Hot Topic: Nursing Homes for Sex Offenders & Violent Offenders

Ramsey County cuts support for sex offender day-treatment center

11-18-2014 Minnesota:

Dane Jorento does the kind of job most people would pay to avoid. For the past nine years, he's been the director of ABC Mental Health Therapy, an East Side day-treatment center that works with sex offenders who suffer from traumatic brain injury, developmental delays, autism and various forms of mental illness.

The nonprofit clinic is one of three agencies in the metro area that offer group therapy to low-IQ sex offenders. They range from peeping Toms to convicted rapists. Of the three agencies, only ABC is targeted to low-income clients.

And within weeks, ABC may close its doors.

Ramsey County made the decision last year to discontinue its two day-treatment therapy contracts by Dec. 31, although the county has offered ABC an extension through March 31, 2015.

"The day treatment services ABC provides are no longer in alignment with the state and county direction towards individualized treatment plans and contemporary evidence-based practices," said John Siqveland, a spokesman for Ramsey County.

Jorento disputes that his agency's services have fallen out of favor with the state's best practices. In fact, the Minnesota Department of Human Services recently chose ABC Mental Health Therapy as a community partner.

At a time when state and federal officials are struggling with how best to treat, monitor and fund services for convicted sex offenders after they've served their criminal sentences, Jorento thinks the county's decision is a step in the wrong direction.

"Closing ABC would reduce by 100 percent Minnesota's and Ramsey County's non-profit options," said Jorento, in a Nov. 6 email to the county's board of commissioners.

Jorento said over the past nine years, Ramsey County's contract with ABC Mental Health, located in a converted movie house on Payne Avenue, has never required a commitment of county funds or county insurance. Rather, the county served as an authorizer, allowing ABC to access state assistance.

Unlike many private treatment organizations for the mentally ill, ABC Mental Health Therapy accepts clients enrolled in Minnesota's Medicaid medical assistance program, known as MA.

"A lot of therapy clinics don't accept clients on MA, because the reimbursement rates are too low," Jorento said. "Most clinics accept private insurance but not public insurance."

Treating a client at ABC costs the state $10 per hour and the federal government $10 per hour, Jorento said. That is a fraction of the cost to the taxpayer of lifelong incarceration.

Ramsey County Board Chair Jim McDonough said the county reviews all of its contracts every five years to make sure they're living up to expectations for their industry. While he was not aware of any specific complaints against ABC Mental Health, McDonough said he trusted the opinions of county staff.

"The overall position of the board, and the county manager's office, is between all of our departments, we manage a wide variety of contracts, and they're all set up to align with best practices," McDonough said.

"We have a responsibility anytime we sign on," he continued. "It's not just about the money. It's about providing confidence to the state that we're making sure they're providing service to the level we expect them to."

As a result of the review, the Pathways Counseling Center on University Avenue also lost its county contract. Pathways works with mentally-ill clients who have had a brush with the criminal justice system, such as gambling addicts, as well as refugees who have survived trauma.

Jorento said state officials have come to a different conclusion about his program. Like other states, Minnesota is under growing legal pressure to release sex offenders who have completed their criminal sentences but remain in custody at the state psychiatric facility in St. Peter, Minn.

DHS officials confirmed Tuesday that if more offenders are released into the community, ABC would become a potential day-treatment site for released offenders. To date, the Minnesota Sex Offender Program has released one offender back into the community.

County officials said they've given ABC Mental Health ample warning over the past year that they plan to move in a new direction by the end of 2014 and eliminate all of the county's day-treatment contracts.

On Nov. 7, McDonough informed Jorento by email that all of ABC's clients "will receive individualized treatment services and plans."

"Ramsey County Community Human Services and Ramsey County Community Corrections will be working together to help these individuals access services in alignment with evidence-based practices provided either directly by the county and/or through the network of community service providers," McDonough wrote.

Jorento said county officials have encouraged him and other providers to seek out new funding streams. One option would be to reorganize ABC Mental Health Therapy as a general mental health clinic under Rule 29 of Minnesota's mental health laws.

"Rule 29 provides generalized mental health services to adults and children," Jorento said. "What Ramsey County is basically asking us is, can we put sex offenders with mentally ill children? There's no such place in the country."

As a licensed social worker, Jorento is considered a mental health professional, but not a doctor. His staff includes six full-time and two part-time therapists, but no licensed psychiatrists.

"The other piece is Rule 29 requires a psychiatrist on staff," said Jorento, who said his agency can't afford a doctor. "Our reimbursement rates for day treatment are very low. We actually only cost the state $10 per hour." ..Source.. by Frederick Melo

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