SIOUX FALLS, S.D. (KELO) – More than two years after first opening in downtown Sioux Falls, The Link Community Triage Center continues to keep pressure off local hospital emergency departments but continues to deal with workforce struggles and transitional housing gaps. 

Since opening June 2021, The Link has had more that 8,300 visits by more than 2,698 different people. Thomas Otten, Avera Behavioral Health assistant vice president, told Sioux Falls city council members there’s patients staff at The Link have seen close to 100 times since it opened. 

“There is a patient who came to us 68 times and was in the sobering center but never ready to get well,” Otten said. “On the 69th time, they entered the medically managed detox, went through the whole detox process and went to a treatment program. Last I knew, several months ago, they were still clean and sober. It is a program that you just have to stay with patients.”      

Otten highlighted The Link, which started as a partnership of Avera, Sanford, the city of Sioux Falls and Minnehaha County, works with a number of treatment and nonprofit organizations aimed at helping people. He said prior to the creation of The Link, many of the patients would show up to emergency departments or be booked into jail for minor offenses. 

“Alcohol by far remains the king,” Otten said. “It is by far the substance we see abused.” 

Council chair Marshall Selberg asked Otten about challenges with staffing at The Link. 

Otten said about one-third of the staff working at The Link have personal addiction stories, but also added keeping staff at The Link has been a significant challenge. 

“It’s a hard, hard job,” Otten said. “They’re working there because of the passion of that program.”

He said The Link suffered a significant staff injury from a patient. 

“It sent shockwaves through the staff that we’ve had,” Otten said. “It’s critically important that we keep the staff safe.”  

He said The Link unit has the highest turnover through Avera’s system. He said higher pay or different work strategies are all on the table but noted future funding is a concern. 

Future funding for The Link

Council member Rich Merkouris asked Otten about funding for The Link noting the city has been paying $357,000 for consecutive years without increases. 

Otten said there have been increased costs and pointed to philanthropy as a way to expand funding. Otten said The Link’s budget is about $2.1 million and collected about $300,000 from patients with health insurance but noted 80% of the patients don’t have any health insurance. 

“There will come a day that either the contributions will have to go up or the program will cease to exist,” Otten said. 

Merkouris also asked Otten about the conflict of interests with Avera and Avera Behavioral Health being the lead agency performing the work at The Link. 

Otten said Avera doesn’t take on the work for the money because a best-case scenario would be to financially break even. Otten said he had concerns about how the detox center would be operated if it was outsourced to another company. 

“It is a very complex program to run and it’s hard to have four masters,” Otten said. “Avera and Sanford behavioral health get along very, very well. We meet on a regular basis and we like each other a lot. I think we’re largely just trying to do the right thing for the right patient at the right place.”  

Merkouris said he believes city funding might be needed for a position to focus on philanthropy for The Link. 

“A nurse manager is not in the business of developing philanthropy,” Merkouris said. “Philanthropy is not going to be built without intentionality and leadership on a regular basis.” 

Otten said he believes philanthropy is a way to raise money for The Link. He said long-term funding has to come from somewhere. He said he wasn’t sure if the four partners would support funding full operations by just dividing the total budget by four. 

“That would be a wonderful solution for The Link. That may or may not be in the cards,” Otten said. 

Housing after The Link 

City Council member Pat Starr asked when people should go to The Link instead of waiting until a weekday to see a physician or some other program. 

Otten said The Link tries to be “no wrong door” and staff would talk with anyone who came as a free service. Otten said of the 8,000-plus visits to The Link, a fair number never were fully admitted to The Link. 

Starr also asked about housing placement after someone attends The Link. 

Otten said there’s not a great answer for housing challenges and said there’s a gap with transitional housing. 

“There is no easy solution and more transitional housing is something we would need,” Otten said. 

Otten shared a personal example about his own sister being admitted into The Link for alcoholism and has since moved onto a treatment center. He said he’ll be facing the housing challenge when his sister leaves because she lives in a room with another sister that uses alcohol. 

“I can’t have her return to that same environment. I got to figure out that exact problem for my own family and once I figure it out, I’ll get back to you,” Otten said. “We’re definitely trying to take on that problem right now and there may be a lot of different solutions.”