County staff report high deferral rate at Riverbend as budget choices loom

Washington County Health & Human Services staff reported on June 25 that most referrals to Riverbend’s newly retooled program are being deferred and said the early data will inform a potential decision this summer about whether to keep a comprehensive residential program or pursue a shelter-only option.

Julie (county staff) told the committee the program’s referral-to-admission data are incomplete but troubling: referrals are being made, yet a large share are not admitted. Julie said Riverbend reported deferral rates in the “sixty-eighth percentile” for June and later described an overall deferral rate “around 63 percent,” with the leading reasons being “no appropriate match” (a cited “milieu fit”) and cases where the referring county did not respond when Riverbend followed up.

The memo provided with the update shows Riverbend’s current census and reasons for deferral. Julie said Riverbend had three children in a short-term “shelter” status and two in residential placement at the time the report was produced; she said Riverbend’s physical capacity is 14 to 16 beds and that the operator generally attempts to stay around 12 occupied beds.

Supervisors pressed for financial context. Julie said the county’s contract and budget model assume revenue from out-of-county placements will offset a portion of the facility’s cost; she estimated that, to return to historic funding levels, the program would need roughly eight children on average at any given time (the vendor’s stated operational target is about 12). She warned that if current admission patterns continue, it will be difficult to justify maintaining the full residential model.

Committee members asked whether deferral rates reflect inappropriate selectivity by the vendor, referral quality from counties, or other process issues. Julie said Riverbend makes clinical decisions about whom it can safely serve and that county staff are continuing conversations with the vendor. She also said some referrals are closed by the referring county after a placement is found elsewhere, which can produce “no response” records in Riverbend’s tracking.

Julie told the committee the data are still early and that staff intend to bring a more formal framework in August (a budget decision period) for whether to continue the full program, slow-roll to shelter-only, or take other steps. She said contracts include a 60-day out provision, so terminating the vendor arrangement would not trigger a long penalty period.

Committee members asked whether other funding sources could be used to cover transitional costs. Julie said staff would include potential funding sources — including one-off settlement or grant funds discussed elsewhere in county planning — in their August framework.

Why it matters: The Riverbend program addresses county needs for both short-term sheltering and longer residential placements for children. If admissions remain low while fixed costs continue, staff warned the county may face a policy and budget choice in August about scaling back to a shorter-term shelter model or continuing to subsidize a larger residential operation.

Looking ahead: Staff expect to return with additional data in July and a more developed proposal in August tied to the county’s budget process.