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Region 5 officials warn state psychiatric bed closures shift millions in costs to counties
Summary
Sourcewell’s regional transition administrator told the Todd County Board that state-level changes and hospital capacity shortfalls have forced counties to absorb expensive 'does not meet criteria' hospital days. Region 5 reported roughly $2,500,000 in avoided costs over recent years but said statewide county liabilities remain large.
Todd County heard a regional briefing on Tuesday about the financial and operational impact of state psychiatric hospital capacity, a briefing county leaders said they intend to take to the state legislature.
Mike Wolley, senior regional transition administrator for the Sourcewell–Region 5 Adult Mental Health Initiative, told commissioners that counties in Region 5 took steps beginning in 2017 to reduce unnecessary hospital days and to coordinate discharge planning. He said a single 'does not meet criteria' (DNMC) hospital day can cost roughly $2,000, and urged legislative attention to how those costs are billed to counties.
Wolley said Region 5’s coordinated efforts produced estimated savings of roughly $2.5 million across the region in the 2020–2023 period compared with earlier years, but that counties still face a statewide billing exposure the state has quantified at about $44 million. He described the reason: the state reduced hospital capacity and in some cases lacked staff to operate beds, while billing counties for the ongoing daily costs of patients who could not be discharged to community placements.
County Coordinator Jackie and commissioners discussed how the county has paid large daily rates for individual high‑need clients and the difficulty county case managers face when hospital discharge processes are inconsistent across facilities. Wolley said Region 5 serves roughly 80–100 individuals a year and that about 36 in the last year were on commitment and therefore likely to occupy hospital beds at some point.
Why it matters: Commissioners were told that the county is effectively subsidizing state psychiatric care through the DNMC billing policy and that the problem will grow if state policies and capacity do not change. County staff said they plan to bring the data to state legislators to seek relief or policy change.
What's next: Officials asked county staff to share the briefing and supporting data with their legislative contacts for the current session.
