Minnesota’s mobile crisis system for responding to people suffering from mental health emergencies has been thrown into uncertainty by bureaucratic delays in state agencies charged with overseeing the service.
Statewide, Local Corresponding institution Experiencing suicidal ideation and other mental health crises after the Minnesota Department of Social Services (DHS) failed to provide tens of millions of dollars in grant contracts to help cover the costs of life-saving programs People are warning of service interruptions.
Mental health providers say timely delivery of grant contracts is critical. Without them, we can’t pay for round-the-clock call centers and mobile crisis management teams that travel to homes, schools, and hospitals to provide counseling and non-violent conflict resolution.
the mobile team all counties It also fills critical gaps in the health care system and helps people who are often unable to visit clinics or seek professional help because of their mental illness. It also reduces the burden on local law enforcement agencies, which are often unable to respond to mental health emergencies.
But crisis responders have been operating in a state of financial turmoil since late December. Behavioral Health Division DHS notified us of the delay in completing the contract. The agency noted that a draft of the grant agreement wouldn’t be ready until the end of January — providers say it’s over a month late.
As a result, crisis responders are in the unusual position of having to provide safety net services without a contract or guaranteed payment.
“It’s frustrating because it’s an important service that we can’t easily turn off,” said Ashley Kjos, chief executive of Wilmar nonprofit Woodland Centers. , disappointed: “It’s not like they can say, ‘Sorry, I can’t answer the phone because I don’t have a contract.’ We’re their lifeblood.”
DHS officials declined interview requests. However, in a written statement, deputy commissioner Eric Gramdahl said contract delays were due to leadership changes, staff turnover and changes to contract management processes. said it could continue to provide services but would not be paid until the grant contract was completed. He said the store doesn’t expect to be late on payments to providers.
Gramdahl to oversee Behavioral Health Divisionsaid the contract delays were related to the rollout of a new contract management system that streamlines contract renewals across agencies.
“These rapid response teams play a critical role in assessing individuals, resolving crisis situations and connecting people to the services they need,” Grumdahl said in a statement. “Ensuring the uninterrupted continuity of these services is important to Minnesotans and a key priority for DHS.”
Crisis responders said they were not told the reason for the contract delay, which has already caused a service disruption.
Some providers are suspending staff hiring to fill vacancies in call centers and crisis response teams. This means that we cannot respond directly to emergencies and many calls. Others have withdrawn their marketing and expansion plans until they know they will be paid, according to the Mental Health Providers Association.
“When agencies have to rush to put together a contingency plan and public program refunds for contract delays or interruptions, people have to move it from other areas of practice to compensate. This diverts attention, resources and capacity from our system.”Executive Director Jin Lee Palen Minnesota Community Mental Health Program Associationwhich represents 34 mental health providers.
budget struggle
Contract delays reflect long-standing problems within the behavioral health department that have been plagued by widespread problems processing grants in recent years.
In March 2021, Legislative Auditor’s office found The department subsidized mental health and substance abuse services tens of millions of dollars for nearly three years without proper oversight. Legislative auditors have identified problems at nearly every stage of the grant-making process, from failure to document potential conflicts of interest to inadequate evaluation of grant recipients. In late 2019, the division will also caught fire For its role in overpaying Indian tribes for drug treatment services.
Human Services Commissioner Jody Harpstead has repeatedly pledged to strengthen the agency’s finances and has rolled out a series of measures to improve the grant-making process.
Senator John Hoffman (DFL-Champlin), chairman of the Senate Welfare Committee, said: He vowed to investigate the cause of the delay.
“If we don’t fund mobile crisis response teams, people will die,” Hoffman said. “And I don’t want people to die.”
Mobile crisis teams, who are often first responders to mental health emergencies, are often bombarded with phone calls. In 2020, statewide, he responded to over 16,000 incidents. This includes approximately 13,400 face-to-face visits with people experiencing crisis.
DHS estimates that $41.2 million in state grants will be available to mobile crisis providers over the next two years. This is about a third of what the provider requested.
Even before the contract was delayed, providers were struggling with tight budgets and surging demand.
Mobile crisis programs are expensive to operate because they require trained staff to be on standby 24/7. In rural areas, responders may travel 100 miles or more each way to make a home visit. Sometimes they spend hours with someone who is in psychological crisis, helping them ease their anxiety and access psychiatric care.
“We are in an unprecedented time when mental health is at the forefront and people are often waiting to get help until things reach crisis levels,” said Eight Northwest Minnesota. It operates a mobile crisis call center that serves the county. “Too often, emergency services are the gateway to mental health services.”
A 10-person crisis management team at the Human Development Center (HDC), a nonprofit organization in Duluth, handles more than 100 calls a month in southern St. Louis County. Teams meet people in crisis at fast food restaurants, skyways, hospitals, homeless shelters and even cars.
Responding to a crisis may include stabilizing a stressful home environment. According to Cortney Buchholz, a nurse and her HDC community coordinator, HDC crisis responders have cleaned the house, cooked meals and helped the children with their homework.
With the help of state grants, the agency is able to speed up the process for people to get psychiatric care, often arranging appointments within 48 hours instead of waiting months. You can, says Buchholz.
“Enabling people to get treatment quickly when they are experiencing that high need is a huge boon to our population,” she said. is often the time to receive the most help.”
