Providing mental health services to adults in Morrison County is a complex task, but one that the Health and Human Services (HHS) department is dedicated to improving. HHS Director Nathan Bertram and Adult Services Supervisor Jeff Bowman recently updated the County Board of Commissioners on the programs and partnerships in place to help those experiencing mental health challenges during its Tuesday, May 7 meeting.
Adult case management is a core service offered. To qualify, an individual must have a diagnosed, serious and persistent mental illness like schizophrenia or bipolar disorder. Case managers work with clients on a voluntary basis to establish goals and identify necessary support. This may involve traditional therapy or assistance applying for long-term care medical benefits through the state’s waiver program.
Bowman said there is a team of four full-time case managers who currently provide services to adult county residents and one additional case manager who works with both children and adults. Their caseloads involve both those eligible for targeted mental health case management as well as those transitioning to waiver services as needs increase. Revenue to fund this work comes through billing medical assistance, with rates set by the state each summer posing budget uncertainties.
Bowman said because the amount of funding the state of Minnesota gives to Morrison County is based on the past three to four years of need for adult mental health services instead of real-time needs, it can be difficult to predict how much of the needs of Morrison County adult residents facing mental health challenges will be met. Showing how much funding could fluctuate, Bowman showed a graph of revenue for the county from 2017 through 2024, with the lowest revenue total being $254,658 in 2018 and $434,713 in 2020. As of Feb. 29 of this year, revenue is at $54,484.
As shown in a graph, the number of total active cases at the end of each year has been relatively stable since 2019, with the lowest number being 105 cases in 2023 and the highest number being 125 in both 2021 and 2022. The number of new cases being opened each year has also remained steady, with the highest number of new cases being 44 in 2023 and lowest being 29 in 2022. The current number of new cases in 2024 is 23, but that number is expected to grow as the year progresses. Existing cases that were closed saw the highest number in 2019 with 50 cases and the lowest in both 2020 and 2021 with 40, although the current number in 2024 was 14.
Involuntary commitments through the civil court system also fall under the department in severe situations when an individual is deemed a danger to either themselves or others. Screenings are conducted to determine the least restrictive level of care needed while still protecting safety. Commitment numbers fluctuate yearly but were relatively low in recent periods according to data. Since 2017, the highest number of mental illness civil commitment cases was 24 in 2018, gradually lowering each year until 2022 with just nine cases. That number rose slightly to 13 cases in 2023, and the current number of cases in 2024 as of April 30 is five.
Bertram said that collaboration is key to success. Partnerships with local hospitals, clinics, law enforcement and the Region V+ Adult Mental Health Initiative allow for coordinated crisis response and grant-funded programs to fill service gaps. This initiative is composed of Aitkin, Cass, Crow Wing, Morrison, Todd, Wadena counties as well as the Leech Lake Band of Ojibwa and Mille Lacs Band of Ojibwe tribes. The county also maintains a local advisory council of professionals and community members to identify unmet needs.
Looking ahead, Bertram expressed hope that upcoming state funding changes through legislative action and case management redesign help stabilize support levels. Commissioners praised staff for navigating unpredictable funding streams to continue meeting residents’ mental health needs. Bertram and Bowman said Morrison County will keep working to build on established partnerships and programs to serve those facing one of society’s most misunderstood illnesses.
“You guys are shooting at a moving target. That’s hard, trying to keep budgets. It’s like a roller coaster, and you’re chasing it. Thank you for all your work,” said Commissioner Robert Kasper. “Thank you for being there for these down-and-outers. We greatly appreciate your work and thank you to all your staff.”
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