Funding Douglas County health services faces challenges - Superior Telegram

The department is proposing taking $240,000 from various reserve funds to launch a Comprehensive Community Services program in Douglas County. After losing one potential partner because of funding issues, the county is searching for a new partner without promises of funding for non-billable services that support the program.

Funding for administrative costs is recaptured through a year-end reconciliation, a process that could take up to 16 months to reclaim, said Pat Schanen, director of Health and Human Services. She said the one-time funding from Douglas County could fill the gap for administrative costs for the program until the first reconciliation is complete. In subsequent years, the annual reconciliation would pay for those costs.

"Most agencies don't have the money to fund those services on the front end without reimbursement," said Dave Longsdorf, mental health and substance abuse supervisor for the Health and Human Services Department.

In fact, one potential partner dropped out for that reason and the county is seeking a new partner to provide services through the CCS program without a promise to help with the administrative costs, Schanen said.

"I wouldn't apply either if you told me there was no money," Supervisor Marvin Finendale said.

"We do have some reserves that we felt comfortable using for this," Schanen said.

However, supervisors expressed concerns about expending the reserves with ongoing cost overruns as placements for child protective services and institutional commitments continue to mount.

"We haven't dipped into these to cover budgets, yet," County Board Chairman Mark Liebaert said, stressing "yet."

Schanen said while the reserve funds could help with cost overruns in the budget, the one-time money wouldn't solve the problem.

"We've been seeing an increase in children's mental health," Longsdorf said. "We've seen an increase in commitments. We've seen an increase in alcohol and drug abuse, specifically drug abuse. This is actually the program that the state put out there that's now 100% Medicaid funding in an effort to combat, to help with that." He said the counties that have the program report that it has been a huge boon those counties.

Longsdorf said while the program wouldn't fix everything, it would address the issues that are resulting in increased commitments and placements.

"It will really return the investment," he said.

Comprehensive Community Services helps individuals of all ages live their best life by providing support to address needs related to mental health and substance use. It is intended to assist individuals who are in need of care outside of inpatient settings, but who may have ongoing needs that, if left unaddressed, could result in hospitalizations during times of crisis, according to the Wisconsin Department of Health Services. As of Dec. 31, 2018, the latest data available, 7,543 individuals were enrolled in the 66 counties and three tribes where the program is available.

"The program has merit; there's no doubt about that," said Supervisor Larry Quam, chairman of the Health and Human Services Committee. However, he shared Liebaert's concerns about the "big picture" financially.

"If we were to say to you 'is this the best expenditure of $240,000 faced with what we're coming up with," Liebaert asked.

"I would say it is," Schanen said. She said the program would provide a broader array of services than the Health and Human Services Department is equipped to handle. When a child comes out of foster care, the department no longer has jurisdiction to work with the children but a program like CCS could provide the continuum of care that a child needs to succeed, she said.

"I see this as having potential for reducing the number of kids that have to go to residential and getting them out and back home faster because there is going to be such an array of services for that child," Doreen Wehmas, intake and assessment supervisor, said. "And potentially the parent would have their own array of services."

Wehmas said there have been multiple cases where she thought a CCS model of care would have been helpful.

"We certainly don't have enough services for children," said June Farkas, a registered nurse serving on the Health and Human Services Committee. She said she trusts the judgment of the Health and Human Services Department in developing the program.

"We have trouble with the budget because of all the commitments that we have," said Dr. Amida Gallito, a member of the Health and Humans Services Committee.

The Health and Human Services Committee approved the request, sending Administration Committee, which will discuss it at 9:30 a.m. Thursday, May 2. The full County Board would have to approve the request before it could be implemented.

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