Last week, Supervisor Jodi Heurung with Sherburne County Health & Human Services updated the county board on some of those changes.

 

Since 2001, the Centers for Medicare and Medicaid (CMS) have allowed Minnesota to receive federal Medicaid funding for residential mental health treatment for children on medical assistance. The split was 50% federal and 50% county funding.

 

That changed when the feds decided to re-evaluate children’s mental health facilities and create two categories: Institutions for Mental Disease (IMD) and

Psychiatric Residential Treatment Facilities (PRTF).

 

Under the new system, the feds pulled matching funds for all IMDs. In Minnesota, 11 facilities have been identified as IMDs. Last year, the state legislature authorized temporary funding to cover the amount pulled by the feds, making it a 50-50 split with county and state funds.

 

“They put a stop-gap in place,” said Heurung. “But without further legislative action, by April 30, 2019 counties will become 100% responsible for placement costs.”

 

The average cost for placement in an IMD is $300 per day. In 2016 and 2017, the county had 25 youth receiving that level of care.

 

“It can be for six months, and we’ve had kids in up to  a year,” said Heurung. “It’s based on mental stability and the ability to get them into a less restrictive level of care back in the community.”

 

Heurung said the county spent $373,000 for placement in 2017 and is projecting $400,000 in 2019.

 

The other part of the equation are the PRTFs, which also require a medical necessity for placement by recommendation of a physician or medical professional.

 

Heurung said that level of care is provided in a residential facility instead of a hospital.

 

“It’s a pretty intensive program designed to be shorter term than traditional residential treatment,” she said.

 

The cost at PRTFs are covered 100% by health insurance. One PRTF facility opened in Duluth in June, providing 48 beds. Three more facilities will be opening by the end of 2019, which will create 150 beds in the state.

 

But just which youth will be admitted to those facilities is still a question.

 

“It’s unpredictable. We need to prepare for the worst and hope for the best,” said Heurung. 

 

HHS is also looking at what happens if a youth in a PRTF no longer has a medical necessity.

 

“What is the cost to the county?  We’ve been having discussions with the DHS (Dept. of Human Services) to prepare for this. There’s not a lot of answers yet.”