Meeting was opened at 6:36 15 attenders.
HC Attorney Sandra Filardo opened the meeting, introducing the presenters, Kafayat Jumat (Cope), Candace Hanson (Behavioral Crisis Response), Kate Erickson (Behavioral Health Center at 1800 Chicago), and Reid Raymond (HCAO: Commitments and Guardianships). She also introduced William Neiman from HCAO, who was sitting in on this presentation to add his perspective.
What is COPE? / Kafayat Julmat
Cope: Mobile Crisis Response,is Hennepin County’s Crisis Response service for people who are having a mental health crisis.
Cope takes calls from anyone and everyone who is concerned about a family member, a friend or neighbor, or themselves. In contrast with other responding services for people with mental health issues, COPE responders go out to meet with the caller where they are, and do the crisis assessment there. If a person doesn’t want to meet in person, counselors can support a person over the phone or via a Zoom video — which is telehealth, a development that came up in reaction to the pandemic.
If a person is not actually in Hennepin County, Cope will connect them with their county crisis response agency. Call CRISIS (274747) from anywhere in the State of Minnesota to reach the caller’s local county crisis team.
Clients define the crisis so Cope will go out for a variety of reasons. Cope services are voluntary; many of the referrals offered will require the client’s willingness to receive and participate in these services and follow through with recommendations.
Cope gets a lot of calls from family and friends, but does try to contact the actual client (whether that’s a phone call or visiting their home) to explain what Cope can offer them. The client has the right to decide whether or not they want to engage.
If a person is struggling with thoughts about suicide or dealing with psychosis, however, going to a hospital for an inpatient stay may be considered an option if safety is a concern. COPE responders are Health Officers who have the ability to write transportation holds. Those holds, if enforced, guarantee that the client will get to a hospital. The hospital, in turn, may do its own assessment. If hospital admission seems appropriate, the client will be admitted for at least 72 hours.
If a client is not willing to go to a hospital, COPE can call for assistance from local law enforcement. This brings the local law enforcement agency to the scene, including the other agency’s protocols — it’s a judgment call by the counselor if this will be beneficial to the client or not.
COPE also offers “stabilization services” when someone is “safe to remain in the community” but “having continued difficulty managing symptoms” which are not acute enough to suggest hospitalization. COPE might refer this person to “stabilization service”. In stabilization, a counselor works with the client for about four weeks, supplying additional support and case management, perhaps trying to get them connected with other long term services.
COPE is connected with the Mental Health Center on Lake Street, which provides access to psychiatric services and can make referrals for long term therapy. COPE also has two psychiatric nurse practitioners who are with Health Care for the Homeless. https://nhchc.org/hennepin-county-health-care-for-the-homeless/
COPE’s financial team helps clients navigate access to insurance and county benefits like food stamps.
For more information about COPE, see its home website: https://www.hennepin.us/residents/emergencies/mental-health-emergencies
Minneapolis Behavioral Crisis Response / Candace Hanson
The Minneapolis Behavior Crisis Response is a team of mental health first responders. The Office is fully integrated in the 911 emergency response system.
The BCR can respond to behavioral health-related calls independent of police, though many of our calls involve providing “backup” to police. We also sometimes request police backup, although this happens less often. Sometimes 911 dispatch will assign a call to both BCR and police to attend together.
We provide crisis intervention and connection to community resources, as well as emotional de-escalation, in situations where there isn’t an explicit threat of danger, or weapons/firearms involved. We are able to transport community members in instances where safety allows and doing so supports the addressing of their behavioral crisis.
We are able to assess for “danger to self/others due to a mental illness or intoxication” and recommend/sign off on transportation holds, but because our service is 100% voluntary, we cannot transport a person on a transport hold, so we must utilize EMS or police for the transportation or execution of the hold we recommend.
This is the team that was first developed as an alternative response to MPD calls. The BCR responds to all calls for service, and often refers clients to other services, including COPE.
See their website FFI: https://www.minneapolismn.gov/resident-services/public-safety/unarmed-public-safety/behavioral-crisis-response/
Behavioral Health Care Center / Kate Erickson,
Erickson is a Manager at the Hennepin County Behavioral Health Center at 1800 Chicago, in Minneapolis. The Behavioral Health Center serves adults in Hennepin County, centering needs related to mental health and substance use. The Behavioral Health Center offers walk-in care, and serves as a stabilization center; first responders bring adults who need assistance to the Center as well. There is a Walk-in Center on 1st floor, a crisis residence on 2nd floor, withdrawal management on 3rd floor and recovery programs on site. Other programs on site include SSI/SSDI application assistance, health insurance navigation, Vocational Services Program (VSP), Project Child, and the Diversion and Recovery Team (DART). The website is up to date and has a description of each of the services: www.hennepin.us/1800-Chicago.
Erickson started screen sharing [EQ: which will appear on the YouTube video] showing the BHC in an aerial view. This site was chosen because of proximity to shelters, the hospital, community clinics, public safety facility, a major highway, and bus routes 2, and 9, and near the Metro D line.
The purpose of the Behavioral Health Center is to be a specialty center, serving Hennepin adults 18+ who are living with a mental health condition and/or a substance use disorder. It is a “blended environment”, meaning that some of the people that work there are Hennepin County employees (operated teams) and some of the services are contracted with community-based organizations (contracted teams).
The overarching goals of the Behavioral Health Center at 1800 Chicago are to:
- Reduce unnecessary emergency room use or inpatient hospitalization,
- Reduce unnecessary criminal justice involvement, and
- Increase access and connection to community health supports.
Withdrawal management (3rd floor) a contracted service with the AICDC (American Indian Community Development Corporation). This is a 60-bed facility that provides detoxification and withdrawal management from alcohol and/or drugs. It assists clients in connecting with substance use disorder services and supports. It is always open, walk-up or pre-register.
Crisis residence (2nd floor) a contracted services with Re-Entry House Crisis Stabilization Services (REH). This 16 bed facility provides mental health crisis stabilization services for 3-10 days. It assists clients in connecting with mental health services and supports. This service is always open; a phone screening is conducted over the phone with potential residents to ensure the mental health crisis residence is the appropriate level of care.
Walk-in center (1st floor) is operated by the Hennepin County Behavioral Health. It has 12 assessment rooms and 2 treatment rooms where team members focus on mental and chemical health needs for any adults in Hennepin County. We work with residents to address their immediate needs, and work with residents up to 60 days until they are connected to longer term services and supports. Residents can walk-in on their own, or family members or friends can accompany them. No need to call ahead. No appointment needed. Wait times vary throughout the day; ask during check-in for an approximate wait time. Open M-F 9am-9pm except holidays.
Important: First responders like Cope, Minneapolis BCR, Law Enforcement, and DID Social Workers use the drop-off function at the Center; when first responders bring an adult into the Center for services, we will have the first responder in and out within 2 minutes so that they can respond to other calls for service. There is more information about the drop-off function for first responders on our website: www.hennepin.us/1800-Chicago.
To summarize: The Behavioral Health Center offers walk-in services focused on adults who need help for mental and chemical health. The interdisciplinary team serves Hennepin County residents 18 and over. The team addresses immediate needs on site and makes connections to longer term treatment and recovery supports. The BHC provides triage, assessment, and connection to resources. It makes referrals for mental health, substance use disorder, social services, basic needs, community resources, and social determinants of health. Staff at the Center include office support, case management assistants, social workers and senior social workers, peer recovery support specialists, the medical team and on-site supervisors.
At this point, Erickson’s power point gave a tour of the building, starting with the entry on Chicago Avenue. [EQ The power point will display in the YouTube video]. The team recently attended roll calls within the Minneapolis Police Department, to ensure Officers are aware of the Behavioral Health Center at 1800 Chicago as an option for connection to voluntary social services.
Where does the Behavioral Health Center fit into a continuum of care?
All services are voluntary and non-coercive in nature. It is appropriate for adults, who have needs related to mental health or substance use, but it is a not a hospital-level need and it is a not a public-safety issue. The Behavioral Health Center at 1800 Chicago is an alternative to the hospital and jail, when appropriate. If you don’t know where to start, the Walk-in Center is available Monday-Friday 9am-9pm, except holidays. More information available on the website: www.hennepin.us/1800-Chicago.
IMPACT in 2021
Of those who participated in services within the Behavioral Health Center at 1800 Chicago, participants experienced a:
- 16% reduction in Emergency Department visits
- 21% reduction in inpatient hospitalization
- 11% reduction in bookings
These data are based on 359 participants, where pre and post data was available. This analysis includes a 6-month look back and a 6-month look forward. Data is gathered from a variety of sources including claims, behavioral health codes, and the Sheriff’s Office. This is a non-experimental design, meaning that change can be from a variety of factors. This analysis is conducted each year, for residents served in the previous year.
IMPACT IN 2022
The Walk-in Center team at 1800 Chicago facilitated 3,322 connections to services and supports in 2022.
The Walk-in Center team at 1800 Chicago facilitated connections to services and supports for a variety of topics, including but not limited to:
- 816 connections to mental health services and support
- 477 connections to public assistance
- 437 connections to housing supports
- 408 connections to substance use services and supports
- 399 connections to basic needs and supportive services
- 345 connections to physical health services.
EXPANSION SINCE 2020
In 2020 the BHC launched a pilot program after completing renovation of the building
In 2021 the BHC started with a volume of 100 visits /month and closed the year with 250 visits a month, open M-F, 9-5
In 2022 the BHC started with a volume of 400 visits/month and closed the year at 600 visits a month, open M-F, 9-9
In 2023 the BHC is serving 700/visits a month in the Walk-in Center, up to 16 beds a night in the mental health crisis residence, and up to 60 beds a night in withdrawal management. Other services are available on site as well. Check the website for the most current hours and services: www.hennepin.us/1800-Chicago.
Civil Commitment / Reid RaymondAtty. Raymond is an Assistant County Attorney in the Adult Services Division. He is here to explain Commitments,
Guardianships and Community Commitments. What is a commitment? A commitment is a court order for treatment.
When a court finds that a person is mentally ill or developmentally disabled, and that harm has occurred and that commitment is necessary for the person to receive the treatment they need, the commitment will be ordered. The court does not specify what treatment is needed, but leaves those decisions up to the treatment facility. The facility is almost always a hospital, and likely one of our community hospitals, like Abbott-Northwestern, HCMC, Fairview, North Memorial. A medical professional at these hospitals is most often the petitioner who says it’s necessary to have a commitment.
At this point, a petition is filed and the County Attorney’s office handles the petition in court.
A guardianship is created for a person who has been found incompetent, who can’t make decisions about the major portions of their life. If the court finds a person has this deficit, the court will issue an order to appoint a person to make these decisions for a person. Sometimes a person may be subject to both a commitment order and a guardianship. The hope is that if a guardian has already been appointed, there will be no need for a commitment as well.
Other tools available are “Community Commitments” and “Family Commitments”.
The HCAO handles about 1500 commitments per year. Very few of those are NOT initiated by hospitals. Sometimes, however, a citizen will report a person who is mentally ill or chemically dependent and needs treatment, but that person is not getting treatment . No petition has been filed by the hospital. The HCAO will take a look at this.
THe HCAO wants people to use the services that are already available if appropriate.
For example, it’s much better if a person (who needs services) has already been referred to COPE, or if the person has gone to 1800 Chicago. Reports from those places will have some level of information about this person that the Attorney’s Office can use to shape appropriate recommendations for future services.
Sometimes a family will start the process, getting the person to contact COPE or 1800 Chicago. One example the attorneys point to was a person who was living in the basement and refused to leave. Because the person was not suicidal, the hospital wouldn’t admit them and didn’t initiate a referral, even though that person was very ill. That is a case where the HCAO can initiate a petition — there is an established process for that.
Atty. Filardo reported that 2nd Precinct CPS Ali helped a 2nd Precinct neighbor get the help they needed using the Civil Commitment process. The case worked out very well.
H.C. Atty. W. Nieman added that the office is presenting this information because they want to reach out to underserved communities. Too many people are unaware of the many life-saving and health-saving free and voluntary services which are available to them in Hennepin County. Also, if the voluntary services fail, concerned family members may have a legal option.
There are disparities in the legal system. They are not as glaring as those in the criminal law system, but the disparities are there. The HCAO believes the disparities are not due to racism or bias, but only due to lack of knowledge about resources. The whole point of Atty Raymond’s presentation is to let people know there are resources, they are voluntary and they are free.
They hope people will make use of these resources so that the HCAO doesn’t have to use community commitments.CPS Ali asked what happens when the beds are all full and there’s no more space.
Kafayat Julmat: Every day “happens.” We plan but “things happen.” For the most part, every request we get will be attended to, that day. The goal is to get out to that call site within the hour. If that can’t happen, COPE will try to set up a different way to respond, as over the phone (telehealth), or another means.
Kate Erickson: The BHC response is similar. We coordinate among teams and do the best we can. We’re fortunate that in the Walk-In center, we don’t have a limit. (That may change.) When someone walks in, we give them an estimate of how long it will be until they can see a counselor and if that will work for them. Drop offs are handled slightly differently because those clients are often in a more complex state. They will be put in a room first. Then we see people in the order they arrived in the lobby. It may take an hour to get to a walk-in client. (They receive repeated updates, through that hour — they need to know they have not been forgotten in the lobby.)
For the other services at 1800 Chicago, there’s a limit. They have X number of beds; when they’re full, they’re full. Then we work with clients about other places where they can get help which may be a different detox or withdrawal management site.
QQ: You only serve people over 18. What happens when a juvenile shows up at your door.Erickson: We will find a place that will serve them, or that we can refer them to. COPE, for instance, does serve juveniles. The same happens when someone who does not live in Hennepin County shows up: we refer them to their county services. In either case we can not initiate services.
QQ: How many of the people you serve are repeats?Erickson: Good Question! We do serve people up to 60 days. The majority of the people we serve are unique residents. Some people might make 2, 3 visits, some may stay the 60 days if their case is more complex or we’re waiting to get connected to a longer term service. Even so, the majority are unique visits.
28 day report: crime incidents in the 2nd Precinct
|NIBRS Crime Metrics 28 days||2023||2022|
|Incl. domestic aslt.||7||9|
|Destr. of property||61||56|
|Motor vehicle theft||89||65|
|Incl car jacking||1||8|
|Stolen property offenses||1||1|
|Weapon law violations||0||1|
|Gunshot wound vics.||0||2|
H.C. Atty Filardo: no updates.
City Attorney Nnamdi Okoronkwo: finishing up on the cases stemming from the Nicollet Island protest two years ago. They’ve tried using a “global” approach and our attorneys have “prevailed”, but, “There’s a certain group of people that are not going to admit to anything. They have a right to their day in court.” A person who has been convicted has the right to appeal the decision.
Before closing, CPS Rashid Ali applauded the good work Cope, 1800 Chicago, the BCR and the HCAO are doing for t;he community. He’d like to arrange presentations out in the community. How can this happen? Atty. Neiman stated “We come as a group.” Atty Filardo offered to be the contact and arranger.
Youtube recording of this meeting: https://youtu.be/ixbU-UdtTQU
Emilie Quast, 2-PAC member
1911 Central Ave NE
Minneapolis, MN 55418