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2015 could be 'mental health' legislative session

West Central Tribune (Willmar, MN) - 10/23/2014

Oct. 23--WILLMAR -- Modernizing the mental health system in the state is expected to be a major issue in the 2015 legislative session.

Dr. Rick Lee, CEO of Woodland Centers in Willmar, said next year could be the "mental health legislative session."

During a report to the Kandiyohi County Board of Commissioners Tuesday, Lee said that Gov. Mark Dayton has identified mental health as a major focus of the next session if he's re-elected.

Lee said gaps in the availability of mental health care and gaps in the reimbursement rate for providing those services are some of the issues that the state Department of Human Services intends to bring to the Legislature next year.

"Counties should be really interested in this," Lee said.

Because the state's reimbursement rate for providing mental health services does not come close to covering the costs, counties subsidize those expenses.

Lee said, for example, that in 2011 every hour of psychiatric care provided at Woodland Centers resulted in a net loss of $277 per hour.

With more people now covered by health insurance that provides third-party payment for mental health care, the net loss in 2013 was at $216 per hour.

That improvement is a positive step, but Lee said facilities like Woodland Centers are reluctant to hire much needed psychiatrists because of the financial burden.

"The more psychiatry we deliver, the more we lose," he said, adding that rate reform is high on the list of legislative requests.

"It's my hope that the need for subsidies goes down," Lee said.

The Commissioners renewed the county's contract with Woodland Centers, which was the state's first community mental health program in Minnesota. It was started in 1958 as a partnership between Kandiyohi, Lac qui Parle, Meeker, Renville and Swift counties.

Lee said he values the positive relationship Woodland Centers has with its supporting counties and he tries to be "as transparent as I possibly can" in an attempt to foster a good working relationship with Woodland Centers' partners. That lesson hit home for him when a similar facility in east-central Minnesota called Riverwood Centers abruptly closed this spring, leaving thousands of people without mental health care.

Earlier this year Woodland Centers closed its 14-bed intensive residential treatment services facility in Atwater.

Closing the facility was a "very difficult" decision and has increased the gap in services in the area, but Lee said the facility lost about $200,000 to $300,000 every year.

He said it was also difficult to adequately staff the facility to ensure that it was a "safe place for people."

Lee said other community mental health centers are also eyeing closing their intensive residential treatment facilities because the reimbursement rates are "so poor" that it's impossible to break even financially.

"It's a crisis in the system," Lee said.

He said the Department of Human Services is "acutely aware" of the situation.

Regarding the 4,300 clients that use a variety of Woodland Centers' mental health services, Lee said about one-third are from Kandiyohi County.

He said that's representative of the overall population breakdown. Kandiyohi County has about one-third of the total population in the six-county area, he said.

Unlike the national trend that three-fourths of individuals seeking mental health care are female, Lee said Woodland Centers' clients are split 50-50 between male and female. He said the difference may be because of expanded services to young children in schools, where there are significantly more boys than girls needing mental health care.

Lee said the primary diagnoses of clients at Woodland Centers are depression and anxiety, which are "highly treatable conditions."

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