Sponsor: Social Services
Title
title
Single Source Agreement with Regions Hospital for Inpatient Hospital Services
end
Recommendation
recommendation
1. Approve the selection of and single source agreement with Regions Hospital, 640 Jackson Street, Saint Paul, Minnesota 55101 for inpatient hospital commitment services for the period of May 12, 2026 through May 11, 2029 in the not-to-exceed amount of $998,500 annually, with the option for two additional one-year renewal periods, with a total not-to-exceed amount of $4,992,500.
2. Authorize the Chair and the Chief Clerk to execute the agreement.
end
Background and Rationale
body
Ramsey County has a statutory obligation under Minnesota Statutes Chapter 253B (Civil Commitment Act) and Rule 20 of the Minnesota Rules of Criminal Procedure to provide inpatient hospital care for individuals who require evaluation, diagnosis, treatment, and confinement due to mental illness, mental illness and dangerousness, developmental disability, or chemical dependency. These services are court-driven, time-sensitive, and legally mandated. The county must ensure access to appropriate inpatient psychiatric care to meet due process requirements, protect public safety, and support clinical stabilization during periods of acute behavioral health crisis.
Individuals subject to civil commitment and Rule 20 proceedings are disproportionately people of color, reflecting wider inequities in access to preventive behavioral health care, housing stability, and community-based supports. When inpatient capacity is limited or coordination is delayed, the impacts can be significant, including involvement with law enforcement or extended stays in inappropriate settings. Maintaining reliable access to inpatient psychiatric services within Ramsey County helps reduce service gaps and supports more timely, clinically appropriate responses during acute mental health crises.
For more than 15 years, Ramsey County has contracted with Regions Hospital (Regions) to fulfill these statutory responsibilities. Regions has a longstanding experience providing inpatient psychiatric services for individuals involved in civil commitment and Rule 20 proceedings and maintains the clinical staff, secure infrastructure, and accreditation required to safely manage this population. The hospital operates secure units that can be locked at all times and includes environmental safety features designed to prevent elopement. Regions prepares psychosocial assessments, pretrial reports, discharge summaries, and provides physician and staff consultation and recommendations as needed for commitment proceedings. When individuals are admitted under a criminal hold or are in the custody of the Ramsey County Sheriff’s Office, the county provides 24-hour law enforcement presence to ensure compliance with custody and security requirements.
Regions agrees to admit and provide inpatient care to individuals referred by the county provided that the patient meets clinical criteria for admission and that an appropriate psychiatric bed is available. Continued partnership with Regions supports coordination among the courts, County Attorney’s Office, Sheriff’s Office, and Sheriff’s Office personnel, promoting timely evaluations and reducing unnecessary delays in legal proceedings. The agreement also allows the county to monitor utilization and demographic trends to identify and address potential disparities in access or length of stay.
The previous agreement with Regions ended on February 28, 2026. The County Attorney’s Office approved a 90-day extension permitted within the current contract to avoid disruption of mandated services. That extension expires on May 29, 2026.
end
County Goals (Check those advanced by Action)
☒ Well-being ☒ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
People who experience civil commitment or Rule 20 proceedings are disproportionately people of color, reflecting broader inequities in access to mental health care, housing stability, and community-based supports. These disparities increase the likelihood that individuals from historically marginalized communities enter the behavioral health system at moments of crisis rather than earlier points of care.
This agreement supports timely access to inpatient psychiatric services within Ramsey County, helping ensure individuals receive appropriate evaluation and treatment when they need it most. Consistent access to secure, accredited care reduces unnecessary delays, limits prolonged involvement with law enforcement, and supports more humane and clinically appropriate responses during acute mental health crises.
By maintaining a centralized, coordinated inpatient care model, the county can better monitor service access and outcomes and identify disparities that may exist across race and ethnicity. This approach supports Ramsey County’s commitment to equitable service delivery by reducing administrative barriers and ensuring that systems designed to protect public health and safety also promote fairness, dignity, and wellbeing for all residents.
Community Participation Level and Impact
Ramsey County Social Services department has engaged internal teams, advisory councils, state partners and other stakeholders to help assess and identify those residents with the most critical mental health needs. Collaboration will continue throughout the duration of the contract.
☒ Inform ☐ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
Funds for this agreement are included in the Ramsey County Social Services budget for 2026-2027. The not-to-exceed amount for the agreement is $4,992,500 over five years.
Last Previous Action
On February 16, 2021, the Ramsey County Board of Commissioners approved the Single Source Agreement with Regions Hospital for Inpatient Services (Resolution B2021-036).
Attachments
1. Client Services Agreement