Rethink plan to exit mental health ‘demo’

Opinion Editor’s Note: Editorials The Star Tribune represents the opinion of the editorial board, which operates independently of the newsroom.

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While four members of Gov. Tim Walls’ cabinet recently announced they will not seek reappointment, one key commissioner remains to serve a second gubernatorial term.

Judy Harpstead leads the Minnesota Department of Human Services (DHS). It’s a tough job with responsibilities that include running the state’s medical and public assistance programs, as well as direct care and treatment systems.

Harpstead stepped in to lead the agency in August 2019 after a leadership shakeup and allegations of improper spending plagued the agency. He has worked hard to strengthen financial controls and mend strained legislative relations.

Addressing the same practical issue is again needed to address a troubling rift between DHS and the state’s mental health community. At issue: An agency’s decision to withdraw from a federal program that is launching a promising next-generation model of care.

Although an interview with DHS this week indicated the agency is not inclined to reconsider, the editorial board encourages the agency to do so. Harpstead and his agency’s top behavioral health lieutenants must also soon sit down with mental health advocates who say the agency is making the wrong decision, leaving millions of federal funds on the table and its logic. is not transparent about

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At the center of the controversy is an innovative federal program known as the “Certified Community Behavioral Health Clinic (CCBHC) National Demonstration.”

Among the requirements of being a CCBHC: Crisis services that are available 24 hours a day, seven days a week. In addition, according to federal officials, CCBHCs must “provide a comprehensive array of services so that people who need care are not caught trying to cobble together the behavioral health support needed by multiple providers.” “.

To do this, CCBHCs must provide core services including crisis support, screening and risk assessment, treatment planning, outpatient mental health and substance abuse services, targeted case management and veterans. Includes community-based mental health care. The list also includes psychological rehabilitation services and “peer, family support and counselling” services.

If that sounds like a lot, it is. But that’s the beauty of CCBHC’s approach. It’s a one-stop shop, helping people access care faster and better navigate the fragmented care system. This is important to help people in crisis and ensure they have ongoing care.

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U.S. Senator Roy Blunt, Republican of Missouri, is an advocate for the CCBHC. His office reports that “Department of Health and Human Services statistics show that people who received services at these clinics had 63.2% fewer emergency department visits; spent 60.3% less time in jails; and A 40.7% reduction was observed in being at home.”

There are more than 450 CCBHCs across the country. Minnesota, to its credit, was one of the early adopters of the program and currently has 13 CCBHCs, with eight more federal grantees coming online, giving the state a wealth of mental health advocates. A total of 21 will be found “over the next four years” accordingly.

As its name suggests, the grant to implement the program and the CCBHC model was not intended to be permanent. However, federal lawmakers have passed several extensions. In 2022, Congress expanded the program and extended funding through the fall of 2025.

DHS’s decision to pull out next month comes after states are required to “graduate” the program and transition away from federal support, giving the state a chance to pay for lost federal dollars from its current large surplus. does. Mental health advocates opposing the decision estimate the state could lose up to $30 million in federal matching funds annually.

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DHS’s decision may have been made before Congress renewed its CCBHC commitment, raising questions about whether it was the right time to “graduate.” Leadership churn within DHS’s behavioral health division raises further concerns.

Advocates opposing the DHS decision are the state’s most respected mental health organizations — the state chapter of the National Alliance on Mental Illness, the Minnesota Association of Community Health Programs and prominent providers.

“In choosing to remove Minnesota from the DEM, the state’s national reputation suffers, leaving a key state behind in transforming mental health care in America as the rest of the nation tries to join the DEM” . said the statement.

The gap between DHS and these critical voices is alarming and needs to be addressed. Harpstead is a capable commissioner and should see his team as an opportunity to navigate differences and build consensus.

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