Medications might be scarce for ex-offenders after GAMC eliminationby Rupa Shenoy, Minnesota Public Radio
St. Paul, Minn. — Charles Jensen has been in and out of prison 89 times, being arrested countless times for loitering, begging, and theft before a probation officer realized he was ill.
Jensen's illness makes him do things like walk out of stores without paying for merchandise that he thought was his.
"I'm guilty of being mentally ill," he said.
It took doctors seven tries to find the right medications. Now, the 58-year-old St. Paul resident is out of jail, but he remains on a cocktail of drugs.
"Twice a day I take two Lamictal, that's a mood stabilizer," he said. "I take three lithium twice a day. That again is a mood lifter. Seroquel, now this is a big one, it's an antidepressant, it's a mood stabilizer and it's an anti-psychotic. If I was off this drug for very long, I wonder if I would not end up assaulting somebody."
There are about 9,400 people in Minnesota's correctional facilities, and one-fourth are on psychotropic drugs. When they're released, prisoners continue to receive their medication through state General Assistance Medical Care, or GAMC.
Early next year, GAMC will likely be replaced by MinnesotaCare, another state program for the poor, and the switch may mean some ex-offenders won't have access to the mental health medication they need. The program was a victim of Gov. Tim Pawlenty's unallotment earlier this year, a tactic he used to balance Minnesota's budget.
Prisoners will have to apply to counties for a transitional form of MinnesotaCare 45 days before their release. But there's a delay of about two and a half months before they're covered by the program. That creates a critical window during which ex-offenders probably won't be seeing their doctors or receiving their medications.
And many in the justice system question whether ex-offenders will pay the small MinnesotaCare premiums to stay on their drugs. GAMC didn't require premiums.
Minneapolis Mayor R.T. Rybak said the switch from GAMC to MinnesotaCare means more homelessness and more crime.
"This may have been passed off as a way to save money at the state but this is one of the most costly decisions that's been made in a long time," Rybak said. "When people with mental illness don't get the treatment they need they wind up doing things they never would've done before, they break the law, do a deadly act in a community. So if anybody thought this was going to save money, it's not."
People can start showing symptoms within days of going off mental health medications. Minnesota department of human services commissioner Cal Ludeman said he knows time is critical. That's why he's open to prioritizing inmates' MinnesotaCare applications.
"We're bringing that time of application and enrollment down every week, but it is still too long, no doubt about it," Ludeman said. "If it gets to a point where I believe that we will have such a gap that it will create a special problem we may have to look at how we queue up our applications."
Law enforcement and mental health personnel say the state hasn't contacted them about the situation, so they're trying to figure out what to do own their own.
Counties will have to decide how to deal with probation requirements that include finding a job and seeing doctors if ex-offenders don't have health care.
"To be compliant on meds as part of probation that's pretty common. But when you don't have access to services and medication, who is to blame? That's a huge question," said Steve Wickelgren, president of the MN Crisis Intervention Team (CIT) Officers Association.
Wickelgren is also a 20-year member of the Minneapolis Police Department. He said police officers will be on the front line when fallout from a health coverage gap hits.
"The transition from GAMC to medical assistance will be clumsy," he said. "Many people will be falling through the cracks, which means mostly for police officers is people that may not be getting their medications.
"I don't know how we're going to prepare for it other than we will be looking for it. Personal safety, others' safety, always comes first. So issues that tend to come up like using force, using a Taser, if they have to be used, they will be used by officers."
Wicklegren said 1-in-3 people that officers deal with have a mental health issue. Unless something changes, there are four months to prepare before that number gets bigger.
- Morning Edition, 12/02/2009, 6:40 a.m.