County behavioral health division reports rising caseloads, new staff and program shifts to keep people out of hospitals

Walworth County behavioral health staff reported July 16 that the division served more than 1,000 county residents in 2024 and has made several operational changes intended to reduce hospitalizations and improve community-based supports. Amy Hart, behavioral health division manager, told the Health and Human Services Board that crisis services handled over 10,000 contacts in 2024 and completed 925 risk assessments; of those risk assessments, about 14% resulted in inpatient admission. In total, staff recorded 130 admissions via emergency detentions that year, accounting for 1,245 hospital days. Hart said the division’s approach is a continuum of care — crisis services, case management, outpatient treatment, Comprehensive Community Services (CCS) and Community Support Program (CSP) — and that the department uses flexible enrollment to meet individual needs. She said the county now serves roughly 149 children, 762 adults ages 20–64 and 99 adults over 64 in behavioral-health programs. The division reported operational changes that include hiring a full-time advanced practice nurse prescriber (APNP), restoring two full-time prescribers for medication management, and dually enrolling case managers in CCS and CSP to allow smoother transitions between programs. Hart said those changes have increased available services and revenues and allow staff to move about 30 consumers from CSP into CCS when clinically appropriate. Staff presented a composite case example in which an individual had four hospitalizations in six months totaling 121 days; after enrollment in CCS and placement in a supported apartment with on-site assistance, the individual stabilized and began seeking independent housing. Hart attributed the outcome to time-sensitive intervention, case-manager advocacy and wraparound services. Several consumers and a partner provider offered short testimonials. Michael (a program participant) credited medication monitoring, group activities and supported apartments for greater independence. Crystal Flood, executive director of Casa Mia (a CBRF and supported-apartment operator), described Casa Mia’s supported-apartment model and a workforce-readiness program called “Casa Mia cookies,” which helps residents learn employment skills and community engagement. Hart and staff said program goals include resolving immediate crises, transferring people to long-term services when appropriate, improving functioning, and providing a persistent “no wrong door” point of access for residents. The board received the presentation; no formal action was taken on program structure during the July 16 meeting. Ending Staff asked the board to continue supporting flexible, community-based services and noted that changes in program codes (for example, older CSP administrative rules) have constrained some service options, a reason the department favors CCS where permissible.