METO: Minnesota Extended Treatment Options

The 1995 Legislature authorized the commissioner of Human Services to develop a specialized service model at the Cambridge Regional Human Services Center campus to serve Minnesotans who have a developmental disability and exhibit severe behavior problems that present a risk to public safety. The program developed is known as the Minnesota Extended Treatment Options (METO). Admission to the program is limited to those few individuals who exhibit such extreme behaviors that they cannot, at present, be served safely in their communities. METO serves the public interest by providing comprehensive treatment to individuals with mental retardation and co-occurring conditions to promote safe and sustainable return to their communities of origin.

To be admitted to the METO program, an individual must have mental retardation or related condition, be of adult age, exhibit behaviors that present a risk to public safety, and be civilly committed as Mentally Retarded and/or Mentally Ill. METO does not accept admission of individuals civilly committed as Sexually Dangerous Persons or Sexual Psychopathic Personalities.

Residential units balance security with opportunity

A statewide program, METO has the capacity to provide specialized residential services for up to 48 clients on the Cambridge campus. The program makes use of intense levels of staff supervision and internal client management procedures to maintain security. Residential units have been constructed to be as homelike as possible, permitting clients to maintain or improve daily living skills that facilitate development of self-esteem, acceptance of personal responsibility, and eventual reintegration into the community.

Vocational and day program services are provided. Work opportunities are provided on the METO campus and through contracts with community day training and habilitation sites. METO has both indoor and outdoor recreational facilities for activities, such as volleyball and basketball, on the Cambridge campus.

METO provides general medical and psychiatric services several days per week. On-site nursing services are available 24 hours a day, seven days a week. Ancillary health care services (such as physical therapy, occupational therapy, speech/language services, audiology services, neuropsychological services, dental services, and pharmacy services), specialized diagnostic services (such as X-ray, lab, electroencephalographs) and medical specialties are arranged through outside agencies.

Treatment services

• Mental health: Individual psychotherapy and counseling, psychiatric assessment and follow-up and psychotropic medication evaluation and adjustment are included in mental health treatment.

• Treatment for individuals who have committed criminal offenses: Treatment focuses on teaching alternatives to aggression, enhancing self-concept and learning to accept personal responsibility. METO serves some individuals who have demonstrated sexually inappropriate behavior, which may have resulted in criminal charges. The treatment component addressing sexually inappropriate behavior is integrated into the individual treatment plan. Individuals in need of secure settings are transferred to other DHS settings.

• Treatment and support for victims of sexual abuse: Individual counseling and support.

• Treatment for aggressive/assaultive and other challenging behaviors: Treatment includes behavior management/therapy.

• Substance abuse treatment: METO is not a chemical dependency treatment program. For METO clients having a history of chemical dependency or substance abuse, a modified health education curriculum to address these issues is provided.

• Treat to competency: METO has the capacity to perform psychological examinations in situations where a client’s competency to proceed to trial may be impaired as the result of mental retardation. METO provides a structured competency restoration program for clients committed to the program under Minnesota Rules of Criminal Procedures, with a charge to "treat to competency."

• Transition services: As a part of transition and follow-up services, METO outreach staff assist case managers in identifying services and supports required by individuals leaving the specialized residential program, assist the selected community provider to prepare for the client, provide staff training specific to the needs of the client, augment direct support staff during criminal transition periods, help identify potential problem areas and ways to address them, provide consultation as required, and monitor the client after discharge. METO can coordinate transition services with Regional Community Support Services teams to further provide transition services, regardless of where the individual is placed.

• Community Support Services: METO coordinates its outreach and support services with State Operated Community Support Services (CSS) teams. CSS teams provide a package of services including expert consultation, on-site evaluation, direct service support, and crisis services with the goal of preventing the unnecessary removal of individuals from their communities. CSS services are not limited to individuals who present a risk to the public, but such individuals constitute a subset of the larger target group CSS serves. Through coordination with CSS, most individuals with challenging behaviors—- including those who initially appear to present a risk to public safety― can live in their communities with appropriate services and supports.
For more information about METO, call the Minnesota Department of Human Services at (763) 689-7200. For TTY service, call the Minnesota Relay Service at (800) 627-3529.