Simplified: The Link downtown triage center has been managed by Avera Health since opening in 2021, but that could all change next year because the board recently released a new request for proposals for clinic operations – and Avera is no longer throwing its hat in the ring.

Why it matters

  • The Link opened in 2021 with the goal of giving inebriated people a place to land that wasn't jail or the emergency room. The facility provides medically managed detox, a sobering center, a space for folks experiencing a mental health crisis to go, and – as the name indicates – a "link" to other services in the community.
  • About 1 in 4 patients at The Link go on to inpatient addiction treatment, and the vast majority, about 79%, of patients are unhoused, according to Thomas Otten with Avera Behavioral Health, who presented an update on The Link to the City Council on Tuesday afternoon.
  • Part of that presentation included unveiling new board members for The Link, as well as sharing details for a newly released request for proposals (RFP) seeking someone new to take over clinical operations. The change comes as The Link faces a $546,000 deficit this year.
"We’re very dedicated to this mission," Otten said. "We will not walk away from it. We’re not walking away, but we are not submitting an RFP either."

Tell me more

One of the biggest challenges for The Link is funding.

  • When it initially started, the four founding partners – Sanford, Avera, the City of Sioux Falls and Minnehaha County – each contributed the same amount annually at $400,000.
  • Over the years, that's changed with the city and county kicking in more at about $600,000, while Sanford has dropped its investment to $200,000.

Part of what makes it easier for the city and county to kick in more cash is the obvious savings from having The Link in operation.

  • Because people are no longer taken to the jail to sober up, the county is saving money on jail bookings. The Link has helped divert about 2,500 jail bookings annually by providing a sobering center that doesn't require incarceration.
  • Additionally, police officers can be in and out of The Link in about 10 minutes rather than spending an hour filling out paperwork at the jail or emergency department. Otten estimates that's saved more than 3,800 officer hours in 2025 alone – which is nearly enough hours to account for two full-time police officers.

Councilor Rich Merkouris pressed Otten about why healthcare organizations aren't contributing more money to The Link if they're seeing savings, to which Otten said the savings on the medical side are harder to quantify.

  • The Link last year took in an estimated 689 people who would've otherwise been sent to the emergency room, Otten shared, but it's harder to quantify the exact savings there.

What happens next?

The request for proposals is open through Sept. 17, and ideally the new clinical operations organization will take over Jan. 1, 2027 after Avera's contract ends at the end of this year.