The Free Press, Mankato, MN

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March 17, 2010

Our View: Cut's costs exceed savings

The Free Press

There’s nothing like the blunt ax of recent state budget cuts to bring back inefficiency just about the time we thought we had it beat.

Just five years ago, the Mankato Crisis Center was heralded as a new kind of state-run mental health clinic that would save the state and taxpayers millions of dollars. Recent state budget cuts have shuttered the facility that was touted at its opening as saving nearly $600 a day.

It was the first of its kind short-term clinic in the state and was designed to assist people who just needed temporary help getting through mental health issues and did not need to be hospitalized at more expensive facilities in St. Peter and Rochester.

The recent budget cuts call for the 10-bed facility to be closed because the state is “redesigning” mental health services once again. The patients will apparently now go back to the larger and more costly St. Peter and Rochester facilities. But Blue Earth County Human Services Director Bob Meyer said it’s not clear if they will be provided some of the same urgent care or crisis intervention services the center provided. If not, these patients will likely end up in hospital emergency rooms or clinics, says Meyer.

In June 2007 the Mankato center was well on its way to serving the mental health needs of area residents at a low cost. Its use tripled two years after it opened from an average of 85 days of service in 2005 to 214. The costs were approximately $262 each day, according to the state, far below 16-bed facilities in Rochester and St. Peter that were more like hospitals and had costs of $845 per day.

The crisis center concept was meant to “avoid an emergency room as a front door for mental illness,” said state adult mental health services administrator Rod Kornrumpf in 2007. He said sending these folks to a hospital bed is usually “overkill.”

Meyer notes nurses with expertise in mental health staffed the crisis center and were able to handle many of clients’ mental health issues. Clients now going to the St. Peter center may be dealing with a psychiatrist whose hourly service is much more costly.

Now, the state is moving these patients back to the larger hospital-like facilities where consultants have told them both short-term and long-term services can be provided under the same roof. Meyer says the county’s cost will  now go up because it must pay for these services at the regional centers.

Dr. Read Sulik, assistant commissioner for chemical and mental health services, told The Free Press it’s not that the services provided by the crisis center aren’t needed, it’s that they can be provided more efficiently at the larger facilities.

The St. Peter facility apparently has extra capacity and while it doesn’t provide the lower level services the crisis center did, the state is considering making a few beds at the facility “crisis beds.”

Closing the center will apparently save $1.3 million a year. But that savings doesn’t include the cost to the state, counties and hospitals who will have to deal with the patients knocked out of the crisis center. The crisis center appeared to be saving the state, Blue Earth County and taxpayers far more than the $1.3 million budget reduction.

The plan looks like a cut, but appears to be only a temporary way to pay more later, and increase inefficiency and expense to taxpayers. Those seeking mental health services will likely have a safety net that not only has more holes but is more costly.

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