Budget cuts would deepen statewide shortage of psychiatric beds, Minnesota commissioner warns

A statewide effort to alleviate Minnesota's chronic shortage of psychiatric beds by freeing up space at state mental hospitals would be jeopardized under budget proposals before the Legislature, the head of Minnesota's largest state agency warned Tuesday.

During a visit to a community mental hospital in Baxter, Minn., Human Services Commissioner Emily Piper said a proposed $600 million reduction in the Human Services budget would force the state to reduce staffing and capacity at state-operated mental facilities, reversing a year of progress in expanding access to treatment for psychiatric patients.

"It's extraordinarily important to fund our facilities so they are operating at full capacity, when we already know that we have an overloaded mental health system across the state," Piper said in an interview.

Over the past few years, Minnesotans with serious mental illnesses have faced significant barriers to inpatient treatment. A 2013 law that gives jail inmates with mental illnesses priority for psychiatry beds in state-run facilities strained an already stressed system, causing backlogs of patients at emergency rooms across the state. The patient-flow bottlenecks were so severe that, in some cases, mental health patients were forced to wait on stretchers in hallways, or were sent out of state for treatment, hospital administrators said.

A study released last August by the St. Paul-based Wilder Foundation found that nearly one in five psychiatric patients across the state is stuck in a hospital bed even after being stabilized because of delays placing patients and a lack of treatment options.

While backlogs persist, the crisis has abated somewhat since last fall as the state has ramped up hiring at facilities it operates. With $20.8 million in new funding from the 2016 Legislature, the Department of Human Services (DHS) was able to increase hiring at the state's network of six smaller, community-based mental hospitals. Those 16-bed hospitals, which had been able to fill only half their beds because of funding constraints, are now operating at or near capacity, DHS officials said.

But proposals before the Republican-controlled Legislature would undo those gains, Piper warned. Without more funding, the agency would be forced to eliminate more than 200 positions at state-operated facilities and programs.

The cuts could have a major fiscal impact on county governments if backlogs worsen. Under state law, counties are required to cover the daily cost of care for psychiatric patients who no longer require hospital care but are kept at state hospitals because they have nowhere to go in the community. DHS bills counties nearly $2,000 for every day of non-acute care at the state-operated community behavioral hospitals.

"It's illogical to have partially empty facilities when we know that people are backed up in emergency rooms across the state and are not receiving the care they need," Piper said.

Chris Serres • 612-673-4308