The Crow Wing County Board is expressing its displeasure with a state cost shift in an official resolution passed Tuesday.
The resolution addressed the costs associated with mental health care at state-operated facilities, including Anoka-Metro Regional Treatment Center and community behavioral health hospitals, or CBHHs.
A cost shift approved by the state Legislature in 2015 made Minnesota counties fully responsible for a cost once shared with the state. That cost is derived from the care for patients at Anoka-Metro Regional Treatment Center who no longer meet medical criteria for facility-level care. Another change passed in 2016 shifted those same costs for patients at CBHH facilities.
Tami Lueck, adult services supervisor in community services, said this shift resulted in a major overrun in costs budgeted for state-operated expenditures.
"The cost we've endured through this is three times what we were paying in 2015," Lueck said. "With the new CBHH costs, it could be at four times the cost in 2017."
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Once Anoka and CBHH staff determine a patient no longer meets the medical need to stay at the facility, the meter starts running for the county of residence-even though, Lueck told the board in August, it's often seven to 10 days before notification of the change in patient status is received.
The resolution approved by the board Tuesday asked the state to discontinue its reliance on county coffers to cover those costs.
"The Crow Wing County Board of Commissioners supports the state of Minnesota appropriating funds necessary to return counties to their previous cost share role of 50 percent," the resolution stated.
At $1,309 per day for care in Anoka and $1,866 at CBHHs, the costs to counties add up quickly. Eight patients from Crow Wing County were receiving treatment in Anoka between July 2015 and June 2016. Of those, six were discharged for no longer meeting medical need. The quickest discharge took a week, while the longest discharge took 62 days. That lengthy discharge time alone cost county taxpayers $81,158.
In August, when the board first discussed the issue, County Administrator Tim Houle asked Lueck to explain why these patients were remaining in the facility when they no longer needed care there. Lueck said this was a question community services staff presented to the Anoka hospital as well, requesting a written explanation for the lapse of time.
Reasons offered included transportation challenges, time needed to determine where a patient will go once they are discharged and time needed to coordinate physical examinations and order medications.
"This is a really significant budget buster for us," Houle said Tuesday. "We're trying to fund mental health services in the state of Minnesota with local property tax."
Houle said Crow Wing County was not the only county with concerns about the shift, and it would be discussed at an upcoming Association of Minnesota Counties legislative conference.
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The resolution passed 3-0. Commissioners Paul Koering and Rachel Reabe Nystrom were not at Tuesday's meeting.
