Two nonprofit agencies are planning a move without the boxes.
The Human Development Center will transfer its outpatient mental health and chemical dependency treatment programs to Lake Superior Community Health Center in February. The move only affects services in Douglas County.
Although bills will come from the health center, and clients may hear a different voice on their reminder calls, everything else should stay the same. Providers will remain in their current Superior HDC offices, which will be leased by the community health center.
The "move," which affects nearly 600 clients and eight providers, was needed to ensure program survival.
Medicaid reimbursement rates for mental health and substance abuse treatment are much lower in Wisconsin than Minnesota.
"So low that it was jeopardizing the viability of the agency," said Jim Getchell, executive director of HDC, which operates in four Minnesota counties and Douglas County.
Although Wisconsin's Department of Health Services will be raising reimbursement rates 13 percent in January, that extra $7 per hour (from $55 to $62) wasn't enough to ensure program survival.
Similar financial woes closed the Lutheran Social Services Superior office in March this year. Roughly 115 clients receiving outpatient mental health services were affected.
"It's not an option in our community to lose more services," said Betsy Byler, outpatient and youth treatment supervisor at HDC, especially when the need is so great.
HDC currently has 92 people on the waiting list for mental health services, 52 of them children.
Partnering with the community health center made sense for HDC. As a federally-qualified health center, it receives a higher reimbursement rate, a flat fee, because it accepts all patients regardless of their ability to pay. Byler likened it to a critical access hospital, and said there are federal centers throughout the nation.
Transferring to the health center will allow mental health services to expand and opens the door to adding medication-assisted treatment for those suffering from opioid addiction, Byler said.
The move will also integrate services for clients. The health center provides medical, dental and behavioral health services. This will expand behavioral health services and add chemical dependency treatment to the mix - a one-stop shop, as it were.
"It's a fantastic opportunity for us, when we get a new patient, to ask questions about their total needs and the extent to which they want us to meet those needs," said Dayle Patterson, CEO of Lake Superior Community Health Center.
The mission of community health centers is to improve access to quality care for all and meet the needs of the community. That's why dental care was added to the Superior clinic in 2005 and the Duluth clinic in 2007.
"We are really the only place people can go and receive (dental) care on Medicaid or with no insurance," Patterson said.
The transfer is an amiable one, not a hostile takeover.
"I see no downside to this change, only upside," Getchell said. "The clients will have access to integrated medical/dental/behavioral health services under one roof, and our therapists and drug counselors will switch out of a really good integrated behavioral health clinic model to another really good integrated medical model."
Both nonprofits will continue to operate in Douglas County.
"HDC never contemplated closing," Getchell said. "We looked around the region and the state for a model for community mental health that worked for Wisconsin. We found it."
Patterson credited Getchell and the HDC board for making the transfer possible and keeping services in Douglas County.
"They worked hard to find a successor," Patterson said.
The move will shrink HDC a bit, but put it on better financial footing. The nonprofit will continue to provide psychiatry resources to Superior, operate its community support program and several youth services. About 25 employees - including HDC's central administrative staff - will continue to work out of the Superior offices.