Several times each day, a Lincoln police cruiser pulls up to the three-story brick building just south of the O Street viaduct.
The officer helps someone out of the back of the cruiser, often people so drunk they can barely stand, so high they weave on the walk into the building.
Decades ago these people ended up in jail — for public intoxication, for trespassing, for disturbing the peace, for drunk driving.
But in 1979, the state abolished public intoxication as a crime, and cities such as Lincoln turned to a less-expensive alternative than jail for people who commit a minor crime while drunk or high or who are so high or drunk they are a danger to themselves or others.
In Lincoln, the Bridge (formerly Cornhusker Place) fills that role, providing a safe place for several thousand people a year in a program called civil protective custody.
But the Bridge is facing the loss of $50,000 to $60,000 a year in federal Medicaid funds from its $650,000 annual civil protective custody budget. And the nonprofit agency fears it could lose even more under the state’s new managed-care system.
Police Chief Jeff Bliemeister is concerned about the loss of civil protective custody services, an important service for the community. And he’s been raising the Bridge’s financial problems at county and city government meetings for several months.
Law enforcement officers bring someone to the Bridge for civil protective custody services more than 3,600 times a year, and city police bring in about 85 percent of those people.
The sheriff’s department, state patrol, university police and police from 15 other counties in Southeast Nebraska also bring people to the Bridge.
The city already provides about $373,000 a year for the Bridge program, which is a significant financial commitment, said Bliemeister.
“But I believe their services are so valuable to overall public safety that I am searching internally for stop-gap funding,” he said.
The Medicaid funding issue surfaced in January, when a new managed-care company handling the state’s Medicaid program determined civil protective custody didn’t qualify under any Medicaid medical definition and stopped paying for that service for people on Medicaid.
For the past decade, the state Medicaid manager has paid for the Bridge’s civil protective custody services using the Medicaid code for social detoxification services, said Phil Tegeler, executive director of the Bridge.
Technically, civil protective custody services, which last up to 24 hours, aren’t as broad as social detoxification, where people stay for several days and are offered longer-term treatment options. Medicaid does cover social detoxification services.
In January, with new Medicaid management in place in Nebraska, the Bridge billed for those services as it had always done. But it was not paid.
So Tegeler’s staff began to ask questions. That’s when they discovered Medicaid does not have a level of service defined as civil protective custody, and the new managed-care company said those services do not fall under any Medicaid definition.
The Bridge is continuing to work with state Medicaid staff hoping to find a solution, but for now the Bridge is losing about $4,800 a month in funding, Tegeler said.
The budget for civil protective custody “has never been easy, but it’s always been doable,” said Tegeler. “This makes it a lot more difficult.”
“It’s hard for me to understand how this issue comes to light today” when there was no problem for decades, he says.
Tegeler is also concerned that a state decision relating to Medicaid funding may also affect another $100,000 in state and federal funds that flows through Region V Systems to the Bridge to help with the civil protective custody budget.
But Region V Director C.J. Johnson believes he can extend the flow of state and federal funds, even if he has to get a waiver from the federal government.
Region V did give the Bridge about $22,000 to help cover most of the $29,600 Medicaid funding loss from January through June.
Civil protective custody gives police a safe place, other than jail, to take people who are drunk and commit a minor crime or who are so drunk they are a danger to themselves or others, Bliemeister said.
About 70 percent of the people who were committed to civil protective custody last year were one-time admissions. About 20 percent were episodic, and were admitted several times. And about 10 percent are chronic, going in and out of civil protective custody over and over, Tegeler said.
By law people can be held for no more than 24 hours in civil protective custody. They can be released earlier to a sober, responsible person or if they are no longer legally drunk.
Civil protective custody prevents booking people in jail, saving money. It also saves time for officers attempting to find a family member or friend willing to take responsibility so the person won’t go right back to his or her car and drive away still intoxicated, Bliemeister said.
And it provides a place for people who are so intoxicated they can’t take care of themselves, he added.
“This is one of our important nongovernment partners that keeps our community safe and the people who live here safe,” he said.