Minnesotans suffering from severe drug addictions are getting wait-listed.
Some are waiting at home. Others are languishing in detox facilities or hospital beds intended for short-term medical care. Some are sitting in jail cells.
On July 1, the state cut 66 beds from its six state-run, residential drug treatment programs, bringing the collective count down to 108, according to Department of Human Services (DHS) data. The programs — known as Community Addiction Recovery Enterprise, or CARE — serve patients with severe addiction, usually accompanied by other mental illnesses.
Before July, the CARE programs took a mix of patients who came for help voluntarily and those ordered into treatment by the courts. Now the centers only accept clients committed by a judge, a measure reserved for extreme cases, such as when a person can no longer take care of him/herself or has become a danger to self or others as a result of addiction.
As of mid-August, 43 patients were on the waiting lists, according to the data. The CARE center in Carlton had the longest wait, with a 7-8 week backlog. In Fergus Falls, patients were waiting 3-4 weeks to get in.
Here's the full waitlist, according to DHS:
|CARE Site||Patients Waiting|
(as of 8/13)
|Fergus Falls||8||3-4 Weeks|
|St. Peter||1||No Wait|
These delays amount to a serious problem, said Ashley Erickson, spokeswoman for Minnesota Association for Professional Employees, or MAPE, the union that represents about 1,800 DHS staff. While these patients wait for a bed to open, there is no designated place for them to stay.
“There’s no way to stay in touch with them,” said Erickson. “We’re worried about them ending up in jail or on the streets. We’re worried about them causing harm to themselves or others.”
So far this year, the majority of patients admitted to the CARE programs have come from hospitals, like Hennepin County Medical Center. Megen Cullen, senior director of psychiatry at HCMC, said they commonly languish in beds for months designated for general medical care, not chemical dependency treatment.
”We have a ton of people that need long-term care, and because there aren't enough beds, they don’t ever get it, or they wait a really long time,” she said. “It’s quite frustrating.”
The move to reduce the bed counts and cease accepting volunteer patients came in response to a 2013 report from the Office of the Legislative Auditor, said Wade Brost, executive director of DHS’s Mental Health and Substance Abuse Treatment Services. Among the key recommendations from the 155-page report was that DHS rethink the role of its state-operated residential and inpatient facilities, and act as a safety net of sorts by focusing on services that fill gaps in the system. Since many private facilities also offer addiction services, DHS determined the CARE programs didn't need to serve volunteer patients.
There were also financials considerations: The CARE centers cost more than they billed (usually to patient insurance companies), so they were losing money.
Borst said it’s too soon to know what to make of these wait-list data. Since DHS narrowed the clientele to only committed patients in July, there’s no point of comparison before then.
“It’s really quite early to tell how the wait list is going to fluctuate, or whether this is a good number or a bad number,” he said.
More cuts are expected over the next 10 months, and people like Erickson fear that the waiting periods could be further exacerbated in that time.
But patient backlog isn’t the only worry, she said. As a consequence of only taking in committed patients, CARE staff members are dealing with more clients with higher likelihood of mental illness beyond drug addiction. “Kind of the worst of the worst end up going into these facilities,” she said. “It’s really changing the clientele of these facilities.”
She’s heard complaints from frustrated union members who feel underqualified taking care of these patients. “The turnover has been insane,” she said.
“We want to be hopeful, with our main priority being the care for these [patients],” she said. “We have another 10 months for these cuts to be complete, and wait and see.”