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Milwaukee County Mental Health Board approves UHS contract

The Milwaukee County Mental Health Board approved a contract Wednesday with a Pennsylvania-based provider to take on inpatient services now offered at the Mental Health Complex.

The approval caps a multi-year search by the board to find a provider. Universal Health Services, which runs psychiatric hospitals throughout the country, was the last vendor left in the process.

“It has been a long three years,” said Tom Lutzow, board chair. “I think everybody is pleased with the level of work, the detail involved.”

But, Barbara Beckert, Disability Rights Wisconsin Milwaukee Office director, said that she was concerned about the process the board took. The agreement approved by the board wasn’t available for members of the public to see and weigh in on before the board met to approve it.

“These are public funds,” she said. “This is a very significant change in the way inpatient mental health services will be delivered in Milwaukee County.”

Mike Lappen, Behavioral Health Division administrator, said the board’s vote “symbolically” marks the move away from the county-run inpatient hospital to a more community-based system. He also said it’ll help reduce stigma for patients going to the complex.

“Once UHS is open and working with us, they’re going to serve the entire community,” he said. “That will really turn on its head this stigma of being a ‘county patient.'”

It “can’t be undersold how dramatic that can be” for convincing people to get help when they need it, he said. UHS will also add about 50 new beds in the community, increasing slots for treatment.

Under the contract, the county will pay a per diem rate for clients it refers to UHS, which will be the primary receiving facility for individuals placed under emergency detention.

There’s also a clause requiring UHS to notify the county if it’s reaching maximum capacity so it can hold beds.

Milwaukee County will serve as a “payer of last resort” for those referred to the proposed hospital. Between a quarter and a third of people at the current facility at any time have exhausted payer sources, Lappen said.

Lappen said the county will save money over time as they won’t have to build a new hospital or maintain an oversized “crumbling building.” But they’re planning to reinvest those savings into expanding community services to coordinate care and preventive work.

Shuttering the county hospital “is extremely complicated,” Lappen said, and they’re targeting a close date of June 2021.

The proposed $25.7 million facility will have 96 adult beds and 24 beds for children and adolescents. It might be able to expand based on demand, Lappen said.

UHS will likely end up hiring current county employees given the size of their facility and a competitive market for mental health workers, Lappen said.

“Even though it’s not part of the contract, we believe it’s just an operational necessity,” he said. “They’re going to have to work with us because we have so many good staff.”

Several investigative reports by Buzzfeed during the county’s process also raised concerns about the quality of care provided by UHS.

Lappen said the Mental Health Board can appoint two non-voting members on the provider’s local oversight board. UHS will also have to report quality data on a quarterly basis, and the county will play a role in managing and monitoring the contract.

Diane Henneman, UHS regional vice president for the Midwest, told board members that they’ve worked “long and hard” on the contract. They’re working to finalize the location in Milwaukee County.

“We’re very pleased and excited and happy for this opportunity,” she said. “We’re ready to go.”

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.

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