Transportation, housing are major needs, say local mental health advocates (2025)

Liaisons from the Hubbard County Local Mental Health Advisory Council (LAC) met with Hubbard County commissioners on Tuesday, April 8 to emphasize the importance of cooperation and services.

Kellsey Firehammer is Region 2 Adult Mental Health Initiatives (AMHI) coordinator. She serves Hubbard, Beltrami, Clearwater and Lake of the Woods counties. She also sits on the LAC.

Emily Utech is the current LAC chair.

The council also includes county commissioner Tom Krueger, County Human Services Director Brian Ophus, Transit Coordinator Jason Ness and Shawn Anderson of Lake Country Associates.

Mental health affects everyone, Utech said. “If you say you don’t know someone with mental health illness, I’d say you’re lying. We all know at least one person.”

According to the Minnesota Department of Human Services (DHS), 1 in 5 U.S. adults will have a diagnosable mental health condition in any given year, yet 54.7% of adults with an illness did not receive any treatment.

The duo shared a DHS fact sheet explaining that Medicaid pays for more mental health care for Minnesotans than anyone else – 20% of all treatment.

County commissioner Char Christenson asked, “Does that mean they cover more mental health cases or are they paying at a higher rate?”

Firehammer replied, “They don’t pay at a higher rate. They’re covering a larger percentage of the population. A lot of Minnesotans qualify for Medicaid, and therefore, utilize that service.”

In 1966, Minnesota implemented the state’s Medicaid program, which is also known as Medical Assistance (MA). Today, DHS says Medicaid/MA covers 1 out of every 4 Minnesotans. It is the largest single source of health insurance in Minnesota.

Currently, the federal government shares financial responsibility for the Medicaid program by matching state costs with federal dollars.

An individual’s eligibility for Medicaid/MA is determined by factors such as household income, family size, age, disability status, citizenship or immigration status. These criteria are set by federal and state law and vary by category.

“There’s been a lot of information coming out about potential cuts to Medicaid, and so we’ve been advocating to get more information out there about how Medicaid supports Minnesotans,” Firehammer said. “That’s why I included that statistic – because it is a large supporter of mental health in Minnesota, specifically.”

If there wasn’t MA, Utech said she wouldn’t be alive. She’s had chronic depression since she was 12. Utech said she has attempted to take her life, and her husband committed suicide 9.5 years ago.

“Suicide prevention and mental health is more dear and near to my heart than ever,” she said.

A DHS fact sheet states, “AMHIs are regional organizations that oversee adult mental health services and funding to counties and tribal governments in their area. The AMHIs serve as a mechanism for regional collaboration to build effective community-based mental health services across Minnesota.”

With the closure of state institutions in the early 1990s, DHS says counties were encouraged to develop partnerships to “develop acute care and community-based mental health treatment for those who had been served by the state hospital.”

There are currently 19 AMHIs in Minnesota. “The AMHIs continue to monitor, evaluate and reconfigure their service models while, at the same time, each county retains its role as the local mental health authority,” says DHS.

According to DHS, all counties in Minnesota are required to have a LAC. They are usually established by the county board.

DHS explains that “LACs provide recommendations specific to changes, additions and

improvements to the local mental health delivery system that impacts individuals receiving services, family members, community members, stakeholders and service providers.”

Legislation requires that the membership of LACs include people who have received

mental health services as adults, have received mental health services as children or adolescents, and are parents and family members.

For more information about LAC, visit http://mn.gov/dhs/lac .

Firehammer and Utech met with District 2B State Sen. Paul Utke and District 5A Kristin Knudsen at the State Capitol in February.

Utech said they easily spent a half-hour with each.

“It was overwhelming to see so many of our representatives caring about how important mental health is – not just to their constituents, but to their own family and friends,” she said.

LAC members identified priorities for each legislative district. Among them is funding for school-linked mental health because rural schools have limited options for accessing resources and it reduces transportation barriers for parents.

Transportation to medical appointments is a major issue in rural areas, Utech said.

“There are a lot of people that just don’t have vehicles,” she noted. “We have only so many volunteer drivers, and that makes it more difficult as well.”

Prior to COVID, a bus used to stop in Nevis and Akeley. “They’re trying to reincorporate that, which I think is great.”

Utech said affordable housing for mentally ill patients is another priority.

Firehammer said there have been reports of people having a mental health crisis, upsetting the landlord, getting evicted and then can't find new housing because rentals use the same property management company.

There’s a need for housing “that is supportive and more aware of potential concerns that people with mental health conditions may have and how that may impact how they show up in a housing situation,” she said. “Just be more flexible and understanding about those types of things.”

Firehammer said there are supportive housing models that have case managers onsite 24/7 rather than involving the police.

The trip to the State Capitol was funded by AMHI dollars, she concluded. “We shared a bus with Beltrami County.”

She noted that 11 of the 17 attendees were consumers, joined by staff from Lake Country Cottage in Park Rapids and Hope House in Bemidji.

Firehammer said LAC is developing a website and planning an annual needs survey.