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Mental health drugs carry a cost for county jails

A surge in the number people with mental health problems continues to strain county jails, and in Goodhue County, the cost of managing their care is increasing.

The county recently renewed a $406,000 contract with Advanced Correctional Healthcare (ACH), an Illinois-based contractor which attends to inmates' medical needs in several states.

County jails are required to provide health care for inmates, but with more mentally ill inmates entering into jails, counties are absorbing higher costs and legal responsibilities for their care.

The contract will add nurses for managing medical prescriptions at the Goodhue County Adult Detention Center.

It also comes at a $110,000 bump from last year and made up a share of the county's $33 million levy from the previous year.

The Goodhue County Board of Commissioners approved the measure by a 3-2 vote last month.

Because jail staffers administer medications, officials said they worried the facility could be liable for errant deliveries, which have also been on the rise.

According to county data, the jail saw 24 prescription drug errors in 2017 ranging from giving inmates improper dosages to administering the wrong medications this past year. Jail staff logged about four or five in past years, said Goodhue County Jail Capt. Brian Coleman.

"It's gotten critical," Coleman said at a recent board meeting. "We've dodged a few bullets, I have to be honest, because some of those medication errors could have been serious."

According to county data, some 25 percent of inmates at the Red Wing facility receive psychotropic drugs for mood and behavior conditions, a fivefold increase from 2012.

Goodhue County Sheriff Scott McNurlin said the challenges stem from the 1960s when state lawmakers closed public psychiatric institutions. The remaining state psychiatric facilities in St. Peter and Anoka mainly serve patients at risk of becoming violent.

The move also gave rise to the concept of people self-managing their mental health care.

"The one thing, I don't think we didn't bank on was people would stop taking their medication," McNurlin said. "They start to feel better, and they stop taking it."

Roughly 10 percent of emergency calls in Goodhue County are related to a mental health concern, he said.

Law enforcement officials in nearby counties have also noted a heightened number of inmates with mental or behavioral health conditions.

Washington County Sheriff Dan Starry said some 60 percent of inmates in the Stillwater jail have some form of mental health condition.

The east metro county spends about $120,000 on prescription medications annually, according to county data. More than two-thirds of the costs covered mental health medications.

Dakota County Sheriff Tim Leslie said the county spent more than $104,000 on prescription drugs. He estimates about one-third of the jail's inmate population has a mental illness.

With inmates averaging about eight days in jail, Starry said much of the focus is getting them stabilized.

"We just want to make sure those that need the help get the correct help," Starry said. "We deal with this on a daily basis."

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