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NAMI Minnesota Legislative Update
March 5, 2016OLA Report on Mental Health Services in the Jails
The Senate Health, Human Services and Housing Committee met to review the report from the Office of the Legislative Auditor (OLA) on Mental Health Services in County Jails. Jim Nobles, OLA Commissioner and Joel Alter presented the report. "Ultimately the issue here is people, people with mental illness and people in law enforcement. People with mental illness face challenges everyday that the rest of us probably will never experience. And when a person with mental illness is taken into custody by law enforcement those challenges can escalate dramatically and rapidly." stated Mr. Nobles in his opening remarks. Mr. Alter reported"when someone with mental illness is taken into custody, law enforcement faces a dilemma. If a person needs care or treatment rather than jail, there are limited service options, sometime available, but often not."
The report contains these key findings:
· Problems with service availability inMinnesota's adult mental healthsystem have persisted for years,limiting peace officers' options forreferring persons with mental illnessthey take into custody.
· The Department of Corrections has not collected reliable data from jailson the number of inmates assessed formental illness. However, our surveysof sheriffs suggest that one-third ofjail inmates may be on medicationsfor a mental illness. (Note: NAMI wrote the bill to require mental health screenings)
· State rules do not adequately addresssome important areas of jail-basedservices, including mental healthassessment of inmates followingadmission to jail.
· Most sheriffs and county humanservices directors believe that jailinmates should have better access topsychiatric services, counseling, andcase management than they nowhave. In addition, theseofficials widely believe that thenumber of beds in Minnesota's mentalhealth facilities-particularly secureinpatient beds-is inadequate to meetcurrent needs.
· There is limited compliance with astate law that requires dischargeplanning for sentenced jail inmateswith mental illness. (Note: A bill NAMI wrote)
· Contrary to law, some Minnesotadefendants deemed mentallyincompetent to stand trial remain injail while awaiting court action ontheir possible civil commitment tocompetency treatment. Manyincompetent defendants do notultimately receive treatment to restoretheir competency.
· A 2013 law (the "48-hour law") thatgives jail inmates priority forplacement into Department of HumanServices (DHS) facilities has notalways worked as intended, and it haslimited the access of other patients tothe Anoka-Metro Regional TreatmentCenter.
Key Recommendations:
· The Legislature, DHS, and countiesshould fund and implement a morecomprehensive set of community-basedmental health services.
· DHS, with legislative support, shouldrelocate some Anoka-Metro RegionalTreatment Center patients who do not need hospital care so that this facilitycan better serve patients withchallenging behaviors. TheLegislature should fund DHS'scommunity behavioral healthhospitals so they can use more of theirlicensed beds and provide a betterresource for law enforcement.
· The Legislature should authorize astreamlined judicial process forindividuals deemed incompetent tostand trial to be placed into treatmentor referred to county social services.If the Legislature retains thecurrent process, however, it shouldspecify a time limit in law forincompetent inmates to remain in jailwhile awaiting commitment.
· The Legislature should amend statelaw to require mental healthassessments of persons who remain injail at least 14 days.
· The Legislature should amend statelaw to allow jails that have properstaffing and training to administermedications involuntarily, pursuant toa court order.
NAMI Minnesota is not surprised by the findings. We have heard from many people who were not provided adequate mental health treatment in the jails, including not being provided with their medication. These are issues that we have examined and researched. The 48 hour rule has backed up the community system and there has not been a careful assessment as to whether these individuals could be served in the community or if they even need the level of care provided at Anoka.
Our hope is that the legislature will continue to build on what works by increasing funding for the wide array of community services that were funded last year. We also hope that jails will be held more accountable for providing treatment in the jails. We've been told that the average time someone is held in a jail is 7 days, so that they can't do much for people. However, the average length of stay in an inpatient psychiatric unit is 8 days. With counties paying 100% of the cost at Anoka once someone doesn't need to be there anymore ($1309 a day), and knowing that over 50% of the people don't need to be there anymore, you have to begin to ask if those county funds couldn't be used better to treat people in the jails and to develop community services. The truth is that jails are not the largest mental health treatment facilities, because they are not providing very much treatment. Stay tuned for more on this topic in the weeks ahead.
Click for an article on the hearing from MPRNews, Grand Forks Herald, Mpls Star Tribune, St Paul Pioneer Press, KSTP
February 2016 Budget & Economic Forecast
Twice per year, Minnesota Management and Budget (MMB) prepares a state forecast as required by state law. The projected balance for FY 2016-17 is a surplus of $900 million, $306 million lower than the $1.2 billion surplus estimate released in November 2015. The surplus reduction may be attributed to an overall slowing U.S. economy. MMB Commissioner Myron Frans said that Minnesota is prepared to weather a global slowdown and stay the course in order to build the surplus back up.
The legislature has already been developing plans and proposals on how to use the surplus for transportation improvements, tax relief and creation of early education programs. With the most recent forecast, in addition to a short session, coming to an agreement will be more difficult than legislators may have predicted last year. A number of legislators including Sen. Bakk and House Speaker Rep. Daudt expressed concern with the new $900 million projection.
Click here for video of MMB presentation on the February forecast. Click here for details on the budget forecast from MMB. Read more from the StarTribune, MPR, MinnPost, andGrand Forks Herald.
Contact Legislators This Week
The 2016 session begins Tuesday, March 8, 2016. Carefully read NAMI Minnesota's weekly legislative updates for summaries of committee hearings, updates on bills pertaining to mental health and our legislativeinitiatives and calls to action. Click here for House committee schedules and here for Senate committee schedules.
We are urging everyone to send an initial letter or email to your state representative and senator before March 8th. They need to hear that funding mental health must continue to be a high priority. Make these points in your letter:
· We made huge gains last session by funding a wide array of community-based services and addressing our workforce shortages.
· We need to continue to build our mental health system by investing in what we know works.
· Our work isn't done. We still need to increase our capacity to serve all children and adults with mental illnesses through services and programs such as school linked, ACT teams, ARMHS and CTSS services, supportive housing, crisis teams and more.
Be sure and state that you are a NAMI member, include a paragraph about you or your family's personal story (or the needs you are seeing in your agency) and then thank them. To learn who your legislators are and how to contact them, see the box below (Not Sure Who Represents You). Thanks everyone - remember we need to make our voices heard!
Mental Health Day on the Hill - March 31st
The annual Mental Health Day on the Hill is set for Thursday, March 31st. Due to construction at the Capitol the legislative briefing and rally will be held from 10:00 AM to Noon at Christ Lutheran Church on Capitol Hill, 105 University Ave. W., St. Paul and followed by meetings with legislators. Bus rides are available from a number of stops throughout the state. Buses are free, but pleaseregisterahead of time to reserve a space.
When you schedule meetings with your legislators please contact Lynn Sando r 651-645-2948 ext. 107. She will be keeping a list of meetings and to help coordinate the day of.
Not sure who represents you?
Senate Committee Hearings
Joint HHS and Education Committee - Feb. 23 - Overlap of Services
A joint meeting was held for members of the Senate Education Committee; Committee on Health, Human Services and Housing; and Health and Human Services Budget Division. The committee reviewed the overlap of services for children birth to age five relating to education and health and human services policy/finance. Among the several testifiers was Superintendent Lewandowski, Intermediate School District 287,who spoke on behalf of all three ISDs in Minnesota. Superintendent Lewandowski explained her testimony was tostress the health crisis occurring in these programs. She stated that "we [public schools] are now the de facto mental health system for our most serious youth," and called on legislators for solutions.
Education Committee - Feb. 29 - Advocate Session Priorities
The Senate Education Committeemet to hear from advocates on their session priorities. Over 35 people testified including the teachers union, school board association, administrators, principles and NAMI Minnesota. Supt. John Christiansen, Intermediate School District 917 testified to the need to increase funding for special education and mental health services. He stated that public schools have become the "de facto mental health system during the school day" and explained schools do not have the necessary funding for training, staff support or specialized mental health services to meet the needs. Leah Kent, Minnesota School Counselors Association presented on the Supporting our Students Act (SF 1364/HF 2045): funding to invest in professionals including psychologists and chemical dependency counselors. Lynn Sando, public policy coordinator from NAMI Minnesota, provided an overview of NAMI's legislative initiatives related to the education system including: alternatives to suspension for students K-3, funding for experts to reduce the use of seclusion and restraints and requirements for teachers to receive continuing education on suicide prevention. Click hereto watch the video of this committee.
House Committee Hearings
Capital Investment - Mar. 3 - Overview of Bonding Proposals
The House Capital Investment Committee convened to review bonding proposals for the upcoming session. Click hereto listen to the day long hearing.
Terry Carlson, Department of Corrections (DOC) deputy commissioner of facility services explained that there are about 400 to 500 inmates housed in county jails as a result of overcrowding in the prisons and as a result 3 of their 7 priorities are focused on adding beds to the Willow River, Togo and Lino Lakes prisons. She emphasized the importance of creating space at these prisons because of the lack of rehabilitation services inmates are receiving. The DOC is looking to add 45 more beds for the Challenge Incarceration Program (CIP), increasing the total to 225. This priority also looks to provide a chemical dependency treatment space for those in the CIP.
Mary Tingerthal, commissioner of the Minnesota Housing Finance Agency (MHFA) reported on Governor Dayton's bonding proposal of $90 million for housing infrastructure and rehabilitation. Commissioner Tingerthal reported that a portion of the bonds would go towards supportive housing for youth and veterans who have experienced homelessness as well as individuals and families. Rep. Hausman asked "what is the cost of not doing something?" and noted that, at a recent NAMI legislative house party in Roseville, her constituents talked about the difficulties of obtaining and maintaining stable housing in addition to caring for their mental health needs. Even with supports, voucher or subsidies, people are still waiting for housing. Commissioner Tingerthal responded with wait lists have been increasing.
The Department of Human Services (DHS) presented on their capital budget recommendations which included improvements and renovations to the Minnesota Security Hospital and Anoka Metro Regional Treatment Center (AMRTC). Commissioner Emily Johnson Piper reported there is a critical need for improvement to Minnesota's direct care and treatment facilities. She explained the need for improved safety and to create a more therapeutic environment. "Our challenges relate to sometimes the age of the building, but also dealing with the increasing mix of patient populations between our state sex offender program and the people in our state security hospital, some really vulnerable people, who are committed to me as mentally ill and dangerous." reported Commissioner Johnson Piper.
Commissioner Johnson Piper referenced the hearing on the mental health treatment in jails report by OLA explaining that taking patients from jail is one of the challenges at AMRTC.She stated "as a result, in part of this new influx over the last couple years of patient in jails we're seeing higher levels of aggression and feel very strongly we need to improve security of that hospital [AMRTC]." She noted that although AMRTC is designed to be a hospital, "we are seeing an increase in violence we feel very strongly we need to make some security improvements."
Rep. Dehn questioned whether the state is looking at improvements to treatment methodology in additional to addressing security concern and stated "the security takes care of today, but doesn't necessarily take care of the future. Is there anything out there on the horizonrelative to how treatment might actually reduce some of the safety concerns as well?" Commissioner Johnson Piper explained that while she is focused on security, she is also focused on creating more a therapeutic environment; "they do go hand in hand with the security and the therapy." Click here to view the commissioner's testimony.