Consultants tell Douglas County commissioners TRC is valued but limited by state licensing, staffing and funding

At an April 22 work session, Douglas County commissioners and consultants reviewed an interim assessment of the Treatment & Recovery Center, a community crisis facility run by Bert Nash, and identified three immediate constraints: a state licensing cap on admissions, staffing and training shortfalls, and outstanding questions about the TRC’s budget and reimbursement.

Consultant Margie Balffor said the interim report found broad community support for the center. “The community really values the TRC and that’s what we heard time and time again,” Balffor said, urging operational refinements rather than closing the program. Consultants confirmed they will deliver a final report in May with more detailed recommendations.

A central issue is capacity. Commissioners and staff said the physical building was designed to hold as many as 32 people but that the state licensing agency (KDADS) currently limits observation and stabilization admissions to 16. Staff described that mismatch as “fundamentally different from the financial model that we built,” and said it has affected revenue projections and reimbursement under the PPS payment methodology. The timeline for any change in the PPS update was described as “not specified” in the session.

On data and reporting, consultants recommended streamlining metrics and adopting automated dashboards so TRC staff focus on analysis instead of producing repetitive reports. County IT staff were already developing PowerBI visualizations to track visits, admissions and flow across partners.

Bert Nash leaders and consultants outlined staffing and training gaps. Ryan Storch, Bert Nash’s crisis services senior director, described the TRC’s intensive de-escalation training program and safety equipment: “For our crisis de-escalation modality at the TRC, we use a product called Safe Clinch,” he said, and noted a three- to four-day deep dive training is supplemented by in-service sessions, additional security staff and wearable communication devices. Speakers emphasized mentorship for new hires and the need to elevate experienced workers into supervisory roles to reduce single-point dependency.

Officials clarified usage numbers: roughly 3,500 visits in a year include a large number of brief urgent-care contacts, while about 1,500 distinct people were admitted into observation or stabilization. Staff said roughly 14 people are typically on the local “familiar faces” list — individuals who cycle through services repeatedly — and that, since the capacity cap was imposed, admissions into the observation/stabilization units fell by about 18% year over year.

Commissioners pressed for more financial detail. Consultants and Bert Nash staff said they are separating TRC costs into three buckets to distinguish direct TRC expenses from broader agency costs and are working with finance and revenue-cycle consultants to produce clearer numbers. Staff signaled they aim to provide commissioners with revenue-cycle analyses and a proposed financial framework ahead of a scheduled May 20 funding discussion; the consultants said a cost-decision support model will accompany recommendations.

Throughout the discussion, speakers urged continued system mapping with emergency departments, EMS and law enforcement to align medical-clearance criteria and to reduce operational friction when patients transfer between agencies. Consultants noted they had interviewed a broad set of partners — the TRC advisory board, the Crisis Systems Operations Team, EDs, law enforcement, EMS, substance-use providers and peer organizations — and planned follow-ups with TRC leadership and finance consultants.

The consultants’ interim memo and exchanges in the work session framed the TRC as an early adopter of a new crisis model in Kansas: one that has demonstrated community value but needs clarified regulations, improved data systems, targeted staff training and a transparent financing plan to reach sustainable throughput and reimbursement levels. The consultants said their final report will include specific operational and financial recommendations due in May. The work session recessed to the 5:30 p.m. business meeting with commissioners expecting additional financial materials ahead of the May budget discussion.