FAIRBURY - How do statewide organizations work to provide services locally to people working through mental health concerns or developmental disabilities?
Officials from Region V Systems and APACE stopped in to deliver insights into that subject and more in their annual report to government officials in Jefferson County this week.

APACE works with people dealing with disabilities in 16 counties across Southeast Nebraska, including in Jefferson County where 37 APACE employees serve 26 at-risk individuals, helping some of them enter the workforce or simply enter into adulthood.

"Employment is such an important thing for us, and the people we support. Oftentimes individuals with disabilities don’t get the same opportunities that we all get, so I really appreciate and recognize the employers that take a chance on individuals with disabilities," CEO Matt Kasik said. "What you generally find out when you take that chance is that you end up with one of your most loyal and best employees that you could ask for."

Like it has been for many other similar social work organizations, financial uncertainty has been a challenge for APACE recently, but though their funding model has changed to be all Medicaid-based, APACE doesn't take any money from county government, and Kasik said that will continue into this next fiscal year. Even still, in this annual conversation with local elected officials, he highlighted the importance of his organization's relationship with local government: APACE's governing bound consists of county commissioners from each of the 16 counties in their service area.

"As a political subdivision, as a public entity, we have a higher level of transparency, a higher level of accountability. And folks have choice – they can choose who their provider is, and when they know that there is this organization that has the eyes of the public on them, that builds trust," Kasik said. 


There is also some uncertainty ahead at the state level: a proposal backed by some state officials would give some of the 2,400 people on the APACE waitlist access to basic services, but would restrict access to more advanced, specialized programs.

"The philosophy is services for everyone but at a lower cost, like let’s just get everybody services. Kind of the problem with that, is that we’ll likely see a secondary waitlist, so folks will be able to get, what we’re seeing, is maybe family support, in-home support, day support, but not residential, and that residential component is what we consider the comprehensive services that folks need to live," Kasik said. "Generally folks would get services, possibly at a younger age, but they’ll likely be older, even in their 30s or 40s, before they’re getting residential services and they’re out independently living on their own."

Region V Systems is a similar organization: regional administrator Patrick Kriefels calls it a "public safety net" for people on the lower levels of the socioeconomic spectrum that are battling mental health and substance use conditions. 25 percent of Nebraska's citizens live in their 16-county service area. Lancaster County unsurprisingly makes up the bulk of the served population - almost exactly two-thirds of the approximately 480,000 people in the region live there - with another 10 percent residing in Gage, Jefferson, Saline, Thayer, and Fillmore Counties collectively.

Unlike APACE, Region V is funded at least in part by county governments across the state, and Kriefels says studies show that money invested into their programs in the present has a pronounced effect in the future.

"I like to say we are better together than we are independently. For every one dollar that each of the counties spends on behavioral health, you are going to save yourselves three, and that is just in regards to helping people recover and getting back into the workforce, so economically. And people do recover, and become well," he said. "For every one dollar you spend, you save five dollars if we look at the whole system, regarding your attorney, law enforcement responses, and the hospitals. In the long run, it’s going to pay off, and research tells us that."

Additionally, Kriefels said his organization has partnered with hospitals in Hastings and Fremont to provide more space for patients in emergency protective custody which will lessen the burden on the single current space in Lincoln that can provide care for those individuals.

"We’ve historically had a single point of entry in Lancaster County, in Lincoln, that has met all the needs of all 16 counties in the region – it has 16 beds. It was full 68 days last year," he said. "We are expanding 368 emergency protective custody bed days within our system. Law enforcement are the only ones who can take an individual into emergency protective custody, if they meet a two-pronged rule: someone has to be defined as mentally ill and they have to be dangerous to themselves or others."

Region V has contracted with Mary Lanning Hospital in Hastings to serve affected individuals in four counties on the west of the region - Thayer, Fillmore, York and Polk - while those in Butler and Saunders Counties to the north will be sent to Fremont Methodist Hospital. Lincoln will still be the home base for any of these patients in the ten remaining counties.