Mille Lacs County board considers costs of mental-health care

The executive director of the Mille Lacs Academy in Onamia, Jason Donahue, asked the Mille Lacs County Board at its Dec. 15 meeting to consider increasing the per-diem rate for the facility by 15 percent so that it can boost the wages of mental health professionals serving clients through the academy. The board anticipated having the item on its Dec. 21 meeting agenda for action.
The academy offers treatment for boys ages 10-19 who have significant mental health issues and harmful sexual behaviors. The nonprofit organization Nexus Treatment runs the academy with Mille Lacs as its host county for the Onamia facility. Donahue said there is a general shortage of mental-health professionals, such as direct-care staff and psychiatrists, and the field has become fiercely competitive.
“What we’re facing at the academy right now is the challenge of being able to hire and keep staff,” he said. “Other providers have described it as a critical or crucial lack of people.”
Donahue said, if approved, the requested increase would take effect Jan. 1. He suggested two other alternatives, one being a 10 percent per year increase for three years and the other being a 30 percent increase up front with a pledge for no increase requests for three years except if the state changes any relevant rules or expectations.
He said the academy pays mental-health staff around $12 per hour but loses those people to mostly state jobs paying $13 or $13.50 per hour. He said it doesn’t help that there are fast-food places offering $15 per hour, and employees saying though the jobs are fulfilling, that fulfillment does not help pay the bills.
Staff wages and salaries are part of a per-day rate that Donahue said stands at $252 for two of the Academy programs, $280 for two special-needs youth and $166 for the group home.
The requested increase would also enable the academy to create a parent-partner position to be filled by someone whose son or daughter has been through the academy. The new person would be focused on helping the kids to not reoffend and helping families achieve sustained success after leaving the academy.
Nexus has two academies, a foster program and its corporate office in Minnesota, as well as locations in Illinois and Maryland. Donahue explained that the corresponding county boards in Minnesota act as the fiscal agents for setting the amounts all counties pay for care at the facilities. When a young person comes to the academy, the person’s county of residence is responsible for paying the costs of their stay, according to Donahue.
The Mille Lacs County Board then becomes a “guardian” of the process for the whole state and must carefully consider how the rates it sets could affect other counties. Their position as the host county makes them keepers of the Academy contract. Donahue said the county boards play an important role as the rate setters for the academy facilities and that in other places, it’s the state that sets the cost.
He personally likes the approach of using county boards because it stays closer to small-town values. “I think that’s the strength of rural America,” Donahue said.
Mille Lacs County Board Chairman Phil Peterson asked how many kids were at the facility and how many of those are from Mille Lacs County. Donahue said the academy has room for 91 boys and has 83 residents now, four of whom are from Mille Lacs County. The care staff attends to the residents 24 hours per day, seven days a week.
County may buy space at new mental-health facility
Beth Crook, director of the Mille Lacs County Community and Veterans Services Department, briefed the board at its Dec. 15 meeting on an opportunity for the county to essentially purchase a permanent bed at an Annandale children’s mental health facility Nexus is looking to start.
“There’s a waiting list for these (overnight) facilities,” Crook said.
Counties and other entities are invited to invest, and they’re in turn guaranteed a bed at the nearby facility instead of having to drive to wherever there is a space available, often hours from Milaca. When a child from the county gets placed far away, the county must pay the social worker’s travel expenses to visit the child for the duration of their stay.
Commissioner Roger Tellinhuisen recognized that so far in 2015, Mille Lacs County has needed to place 16 children in these kinds of facilities. Though she asked to “buy” half a bed, the commissioners agreed that Crook should express interest in one bed, which she said is estimated to cost approximately $150,000. It was established that the cost could likely be managed or recouped without affecting the requested department’s budget for 2016.
Board Chairman Phil Peterson asked what kind of problems a child has to be referred to such a facility. Crook said it’s usually a severe enough emotional disturbance that they’re destructive or abusive to themselves or others and are not successful in home, school or the community. She said many times the parents don’t know how to handle that kind of behavior.
Commissioner Tim Wilhelm observed that the county would be spending the money either way, so it might as well try to procure a spot close to home.