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Human services: Huge deficit

HUDSON: Once the books are closed, St. Croix County's Health and Human Services Department will apparently show a 2003 loss of well over $300,000 - a deficit the county will have to cover.

HHS Director John Borup broke the news to Finance Committee members last Thursday, using a chart he had put together at home the night before.

Actually the department's deficit is $650,353. But Borup asked for reimbursement for $104,000 of employee expenses that the county had agreed to pay, to apply $93,000 in other funds to the deficit, and to attribute $125,000 in pending collections. There was confusion over whether the $125,000 had already been figured as income so the deficit could be close to $450,000.

In 2003, budgeted county taxpayer support for Health and Human Services was $4.4 million on a budget of $23 million.

Borup attributed the current deficit to these costs:

• $382,000 in inpatient and purchased mental health services. The gross amount billed to the county was a "killer," said Borup. Some of the $507,000 cost will be covered through private insurance and other collections.

• $90,000 for the Family and Children's program. This includes about $14,000 in termination of parental rights costs and $50,000 in social worker salaries.

• $132,861 in Long Term Support costs. Borup said $68,000 of that was for Northern Center court-ordered placement not in the budget. Much of the balance is for out-of-home costs.

• $41,168 that the county lost when it terminated its W-2 contract with the state.

"In 27 years as a director, I've never run into this," said Borup of the large unexpected mental health costs. The county is required to pay for certain inpatient mental health care, including emergency care, he said.

Borup said state funding for mandated services hasn't kept pace with growth.

"In terms of the state of Wisconsin, we're basically funded as a 35,000 population county," said Borup. "We're way under funded by the state, and the mandates won't go away.

Committee members had two questions: How did the deficit get so high without being reported? And how can the county budget when it has no control over costs?

Until now there was no indication that the department would be short as much as $450,000, said Finance Committee Chairman Ralph Swenson.

He said there was "no early warning system that we were exposed to a loss of this magnitude."

"Did this just come up in the last couple of months?" asked County Board Chairman Buck Malick.

Borup said he warned his board that mental health hospitalizations were rising and the budget would be short.

"The translation was understated," said Borup. He said some hospitals have also raised their rates.

"Since 9/11 the demand for mental health services has gone up dramatically," said Borup. He said his department can't control the emergency detention process, but it pays the bills.

"The fact that there was no warning is the part that we've got to find some remedy for," said Swenson.

Just because bills come in well after services are provided doesn't mean administrators can't estimate what those bills will be, said Swenson.

Malick said he is concerned that the county has to pay the bills when it has no control over them. "That cannot be right."

Supervisor Daryl Standafer agreed that it's an exercise in futility to set up a budget when the county has no control over services.

Before Sept. 11, the county had a good grasp on the mental health services it would need each year, said Borup. "Now we're getting people that we've never seen before."

He said a significant number of people "who were on the fence" before have needed treatment in the past couple of years.

Swenson said the Health and Human Services Department must determine what the 2003 numbers will be and then work on a warning system to prevent this from happening again.

Malick said he wants the department to keep the deficit on its books for awhile, "So we don't lose sight of it."

"I think for the next few months we need to carry it as it is and not mask it," he said.