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Committee flags rising HHS costs, large out‑of‑county youth placements driving deficit
Summary
Finance staff told the committee HHS ran a $1.566 million deficit in 2024, driven in part by higher youth justice placements and out‑of‑county residential costs; committee agreed to track placements and billing more closely.
Committee staff told the Sawyer County Finance Committee on March 13 that Health and Human Services (HHS) finished 2024 with a deficit of about $1,566,000 and recommended a $1.3 million transfer from general fund surplus to reduce pressure on HHS fund balance.
The committee heard that a principal driver of the HHS shortfall in 2023–24 was rising youth justice costs and the county’s use of out-of-county residential placements. Staff said contracted residential placements and mental-health facility placements can cost thousands per person per month and that transport costs for placements are also significant. The HHS packet projected contracted mental-health placements could total about $2,700,000 in the year shown in the report.
Presenters identified several placement types and facilities used for residents from Sawyer County, including adult family homes (AFH), community-based residential facilities (CBRF), and larger secured facilities such as Winnebago and Trempealeau. Staff noted that local options are limited — for example, there are 10 beds in Ashland — and that increasing local capacity would reduce transport time and cost, but the county lacks control over availability at those facilities.
Staff and committee members discussed juvenile justice case counts and cost trends. A year-by-year analysis in the packet showed juvenile justice costs were relatively low through 2022 and then rose sharply in 2023 and again in 2024; staff said several factors contributed, including increased referrals and added placements that were not previously occurring. Committee members asked whether state reimbursement or Medicaid covered placement costs; staff said Medicaid may cover some placements if the client is eligible, but many costs are borne by the county.
Committee staff said HHS has improved monthly reporting to its Human Services Committee and will bring more detailed placement-level information on high-cost cases when requested. Staff and committee members discussed strategies to address the structural deficit: maximizing billing and Medicaid claims, pursuing grants that align with existing services, reducing duplicated services where appropriate, and, as a last resort, considering levy increases.
Ending: Committee directed staff to include clearer placement and billing detail in future reports and to monitor HHS costs closely as the county moves toward finalizing the recommended transfer to HHS.
