Data from the DHS Direct Care and Treatment Discharge Barriers report (July 2013) indicate there are people who remain in some Minnesota facilities beyond the point of clinical necessity.
The 2013 legislature approved $8.2 million in new funding and grants to support the transition of people from the Anoka Metro Regional Treatment Center (AMRTC) and the Minnesota Security Hospital (MSH) in St. Peter to community resources of their choosing. This is partly in response to the Olmstead v L.C. Supreme Court decision (PDF) requiring services be provided in the most integrated setting appropriate to the person and is consistent with Minnesota's policy and direction under the Minnesota Olmstead Plan.
This funding is to enhance and expand existing resources that support individuals living in the community as well as to develop new services that cover some currently existing community service gaps. To address the various barriers to timely discharges, DHS has taken a number of steps.
People who are eligible for a disability waiver
DHS received additional waiver resources so people can be discharged from Anoka Metro Regional Treatment Center or the Minnesota Security Hospital in St. Peter if they:
These new waiver resources will provide additional waiver allocations and funding if the current allocations are insufficient to meet the needs of the person.
People who ineligible for a disability waiver
For people who are not eligible for medical assistance but otherwise meet waiver eligibility requirements, DHS will pay for certain waiver-like services that the person's discharge team identifies as unmet needs associated with the discharge for which there is no funding.
Continuity of services
To help address barriers to transition to home and community-based services, DHS has established a Transition to Community Work Group. This group is made up of DHS staff from Adult Mental Health, Disability Services, Direct Care and Treatment, Anoka Metro Regional Treatment Center and the Minnesota Security Hospital in St. Peter. In addition, DHS has put processes into place for:
1. Lead agencies to access funding for people who are waiver-eligible through this new legislation.
2. Early identification of people who may be eligible for transition to the community but have barriers to the discharge that must be addressed.
3. Specific guidelines and timeframes for county/tribal case worker involvement.
4. DHS oversight with discharge planning process.
5. Collaborative work across policy areas within DHS to speed up the waiver determination process.
To create long-term solutions to system barriers, DHS must also address service capacity issues. To that end, DHS is:
Establishing within DHS a Community Capacity Building Team to expand and enhance statewide use of positive behavior practices, person-centered planning and evidence-based best practices
Expanding funding for housing costs, including rent subsidies
Expanding specialty community placements for individuals requiring supervised care
Exploring options for the expansion of community-based treatment resources that provide 24/7 care