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Sawyer County staff say out-of-county mental-health placements are costly; seek local alternatives
Summary
Health and Human Services staff reported high placement costs for out-of-county mental-health care, including involuntary admissions to Winnebago, and discussed soliciting local residential options and issuing a request for proposals to reduce expenses and improve oversight.
Sawyer County Health and Human Services staff told the board June 10 that expensive out-of-county placements for people needing higher levels of care are increasing contracted-services costs and prompted staff to seek local alternatives.
The issue matters because the county is paying placement costs for people sent to facilities far from Sawyer County, which staff said reduces their ability to monitor care and raises the county's contracted-services spending. Staff said they will pursue ways to lower costs and to develop local options that would keep people closer to home.
Caitlin, community support program staff, reported the department’s April mobile-crisis activity and consumer census. “For mobile crisis in April, we just got 5 phone calls. Each call, we did a mental health assessment with them. So 2 emergency detentions, and, unfortunately, both of those emergency detentions were placements at Winnebago,” she said. Caitlin also said that in April the Community Support Program (CSP) served 47 clients, 14 of whom were court-ordered, and that a portion of those clients were in placements.
An HHS staff member described how distant placements drive both cost and staffing burdens. The staff member said the county is “really looking at what our needs are and hoping to build something in the right direction” and noted that someone had contacted the agency about starting “a CBRF or a group home.” The same speaker said staff plan to issue a request for proposals to solicit lower-cost or closer placements: “I really would like to put a request for proposal out there to see if we can get some reduced… costs and or get them closer to our area because that's also the other issue is people are so far away.”
Board members and staff discussed how placements can be billed differently when they are voluntary versus involuntary and observed that shorter distances would allow county staff to monitor care more frequently. Staff said one person remained hospitalized at Winnebago but expected an upcoming discharge that would change projections.
Fiscal staff flagged placement costs as an item they are monitoring closely. The county’s fiscal report for the department noted that contracted services overall were “right on budget” but that out-of-home placement and Winnebago expenses merited continued attention.
Staff identified potential next steps: issuing an RFP for local residential providers, projecting future placement needs for youth who will age into adult services, and continuing to monitor individual Winnebago cases for discharge dates.
Questions raised during the discussion focused on placement alternatives, the feasibility of developing local capacity, and how an RFP might lower costs and allow better oversight. No formal motion or board vote on an RFP or new local facility occurred at the meeting; staff said they would bring proposals back for further consideration.
