Inmates sue state over delays in treatment center transfers

Minnesota lawmakers have temporarily suspended a rule meant to keep mentally ill individuals from languishing in jails, after lawsuits started stacking up over monthslong waits for transfers to more appropriate facilities.

Since 2013, a law known as the "48-hour rule" required the state's Department of Human Services to transfer jail inmates who are civilly committed to a state-operated mental health facility within 48 hours.

In many cases the inmates linger in jail for far longer without getting necessary treatment for mental illness because hospitals don't have the space, a bed, or sufficient staffing.

This spring, the Legislature suspended the law through June 2025. Now, DHS has to transfer individuals with mental illness only when a suitable bed opens up.

In May, Attorney General Keith Ellison asked state legislators to suspend the law, noting a "vast" amount of litigation targeting DHS from inmates and their families.

Minnesota is "not meeting the requirements of the 48-hour law, and people are suing," said Ellison, whose office is representing DHS. "I don't believe we can meet the resource needs in an instant, but we can change the law to give DHS enough flexibility so we can meet the requirements of the law."

Department of Human Services (DHS) Commissioner Jodi Harpstead, the defendant in the lawsuits, also attended the hearing.

County attorneys, sheriff's offices and others opposed suspending the 48-hour rule, viewing it as a way to avoid litigation without solving the issue.

"It's not a real solution, but it's the only thing putting pressure on the people to make therapeutic beds available for people who have serious mental health disorders," Ramsey County Attorney John Choi said.

Attorney Dan Gustafson, whose firm is handling multiple lawsuits over 48-hour law violations, said he thinks the solution is obvious. "We need more mental health facilities," he said.

Asked for comment on the struggles with hospital capacity, a DHS spokesperson provided a statement saying it's a "shared problem" requiring "thoughtful solutions that don't pit stakeholders against each other or merely shift the burdens from one stakeholder to another."

On July 31, 48 people had been waiting past the 48-hour period for admission to a mental health facility operated by DHS, according to the department.

Hennepin County Sheriff Dawanna Witt said the lack of available beds has forced county jails to carry the burden of caring for people with mental illness. People are languishing in jail, she said.

"When you're watching people who need to be in a hospital setting diminish before your very eyes, and the people with the power to do something about it are doing nothing, that's not humanizing the people that are in our system," she said.

One Ramsey County jail inmate stayed there 264 days before being transferred to a state hospital Aug. 1, according to Undersheriff Kyle Mestad. In Hennepin County, an inmate has waited 175 days for transfer since being ordered to a state hospital, Witt said.

In a joint letter in May, the Minnesota Sheriffs' Association, County Attorneys Association and other groups condemned the changes to the 48-hour rule.

John Schilz, a lawsuit plaintiff who has schizophrenia, filed with the help of his sister, Catherine Schilz. He has been waiting in Sibley County jail for more than 10 months to be transferred to a mental health facility.

His sister said she hopes the lawsuits put pressure on those working to solve the issue and get him into treatment.

"This isn't helping him in any way; just giving him his meds and locking him in a cage is not mental health treatment," Catherine Schilz said. "They need to look everywhere, even if it's sending my brother three states over."

Catherine Schilz said she has had to argue with jail staff to improve basic conditions for her brother, such as getting him a pillow or having tooth pain examined.

John Schilz is facing two charges for domestic assault and third-degree assault. The criminal complaint says Schilz punched his father multiple times at their home in Winthrop. Schilz later said he didn't remember attacking his father, according to the criminal complaint.

The lawsuit alleges Harpstead violated John Schilz's constitutional and common law rights by keeping him at Sibley County jail without receiving necessary treatment.

The department said the 48-hour law has been "challenging for DHS, law enforcement, counties, the courts, community hospitals and advocates."

Along with suspending the law, lawmakers approved a new taskforce to review the impact of the 48-hour law and suggest possible permanent changes.

Number of beds aside, it can be difficult to transfer someone out of jail, depending on the patient's needs and the level of staffing required to care for them safely. One patient can require space typically used for four patients, and up to four times the number of staff, the department said.

There are also challenges with finding places that will take patients.

"Yes, the mental health system needs more treatment beds – but more of the right kind of beds, not necessarily hospital beds," the DHS statement read.

Sue Abderholden, executive director of National Association on Mental Illness in Minnesota, said it's not as simple as finding space for those in jail. Patients coming from jail typically get priority over those coming from community hospitals, she said, meaning people who haven't been arrested are also waiting long periods for mental health treatment.

As part of a workgroup, Abderholden helped make recommendations for the state to overhaul its "competency restoration" system and better address gap cases where someone is released into communities because they're deemed unfit to stand trial but aren't committed to a hospital.

"The problem is there's been no assessment of what level of care they really need, because many people who are committed don't actually need that level of care," she said.

In the current system, civilly committed patients coming from jail are automatically ordered to go to a state hospital, even when other options are available, Abderholden said.

The state is working on locked residential programs, which Abderholden said could address some cases where a patient doesn't require high-level care.

"There's a whole lot of things we need to do to build our mental health system to be able to meet the needs," Abderholden said. "You can't just add beds."