Dayton: Counties should pay more for mental health treatment at 2 facilities

Minnesota Sex Offender Program
The Minnesota Security Hospital in St. Peter, Minn., in a February 2012 file photo.
MPR Photo/Jeffrey Thompson

Gov. Mark Dayton wants counties to pay millions of dollars more to help fund mental health treatment at two state-run facilities.

The governor's budget proposal, released Tuesday, calls for counties to pay a greater share of the cost for patients at the troubled Minnesota Security Hospital and the Anoka Metro Regional Treatment Center. The two facilities provide long-term psychiatric treatment to adults with severe mental illness.

By requiring counties to pay more, counties will have a financial incentive to work more quickly to move patients back into the community, said Anne Barry, deputy commissioner of the state Department of Human Services. The state would use the extra money to pay for mental health services for former patients who need assistance with housing, in-home medical care and other issues, Barry said.

"We do have people in institutional placements who are ready to move into the community," Barry said. "And this will give us some ability to move them there."

Counties currently pay 10 percent of the treatment costs for each resident at the Minnesota Security Hospital in St. Peter, Minn. Dayton's budget would have counties pay 50 percent. Counties currently pay 50 percent of the treatment costs for each resident at the Anoka Metro Regional Treatment Center, and that share would increase to 75 percent. The cost shift would apply only to patients who are ready for discharge.

Barry acknowledged the proposal may face resistance from cash-strapped counties.

Hennepin and Ramsey counties would be most affected by the cost shift. Hennepin County accounts for 169 of the 386 patients at the Minnesota Security Hospital and 36 of the 102 patients at the Anoka Metro Regional Treatment Center. Ramsey County has 41 patients at the Minnesota Security Hospital and 14 patients at the Anoka facility.

Hennepin County Board Chairman Mike Opat said his office estimates the change in Minnesota Security Hospital payments would cost Hennepin County $1.5 million to $2.5 million over two years.

Opat said he agreed that some patients at state hospitals should be moved into the community, but he said the board needs more information.

"The details are really going to matter here," he said.

Ramsey County Board Chairman Rafael Ortega said he supported the long-term goal of providing more community-based mental health treatment to help patients move out of big state-run institutions but is wary of new costs.

"The goal is the right one," he said. "We've just got to figure out how to get there."

The Minnesota Security Hospital in St. Peter has faced scrutiny for months because of violence, injuries, licensing violations and lengthy waiting lists. It provides treatment for nearly 400 adults deemed "mentally ill and dangerous."

Last fiscal year, the facility discharged only 15 people. The average length of stay is six years.

The lengthy stays have created a backlog in county jails where mentally ill inmates wait weeks or months to be transferred to the Minnesota Security Hospital.

At a news conference at the state Capitol on Wednesday, Hennepin County Judge Jay Quam called the system "cruel."

"Jail is a very bad place to bring people who are living with untreated mental illness," Quam said. "It challenges the strength and stability of even the most healthy people, and it's especially destructive, sometimes irreversibly so, for people with untreated mental illness."

The governor's proposed changes would help reduce the backlog at county jails, said Barry, the DHS deputy commissioner. She estimated that an additional 25 people would be discharged from the Minnesota Security Hospital over the next two-year budget cycle if the Legislature approves the governor's proposal.

Barry said the state would also use some of the extra payments from counties to provide treatment for people while they wait in jail for an open bed.

The changes would also move an additional 50 people out of the Anoka Metro Regional Treatment Center over the same two-year period, Barry said.

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