Journal of Ethical Resource Allocation in Health

Cost of Care for Unnecessary Services

Fraud Waste Abuse

Financial Transparency

Citizen Guide

Isn't it alarming that a human rights crisis misuses taxpayer money?

Learn how our community's safety is impacted. Sex offense civil commitments currently create a human rights crisis and wastes taxpayer money. Join The Journal of Ethical Resource Allocation in Mental Health in advocating for change through known evidence-based insights and innovative strategies for progress.

Minnesota spends nearly $100M annually on civil commitment facilities, compared to less than $7M on community alternatives. In 2025, lawmakers added $55M more in bonding costs to expand capacity. These charts show the imbalance in taxpayer spending.

Facility Breakdown

How the Minnesota Sex Offender Program's (MSOP's) Senior Management Team Successfully Squanders Hundreds of Millions of Taxpayer Dollars on Unnecessary Services

Fraud, Waste, and Abuse 

<h3>Unveiling the Reality of Sex Offense Civil Commitment</h3>The Journal of Ethical Resource Allocation in Mental Health (JERAMH), founded and edited by Alec Cook, is a pioneering platform dedicated to exposing the stark truths behind sex offense civil commitment. Since its inception in October 2025, (JERAMH) has united leading experts, scholars, and individuals with lived experience to shed light on the profound human rights issues and the lack of measurable impact on community safety associated with these commitments. Our rigorous, evidence-based articles reveal a system fraught with failure and exploitation, where civil commitment facilities have become venues for fraudulent schemes that squander taxpayer resources.<h3>Bridging Science and Law for Informed Advocacy</h3>At JERAMH, we specialize in delivering groundbreaking insights that bridge the gap between scientific research and legal frameworks. Our content empowers lawmakers, stakeholders, and the public with undeniable facts necessary for informed decision-making and advocacy. By presenting comprehensive analyses and urgent conversations, we foster a deeper understanding of how sex offense civil commitment fails to fulfill its promises of enhancing public safety and protecting community well-being. Our mission is to catalyze reform through education, transparency, and a commitment to justice.<h3>Join the Movement for Change and Accountability</h3>Beyond publishing, The Journal of Ethical Resource Allocation in Mental Health invites you to join a critical movement aimed at ending sexual violence and reforming a broken system. We provide a platform for voices that demand accountability and seek to protect human rights. Through our articles and community engagement, we cultivate a space for meaningful dialogue and collective action. Connect with us to stay informed, contribute your perspective, and help drive the change that matters for safer and more just communities.

The Journal of Ethical Resource Allocation in Mental Health

Explore groundbreaking insights on sex offense civil commitment and its impact on community safety and human rights. Join us in advocating for evidence-based reform and justice. Together, we can challenge the status quo and protect our communities. Justice through truth ends sexual violence and civil commitment harm.

Unveiling Truths, Ending Violence

Exposing misuse of funds and human rights violations within civil commitment facilities through investigative reports.

A skyscraper with glass windows intersecting with itself, creating a sharp angle.

Transparency Reporting

Engaging with lawmakers and stakeholders to promote evidence-based reforms in civil commitment laws.

A group of young South Africans with diabetes discussing diabetes rights

Policy Advocacy

Comprehensive studies and data-driven insights into sex offense civil commitment and its societal impacts.

Design thinking is a human-centered approach to innovation that draws from the designer's toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success. Design thinking has a human-centered core. It encourages organizations to focus on the people they're creating for, which leads to better products, services, and internal processes.

Research and Analysis

In-depth articles and opinion pieces from leading experts and individuals with lived experience.

Specialist Insight

Educational resources and outreach programs aimed at raising awareness about the realities and issues of civil commitment.

Public Education

Facilitating discussions and forums to connect scholars, policymakers, and the public for meaningful dialogue.

Some candid shots from the 2017 Women’s March in Los Angeles. Powerful image of allies.

Community Engagement

Our Expertise

Frequently Asked Questions

Email address

Name

Phone number

Message

Contact Us

<h3>An Examination Of Fraud, Waste And Abuse Upon Cost Of Care Billing Practices For Mental Health Services Found Not Necessary At Minnesota's Sex Offender Program</h3>Brad Stevens, Chairman Emeritus of the Moose Lake Resident Advisory Family Council (RAFC); Alec Cook, Chairman of the Moose Lake Resident Advisory Family Council (RAFC)<h4>ABSTRACT:</h4>Civil commitment is a restraint on individual liberty that occurs at incredible expense to the State. As a result, good public policy has always been to limit civil confinement only to those individuals who have been found dangerously mentally ill by the courts. In the case of the Minnesota Sex Offender Program (MSOP), the State has an interest to protect the public from sexual violence and rehabilitate the mentally ill. Both the Minnesota and United States Supreme Courts, in regard to the standard of care provided at civil commitment facilities such as MSOP, have established that the State has considerable discretion in determining the nature and scope of its responsibilities in developing treatment regimens. However, both state and federal courts have clearly established that this form of confinement is reserved exclusively for those in need of medical care, concluding that the State serves its purpose of treating rather than punishing sexually dangerous persons by committing them to an institution expressly designed to provide psychiatric care and treatment. Similarly, the Minnesota Supreme Court has held that the Minnesota Commitment and Treatment Act (MCTA)—the law which governs the MSOP civil commitment scheme—protects civilly committed patients' due process rights so long as procedural safeguards that include periodic re-evaluation and competent medical care and treatment are provided. Absent absolute adherence to these strictures, civil commitment devolves from a remedy for those with authentic medical needs for severe mental disorders into preventive detention for those reviled by society. This is exactly what has occurred: MSOP, through their senior management team, knowingly detains patients with no medical needs and then defrauds the taxpayer. The evidence for this is provided below.<h4>Fraud, Waste and Abuse: The MSOP Bills Both the State and Federal Government for Services Not Provided</h4>As part of their requirement to follow the laws as set forth by the Courts to protect the due process rights of civil confinees, the MSOP has historically had to follow certain administrative rules. However, in 2005, then MSOP Executive Director Dean Mooney requested a NON-PUBLIC variance from the Department of Human Services (DHS) Licensing Division owing to perceived difficulties of operating the program in accordance with the law. Specifically, the rule to which Mooney requested exception to was Administrative Rule 9515.3030, subpart 12, which states: A psychiatrist must evaluate each person within three working days after the person is admitted and re-evaluate each person at least annually. This rule is consistent with the due process guaranteed to civilly confined patients by the Minnesota Supreme Court. Mooney, in answering the application's requirement for a reason as to why the MSOP could no longer comply with the rule necessitating psychiatric evaluations, stated: The vast majority of patients committed to the Minnesota Sex Offender Program do not experience symptoms of mental illness that require psychiatric treatment. For unknown reasons contrary to judicial precedent, the DHS approved this variance, thus committing fraud and championing its further proliferation. In lieu of these mandated psychiatric evaluations, the MSOP began providing annual mental health assessments provided by non-medical mental health professionals such as social workers and license-eligible psychologists in order to determine whether or not patients should be referred for psychiatric care to begin with. Absent a psychiatric referral, there is no medical justification for a patient's continued loss of liberty, and patients' commitments are favorably terminated. However, instead of working to discharge the patient without medical needs—as would be lawful—the MSOP instead continues to detain these healthy individuals for years on end, typically until their death, while billing the Legislature $174,835 per year per patient for medical services not rendered. This fraud constitutes the vast majority of the $126 million dollars the Legislature funds the MSOP with each year. This fraud has drained billions of dollars of State funds over the years. The inherent flaw in MSOP leadership's intentional decision to remove itself from the medical model which justified its lawful existence has been repeatedly pointed out to these very same government officials, yet no rectifying action has yet taken place. MSOP's senior management team appears to be having too much fun with the endless faucet of scarce public resources which the Legislature has entrusted them with. These ignored warnings of fraud have come from a variety of sources:In March 2011, the Minnesota Office of the Legislative Auditor found that patients at MSOP remain hospitalized despite no longer meeting the criteria of their original commitment. In 2014 during the litigation process of Karsjens v. Jesson (a lawsuit initiated by detained patients challenging the constitutionality of the MSOP), Minnesota's Federal District Court assembled a panel of experts under Fed. R. Evid 706. At trial in 2015, these experts repeatedly testified that countless patients did not belong at MSOP, either in those patients' cost of care, This fraud costs the taxpayer over $126 million each year. commitment, or could be served in a lesser restrictive (and less expensive) alternative. For instance: Dr. Deb McCulloch, a psychologist employed at Sand Ridge Secure Treatment Center (Wisconsin's sex offense civil commitment program), testified: It is my and our [the other Rule 706 Experts'] belief that there are a number of people at Moose Lake that could certainly be managed and be treated at St. Peter or CPS or even in the community. It was our observation, too, that there is likely people that don't need to be provided with supervision or intervention, legal intervention any longer at all but were still at Moose Lake in Phase I [the very beginning stages of treatment]. Dr. McCulloch further opined that, I do believe there are people both at Moose Lake and at St. Peter that could be served in a less restrictive environment. But I also believe—and there's a good example that was presented in the court and in our report—that there are people that should be discharged completely from commitment. Fellow Rule 706 Expert Dr. Robin Wilson came to the same conclusion in even simpler terms, testifying, There are people at the MSOP who I don't believe belong there. Dr. Michael Miner, another Rule 706 Expert, also concurred in his expert opinion, stating that there are people who are in MSOP who no longer meet the criteria for commitment. Dr. Miner then testified that we [the Rule 706 Experts] could name some of them but I do not believe we could name them all, allowing to the simple fact that they had not reviewed the case of every patient at MSOP.In 2015, Mitchell Hamline School of Law published A Study Of The Efficacy Of The Sexually Violent Predator Act In Florida. 41 Wm Mitchell L. Rev. 780, 813 (2015). The peer-reviewed literature found there is no evidence that shows that state expenditure on inpatient treatment in a secure civil facility is achieving its intended purpose. Even more importantly, the report further stated, neither inpatient nor outpatient treatment appears to have had much, if any, effect in reducing recidivism when compared to the released detainees (no treatment). The 2015 Mitchell Hamline report further included a section titled: A Lesson for Minnesota: Conditional Release and Treatment Efficacy for Persons Considered to Be Sexually Violent Predators. The literature found, with rates of recidivism] as low as they are, even for untreated offenders, it is unlikely that any intervention can significantly lower rates any further.In 2024, Mitchell Hamline School of Law's Sex Offense Litigation and Policy Resource Center released a damning report entitled Sex Offense Civil Commitment: Minnesota's Failed MSOP for wasting scarce public resources on an ineffectual program with no discernible impact on the incidence of sexual violence. MSOP leadership attended the June 7, 2024 conference at Mitchell Hamline concerning the report, but were seen to have left early. These problems arise directly from MSOP's intentional decision to disobey the law requiring a connection between the medical rationale for commitment and the patient's continued loss of liberty. Consistently, the science shows that the MSOP's detained patients are not of any danger to the public, and that ongoing expenditure on their non-medical treatment is a waste and abuse of tax dollars. Despite these warnings, MSOP's senior management team, who throughout this period has been headed by Executive Director Nancy Johnston, has taken no corrective action of any form whatsoever. All the while, the vast majority of these patients from 2011... from 2015... from 2024... they all remain unnecessarily detained, a breathing emblem of the ongoing bill sent to the Legislature for services not rendered.Billions of dollars... for what?This fraud extends all the way to Washington. Minnesota's counties' Health and Human Services Departments apply for federal grants to be reimbursed for MSOP patients' medical expenses, claiming MSOP to be an institution for mental disease (IMD) as defined by federal statute. However, MSOP does not meet the definition of an IMD. An IMD, as defined by federal law, is a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged in providing diagnosis. treatment, or care of persons with mental diseases, including medical attention, nursing care and related services. Federal regulations make clear that whether an institution should be considered an IMD is determined by its treatment of individuals with mental diseases, whether or not it is licensed as such and overall character as that of a facility established and maintained primarily for the care and treatment of individuals with mental diseases. The overall character of the MSOP is to provide confinement and non-medical treatment for risk factors, not a diagnosis, contributing words of Nancy Stacken, the clinical director at the MSOP - Moose Lake facility, Dynamic risk factors, not a diagnosis, are what a person can intervene on their risk to reoffend by addressing their dynamic risk factors in treatment. It is the goal of MSOP and... [their] treatment team that patients do not commit additional sex offenses, and targeting dynamic risk factors is the best approach to that end.Therefore, any reimbursement sought and received by counties for the medical expenses of MSOP patients is fraud upon the federal government. It matters not whether these reimbursements are for physical or mental ailments. In short, MSOP has become the melting pot of rogue bureaucracies defrauding the taxpayer nationwide.CONCLUSIONThe MSOP unlawfully spends over $126 million every year of taxpayer funds upon false pretenses. Civil commitment of sex offenders is explicitly limited to those who require medical care for a mental disorder. MSOP's senior management team has deemed that the vast majority of their detained patients do not meet this criteria. However, instead of facilitating the release of these patients, the MSOP senior management team, as headed by Executive Director Nancy Johnston, has intentionally and systematically removed the medical component from their treatment program rather than the healthy patients from their medical program. The MSOP then bills the State and defrauds the taxpayer for these unnecessary services. This is done with explicit knowledge of wrongdoing.Further, Minnesota counties fraudulently receive reimbursements from the federal government for MSOP patients' costs of medical care when their confinement does not fit the legal criteria requisite to receive such monies. The fraud, waste, and abuse conducted by MSOP's senior management team has become a matter of national interest.<h4>RECOMMENDED LEGISLATIVE ACTION</h4>1. Investigate the MSOP and the counties for fraud, waste and abuse upon cost of care billed to state and federal governments;2. Audit MSOP for any misappropriations of funds;3. Examine solutions to reduce sex offense civil commitments and expressly abolish commitments at the MSOP, unless deemed medically necessary;4. Mandate the Department of Human Services Licensing Board to rescind all administrative variances currently issued to MSOP Facilities. These variances substantially affect and circumvent state and federal legal requirements intended to protect public policy and integrity in mental health care:5. Facilitate the reduction of the MSOP population to those who are presently deemed dangerously mentally ill requiring psychiatric care and/or pharmacologic intervention for a sexual disorder;6. Amend Minn. Stat. 253D.27 to include a subdivision allowing patients to petition the committing court for relief. This would allow patients to transition back to the community on provisional discharges through county level Health and Human Services Departments;7. Remove the Special Review Boards from the reduction in custody process under Minn. Stat. 253D.27 subd. 3. This review process is redundant and an unnecessary waste of taxpayer dollars;8. Amend Minn. Stat. 253D.27 to mandate the reduction in custody process for MSOP patients to take no longer than 180 days.9. Absent the express implementation of these other recommendations, sunset the MSOP.10. Most importantly, reinvest funds once devoted to the MSOP's fraudulent expenditures to primary prevention programs shown to have a demonstrable effect in reducing the prevalence of sexual violence in the State of Minnesota.This report is authored by Brad Stevens and Alec Cook. They may be reached at 1111 Highway 73 Moose Lake, MN 55767 or via voicemail at (218)-351-1900 ext. 052728 (Stevens) and (218)-351-1900, ext. 117718 (Cook).

Cost of Care for Unnecessary Services in Civil Commitment Scheme

Gallery

EVERY HUMAN HAS RIGHTS. Urban street art sticker. Leica R7 (1994), Summilux-R 1.4 50mm (1983). Hi-Res analog scan by www.totallyinfocus.com – Kodak Ektar 100

a protester holds up a sign with a quote from Pope Paul VI

The Minnesota Commitment and Treatment Act (MCTA) provides a manner in which state officials may indefinitely civilly commit men and women found by clear and convincing evidence to have engaged in a course of harmful sexual conduct. Such committees are sent to and detained at the Minnesota Sex Offender Program (MSOP). Given the extraordinary restraint on liberty that such an indefinite and usually lifetime-commitment imposes onto patients, this form of civil confinement remains lawful only insofar as it is for purposes of treatment, treatment which must fulfill the compelling dual state interest of both rehabilitating the mentally ill and protecting the public from sexual violence. The Senior Management Team (SMT) of the MSOP is charged with carrying out these duties. However, the evidence illustrates that the SMT fulfills neither of these mandated roles. The evidence also illustrates that the SMT is aware of their failures as well, yet continue to sit idly by. By the SMT's own estimates, most of their patients are not mentally ill and thus not in need of rehabilitation. Despite this, these patients remain confined, typically for decades on end or until death. Simultaneously, those truly in need of services remain deprived of the care which justifies their confinement and they instead languish, largely unattended to. The SMT currently only provides two hours of nonmedical group therapy per week for its patients. This one-size-fits-all treatment model, which is of limited empirical effectiveness, is delivered universally to all patients, irrespective of whether they are actually mentally ill and in need of rehabilitation or not. The SMT, by choice, fails to distinguish between the two types of patients. This is the return the SMT provides to the State of Minnesota on the $126 million in taxpayer funds it is given every year. Consider this paper a credible allegation of fraud

Abstract

This report is written from the perspective of two detained Minnesota Sex Offender Program (MSOP) patients extensively trained in law, scientific literature regarding sex offense recidivism, and the history of MSOP. The authors of this paper remain incarcerated despite the MSOP having determined that they do not require services for mental illness.The MSOP has a thirty-plus year history of wasting taxpayer funds. The program has been riddled with dubious intent since its origin, a matter which has been left unaddressed due to the political toxicity surrounding the agency. However, certain brave political and judicial leaders have spoken the truth regarding the MSOP, conscientious men and women with respect for the Constitution and the highest principles of morality.For instance, in dissenting to the constitutionality of the MSOP, Minnesota Supreme Court Justice Tomljanovich wrote, "[T]he Due Process Clause of the Constitution prohibits us as a society from locking up persons simply because we fear them" before further noting "that the state did not even bother to argue its compelling interest in passing the SDP Act [thus creating MSOP] was to provide treatment for [the very first committee] Dennis Linehan or any other subsequent committee. And for that, the state deserves credit for its honesty." Yet treatment is for what the MSOP bills the State over $126 million dollars each year.Similarly, Justice Page, also dissenting to the constitutionality of the MSOP, wrote, "In upholding the SDP Act, the court is acting... in violation of our duty 'to provide safeguards against the state's improper use of civil commitment as a constitutionally invalid form of preventive detention." Yet according to law, it is for the provision of "proper care and treatment, best adapted, according to contemporary professional standards, to rendering further supervision unnecessary for which the MSOP bills the people of Minnesota over $126 million dollars every year.Most recently, in 2014, Minnesota Court of Appeals Judge R.A. Randall described the three "great myths" of the MSOP. The first "great myth [is] that civil commitment is 'remedial... for treatment purposes and... not for purposes of preventive detention." "The next great myth (close to being a 'lie') is that it is for medical treatment." "The third great myth or 'lie,' is that once you are civilly committed you have a rational due process chance to be medically discharged." Yet it is for the operation of a functioning treatment program which MSOP invoices the legislature over $126 million dollars each and every year."[A]s a judge," Randall wrote, "I hate lying about it."8MSOP's Senior Management Team (SMT) also appears to hate lying about it. In fact, they are quite open about the fraudulent nature of their program.The authors of this paper have historically been members of MSOP's Resident Advisory and Family Council (RAFC), a statutorily authorized organization tasked with making recommendations to the SMT regarding facility policies. As such, we have had the opportunity to witness and document many of the open denials the SMT has responded with to our rational requests, requests which would help to legitimize the program and facilitate the release of healthy patients.For instance, we have historically recommended that therapists report behaviors that identify whether or not patients' behavior supports their current mental health diagnosis. We have also recommended that the SMT update their outdated program theory manual to accommodate contemporary best practices. Both of these common-sense proposals were denied by the SMT.Similarly, the SMT is charged with providing psychiatric treatment to the mentally ill. But they do not provide annual psychiatric evaluations to their patients. If you ask the Executive Director, Nancy Johnston, how the SMT can provide psychiatric treatment without providing psychiatric evaluations, she will tell you the "vast majority" of her patients are not mentally ill so they do not need psychiatric services."As a result, the minority of patients who are in need of psychiatric services are deprived of care and the "vast majority" of patients who are not mentally ill remain unnecessarily detained. The SMT then bills the State for the "cost of care" of these unnecessary services, currently at a rate of over $126 million dollars each year. With an open checkbook to draw upon and no oversight to date, the SMT has little incentive to petition for the release of patients who no longer require treatment, instead allowing them to wallow, typically for decades, until they die.We find it difficult to understand the rationale behind the SMT's decisions, no matter their brazen and open admissions of disregard for law. Even present Executive Clinical Director Jannine Hébert-who is responsible for the implementation of the MSOP's treatment program, a program which has yet to show any discernible impact on reducing sexual violence in Minnesota despite costing taxpayers over $126 million dollars each year has confirmed our suspicions. In her own words, "I think civil commitment is ridiculous."13How has this happened? The MSOP is a political football which no one wants to touch, and as a result has remained an intentional afterthought year after year despite its vast financial implications throughout the entirety of Minnesota. How many children could go to school and be fed on $126 million dollars? How many homeless families given homes? How many sexual assaults could be prevented through the funding of actually effective programs?How has this happened? Succumbing to fear leads to tyranny in our spots left blind. When we refuse to look, those living without being seen are bound to be dealt with in the currency of cruelty. And in the dark avenues of bureaucracy where the word "accountability" is but an unheard echo, those responsible are bound to drown in the profligacy of an open checkbook. We pray for change.The authors of this paper know what it means to be afraid to do the right thing at all costs; after all, we are choosing to remain anonymous in our authorship for fear of our well-being and safety, retaliation a common practice of the MSOP and their Senior Management Team (SMT). We hope that the readers of this paper, those who likely get to go home to their families after a hard day's work and kiss their children goodnight, have more courage than we.<h3>Our Official Position on MSOP's Senior Management Team (SMT)</h3>MSOP's Senior Management Team knowingly exceeds their lawful authority, ignoring the laws governing the Minnesota Commitment and Treatment Act. The authors of this paper struggle with submitting themselves to believe the reality of the catastrophe that the program has become.The results: The SMT accepts and spends over $126 million dollars from the legislature every year. This money is used to unlawfully detain hundreds of patients who do not require the minimal and ineffective services which are inefficiently provided. At present, patients are five times more likely to die in custody than to return home to their families' arms.This occurs neither by accident nor coincidence. To accomplish this massive feat of waste, the SMT designed and implemented treatment-related policies, practices and procedures far surpassing their limited state interests of rehabilitating the mentally ill and protecting the public from sexual violence.Through these changes, the Senior Management Team harms Minnesota citizens with wrongful hospitalizations and misrepresents their stated purpose to the State of Minnesota. The SMT's management style also enables the prevalence of sexual violence in Minnesota through an exorbitant misuse of taxpayer funds.This is fraud; this is waste; and this is abuse.The SMT is directly culpable this report shall serve as a credible allegation.<h3>Background</h3>The legislative intent of the Minnesota Commitment and Treatment Act (MCTA) is to detain any Minnesotan found to be a Sexually Dangerous Person (SDP) and/or have a Sexual Psychopathic Personality (SPP) and then to release them once their condition is in remission. The Minnesota Supreme Court has interpreted these interests under the MCTA as twofold, stating: "The state has a compelling interest in both protecting the public from sexual violence and rehabilitating the mentally ill."14 In regard to standards of care and treatment in the context of civil confinement, both the Minnesota and United States Supreme Courts have further stated that "[T]he State has considerable discretion in determining the nature and scope of its responsibilities in developing treatment regimens." 15 However, this discretion is not unlimited. Both Courts have concluded that the state "...serves its purpose of treating rather than punishing sexually dangerous persons by committing them to an institution expressly designed to provide psychiatric care and treatment."Correspondingly, the Minnesota State Legislature, through the MCTA, has afforded certain rights to patients detained at the MSOP. These rights include:<ul><li>The right to "periodic medical assessment, including assessment of the medical necessity of continuing care," and that "the physical and mental condition of a civilly committed patient shall be assessed by the treatment facility as frequently as necessary, but not less often than annually" (Minn. Stat. §253B.03, subd. 5);</li><li>The right to "receive proper care and treatment, best adapted, according to contemporary professional standards, to rendering further supervision unnecessary" (Minn. Stat. § 253B.03, subd. 7); and</li><li>Procedures to petition for a reduction in custody every six months (Minn. Stat. § 253D.27-31).</li></ul>These legislatively created rights and procedures were intended to provide layers of professional review to protect patients' liberty interests and to correct an erroneous commitment from continuing." These safeguards exist to limit civil confinement exclusively to those who are dangerously mentally ill. 18 Contrary to the binding rule of statute and judicial precedent, the SMT has implemented policies, practices, and procedures aligned with their own treatment philosophy at the expense of patient rights. This contempt towards the statutory and procedural rights of residents at MSOP has resulted in the unlawful detainment of men for decades. 19 (See Figure 1.)

Executive Summary - A Plea from the Authors

Fraud committed by the Minnesota Sex Offender Program through Service Providers.using url below

<a target="_blank" rel="noopener noreferrer nofollow" href="https://mega.nz/file/vBdjVJYb#r-McXpoCOuxUxkGO9yJH18kWk_eqTpguJ31l58zS6hQ">𝕙𝕥𝕥𝕡𝕤://𝕞𝕖𝕘𝕒.𝕟𝕫/𝕗𝕚𝕝𝕖/𝕧𝔹𝕕𝕛𝕍𝕁𝕐𝕓#𝕣-𝕄𝕔𝕏𝕡𝕠ℂ𝕆𝕦𝕩𝕌𝕩𝕜𝔾𝕆9𝕪𝕁ℍ18𝕜𝕎𝕜_𝕖𝕢𝕋𝕡𝕘𝕦𝕁31𝕝58𝕫𝕊6𝕙ℚ</a>

Cost of Care. pdf

We all want safe communities, so did you know MINNESOTA is spending millions to keep individuals in high-security facilities even after they qualify for community-based support? Let's look at why the 'Least Restrictive Alternative' is actually a path toward better safety for everyone.

Civil rights lawyers are exposing how Minnesota's Chapter 253 placements bypass legal requirements, costing taxpayers millions in unnecessary care. Our placement eligibility engine stops this by verifying each recommendation against DHS policy and legal criteria, eliminating fraud and ensuring only necessary placements proceed. The engine provides transparent, evidence-based decisions that protect both rights and budgets. Discover how to end wasteful, non-compliant placements now.

The introduction of Minnesota Statutes, Chapter 253C represents a necessary and overdue correction to a system that has long operated in the shadows of constitutional law and fiscal transparency. For decades, Minnesota’s civil commitment of sex offenders has functioned as a "shadow prison"—punitive in practice while labeled "therapeutic" in name. This bill provides the legislative mechanism to transition from a cycle of indefinite detention to a system defined by clinical integrity, fiscal accountability, and public safety.The Necessity of ReformThe current reliance on internal staff for risk assessments has created a systemic conflict of interest that stalls reintegration and wastes taxpayer resources. By mandating Biennial Independent Risk Assessments, this bill ensures that data, not "program completion" metrics, dictates a person’s progress. Furthermore, the "Sunset" Determinate Commitment Model restores the burden of proof to the State, ensuring that secure detention is reserved only for those who present a current, evidence-based risk.Fiscal Accountability and TransparencyThe public has a right to know how its funds are managed. The mandated Audit of Managed Care Billing is designed to investigate potential double-billing and ensure that Medical Assistance funds are used for their intended clinical purposes, not to offset the rising costs of secure confinement. Additionally, the Transparency in Capital Planning provision ensures that infrastructure spending aligns with the goal of community reintegration rather than the permanent expansion of secure facilities.Clinical and Human Rights StandardsWe can no longer ignore the physical and cognitive decline of elderly or severely mentally ill clients. The Medical and Elderly Parole Pathway provides a humane, cost-effective alternative to high-security detention for those who are clinically incapable of meeting standard treatment phases. Simultaneously, by Decoupling Security Protocols from Medical Care, we prioritize the basic human right to life-saving medical intervention over administrative "counts" or security metrics.ConclusionThis bill does not choose between safety and rights; it recognizes that true public safety is only achieved through a system that is transparent, legally sound, and clinically effective. We urge the committee to support the transition to Chapter 253C to end the era of punitive civil commitment and restore the rule of law to Minnesota’s treatment programs.

Letter of Intent for the Civil Commitment Reform 

Side by side comparison and Transition of proposed Bill

Section 1. [253C.0100] LEGISLATIVE PURPOSE.​&lt;u&gt;The legislature finds that civil commitment must balance public safety, constitutional rights, and treatment effectiveness. Individuals committed under this chapter must have meaningful opportunities for treatment progression and eventual reintegration when risk is reduced. A structured continuum of treatment placements improves both public safety and rehabilitation outcomes.&lt;/u&gt;​Sec. 2. [253C.0200] MANDATORY BIENNIAL JUDICIAL REVIEW.​&lt;u&gt;Each individual committed under this chapter must receive a judicial review hearing every 24 months. The court shall determine whether continued secure confinement is necessary, whether transfer to a less restrictive placement is appropriate, or whether provisional or full discharge is warranted.&lt;/u&gt;​Sec. 3. [253C.0300] INDEPENDENT CLINICAL RISK REVIEW.​&lt;u&gt;Subdivision 1.&lt;/u&gt; Evaluation required. &lt;u&gt;Prior to each judicial review hearing, an independent clinical risk evaluation must be conducted. The evaluation must include validated actuarial risk assessment tools, treatment progress evaluation, and a placement recommendation.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Independence. &lt;u&gt;Evaluators must be independent from the resident’s primary treatment team and must not be employees of the Department of Direct Care and Treatment.&lt;/u&gt;​Sec. 4. [253C.0400] DETERMINATE REVIEW AND REBUTTABLE PRESUMPTIONS.​&lt;u&gt;Subdivision 1.&lt;/u&gt; Sunset review. &lt;u&gt;Any person committed under this chapter who has remained in a secure treatment facility for a continuous period of ten years is subject to a sunset review.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Rebuttable presumption for transfer. &lt;u&gt;There is a rebuttable presumption in favor of a transfer to a less restrictive alternative if the committed person:&lt;/u&gt;&lt;u&gt;(1) has not had a major disciplinary incident within the preceding 36 months; and&lt;/u&gt;&lt;u&gt;(2) has successfully completed the primary clinical requirements of treatment phases one and two.&lt;/u&gt;​&lt;u&gt;Subd. 3.&lt;/u&gt; Burden of proof. &lt;u&gt;In a sunset review, the burden of proof shifts to the executive board to demonstrate by clear and convincing evidence that the person remains a high risk to the public and that no less restrictive alternative is sufficient.&lt;/u&gt;​Sec. 5. [253C.0500] GRADUATED REINTEGRATION FRAMEWORK.​&lt;u&gt;Subdivision 1.&lt;/u&gt; Placement continuum. &lt;u&gt;The following placement continuum is established:&lt;/u&gt;&lt;u&gt;(1) secure facility;&lt;/u&gt;&lt;u&gt;(2) secure community treatment facility;&lt;/u&gt;&lt;u&gt;(3) transitional residential treatment placement;&lt;/u&gt;&lt;u&gt;(4) conditional community release with supervision; and&lt;/u&gt;&lt;u&gt;(5) full discharge.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Secure community treatment facilities. &lt;u&gt;The commissioner shall establish secure community treatment facilities to provide a less restrictive setting. These facilities must maintain secure perimeters and structured treatment while allowing for gradual community interaction.&lt;/u&gt;​Sec. 6. [253C.0600] MEDICAL AND ELDERLY CARE PATHWAY.​&lt;u&gt;Subdivision 1.&lt;/u&gt; High-need unit. &lt;u&gt;The executive board shall establish a specialized unit for committed persons who are 60 years of age or older or who suffer from a permanent, debilitating physical or cognitive impairment.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Clinical necessity. &lt;u&gt;Clinical necessity for nursing-level care supersedes any requirement for completion of traditional treatment phases if such completion is rendered impossible by the person’s physical or cognitive condition.&lt;/u&gt;​Sec. 7. [253C.0700] POST-RELEASE RISK MANAGEMENT SYSTEM.​&lt;u&gt;Subdivision 1.&lt;/u&gt; Intensive Supervised Release Plus (ISR+). &lt;u&gt;Individuals conditionally released under this chapter must be placed on Intensive Supervised Release Plus.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Conditions. &lt;u&gt;Conditions of release may include:&lt;/u&gt;&lt;u&gt;(1) GPS electronic monitoring;&lt;/u&gt;&lt;u&gt;(2) residency restrictions and curfews;&lt;/u&gt;&lt;u&gt;(3) mandatory treatment participation; and&lt;/u&gt;&lt;u&gt;(4) random polygraph, drug, and alcohol testing.&lt;/u&gt;​Sec. 8. [253C.0800] COMMUNITY REINTEGRATION INCENTIVE FUND.​&lt;u&gt;Subdivision 1.&lt;/u&gt; Establishment. &lt;u&gt;A community reintegration incentive fund is established in the state treasury.&lt;/u&gt;​&lt;u&gt;Subd. 2.&lt;/u&gt; Grants. &lt;u&gt;The commissioner shall provide grants to counties hosting supervised residential placements. Funds must be used for law enforcement, supervision services, treatment programs, and community safety resources.&lt;/u&gt;​&lt;u&gt;Subd. 3.&lt;/u&gt; County distribution. &lt;u&gt;No county may host more placements than a population-based threshold established by the commissioner by rule.&lt;/u&gt;​Sec. 9. [253C.0900] TRANSPARENCY AND REPORTING.​&lt;u&gt;By January 15 of each year, the commissioner shall submit a report to the legislative committees with jurisdiction over civil commitment including:&lt;/u&gt;&lt;u&gt;(1) the total number of committed persons and average duration of commitment;&lt;/u&gt;&lt;u&gt;(2) the number of transfers, conditional releases, and discharges granted; and&lt;/u&gt;&lt;u&gt;(3) recidivism statistics for individuals released under this chapter.&lt;/u&gt;​Sec. 10. Minnesota Statutes 2024, section 246C.13, is amended to read:​246C.13 DIRECT CARE AND TREATMENT; DUTIES.​The executive board &lt;s&gt;shall&lt;/s&gt; &lt;u&gt;must&lt;/u&gt; operate the Minnesota Sex Offender Program &lt;u&gt;until December 31, 2027, and must transition all operations to the community-based treatment system under chapter 253C&lt;/u&gt;.​Sec. 11. REPEALER.​&lt;u&gt;Minnesota Statutes 2024, chapter 253D, is repealed effective December 31, 2027.&lt;/u&gt;​Sec. 12. EFFECTIVE DATE.​&lt;u&gt;This act is effective August 1, 2025, and applies to all individuals currently committed to the Minnesota Sex Offender Program.&lt;/u&gt;

scrabble, scrabble pieces, lettering, letters, wood, scrabble tiles, white background, words, quote, letters, type, typography, design, layout, focus, bokeh, blur, photography, images, image, government, hierarchy, democracy, 

Minnesota MSOP Reform Act (Draft)

The Minnesota Sex Offender Program (MSOP) currently operates on a $121M+ annual budget for ~764 clients. Investigative data reveals a "treadmill" system where high spending does not produce clinical outcomes, but rather sustains a high-security custodial infrastructure through documented reporting fraud and service misrepresentation.

The $121 Million Question: A Taxpayer’s Guide to the MSOP "Treadmill"

<h4>1. What are we paying for?</h4>We pay $180,000 per year for every person in MSOP. For that price, you could pay for a Harvard education, a full-time private nurse, and high-security housing. Instead, taxpayers are funding a system where clients often get only 3 hours of therapy a week.<h4>2. The "Red Flags" of WasteThe Ghost Staffing:</h4>Millions in "vacancy savings" from unfilled clinical roles are often moved into massive overtime checks for security staff.The Litigation Loop: Your tax dollars are being used to pay lawyers to fight other lawyers, just to keep the program from having to release anyone. This ensures the program’s $121M budget stays high forever.The Prevention Gap: For every $50.00 Minnesota spends on MSOP, it spends only $1.00 on stopping new victims or supporting survivors in your community.<h4>3. Why hasn't it changed? Political Risk:</h4>It is easier for politicians to "warehouse" people indefinitely than to fund the community-based housing needed for safe release.The "Prison Economy": In towns like Moose Lake and St. Peter, MSOP is a top employer. Closing or shrinking the program is seen as an economic threat, even if the program is failing its mission.<h4>4. How to Take ActionContact your local representative and ask these three specific questions:</h4><ol><li>"Why is MSOP backdating files to pass audits instead of fixing the treatment gaps?"</li></ol><ol start="2"><li>"Why does MSOP cost 3x more than our state prisons per person?"</li></ol><ol start="3"><li>"Will you support shifting 10% of the MSOP budget ($12M) directly into community victim services and primary prevention?"</li></ol>

Unveiling Truths, Ending Violence

The Journal of Ethical Resource Allocation in Mental Health

Unveiling the Reality of Sex Offense Civil Commitment

Bridging Science and Law for Informed Advocacy

Join the Movement for Change and Accountability

Our Expertise

Specialist Insight

Public Education

Community Engagement

Frequently Asked Questions

What kind of articles does JERAMH publish?

What evidence does JERAMH provide about the impact of civil commitment on community safety?

Where is The Journal of Ethical Resource Allocation in Mental Health based?

Contact Us