Dakota County jail plans to add unit for medical, mental health

Dakota County officials plan to build a specialized health unit at the Dakota County jail dedicated to improving the mental health and medical care that inmates receive.

The facility's staff would treat physical and mental health issues, as well as substance use disorders. The goal would be to reduce the number of inmate hospital visits, provide a more therapeutic environmen and establish a single place where everyone needing care could be treated.

"These aren't just inmates — we talk patients, patient-centered care," said Pat Enderlein, commander of the detention services division at the Sheriff's Office. "This is absolutely needed. We're not providing the level of service we feel we could be."

Studies by the county and an outside consultant over the past two years have confirmed the need for the unit, Dakota County officials said.

About 25% of inmates have a serious health issue that requires treatment while at the 263-bed jail in Hastings, according to the county.

The County Board has approved spending $675,000 to design plans for the unit and has set aside $5 million for its construction. The total price tag, however, will be $12 million to $14 million, so the county is seeking additional funding, including from the Legislature.

If all goes as planned, the unit would open in late 2024.

The jail has seen a sharp increase in the past few years in the number of inmates with mental health concerns, Enderlein said.

The jail has a medical unit, but inmates with mental health issues are often sent to the intake area, he said, placed in a single or group holding cell or a padded cell. That area was only intended as a "brief stop" before inmates head to the general housing unit, Enderlein said.

"That is, in essence, being used as a quasi-mental health unit, which is not conducive to their support ... and it's certainly not good for our staff, who are trying to navigate that while also managing all of the intake," he said.

Inmates with serious problems are sometimes sent to a hospital, but Enderlein said hospitals often are "tapped out" and don't have a bed available. So, he said, the inmates aresent back to jail. Other times, he said, an inmate can't leave the jail because they're a security risk.

"Some people simply need to be in jail. I mean, we can't have somebody that's in on a homicide or criminal sexual conduct or something like that [go to the hospital]," Enderlein said.

In 2021, the Dakota County jail recorded 275 inmates on suicide watch, 503 on watch for substance withdrawal, 265 on medical watches and 739 on "character watches" — meaning "something is a little off" with an inmate or they need observation, Enderlein said.

The jail contracts with Advanced Correctional Healthcare for its health care staff, including on-site nurses 24 hours a day. Additional security and health care staff would be hired to work at the new unit.

Jay Biedny, the county's capital projects manager, said the addition would likely be 13,000 square feet and one story. It would include up to 30 beds — one per cell. Inmates in the unit would also have their own outdoor space.

Jails typically segregate inmates receiving health care but house them throughout the jail, not in one area, Biedny said.

"What we're trying to do is handle people with definite needs in a different way," he said.

Metro-area jails vary in how they handle medical and mental health needs. For example, the Hennepin County jail — the state's largest — has a medical floor with four medical cells and a special area where mental health patients are sent, said Maj. Dawanna Witt, who oversees the jail and court .

Hennepin County contracts with Hennepin Healthcare for staffing, she said, and employs 33 nurses and nearly two full-time physicians when fully staffed, she said.

Inmates with more serious needs are sent to Hennepin Healthcare, she said.

At Scott County jail, which can hold about 260 inmates, three rotating nurses and a medical director staff a medical clinic in the building, said Sheriff Luke Hennen.

Even so, "a lot of emergency room visits happen ... which turn into a lot of security costs," he said, adding that a guard accompanies each inmate to the hospital..

During regular business hours, staff from the nearby county mental health clinic will visit inmates with mental health concerns. After hours, the jail contracts with a mobile crisis team to treat inmates in the intake area.