The Pawlenty Administration’s 2003 mental health reform proposals include expansion of the community-based mental health system, including restructuring of adult mental health residential treatment, and phasing out of adult mental health day treatment. State Operated Services, which includes the state regional treatment centers, would blend, as needed, into the community-based system of care.
Community mental health system expansion
In their role as local mental health authorities, counties will work in partnership with the DHS Mental Health Division to expand the community-based mental health system. The proposal also allows for a broader array of community mental health services and provides incentives to use non-institutional options more likely to meet client needs and to be federally reimbursable. Under part of the proposal affecting about 70 residential treatment facilities, some would be converted to facilities where more intensive treatment, short of hospitalization, can be provided. Others would be converted to needed permanent housing. County mental health grants would be reduced, but overall funding would increase because services would be configured so that Medical Assistance (MA) funding could be captured when possible.
In response to the counties’ planning, State Operated Services will restructure its adult mental health and nursing home services to be integrated into the full health care continuum. By operating multiple smaller hospital units and other community services, such as crisis response, SOS and private vendors will be able to serve clients in or near their home communities and natural support systems. A broader array of services will allow people with mental illness to be more appropriately matched to the services they need, thereby improving care, access and choice while increasing service capacity. This service configuration also will allow all vendors to eligible for new sources of funding. Capture of this revenue and reduction in SOS overhead costs associated with unused buildings and grounds will help to increase funding for the community mental health system.
The phase out of adult mental health day treatment gives consumers flexibility to purchase their choice of services and consider other options, such as supportive employment, tailored to their interests, abilities and schedules. Providers will gain flexibility to offer a wide variety of services and to match payment more appropriately to services.
Specifically, the proposals allow for:
• About 20 percent of SOS adult mental health clients and 50 percent of SOS nursing home clients who do not require hospital level of care to be served under the Community Alternatives for Disabled Individuals waiver or other community-based care.
• Clients who require hospital level of care in SOS RTC-based hospitals to receive services in smaller hospital units located in or near their home communities.
• An incentive to counties to participate in community-based options, as their cost share per patient for institutions for mental diseases rises from 10 percent to 20 percent. Counties’ investment in community-based SOS services will remain at historic levels, based on a 10 percent contribution.
• Services provided by SOS Mental Health Initiative staff to capture maximum revenues to offset costs.
• More stringent prior authorization process in fiscal year 2004-05 for adult day mental health day treatment and elimination of day treatment as a covered MA service for adults on July 1, 2005.
• SOS to retain nursing home capacity for forensic clients who require that level of care.
• Movement to an expanded community-based mental health system to begin in the southwest-region of the state served by Willmar Regional Treatment Center and northern regions served by Brainerd Human Services Center, Fergus Falls Regional Treatment Center, and Ah-Gwah-Ching nursing home.
This information is available in other forms to people with disabilities by contacting us at 651-296-1835. TDD users can call the Minnesota Relay at 711 or 1-800-627-3529. For the Speech-to-Speech Relay, call 1-877-627-3848.
This news release was received by the St. Peter Herald by fax from the Minnesota Department of Human Services on Monday, March 17, 2003, and has been transcribed “as is” from the faxed copy.
