SOS Redesign: Transformation or Degradation?

This was the question Sen. Sheran asked yesterday at the SOS presentation on their redesign.  The Department of Human Services (DHS) released its report and presented at Tuesdays Senate hearings in regard to their redesign of State Operated Services (SOS). The following are key changes to take place over the next fifteen months:

  • Level 1 psychiatric care centers in each region of the state. These centers will provide the highest level of care for individuals with the greatest acuity and complexity and will involve 24 hours of staffed psychiatric coverage such as that now provided by Hennepin County Medical Center, Regions Hospital and the University of Minnesota Medical Center-Fairview, in the metro region. Level 2 inpatient psychiatric care centers, which provide a lower level of care, and Psychiatric Extensive Recovery Treatment Services (PERTS) will also be developed.
  • A new 24-hour psychiatric access service. This service will provide consultation to emergency departments, primary care clinics, mobile crisis teams, jails and other mental health providers. Comprehensive assessments, triage services and referrals to appropriate levels of care will be provided. The access service will also include a new psychiatric emergency transportation system to be developed in consultation with consumers, family members, advocates, law enforcement, providers and other stakeholders.
  • A partnership process to involve service providers. Through this process, hospitals, mental health centers, primary care centers and state-operated facilities in regions of Minnesota can collaborate to respond to state requests for proposals for Level 1 and 2 psychiatric care services and PERTS appropriate to the needs of their areas.
  • Permanent closure of the Community Behavioral Health Hospital-Cold Spring, which has not been operating since October 2009.
  • Closure of the 10-bed Mankato Crisis Center, with those crisis services transferred to nearby Community Behavioral Health Hospital-St. Peter.
  • Closure of the state-operated adult mental health residential facility in Eveleth, to be replaced by a new adult therapeutic transitional foster care facility in northeastern Minnesota.
  • Replace community transition beds with a new adult therapeutic transitional foster care facility in northeastern Minnesota in order to close the state-operated adult mental health recovery facility in Eveleth.
  • Transition of state-operated dental services for people with disabilities to another model of service partnered with community providers.
  • Transition of one unit at Anoka-Metro Regional Treatment Center to a state-operated psychiatric nursing facility in St. Peter. A partnership process would be started for operation of the remaining units at the Anoka facility.
  • Launch of the psychiatric access service to replace the current centralized admission process to State Operated Services facilities. And establish a 24 hour psychiatric access service.
  • Temporary conversion of community behavioral health hospitals in Willmar and Wadena to Psychiatric Extensive Recovery Treatment Services (PERTS). Regional stakeholders would be asked to partner to respond to a request for proposals for psychiatric facilities with levels of care matching the region’s needs.
  • Conversion of Minnesota Neurorehabilitation Services in Brainerd to a 16-bed neurocognitive psychiatric extensive recovery treatment facility and additional adult therapeutic transitional foster care facilities.
  • Conversion of Minnesota Extended Treatment Options in Cambridge to a 16-bed neurocognitive psychiatric extensive recovery treatment facility and additional adult therapeutic transitional foster care facilities.
  • Conversion of Child and Adolescent Behavioral Health Services in Willmar to two child and adolescent psychiatric extensive recovery treatment facilities in Willmar and Bemidji.

Some questions needing to be answered about this redesign:

  • When the Mental Health Initiative passed in 2007, it was the largest investment of new dollars into Minnesota’s mental health system in our history – $34 million. How can we cut half of that money and not have a negative impact?
  • What are Psychiatric Extensive Recovery Treatment Services (PERTS)? Who will be using them? How will they be different than IRTS?
  • Where is $17million in cuts actually coming from? • Where is the actual substance of the plan and when will we see it?
  • What are the consequences and outcomes of this plan? How will it be evaluated?
  • Where is the money for the new level 1 hospitals, PERTS and transportation coming from?
  • Where are details on the Anoka redesign?
  • How will this benefit people with mental illness?
  • Where are the five regions and who will decide?
  • What are the impacts of layoffs?
  • What was the timeline on the decision to close and reorganize facilities?
  • How does this plan fit with the needs, priorities, and goals of the community?
  • How can we make this massive transition in 15 months?
  • Where is the actual transformation?
  • How does this relate to the intensive needs report?
  • How will the 24 hour psychiatric services function?

There were many questions from members of the committee and I’m sure more to come on Friday March 19th when the presentation continues in Sen. Berglin’s committee.