Ramsey County is billing people who call the crisis hotline for help

RAMSEY COUNTY, Minn. (FOX 9) - People in crisis are getting billed by Ramsey County after calling the crisis line for help – including individuals in mental distress and contemplating suicide – which is alarming mental health advocates across Minnesota. 

Why it matters 

Adam Haidet was in mental distress and contemplating suicide one day last January.  

"I felt that I’m not going to make it – and I started crying, locked myself in my house," Haidet said. 

His mother Kathryn said she could tell from his voice "he was in a crisis."

A family friend called the Ramsey County crisis hotline, which dispatched the mobile crisis response team to stabilize Haidet and offer on-site mental health services and resources. Months later, Haidet received a bill from Ramsey County for $342. He was charged for the crisis intervention services and travel time. 

"No one ever told us about a bill," his mother said.

The bigger picture

A check of the Ramsey County website makes no mention of any cost when calling the crisis hotline for mobile crisis response services.  

However, records obtained by the FOX 9 Investigators show Ramsey County charged more than $1.1 million for mobile crisis intervention services over the last three years.

Ramsey County bills insurance providers, but unlike other counties, it also bills patients directly. 

"I think it’s totally wrong to bill the individual," said Sue Abderholden, executive director of Minnesota’s chapter of the National Alliance on Mental Illness (NAMI). 

What Ramsey County is saying 

Ramsey County refused to participate in an on-camera interview. In multiple emails, it offered varying reasons why it’s charging people in crisis. 

Claim No. 1: Federal law requires the county to bill residents beyond insurance.

Fact Check: The county later backed off that claim after the FOX 9 Investigators asked to see the law.

Claim No. 2: The state grants that help fund mobile crisis teams require billing residents directly.

Fact Check: The FOX 9 Investigators confirmed that the Minnesota Department of Human Services does not require grantees to bill individuals directly.

"That grant money is to be used for people who are uninsured or underinsured or simply can’t pay," said Abderholden. "So to say then you’re going to bill the individual directly absolutely makes no sense, and it really is not in the spirit of the law at all." 

Claim No. 3: Ramsey County said "there usually is an understanding by the public that there will be costs." 

Fact Check: The fee for crisis intervention does not appear on Ramsey County’s services website nor its most recently published fee schedule.

Claim No. 4: Ramsey County said it offers a sliding-scale fee option based on financial needs. 

Fact Check: The bill Adam received does not mention a sliding-scale fee or alternative payment options. 

Claim No. 5: Ramsey County said "federal law allows counties to seek reimbursement for the cost of our services where possible."

Fact Check: Ramsey County appears to be an outlier in charging residents directly for mobile crisis services.

What others are doing 

Nearby Dakota, Washington and Hennepin counties do not bill individuals for mobile crisis services.

"There’s no co-pays, there is no out-of-pocket, the county or these resources will bill insurance where we can, but there are no costs to residents," said Hennepin County Behavioral Health Director Leah Kaiser. 

"If the other counties don’t charge and Ramsey County charges, well then what’s wrong with that picture," said Adam’s mother, Kathryn. "That’s terrible, and they should be ashamed of it." 

Related: The FOX 9 Investigators recently showed how the City of Minneapolis is providing city-funded crisis response services for free. 

A costly crisis 

The FOX 9 Investigators interviewed mental health experts, advocates and stakeholders – all who were stunned to learn that Ramsey County is billing people in a crisis.

"As someone who has worked on this issue for decades, we never, ever intended for the individual to be charged for a mobile crisis service and crisis stabilization," said Abderholden.

Meanwhile, Adam and his family are urging Ramsey County to revisit its policy of billing people in crisis – and reconsider the true cost of sticking people with a bill. 

"Lives will be lost, that’s my fear," said Adam. "My fear is that if people are afraid to call, and they don't, and they choose when, people will lose lives."

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. The Lifeline provides free and confidential support to people in suicidal crisis or mental health-related distress 24 hours a day, 7 days a week, across the U.S.