On a white board is the acronym “BRAVING.” Group leader Joanie Sommers says it stands for boundaries, reliability, accountability, the safe, integrity, non-judgment and generosity.

“This anatomy of trust is how we begin to trust again,” says Sommers.

Participants are temporary residents of the Dane County Care Center, a 16-bed unit of Tellurian Behavioral Health, a complex in Monona located behind a nature center on the site of a former tuberculosis sanatorium.

The unit is one of five regional crisis stabilization centers recently designated by the Wisconsin Department of Health Services. It is a precursor to a more intensive form of mental health care the state plans to implement soon: crisis emergency care and observation centers.

Tellurian, which also operates the regional crisis stabilization center in La Crosse, is interested in establishing one of the emergency centers in the Madison area, CEO Kevin Florek said. It’s the same idea Dane County had for its planned crisis triage center, for which no vendor responded to the county’s request for proposals last year.

After the state legislature passed a bill in February to authorize and fund the urgent care centers, the state Department of Health is now working out the details of how Medicaid will be billed for these services and plans to allocate $10 million to establish two centers.

The goal is to reduce admissions to the state-run Winnebago Mental Health Institute in Oshkosh and avoid unnecessary stays in hospitals and prisons. Unlike crisis stabilization centers, which only accept patients who come voluntarily, the emergency centers would also accept involuntary patients in emergency shelters.

“There are people who decompensate in prisons and detention centers, even though they don’t need to be there,” said Florek. “They need to be treated with dignity and respect. A facility like this would help.”

Todd Campbell, Dane County’s mental health administrator, said the emergency center model is largely consistent with what the county had envisioned for its long-planned crisis triage center, which received $13 million in county funding and was sited at the Huber Center on Madison’s south side.

Looking back, the lack of a government reimbursement system for such treatments reduced the interest of providers, says Campbell.

Under the new state law governing the payment system, one of the two emergency centers would be in western Wisconsin and both would be at least 100 miles from Winnebago, a distance that only part of the Madison area meets.

Campbell said the state may eventually allow more emergency centers than the two listed in the law. “We want one of them to be local and provide the option of involuntary admission,” he said.

Tellurian, on a sloping wooded area between Monona’s water tower and the Aldo Leopold Nature Center, is a nonprofit organization founded in 1971 in Oshkosh by Florek’s uncle, Michael Florek, who focused on helping Vietnam War veterans struggling with post-traumatic stress disorder and substance abuse.

In 1984, Michael Florek moved Tellurian to Monona, on the site of the former Morningside Sanitarium, which had treated tuberculosis patients since 1918 until it closed in the 1970s.

Over the years, Tellurian, which means “from the earth,” has become one of the Madison area’s premier providers of mental health and substance abuse treatment. At another location, on Industrial Drive in Madison, south of the Beltline, the company operates the Dane County Detox Center.

In one of two buildings on the Monona campus, Tellurian offers outpatient services, inpatient addiction treatment and halfway houses. The two-story, 55-bed building, known as the Teresa McGovern Center, is named after the daughter of the late South Dakota Senator George McGovern. In 1994, she froze to death in a snowbank behind a Williamson Street storefront after experiencing a relapse into alcoholism.

On the ground floor is the 16-bed crisis stabilization center, known as the Dane County Care Center, which opened in 2014.

Most people who come to the center suffer from depression, anxiety, psychosis or thoughts of harming themselves or others, says Meghan Smits, program director. More than half are homeless, says Smits.

At the center, doctors adjust medications. Peer counselors provide individualized support. Group sessions, like the one Sommers recently led on trust, are held three times a day. Activities like making friendship bracelets, bean bag tossing and nature walks provide breaks.

Eight simple rooms each have two beds, two nightstands and two dressers. A washroom is stocked with soap, toothpaste, clean underwear and other necessities. Case managers try to connect people with assistance such as housing, insurance and food stamps.

People stay an average of six days before moving to an inpatient treatment center, group homes, their own home, or a homeless shelter.

“Whatever they are looking for, we do our best to meet their needs in this short time,” Smits said.

With $10 million in federal COVID-19 relief funds, the state supported the establishment of five regional crisis stabilization centers in Beaver Dam, La Crosse, Monona, Waukesha and Wausau.

Tellurian will receive $500,000 annually for four years for each of its two centers. A new site is scheduled to open in La Crosse in the fall, and the number of beds will be expanded from 10 to 18, Kevin Florek said.

The money was used to increase staffing levels, said Florek, by hiring more highly qualified social workers to provide counseling and trained nursing staff who can prescribe medication around the clock.

Tellurian also bought a van and hired a driver to bring people from other counties. With the state’s money, the center in Monona now serves people from 14 counties and the center in La Crosse serves people from 18 counties.

Dane County has a contract for ten beds at the Monona facility. The other six beds are occupied by people from other counties or with private health insurance.

Another crisis stabilization center in Madison, the 12-bed Bayside Care Center, which was operated by Journey Mental Health Center, closed in 2022. Journey continues to provide crisis stabilization services in people’s homes. It also operates the county’s crisis unit, including the crisis hotline at (608) 280-2600, and provides staff for crisis response teams known as CARES, which stands for Community Alternative Response Emergency Services.

While the state develops an administrative rule for the emergency centers, whose level of care falls between the Crisis Stabilization Centers and Winnebago, it has adopted a national “Crisis Now” initiative. The model emphasizes having someone to contact, someone who will respond and a safe place to get help. This includes the 988 Suicide and Crisis Lifeline.

Florek said Tellurian could set up an urgent care center at the site of its detox center, a county-owned facility that he said would need to be remodeled and expanded or replaced. Another possibility, he said, would be a new location in the Madison area.

Given the high staffing requirements for such a center, Florek said he hopes to collaborate with the county, hospitals, foundations and police departments on the idea.

“We hope this is a partnership so that we can all work together in the best interests of those in need, but also from a financial perspective,” he said.

Two years ago, Florek and Kalvin Barrett, Dane County Sheriff and a member of Tellurian’s board of directors, visited the Harris Center, a crisis urgent care center in Houston, to solicit suggestions for establishing such a center here.