Adams County Health and Human Services annual report flags aging population, Medicaid reliance and child-welfare costs

Kelly, Health and Human Services staff, presented the department’s 2024 annual report and said the document “is a little under 70 pages long,” providing an overview of program trends and budget implications for Adams County.

The report emphasizes demographic and fiscal pressures. Kelly told the committee that Adams County’s population is “very top heavy,” meaning the county’s population pyramid shows an older age distribution than Wisconsin overall, a pattern she said will likely increase demand for senior services including home-delivered meals, transportation and dementia care.

Kelly said the department is trying to sustain its nutrition program amid rising costs: “The cost of the meal is $12.60 to prepare. The program is based on donations. We can only ask and encourage a donation of $4,” she said, explaining the program reduced restaurant-style congregate dining and moved two full-time cook positions to a contracted nutrition model to capture cost savings.

On behavioral health, Kelly highlighted increases in community-based, wraparound services that the department said are reducing hospitalizations. The department reported 359 crisis calls in 2024 (54 for youth and 305 for adults) and said most callers were able to remain in the community with supports; 49 individuals required hospitalization. Kelly said psychiatric services expanded access and that “we served over 500 people in psychiatry” last year and had 432 people enrolled in crisis services.

Child welfare and long-term support programs were prominent in the presentation. Kelly reported the children’s long-term support (CLTS) caseload grew about 28% since 2020 while enrollment timeliness averaged 43 days at year-end, short of the state standard to enroll eligible children within 90 days of referral. Kelly described state enforcement options if counties do not meet standards — corrective action, repayment of funds, or withholding administrative funding — and said counties must monitor compliance closely.

The committee also heard that out-of-home care counts declined (from roughly 90 youth in 2019 to about 60 in 2024) while the county’s out-of-home placement costs rose sharply between the two most recent years reported. Kelly warned that proposed increases in daily correctional placement rates at the state level could have a “major impact to our budget,” and emphasized local officials do not control judicial placement decisions.

On funding, the report said roughly 46% of the division’s revenue comes from state and federal aid, about 28% from third-party billing (insurance) and 26% from the county tax levy. Kelly noted Medicaid paid for services for about 42% of the department’s clients last year and that block-grant reductions at the federal level could materially affect local programming.

Other operational highlights included an increase in volunteer “in-kind” contributions tied to donated “blizzard boxes” (nonperishable food delivered to homebound seniors, claimed at $12 per box for in-kind match), expanded vaccine outreach that produced a 38% increase in flu vaccinations from 2023 to 2024, approximately 11,000 front-desk appointments scheduled and the launch of appointment reminder texts (about 10,000 texts sent in 2024).

Supervisor Grabarski moved and Supervisor Shelton seconded a motion to forward the annual report to the full county board; the committee approved the referral. The committee accepted the written director and manager narratives and closed the item.

Why it matters: committee members flagged demographic shifts and external funding risks that could require program changes or lobbying at the state level. Kelly repeatedly tied program decisions to statutory and state-level requirements that affect county budgeting and service obligations.