region 5 documents or to approve the EPC pilot; Kreifels asked commissioners to sign the updated interlocal agreement when it is circulated for county signatures. Kasek said APACE will not request county funding this year and that Medicaid remains the primary funding source for its services.

The presenters provided takeaways for commissioners: behavioral‑health services cover a range of needs beyond Medicaid, the region has reduced requested county matches, and adding contracted hospital capacity is a short‑term strategy to increase EPC bed days. Kreifels also said Region 5 will send a return‑on‑investment estimate showing one study’s finding that each dollar invested in behavioral health returns roughly $3 in employment offsets and up to $5 when healthcare and emergency costs are considered.

Commissioners asked clarifying questions about bed‑day arithmetic and capacity; Kreifels explained that 16 beds at the Lancaster center provide about 5,840 annual bed days and that adding 368 bed days increases total bed days to about 6,208 for the year. He said Lancaster County currently dedicates local funds to the Lancaster crisis center and that hospitals are cooperating on overflow.

The board did not vote on funding or contracts at the meeting. Region 5 and APACE asked only that the county sign updated interlocal paperwork and stay engaged on the bed‑day pilot and legislative developments.

For now, county commissioners will await the emailed interlocal documents and any contracts necessary to implement the proposed EPC bed expansion.