Residential treatment conditions need improvement, study says

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An audit of the state’s 130 in-patient services for people with mental illness, developmental disabilities and chemical dependency resulted in several recommendations by the Office of the Legislative Auditor for service improvements from the top down.

“It absolutely needs to improve,” said Legislative Auditor Jim Nobles.

The State-Operated Human Services audit report was presented Tuesday to the House Health and Human Services Finance Committee. No action was taken. However, Rep.Thomas Huntley (DFL-Duluth), who chairs the committee, said he expects to work through the summer on issues that would require legislation to improve services at the facilities.

Deputy Commissioner Anne Barry, who oversees state-operated human services for the Department of Human Services, said the findings were “accurate,” and that steps have already been taken to implement some of the auditor’s recommendations, such as elimination of the SOS governing board.

Residential treatment centers vary in size from community-based homes that serve a few residents to large treatment centers, such as the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital in St. Peter. The department has been plagued by problems in recent years:

  • Inappropriate restraint and seclusion of patients led to the closure of a treatment center and a $2.8 million court settlement;
  • There are waiting lists to move into treatment and a lack of transitional housing for moving residents out of treatment;
  • Minnesota Security Hospital is operating under a conditional license and has a shortage of psychiatric staff, and
  • There is a heavier reliance on part-time staff and above-average overtime hours worked, according to Joel Alter, an OLA auditor.

After the state was reprimanded for improper restraint and seclusion of patients, those techniques were no longer used and injuries among staff increased, Alter added.

“In evaluating state-operated services, we found significant and persistent problems and we think, indeed, some people would be better served through alternatives provided in the private, non-profit sector,” Nobles said.

Later this year, a plan is anticipated from DHS showing how the state intends to comply with a Supreme Court ruling called the Olmstead Decision, which requires states to provide adequate placement within the “most integrated setting” that is appropriate to a person’s individual needs.

Some residents have remained in state-run facilities for decades and have not received periodic evaluations or assessments for release, which “could be lawsuits waiting to happen,” Alter said.