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County hears justice grant case-management report detailing client referrals, service gaps and detox funding shortfalls
Summary
A county-hired justice/community case manager reported intake and follow-up numbers for a July-launched program, outlined obstacles to immediate detox placement for people without Medicaid, and estimated community cost savings from avoided homelessness and inpatient care.
Supervisors heard a presentation from Allison, a justice-focused case manager, describing a program launched in July that connects people with substance-use and behavioral-health needs to assessment and treatment services.
Allison said early caseloads exceeded expectations: "I saw the stats that I saw 33 people brand new in July," she said, and described repeat contacts through August and September as the program stabilized (intakes and repeats reported in successive months). She outlined one case in which the team secured an inpatient bed after a local stabilizing placement and coordinated with attorneys and Upper Des Moines for housing assistance.
Allison told the board the program is saving public costs by reducing jail, emergency-room and inpatient use. She cited a working figure used in her quarterly report that "homelessness costs an average about $40,000 a year to the community" and said inpatient treatment costs can run "$1,100 a day." She cautioned those figures are part of her program report and used to estimate cost savings rather than as an audited total.
A major barrier Allison flagged is lack of funding for detox for people who are not on Medicaid or not under a committal. "We don't have money for detox anymore," she said, describing cases in which people needed immediate detox but could not access paid beds without Medicaid. She noted a 30-day timeline to enroll some individuals in Medicaid, and that presumptive Medicaid does not fully cover certain substance-abuse (D3) funding streams.
Allison described an "intercept" model for referrals that includes community, law enforcement, initial appearance, jail and supervision levels; she said many referrals come from law enforcement and attorneys, and that coordination with CFR (a contracted provider) and Beacon of Hope helped move one high-need individual to a 30-day inpatient stay in Des Moines followed by community-based housing.
Board members asked clarifying questions about the grant duration (Allison said it is a four-year grant) and potential ASO involvement to fund ongoing services. Allison said she will return next quarter with further updates and noted staffing and provider shortages are limiting program expansion.
What’s next: Allison will provide a quarterly report with intake and outcomes data; the board discussed moving opioid-related funds and finalizing an agreement with CFR to support detox referrals.
