Updated 10 a.m., March 19
State and county officials are rushing to find care for more than 1,000 people with mental illness in east central Minnesota after a major mental health care provider abruptly shut its doors Monday.
Riverwood Centers closed its clinics and mobile crisis services. The nonprofit was the designated mental health provider for Chisago, Isanti and Pine counties and also provided crisis services to Kanabec and Mille Lacs counties.
The operation simply ran out of money, said Kevin Wojahn, Riverwood's now former executive director.
"We've had three major changes in some of our funding, and the changes were large enough that we could not offset the reducting in funding with cuts to our operation," Wojahn said.
Most of Riverwood's funding came from clients' insurance providers as well as the counties where Riverwood operated, he said. Money has always been tight, but when Mille Lacs County ended its contract last year, things really got bad, he added.
The counties received less than a week's notice that Riverwood could no longer treat people.
Chuck Hurd, chairman of the region's Adult Mental Health Initiative, said he received an email March 12 notifying counties of Riverwood's plans to close March 17, ending services with psychiatrists, therapists, emergency home-visiting services, and a crisis phone line.
"It'll take a while to replace them," said Hurd, who is also the adult social services supervisor for Kanabec County. "But we are hopeful that we can have suitable crisis services within six months to a year."
The toll-free crisis phone line has been picked up by another agency in the interim, he added. "So at least there's someone answering that phone."
The clinics were in Braham, Cambridge, Milaca, Mora, North Branch and Pine City, according to Riverwood's website. Wojahn said Riverwood is calling all of its patients and directing them to other providers.
Although the area does have some private mental health clinics, the non-profit Riverwood was more accessible, used sliding-scale fees and served the uninsured, Hurd said.
It also had crisis beds people could use for about a week at a time if they needed more help than they could get through in-home crisis support but less than what a hospital provided, he added.
The surprise closure comes at a time when mental health resources around the state are strained, he added.
"Abruptly changing therapists...will have a negative effect on people," Hurd said. "Certainly people who have had a long-term therapeutic relationship with Riverwood will probably suffer. And it'll take time to get other services in the region to help."
Hurd and David Hartford, assistant commissioner of chemical and mental health services at the Minnesota Department of Human Services, said they don't know how exactly many people the facilities served.
State law requires Minnesota counties to fund mental health care. DHS plans to work with the counties to understand exactly what happened and why the centers gave such short notice, Hartford said.
"It's rare. It's particularly rare for just such short notice for a non-profit to close its doors," Hartford said. "But I also think the overall reimbursement for community mental health centers -- these are non-profit agencies -- their margins are very narrow. So they need, often times, additional support through philanthropy or grants in order to maintain their financial integrity."
Riverwood received some funding from the counties it served, and was recently a recipient of the state's mobile crisis grant to deliver in-home crisis services, Hartford said.
DHS is searching for another agency to pick up that grant for the region and continue the in-home visits, Hartford said.
The state and counties are working to assess the impact of the Riverwood closure, and assess the region's needs, he added.
Riverwood opened 50 years ago as pharmaceuticals improved and mental health care began shifting from large state residential institutions to outpatient treatment.
Funding community care facilities has always been a challenge, especially in rural areas, said Sue Abderholden, who runs the Minnesota chapter of the National Alliance on Mental Illness.
Still, she said Riverwood's closure took her by surprise.
"We've been fighting for increases for our mental health system forever," Abderholden added. "I think this is a pretty sad day that this many people lose access to basic treatment in our state."