Minnesota
Minnesota mental health patients stay 25 hours longer than necessary in ER because of shortages
When patients in mental health crises get stuck in Minnesota’s emergency rooms, they stay 25 hours longer on average than necessary — taking up hospital space as well as the time of doctors and nurses, who could otherwise focus on the next emergencies.
Researchers documented the length of these delays by studying patient activity over 14 days last fall at more than 30 Minnesota hospitals, but they also provided vital evidence about which patients were most likely to suffer delays, and why.
Knowing which patients are at risk can help the state come up with treatments that target this population and prevent mental health crises and hospital visits, said Kristin Dillon, a coauthor from Wilder Research, which released the report on Monday along with the Minnesota Department of Health.
Delays for patients “in a hospital setting when they can be discharged is harmful to patients, caregivers, hospital staff and the health care system,” she said. “However, we cannot take steps to effectively address these discharge delays without understanding the underlying reasons behind the delays.”
Monday’s findings were presented to an advisory council created last year to reduce delays in care and the worsening problem of ER and hospital overcrowding in Minnesota.
Staffing and bed shortages at nursing homes and rehabilitation centers have worsened since the COVID-19 pandemic, leaving hospitals stuck with frail, elderly patients on their inpatient floors. Twin Cities ERs have treated patients in hallway gurneys at peak times when they have run out of beds. But these delays in many ways just compounded the longstanding problem of patients in mental health crises being boarded in ERs with nowhere to go.
Hospital inpatient psychiatric units were largely full during the study, and they couldn’t take new patients from ERs until they found space to discharge their existing patients to residential or outpatient treatment programs. The study observed 182 patients in hospital psychiatric units whose discharges were delayed, and on average it took 8 days longer than necessary to move them.
The problem was more complex than patients waiting for openings in treatment programs, though. One in five patients stuck in inpatient units was delayed by court decisions over civil commitments, or decisions over their eligibility for insurance benefits or waiver programs, the study showed.
Among patients stuck in ERs, only six in 10 needed inpatient hospital care. The rest were stuck for other reasons, including delays in arranging transportation home or in getting outpatient care lined up. A third of the delayed patients went straight home from the ERs.
M Health Fairview has been confronting the problem, opening a so-called EmPATH unit at its hospital in Edina that provides a relaxed environment and transitional care for patients who can be moved from the ER. The health system also is partnering with for-profit Acadia Healthcare to reopen the Bethesda Hospital campus in St. Paul as a psychiatric facility next year.
In some ways, the delays published in the report underestimated the problem. Delays were only calculated for patients who were discharged during the two-week study. About 5% of the ER patients had yet to be discharged by the end, and some spent the entire two weeks in care. Some hospitals have endured extreme cases, such as the boarding of a child with behavioral problems for months at Ridgeview Medical Center in Waconia.
State lawmakers were so concerned by the delays in 2022 that they waived Minnesota’s hospital construction moratorium through 2027 for any provider looking to add psychiatric capacity. However, the study makes it clear that the greatest need is in community and preventive treatment programs that keep people from crises, said Dr. Will Nicholson, vice president of medical affairs for Fairview’s East Metro hospitals.
“We can take better care of people when we can prevent illness, we can get upstream,” he said.
Minnesota has been locked for two decades in a chicken-egg debate about whether to spend limited dollars on more inpatient beds, or preventive programs to try to reduce the need for those beds. State health economists blocked a proposal in 2008 by then-named Prairie St. John’s to build a psychiatric hospital in Woodbury, based largely on the argument that prevention programs were needed more. The provider later became known as PrairieCare and built and expanded a pediatric psychiatric hospital in Brooklyn Park.
More beds aren’t the only solution at a time of workforce shortages, said Sue Abderholden, who directs the Minnesota chapter of the National Alliance on Mental Illness. Minnesota previously tackled the mental health treatment shortage by creating a stepdown level of care called intensive residential treatment services to ease the pressure on hospitals. The state has about 60 of them operating, but many can’t find enough staff and are operating well below their 16-bed capacities, she said.
The legislature this year OKed funding for counselors who could check on patients who were showing the first signs of struggling — perhaps by skipping medication doses or appointments, Abderholden said. “We’re trying to get way before a crisis, before you need an ER, before you need a crisis team.”
Minnesota
Minnesota sues to block Trump administration’s withholding of Medicaid funds
Minnesota on Monday sued President Donald Trump’s administration in an attempt to stop it from withholding $243 million in Medicaid spending, warning it may have to cut health care for low-income families if the funding is held back.
The lawsuit asked a U.S. court in Minneapolis to issue a temporary restraining order to block the withholding for Medicaid, which is the health care safety net for low-income Americans.
The move came after Vice President JD Vance said last week the administration would “temporarily halt” some Medicaid funding to Minnesota over fraud concerns, as part of what he described as an aggressive crackdown on misuse of public funds.
Minnesota Attorney General Keith Ellison said his office has a strong track record of fighting Medicaid fraud and has won more than 300 convictions and $80 million in judgments and restitutions during his time in office.
“Trump’s attempts to look like he’s fighting fraud only punish the people and families who most need the high-quality, affordable healthcare that all Minnesotans deserve,” Ellison said in a statement. “As long as I am attorney general, I will do everything in my power to defend our tax dollars, both from fraudsters and from the Trump administration’s cruelty.”
The lawsuit names the Department of Health and Human Services and the Centers for Medicare and Medicaid Services as well as Dr. Mehmet Oz, in his official capacity as CMS administrator, and Robert F. Kennedy Jr. in his official capacity as HHS secretary.
The Department of Health and Human Services, which includes CMS, didn’t immediately return messages seeking comment late Monday.
The threatened cuts amount to roughly 7% of Minnesota’s quarterly Medicaid funding, Ellison’s office said in a news release. Minnesota could be required to significantly cut health care services for low-income families or other government services if the cuts take effect, it said.
Medicaid, which is known as Medical Assistance in Minnesota, provides health insurance to 1.2 million Minnesotans who would otherwise be unable to afford it. A family of four may qualify for Medical Assistance with an income at or under $42,759, the attorney general’s office said.
The lawsuit said the administration violated due process procedures because it was taking hundreds of millions of dollars without proving Minnesota’s noncompliance with Medicaid regulations through discovery and an evidentiary hearing.
It alleged the administration failed to provide Minnesota with details about its decision, in violation of federal law. It cited legal precedents, including one that said Congress may impose conditions on states’ acceptance of federal funds, but “’the conditions must be set out unambiguously.’”
Minnesota’s complaint further charged the administration violated the Constitution because the withholding imposed retroactive conditions on Minnesota’s Medicaid funding.
It said withholding the funds was arbitrary, capricious and part of a pattern of political punishment of Minnesota.
The administration said it would hold off on paying $259.5 million to Minnesota for Medicaid spending in the fourth quarter of 2025. Minnesota’s lawsuit challenges the withholding of $243 million of this money.
Minnesota
Iran conflict: 250 Minnesota National Guard member serving in Middle East
(FOX 9) – The Minnesota National Guard tells FOX 9 there are currently 250 guard members on regularly scheduled deployment at the United States Central Command areas of responsibility as the United States leads strikes in Iran.
Guardsman in Middle East
What we know:
The Minnesota National Guard says the deployed airmen and soldiers are serving from Duluth’s 148th Fighter Wing, the Marshall-based 1-151 Artillery, and the Stillwater-based 34th Military Police Company.
What they’re saying:
“While their missions and duty locations vary, all are grateful for the strong support of those back home,” writes Army Maj. Andrea Tsuchiya, State Public Affairs Officer for the Minnesota National Guard.
What we don’t know:
The guard did not disclose the exact bases or countries where the soldiers and airmen are serving.
CENTCOM covers 21 countries including: Afghanistan, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kazakhstan, Kuwait, Kyrgyzstan, Lebanon, Oman, Pakistan, Qatar, Saudi Arabia, Syria, Tajikistan, Turkmenistan, the United Arab Emirates, Uzbekistan and Yemen.
Pres. Trump says Iran operations likely to last 4 to 5 weeks
Big picture view:
In his first public remarks since the launch of the attack on Iran, President Trump said he expected operations to last four to five weeks, but he was prepared “to go far longer than that.”
The president also laid out his objective for the mission: to destroy Iran’s missile capabilities, to “annihilate” their navy, to ensure the country doesn’t obtain a nuclear weapon and that the regime “cannot continue to arm, fund and direct terrorist armies outside of their borders.”
Minnesota
U.S.-Israeli strikes spark dueling rallies in Twin Cities
Iranians in Minnesota react to Khamenei death
Iranians in the Twin Cities gathered in downtown Minneapolis on Sunday to celebrate major developments in the Middle East following the death of Supreme Leader Khamenei. While many Iranian-Americans expressed hope for regime change, anti-war protesters also took to the streets to condemn the military strikes, with some members of Minnesota’s DFL delegation calling the operation “unlawful” and “illegal.”
MINNEAPOLIS (FOX 9) – Iranians in the Twin Cities gathered in downtown Minneapolis Sunday to celebrate major developments in the Middle East. Anti-war protesters also took the streets of Minneapolis Saturday.
Plus, Jewish communities say they are on high alert over concerns of potential retaliatory acts in major cities across the U.S.
‘Massive moment’
What we know:
Following a joint U.S. and Israeli military operation in Iran, Khamenei was killed in an attack, Iranian state media confirmed early Sunday.
What they’re saying:
Iranian community groups rallied at Nicollet Mall and 11th Street on Sunday to express hope for regime change.
Dozens of Iranian-Americans said they are celebrating the news.
“We are here to support Iranian people. Today, everybody is happy, very happy,” said Beheshteh Zargaran, an Iranian-American.
“Killed Khamenei, which was the supreme leader, and hopefully they will continue this action and help Iranians finally topple the Islamic regime,” said Faraz Samavat, an Iranian-American.
“That means a lot. We are fighting for almost half a century to destroy this cruel regime against people of Iran,” said Ali Mohammad, an Iranian-American.
Iranians in MN celebrate strikes by Pres. Trump
Iranians in the Twin Cities are gathering in downtown Minneapolis to celebrate major developments in the Middle East following a joint U.S. and Israeli military operation. Community groups rallied at Nicollet Mall and 11th Street to express hope for regime change after news that Iran’s Supreme Leader, Ayatollah Khamenei, was killed in Saturday’s airstrikes.
The other side:
Protesters also took to the streets in the Twin Cities over the weekend condemning the strikes.
Some people are criticizing the military operation including members of Minnesota’s DFL delegation. Congresswoman Betty McCollum called the strikes “unlawful” and Congresswoman Ilhan Omar called the war “illegal and unjustified.”
Heightened security:
Jewish communities in Minnesota say they are also on high alert following security guidance across the country to prevent potential retaliatory violence.
“A heightened sense of vigilance making sure that everybody is aware of their surroundings and that all of the protective measures are in place,” said Steve Hunegs, executive director of the Jewish Community Relations Council of Minnesota and the Dakotas.
There are currently no known specific threats against local Jewish communities.
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