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County discusses adult placements, MCO shifts and CRU pilot with West Bend

Washington County Health and Human Services Committee · February 26, 2026

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Summary

Officials reviewed adult family homes and group-home placements, noted increased enrollment in managed care organizations (shifting payment responsibility), clarified Calm Harbor’s crisis-stabilization role, and updated the committee on a CRU pilot that will expand to 24 hours in March.

The committee heard a detailed report on adult placements and related programs. Presenter (Health and Human Services department) explained that adult family homes and community-based residential facilities (CBRFs or "group homes") provide 24/7 staffing and support for residents who cannot live independently, and that placement decisions pivot on individual acuity and service needs.

Presenter said the number of clients in these placements has not changed substantially but that the share enrolled with managed care organizations (MCOs) has increased; when an individual moves onto an MCO, the MCO then pays for the placement. "For December, we still have 19 individuals who are in a group home based setting, but 10 of those 19 are now with a managed care organization," the Presenter said. The Presenter added that the county works with adult family homes and CBRFs to bill Medicaid and that those efforts can offset 40%–50% of placement costs.

A committee member asked whether Calm Harbor (licensed as a CBRF) is budgeted in this area. The Presenter said Calm Harbor primarily functions as a crisis-stabilization intermediary, not budgeted in the placement line, and is used when a resident must move from a group home while staff locate an alternate placement.

The Presenter also reviewed CRU fourth-quarter data and a pilot with West Bend intended to increase outreach and response productivity. The pilot began with one staffer for eight hours and will expand to 24 hours in March with three staffers on different shifts. "We add an additional 8 hours to 16. Now we're going to go to 24 in the month of March," the Presenter said. The county plans an assessment meeting in March to determine next steps and whether to propose a formal agreement.

The discussion focused on ensuring placements match resident needs and on the county’s efforts to draw down Medicaid and MCO reimbursement to offset costs. No formal actions were taken during the report.