The Door County Health and Human Services Department and administrative committee worked quickly to hire more Adult Protective Services staff in fall, in response to sharp increases in caseloads.
One new caseworker started in November and another in January, APS Manager Taylor Jandrin said. The program saw a case increase of 65 percent from 2024 to 2025, according to Jandrin’s report at the Health and Human Services board meeting on Jan. 12. In 2025, there were 142 new cases brought to APS regarding adults at-risk; elder abuse and/or neglect; or guardianship and protective service needs. The county saw 89 new cases in 2024, Jandrin said.
Crisis-level mental health or dementia cases represented a significant portion of APS cases overall last year, she added, mostly involving individuals over 65 years old.
The legal system has two separate ways of handling crisis patients depending on whether the individual is suffering from mental illness or dementia, and often in older people it can be hard to tell the difference, according to Health and Human Services Director Joe Krebsbach.
“Dementia doesn’t get better,” he said. “Mental health is treatable.”
If an HHS client has a mental health condition, the county is required to provide psychiatric care, but “a crisis worker trying to figure out in the middle of the night whether this person has a mental health issue or dementia is very difficult,” Krebsbach said. Sometimes, the two conditions can overlap.
Because these cases have complicated behaviors and symptoms, they often have high inpatient costs, according to Krebsbach. The county has had at least a dozen such cases last year, with people over age 65 being hospitalized in a psychiatric facility.
Hiring more APS workers helps manage caseloads, he said, but it does not mitigate the complexity of many of these cases, and HHS will need to figure out a way forward as the Door County senior citizen population grows.
Treatment Court team remains committed
Door County’s Drug Treatment Court program–a partnership between HHS, the courts and law enforcement–has three participants remaining, according to an update at the treatment court committee meeting on Jan. 22.
Treatment Court stopped taking applicants to the program back in July, and program operations are not in the county budget for 2026. There are several positions crucial to Treatment Court operations that have remained vacant since last year.
The committee discussed getting the program back off the ground in order to apply for the state Treatment Alternative and Diversion, or TAD, grant’s next five-year cycle. That cycle is 2027 through 2032. A TAD grant has been the primary funding source for Treatment Court.
There are quite a few people who would benefit from the program, according to District Attorney Colleen Nordin. “It’s hard to watch people who could thrive here being left out,” she said. “There are definitely folks who keep racking up criminal charges who could be helped.”
The committee also reviewed and discussed a review of the Treatment Court program last March. Wisconsin Department of Justice and the state Courts Office staff visited Door County and met with Treatment Court team members. Overall the review was favorable, according to County Circuit Court Judge David Weber, who oversees the program. The review included thirty suggestions for things that could be changed to improve the program, Weber said, but 17 of them were relatively simple language updates in its policy and procedures.
The steering committee agreed all members are still engaged with the Treatment Court program and desire that it continue. The committee will continue to meet monthly and will work on implementing state suggestions in time for training potential new staff.
As far as staffing, HHS is starting the recruitment process for open positions that serve the Treatment Court.
Two program participants are due to graduate in March, and the remaining participant may be leaving soon as well, according to Weber. The goal is to start admitting new Treatment Court participants in June. The county still has funding for the program this year through the TAD grant.
Despite staffing and other challenges during the program’s six-year tenure, the Treatment Court team said they were still committed to it and the good it can do.
“If I’d known what we had to go through from the get-go would we have done it?,” Krebsbach said. “I think we would.”
County sober living home needs a “reset”
A sober living home in Door County for individuals battling substance use disorder has long been recognized as a need, and in fall of 2024 it became a reality. Joe Krebsbach at HHS has always been quick to tell county officials and taxpayers that operating the home would contain a steep learning curve.
“We knew the first year was going to be rocky but it’s been way under-utilized than we were hoping,” he told the Treatment Court Steering Committee during discussion of the topic. “We need to start from scratch.”
The primary issue for the sober living house has been just getting people in residence, according to Krebsbach in a follow-up phone call. Both CORE Treatment Services, who the county partnered with to run the house, and HHS itself have been dealing with high staff turnover the last year, he said.
CORE and HHS staff will be meeting in the next few weeks to “do a reset,” he added. They will address house rules and policies and the lack of referrals and coordination between the two entities, he said.
Drug Treatment Court was intended to be the primary pipeline for participants to get into the sober living house, Krebsbach said, and with that program’s difficulties, there has not been a great way to connect potential sober living residents to the house.
Part of a successful sober living model stems from the community and peer connection offered when more than one or two people in treatment are living together. So far the county’s sober living house has only ever had two residents at a time, Krebsbach said. Currently, the house is empty.
“Not getting enough people in all at once reduces the effectiveness of the program,” he said.