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.
Across the state, local agencies that serve people experiencing suicidal ideation and other mental health crises have received tens of millions of dollars in grants to help the Minnesota Department of Social Services (DHS) cover costs. We are warning you of service interruptions as we failed to provide a contract. of life-saving programs.
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 works in every county, filling critical gaps in the health care system and helping people who are often unable to go to a clinic 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 when DHS’ behavioral health division notified them 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.
Grumdahl, who oversees the Behavioral Health Division, said contract delays were related to the rollout of a new contract management system.
“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.” Jin Lee Palen, executive director of his Minnesota Association of Community Mental Health Programs, which represents 34 mental health providers, said:
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, the Office of Legislative Oversight discovered that the department spent tens of millions of dollars in subsidies on mental health and substance abuse services 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 sector was also accused of overpaying Indian tribes for drug use 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 subsidies, Buchholz said the agency could speed up the process for people to get psychiatric care, often in 48 hours instead of waiting months. Appointments can be arranged within
“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.”