Summary
County mental health staff proposed hiring three behavioral health specialists to run in‑house respite services for children and adolescents at the Youth and Family Services (YFS) facility, aiming to replace a $265,000 contract with an outside provider and to fund the service with Medicaid waiver reimbursements rather than county tax support.
Johnson County mental health officials on Aug. 21 asked commissioners to consider approving three full‑time behavioral health specialists to operate respite‑care services for children and adolescents inside the county’s Youth and Family Services (YFS) facility, a move staff said would reduce contract costs and rely on Medicaid waiver reimbursements rather than additional county tax support.
Tanner Fortney, who presented the item for the Johnson County Mental Health Center, said the county has contracted with outside providers, including Kids TLC and DECA, to supply respite care for families whose children have severe emotional disturbances. "Respite care is essentially a service that allows parents ... to have a reprieve where the child can home, so that there's a caregiver that's able to basically give the parents a break," Fortney said.
Fortney said the county opened a youth crisis stabilization center in 2024 and now has an 11‑bed pod in the YFS facility that has been unused and could be repurposed for respite care. Currently the county contracts for four respite beds under Kids TLC at an annual cost of about $265,000; Fortney said moving the service in‑house would allow the county to leverage existing staff, hire additional FTEs, and increase capacity and Medicaid billing over time.
Financials and assumptions
Fortney presented a multi‑year projection showing an estimated return on investment if the county transitions service delivery to in‑house operation when the current contract ends in October. He said that, in a transition month beginning Nov. 1, the county would see an increase in Medicaid reimbursement of roughly $50,000 for the partial period; a full year in 2026 would show a larger revenue increase if bed occupancy and reimbursement rates hold. Fortney noted the analysis assumes Medicaid reimbursement rates remain stable and that beds can be filled.
County tax support and program design
Fortney emphasized the proposal does not ask for additional ad valorem (property tax) support. When the chair asked for clarity, Fortney confirmed: "That is correct." Commissioners who reviewed the presentation generally praised the analysis and the concept of managed competition—comparing external contract delivery versus in‑house operations—while asking operational questions about room occupancy and flexibility between respite and crisis stabilization uses.
Commissioner questions and operational matters
Commissioners asked whether the YFS pod’s rooms were single or double occupancy and how gender separations and variable daily census would affect capacity. Fortney said rooms could be doubled in some circumstances but noted compliance and safety (for example, male/female separation) can constrain use. Commissioners also emphasized that projected revenues do not imply a profit motive and that the county must account for facility upkeep, training and staffing costs when assessing whether the program will be budget‑neutral over time.
Next steps
The item—"Consider approving 3 FTE behavioral health specialists for the Johnson County Mental Health Center to provide respite care services for children and adolescents at the Youth and Family Services facility"—was scheduled for formal consideration at the board’s next business session. Staff said the transition could begin when the existing contract expires in October and that they expected to bill Medicaid waiver services to sustain the program.
