As the county struggles with how to make up for a possible $500,000 budget shortfall, one new program has helped the county save money and serve county residents better.

The legal affairs committee received a report from human services director Pam Eitland last week about a mental health crisis team that is streamlining how the county deals with mental health situations.

Eitland said shortly after she began to work in the county in 2005 she looked at the number of mental health crisis calls and the numbers seemed very high and cost the county a great deal of money. Eitland said in 2006 Dane County had 120 crisis situations and Vernon County had 94.

But Eitland noticed many of those calls resulted in individuals going to the hospital because law enforcement did not have any other options to deal with crisis situations. Eitland said of the 108 calls in 2007, 41 of those individuals were discharged with no further action.

"So, I began to ask what is going on here," said Eitland.

Eitland began to talk to law enforcement and see if there were other options that could be developed.

"We talked to law enforcement, we talked to others in the state and we talked to people locally," said Eitland.

The result was the crisis team program that uses trained regional volunteers that can work with law enforcement to make determinations about mental health treatment. The team consists of Eitland, county corporation counsel Greg Lunde, a counselor from the Family and Children's Center and trained volunteers. Eitland said the volunteers are often mental health professionals or social service workers trained in making on-the-spot assessments.

Eitland said the program gives law enforcement another option that often results in follow up services, but does not require immediate action, like taking an individual to a hospital or a mental health facility. Those options were often unneeded and expensive, said Eitland.

The program started operations in November of 2007 and in the months since it began the program has handled 39 cases and only three of the cases have resulted in individuals needing immediate mental health services. Eitland said the program gives the individuals who need services and law enforcement another option that was never there before.

"These options just were not there before," said Eitland.

Eitland said the county and individuals benefit because they are not admitted to a facility for something that can be handled in another way. Eitland said not all situations can be handled with the team. In 27 other situations, the team was not used because the situation was either unsafe or progressed to stage that immediate action was needed. If an individual has a weapon or has already taken an overdose or is in any way not safe it is handled by law enforcement, but for those situations that are safe the county can step in.

Eitland said for every individual taken to a health facility it costs that county about $1,500. Eitland said there are additional savings because the program has received state certification and that allows the county to bill medical assistance for services and follow up work after an assessment, said Eitland.

"At the rate we are going… 39 calls… 27 emergency detentions… if they had all been emergency detentions we would be in some serious trouble financially," said Eitland. "We are almost to 70 calls and we had 108 on the whole year of 2007. That is the kind of mental health situation we are in in this county."

"Why?" asked committee member Jerry Cade.

"Late year it was the war and the flood," said Eitland.

"This year it is the economy," said Lunde. "It seems to be money."

"And people can't afford their medications and they are not taking them," said Eitland.

There are some additional mental health costs that can quickly drive the county human services budget up. Eitland said for individuals that require services from a state mental health facility like Mendota or Winnebago the bill can often be $750 to $900 per day. And there are the additional costs of a sheriff's department deputy, or sometimes two deputies, transporting an individual to those facilities.

"That often means overtime hours and sometimes a whole shift for two people to transport to Winnebago," said Eitland.

Lunde said there is normally a 72-hour hold requirement if someone is taken to a state facility.

Eitland said the because of the certification the county established walk-in services that can handle mental health situations that can come up at local clinics. This allows medical professionals the ability to refer individuals for services that may have otherwise had to be handled by law enforcement.

Eitland said the county also has the ability to give follow-up services that make sure individuals are following through with mental health treatment programs to reduce repeat incidents. Eitland said the program gives the county the ability to go into schools and hospitals and other areas to handle mental health situations.

Eitland delivered the report to the committee as part of an update on how the establishment of a full-time corporation counsel is helping the county. Eitland said having an attorney on board full-time has helped her department save money and deliver services more efficiently.

"I was one of those who gave a big applause when you hired a full-time corporation counsel," said Eitland.