Shutdown forces mental health crisis programs to cut services

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Nearly two weeks into the state government shutdown, mental health providers say they're still trying to correct an "oversight" that has left them without funding for crisis services for people with severe mental illness.

Prior to the shutdown, Ramsey County District Court Judge Kathleen Gearin ruled that basic care and medical services would continue to receive funding.

Providers told MPR News they assumed this would include funding for state workers who dispense psychiatric medication, respond to mental health emergencies, and operate crisis facilities. But 135 state mental health workers were among those laid off when the government shut down July 1.

"It happened so quickly," said Jim Riebe, who manages a mental health crisis response team in St. Cloud. "And there haven't been any real efforts that we're aware of by the state to prevent it."

ONE CLOSURE — SO FAR

The layoffs have forced the closure of at least one crisis mental health facility, Bridge House, in Duluth. Crisis response teams in the Duluth and St. Cloud areas rely on state workers for about half of their staff.

A Department of Human Services spokesperson said the 135 laid off workers provide services for people with severe mental illness at 36 counties and centers in Greater Minnesota.

The loss of state workers means St. Cloud no longer has enough employees to leave the office to meet with people and transport them safely to a local crisis bed facility that was unaffected by the shutdown. Instead, it handles all emergencies over the phone.

In Duluth, the team doesn't have enough staff to provide 24-hour service. It shuts down at midnight and reopens in the morning.

"We've not been about to go out and see folks that we thought we really needed to," said Catherine Lagow, the clinical supervisor for the St. Cloud crisis team. "That increases the possibility that a crisis situation would turn into an emergency."

Social worker Mary Jo Cobb, a mental health supervisor for Sherburne County, said she's aware of at least two people who were hospitalized because of cuts to community care. "It's far more expensive and it's a bigger deal," she said.

Programs that provide intensive in-home services and medication management have also lost staff. One program in St. Cloud lost six state workers — more than half of its employees. The remaining workers are now trying to provide care for 78 clients with severe mental illness.

"Every morning, we're trying to figure out who's having the most difficulty," Riebe, the program manager, said. "But sometimes the people you worry about the most are the people you don't hear from."

Providers said they were unprepared for the loss of the state mental health employees who often work alongside them in community clinics.

NO RESPONSE TO FUNDING REQUEST

Several providers have requested funding from Special Master Kathleen Blatz, a former judge who has been appointed to make recommendations about which programs should be funded. Nearly two weeks into the shutdown, they have not received an answer.

"This definitely was, I believe, an oversight," said Dave Lee, Carlton County's director of public health and human services. "I don't know where it broke down, but if you pull services like Bridge House, it's not a matter of if something bad's going to happen, it's a matter of when."

The Department of Human Services did not immediately provide information on why the mental health workers were among those laid off. The employees work for State Operated Services, a division of the Department of Human Services. The division provides services for people with mental illness, developmental disabilities, chemical dependency and traumatic brain injury at nearly 200 sites around the state.

The shutdown ruling preserved funding for many of these services, but the ruling did not include everyone, said DHS spokesperson Terry Gunderson.

Gov. Mark Dayton's office submitted a proposal to the Special Master on Monday that included funding to rehire an unspecified number of State Operated Services employees who provide mental health services.

But as of Wednesday afternoon, no recommendations had been issued by the Special Master in response to the request. Any recommendation would also need to be approved by Ramsey County District Court Judge Kathleen Gearin.

Providers said they hope a decision comes soon. Riebe, the St. Cloud crisis team manager, said many clients view the state workers as part of their families.

"That's really what it comes down to, someone they can trust," he said. "And it takes a long time for clients to develop that trust because of their illness."

Riebe doesn't know how to explain the situation to those who receive care.

"The clients have been asking, 'Where are they? How come they're not coming to work? Am I ever going to see them again?'' he said.

Riebe hopes he'll be able to answer those questions soon.