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County staff warn rising contractor rates, high CBRF costs and Rivers Bend contract pressures
Summary
Staff told the Human Services Committee that provider contract rates are rising — in some cases sharply — increasing pressure on the county budget and prompting a review of out‑of‑county and youth shelter arrangements.
Washington County Human Services staff told the committee that annual contract renewal rates for several provider types have increased in recent years and in some instances approach 40%, straining the department’s ability to realize savings from prevention and other initiatives.
Julie, a Children and Families Division staff member who presented the overview, said the packet contained only examples of contracts and not an exhaustive list. "Some of them [contract increases] as high as 40%, some a standard 3 to 4%," Julie said, adding that placement contracts such as community‑based residential facilities (CBRFs) can produce large per‑person cost differences depending on the provider and level of care.
Julie told supervisors that CBRF homes in the county typically are four‑bed facilities and occupancy varies by home — some have all beds filled, others one or two. She noted the county sometimes places individuals in CBRFs when independent housing is not available because of limited landlord participation and low incomes, and that using a CBRF can be far more expensive than independent rent. "$8,500 to pay for somebody to be in a CBRF when rent could be $800 is a huge difference," she said. Staff also said they work with CBRF providers to bill Medicaid where appropriate for services such as independent living skills to offset costs.
The county also discussed the Rivers Bend youth shelter and treatment contract. Julie said the Rivers Bend contract previously provided a flat annual payment; "Two years ago, it was about 800,000. Last year, it went up to the the 9.98. And now they've essentially said to us that ... they want us to contract with the whole for the whole amount that it costs for them to run that facility." Committee members and staff discussed that the facility is often under‑utilized but must be maintained when beds are needed, creating a recurring cost/benefit tension between maintaining capacity and paying unused bed costs. Julie said the county is negotiating a new strategy with provider Norris and will present a fuller plan to the county board.
Supervisor Bossert highlighted savings from avoiding high‑cost psychiatric hospital stays and encouraged continued efforts to find lower‑cost housing and services that reduce inpatient use. Staff said they are attempting to draw down Medicaid dollars where feasible and negotiating with providers on rates.
No formal action was taken during the meeting; staff said the items are under ongoing review and that a broader county‑level conversation on the Rivers Bend contract and youth crisis shelter will be forthcoming.
