OLA

OFFICE OF THE LEGISLATIVE AUDITOR
STATE OF MINNESOTA

EVALUATION REPORT 


Civil Commitment of
Sex Offenders

MARCH 2011
PROGRAM EVALUATION DIVISION
Centennial Building – Suite 140
658 Cedar Street – St. Paul, MN 55155
Telephone: 651-296-4708 ● Fax: 651-296-4712
E-mail: auditor@state.mn.us ● Web Site: http://www.auditor.leg.state.mn.us
Through Minnesota Relay: 1-800-627-3529 or 7-1-1

Program
m Evalua
ation Divvision

Evaaluation Staff

The Program
m Evaluation
n Division waas created
within the Office of the Legislative Auditor (OLA)
w,
in 1975. Thhe division’s mission, as seet forth in law
is to determ
mine the degreee to which sttate agencies
and program
ms are accom
mplishing theirr goals and
objectives and utilizing resources effiiciently.

Jamess Nobles, Legiislative Audittor

Topics for evaluations arre approved by the
mission (LAC)), which has
Legislative Audit Comm
equal representation from
m the House and Senate
and the twoo major politiccal parties. However,
evaluationss by the officee are independdently
researched by the Legisllative Auditorr’s professionnal
staff, and reeports are issu
ued without prior review by
the commisssion or any other legislatoors. Findings,,
conclusionss, and recomm
mendations doo not
necessarily reflect the viiews of the LA
AC or any of
its members.
A list of reccent evaluatio
ons is on the last page of
this report. A more com
mplete list is avvailable at
OLA's web site (www.au
uditor.leg.statte.mn.us), as
are copies of evaluation reports.
The Office of the Legislative Auditorr also includess
a Financial Audit Divisio
on, which annnually
conducts ann audit of the state’s financcial statementts,
an audit of federal fundss administeredd by the state,,
and approximately 40 au
udits of indiviidual state
agencies, booards, and co
ommissions. The division
also investiigates allegatiions of impropper actions byy
state officiaals and emplo
oyees.

Joel Alter
Emi Bennett
Valeriie Bombach
Jody Hauer
Davidd Kirchner
Carriee Meyerhoff
Judithh Randall
Sarah Roberts
KJ Staarr
Julie Trupke-Bastiddas
Jo Vos
John Yunker
To obttain a copy off this documeent in an accessible
format (electronic ASCII text, Braille, large print, or
audio)), please call 651-296-47088. People witth
hearinng or speech disabilities maay call us throough
Minneesota Relay byy dialing 7-1--1 or 1-800-627-3529.
All OL
LA reports arre available att our Web sitee:
http://www.auditor
/
r.leg.state.mn..us
If youu have commeents about ourr work, or youu want
to sugggest an audit,, investigationn, or evaluatioon,
pleasee contact us att 651-296-47008 or by e-maail at
auditoor@state.mn.uus

Printed on Recycled Papeer

OL A

OFFICE OF THE LEGISLATIVE AUDITOR
STATE OF MINNESOTA • James Nobles, Legislative Auditor

March 2010
Members of the Legislative Audit Commission:
Minnesota’s approach to civil commitment of certain sex offenders is controversial for
various reasons. Our evaluation focused on the program that confines and treats civilly
committed sex offenders and the process that is used to place them in the program.
We found that the costs of the Minnesota Sex Offender Program (MSOP), which is
administered by the Department of Human Services, have nearly tripled in the last six years.
In addition, they are expected to grow significantly in the future, since the number of civilly
committed sex offenders at MSOP facilities is expected to almost double in the next ten years.
Furthermore, despite the treatment provided by MSOP, no sex offender has ever been
discharged from civil commitment.
Among the 20 states with civil commitment programs, Minnesota has the highest number of
civilly committed sex offenders per capita. However, we found significant inconsistencies in
the commitment process, which have resulted in the commitment rate in some parts of the
state being almost double that in other areas. These differences raise questions about the
application of Minnesota’s civil commitment criteria.
Currently, civilly committed sex offenders can only be confined and treated at two high
security facilities. We recommend that MSOP develop a plan for housing some offenders—
particularly certain low functioning individuals—in alternative settings. We also recommend
MSOP develop a stay of commitment option appropriate for certain sex offenders. Both of
these options may help mitigate MSOP’s accelerating costs but still offer the necessary
security to protect the public.
Our evaluation was conducted by John Yunker (evaluation manager), KJ Starr, and Justin
Roskopf. The Department of Human Services, the Department of Corrections, and others
cooperated fully with our evaluation. We thank them for their assistance.
Sincerely,

James Nobles 

Legislative Auditor


Room 140 Centennial Building, 658 Cedar Street, St. Paul, Minnesota 55155-1603 • Tel: 651-296-4708 • Fax: 651-296-4712

E-mail: auditor@state.mn.us • Web Site: www.auditor.leg.state.mn.us • Through Minnesota Relay: 1-800-627-3529 or 7-1-1


Table of Contents 

Page
SUMMARY	

ix

INTRODUCTION	

1

1.	

BACKGROUND
Civil Commitment Population
DHS Facilities
Costs of Civil Commitment
Other States

3
3

9

11 

16 


2. 	

CIVIL COMMITMENT PROCESS
Standards for Civil Commitment
Commitment Process
Referrals
Variation in Commitment Practices
Commitment Alternatives
Recommendations

23 

23 

25 

27
30 

42 

44


3.

M
	 SOP TREATMENT
Legal Requirement for Treatment
Effectiveness of Sex Offender Treatment
MSOP's Treatment Program
Assessments of Need and Treatment Progress
Clients with Special Needs
Client Releases

51
51

53

55 

72 

78 

85 


LIST OF RECOMMENDATIONS	

93 


AGENCY RESPONSE: Department of Human Services

95 


AGENCY RESPONSE: Department of Corrections	

97 


RECENT PROGRAM EVALUATIONS	

99 








List of Tables and Figures 

Page
TABLES
1.1 Type of Felony Convictions of Civilly Committed Sex Offenders
1.2	 Minnesota Sex Offender Program Operating Expenditures
and Staffing, by Type, FY 2010
2.1	 Outcome of Sex Offender Referrals by Population of County, 19912008
3.1 	 Dynamic Risk Factors and Their Corresponding Behavioral Areas on
MSOP’s Treatment Matrix
3.2 Sample Matrix Behavioral Area (Emotional Regulation) 	
3.3 MSOP Programming Units 	

8
13
35
76
77
78

FIGURES
1.1	 Total Number of Civilly Committed Sex Offenders in Minnesota, as
of July 1 of 1990-2020
1.2	 Number of Felony Convictions for Civilly Committed Sex Offenders
in Minnesota
1.3 	 Projected Growth in Civilly Committed Sex Offenders and Existing
Bed Capacity, 2010-22
1.4 	 Number of Civilly Committed Sex Offenders per Million Residents,
2010
2.1	 Referrals by the Department of Corrections and Numbers of Sex
Offenders Entering the Minnesota Sex Offender Program, 1985­
2010
2.2 Minnesota Judicial Districts, 2010	
2.3	 Sex Offender Civil Commitments per 100,000 Residents by Judicial
District, as of July 2010
2.4	 Percentage of Referrals Resulting in Civil Commitments by Judicial
District, 1991-2008
2.5	 Percentage of Referrals Resulting in Petitions for Civil Commitment
by Judicial District, 1991-2008
2.6	 Percentage of Petitions Resulting in Civil Commitment by Judicial
District, 1991-2008
3.1	 Minnesota Sex Offender Program Client Population by Treatment
Phase, 2010
3.2	 Clinical Organizational Structure of Minnesota Sex Offender Program,
2010
3.3 Alternative Program Client Population by Treatment Phase, 2010

4
7
10
18
30
32
33
34
36
37
56
59
80

Summary 

Major Findings:
	

The number of civilly committed sex
offenders in the Minnesota Sex
Offender Program (MSOP) nearly
quadrupled during the last decade and
is expected to nearly double over the
next ten years. (pp. 3-5)

	

Minnesota is one of 20 states with
civil commitment programs for sex
offenders and, in 2010, had the
highest number of civilly committed
sex offenders per capita. (pp. 16-18)



To control
accelerating costs,
Minnesota could
develop lowercost facilities to
house some civilly
committed sex 	
offenders and 	
create an 	
enhanced stay of 	
commitment 	
option for others. 	

	

MSOP’s annual cost is $120,000 per
offender, or about three times the cost
of incarceration in Minnesota, but
close to the average for other secure
treatment facilities for civilly
committed sex offenders. (pp. 11,
15-17)
The number of court commitments as
a percentage of referrals from the
Department of Corrections varies
significantly across the state. Our
statistical analysis suggests that some
sex offenders being committed may
have a lower risk of recidivism than
others who are being released from
prison. (pp. 34, 39)

	

Minnesota lacks reasonable
alternatives to commitment at a high
security facility. Lower-cost
alternatives may be appropriate for
some sex offenders being considered
for commitment or already residing at
MSOP facilities. (pp. 42-44)

	

No sex offender has been discharged
from MSOP since it was created in
1994. Without releases, Minnesota is
susceptible to lawsuits challenging
the adequacy of the treatment
program. (pp. 19, 52)



MSOP’s treatment program has
experienced frequent leadership
changes and significant staff
vacancies, and it has struggled to
maintain the type of therapeutic
environment necessary for treating
high-risk sex offenders. (pp. 58-61,
65-72)



Current MSOP management has
worked to address security problems
and clinical deficiencies, but it still
needs to increase the number of
treatment hours provided, improve
the therapeutic environment, and
establish clearer guidelines for
judging treatment progress. (pp. 60­
77)

Key Recommendations:


The Legislature should require MSOP
to develop a plan for lower-cost
alternative facilities to be used by
certain sex offenders. The plan
should also outline the changes
needed to implement a stay of
commitment option. (p. 45)

	

The Legislature should consider a
variety of other options for reducing
the costs of civil commitment,
including changes in the commitment
process, commitment standards, and
financing of commitment costs, as
well as changes in sentencing policy.
(pp. 46-49)

	

The Department of Human Services
should require MSOP to provide
more treatment hours per week than
are currently provided. (p. 65)

x

CIVIL COMMITMENT OF SEX OFFENDERS

Report Summary
Among the 20
states with civil
commitment
programs,
Minnesota has the
highest number of
civilly committed
sex offenders per
capita.

Minnesota and 19 other states have laws
allowing the courts to civilly commit
dangerous sex offenders following their
release from prison. In Minnesota, the
Department of Corrections screens
offenders scheduled for release and
refers those who may be appropriate for
civil commitment to county attorneys.
County attorneys decide whether to file
a petition for commitment with the
district courts, which make the final
determination on commitments.
Committed sex offenders are sent to the
Minnesota Sex Offender Program
(MSOP), which has facilities in Moose
Lake and St. Peter.
Civilly committed sex offenders retain
certain civil rights, including the right to
treatment. Without an adequate
treatment program, Minnesota could
face a legal challenge.
Minnesota’s population of civilly
committed sex offenders has grown
significantly in the last decade and is
the highest in the nation on a per
capita basis.
The total number of civilly committed
sex offenders in MSOP has grown from
less than 30 in 1990 to 149 in 2000 and
575 in mid-2010. The 2010 figure does
not include another 55 or so civilly
committed sex offenders who were
temporarily transferred to correctional
facilities.
In 2010, Minnesota had the third highest
population of civilly committed sex
offenders—after California and
Florida—and has the highest number in
the nation on a per capita basis. It is
unclear exactly why Minnesota has so
many civilly committed sex offenders
compared with other states. Minnesota
has a lower overall incarceration rate
than most states, but there are no data
available to determine if Minnesota has
a lower rate for sex offenders. Another
possible explanation is that Minnesota’s

laws facilitate the civil commitment of
sex offenders. Unlike most states,
Minnesota does not allow jury trials for
civil commitment. Minnesota also
allows hearsay evidence and requires
the commitment standard to be met with
“clear and convincing evidence” rather
than proven “beyond a reasonable
doubt.” Minnesota also considers
offenses involving emotional harm to
victims, rather than just physical harm
or violence.
The largest increases in commitments,
however, occurred after the Department
of Corrections (DOC) changed its
referral practices. From 1991 to 2003,
DOC referred about 26 offenders per
year to county attorneys. Following a
November 2003 rape and murder by a
sex offender recently released from
prison, DOC began referring all
offenders who might meet the legal
standard for commitment. With that
change in policy, the number of annual
DOC referrals after 2003 grew to about
six times its previous rate.
The costs of civil commitment in
MSOP are high relative to
incarceration and other alternatives.
The annual cost per resident in MSOP is
$120,000. This cost is at least three
times the cost of incarcerating an inmate
at a Minnesota correctional facility.
Although treatment costs play a role, the
primary reason why costs are higher at
MSOP facilities is security, which is the
biggest spending component at both
MSOP facilities and Minnesota’s
prisons. Overall staffing per resident is
about three times higher at MSOP
facilities than at Minnesota’s prisons.
This difference largely reflects
differences in the mission and average
size of the two types of facilities.
The annual cost of civil commitment
programs in other states with secure
facilities like MSOP ranges from about
$36,000 to $180,000 per year.
Minnesota’s annual cost was the fifth

SUMMARY

There is
considerable
variation in
commitment
practices,
particularly
among
prosecutors.

xi

highest of 12 states that responded to a
recent survey.

commitment practices is more limited
than that among prosecutors.

The civil commitment program in
Texas, which does not rely on the same
type of facilities, has an annual cost of
only about $27,000 per offender. Texas
houses its committed offenders in four
halfway houses specifically for this
population and provides outpatient
treatment. In addition, the Texas
program provides close supervision and
monitoring and restricts the ability of
residents to travel outside the halfway
houses. If offenders violate the terms of
their commitment, they may receive
lengthy prison sentences.

Minnesota lacks reasonable
alternatives to commitment at a high
security facility.

Among Minnesota’s judicial districts,
commitment rates vary significantly,
with the percentage of referred
offenders being committed varying
from 34 to 67 percent.
Commitment rates in Hennepin and
Ramsey counties and northeastern
Minnesota are 34 to 36 percent of DOC
referrals, while the rates are 43 to 45
percent in the judicial districts
immediately north and south of
Hennepin and Ramsey counties.
Commitment rates in judicial districts
throughout the rest of the state vary
from 59 to 67 percent.
Statistical analyses we conducted
strongly suggest that the probability of
being committed is significantly higher
in most of the rest of the state than it is
in Hennepin and Ramsey counties and
northeastern Minnesota. These analyses
take into account known differences in
the recidivism risk posed by offenders
considered for commitment.
The differences in commitment rates
appear to be largely the result of
differences in the percentage of referred
cases for which county attorneys file a
petition. The DOC’s referral practices
are unaffected by geographic difference.
In addition, the variation in court

A major problem with Minnesota’s
commitment process is that it generally
involves a choice between a high
security facility and release from prison
with no supervision, if the offender has
served his entire prison sentence.
Minnesota law allows for consideration
of a less restrictive alternative, but there
are no alternatives available. Minnesota
has one private residential facility for
sex offenders, but it will not take any
offenders being considered for
commitment.
One lower-cost alternative would be to
establish group homes or halfway
houses for certain civilly committed sex
offenders who could be managed in
such a setting. Currently, there are low
functioning adult offenders at MSOP for
whom the impact of the treatment
program has probably been maximized.
Some of these offenders are probably
suitable for a group home setting that
lacks the high security of an MSOP
facility but retains sufficient supervision
and monitoring. In addition, there may
be other individuals in MSOP whose
risk level has been reduced and may be
suitable for a halfway house alternative
such as that provided in Texas.
Sufficient supervision would be needed,
along with appropriate consequences if
individuals do not comply with the
rules.
Minnesota law currently provides for a
stay of commitment option, but it is
rarely used since it was designed
primarily for populations other than sex
offenders. That option would become
more viable if the law provided for
supervision by MSOP or DOC instead
of a social service agency, and if the law
was more explicit about the conditions

xii

CIVIL COMMITMENT OF SEX OFFENDERS

an offender must meet to avoid
revocation of a stay.
With the large influx of commitments
since 2003, MSOP has struggled to
provide adequate treatment and
maintain a therapeutic environment,
particularly at its Moose Lake
facility.
Over the last eight years, MSOP’s
treatment program has experienced
frequent leadership changes and has had
a significant number of staff vacancies.
In addition, it has been difficult to
maintain the therapeutic environment
necessary for making progress with
high-risk sex offenders.

No civilly
committed sex
offender has ever
been discharged
from the
Minnesota Sex
Offender
Program.

The problems have been particularly
acute at MSOP’s Moose Lake facility,
which serves clients in the beginning
stages of treatment. At one point last
year, six of the eight clinical supervisor
positions were vacant at Moose Lake.
In November 2010, MSOP had 17
vacancies for nonsupervisory clinical
positions, with 16 of them at Moose
Lake.
The lack of adequate numbers of
clinical staff has meant the number of
hours of treatment provided by MSOP is
generally lower than that provided by
civil commitment programs in other
states. In addition, the number of hours
provided by MSOP is less than that
provided at Minnesota correctional
facilities or the only private residential
facility for adult sex offenders in the
state.
The treatment environment has also
been adversely affected by reductions in
security staff and a change in their role.
In recent years, the number of security
staff was cut significantly, and security
counselors were no longer expected to
provide therapeutic support to residents.
While these changes made some sense,
clinical staff have not been available in
sufficient numbers to fill the void.

Current management at MSOP has
taken steps to address problems at its
facilities. For example, despite the
reduction in security staffing, MSOP’s
facilities have become more secure,
partly due to the adoption of clear
policies for resident and employee
behavior. Current management is also
taking steps to fill the vacancies in its
treatment program. In addition, it has
implemented a treatment program that
appears to be consistent with accepted
“best practices” in the field. Further
work will be needed to make sure the
program provides clear guidelines for
assessing treatment progress and is
implemented consistently by the
clinicians who treat offenders.
No civilly committed sex offender has
ever been discharged from MSOP,
although MSOP is now proposing to
provisionally discharge two offenders
in the next six months.
Several factors may explain why no
MSOP clients have been discharged
from the program. First, problems in
the treatment program over the last ten
years have likely affected the progress
of some sex offenders. Second, while a
specialized court now determines
whether offenders are discharged, the
previous administration issued an
executive order discouraging any
discharges. Finally, Minnesota has a
release standard for offenders who are
civilly committed that, in practice, is
stricter than other states. MSOP does
not support any discharges without
completion of the treatment program.
Most states explicitly allow for
discharges if an offender no longer
meets the commitment criteria.

Introduction 


Minnesota and 19
other states allow
for the civil
commitment of
dangerous sex
offenders.

M

innesota and 19 other states have laws allowing the courts to civilly
commit dangerous sex offenders following the completion of their prison
sentences. In most of these states, civilly committed sex offenders are placed in
secure facilities that provide treatment. In a few states like Texas and, to some
extent, New York, civilly committed sex offenders receive treatment while living
in halfway houses or other community settings.
The major public benefit of civil commitment is increased public safety. If states
use the civil commitment process appropriately, sex offenders who are most
likely to reoffend are living in a secure facility and not among the general public.
Furthermore, such dangerous sex offenders are not released into the community
until the risk that they will reoffend is lowered through treatment or for other
reasons.
While civil commitment increases public safety, confinement in a secure
treatment facility is costly. In Minnesota, it costs the Department of Human
Services (DHS) about $120,000 per year to house and treat a civilly committed
sex offender in a secure facility. The cost is roughly three times the cost of
incarcerating inmates at Minnesota’s correctional facilities. The high cost of
civil commitment can be worth the price if civil commitment is reserved for the
most dangerous offenders and if treatment is effective in reducing the risk of
recidivism for at least some offenders.
There are concerns, however, that Minnesota has built an expensive system of
civil commitment and has committed some offenders who could be safely treated
and supervised in a less costly community setting. The number of civilly
committed sex offenders has grown dramatically over the last two decades.
From 1990 to 2000, Minnesota’s population of civilly committed offenders grew
from less than 30 to 149. As of January 1, 2011, the number has grown to 656,
including 605 at DHS facilities and 51 at Minnesota correctional facilities. In
2010, Minnesota had more civilly committed sex offenders than every state
except California and Florida. In addition, Minnesota had by far the largest
number of civilly committed sex offenders per capita in the country. Current
projections indicate that, under current policies, significant growth is likely in the
future. According to DHS, the number of civilly committed sex offenders at
DHS facilities is expected to nearly double between 2010 and 2020.
In addition to concerns raised about the number of sex offenders who are civilly
committed, another significant issue is the apparent ineffectiveness of treatment
at DHS facilities. No sex offender has been successfully discharged from the
Minnesota Sex Offender Program (MSOP) since it was created in 1994. Only
one offender has ever been provisionally discharged and that offender was
brought back to MSOP due to technical violations of his release conditions.

2

CIVIL COMMITMENT OF SEX OFFENDERS

As a result of these concerns, the Legislative Audit Commission directed the
Office of the Legislative Auditor to conduct a program evaluation of the civil
commitment process and the Minnesota Sex Offender Program. Our evaluation
focuses on the following issues:
	 How has the population of civilly committed sex offenders grown in
Minnesota? How does the size of Minnesota’s population compare
with those in other states?
	 What accounts for the high costs of civil commitment? How does the
average cost of civil commitment in Minnesota compare with similar
facilities in other states and with other public facilities in Minnesota?
	 Is Minnesota committing the most dangerous sex offenders? Are
commitment decisions being made in a consistent manner
throughout the state?
	 Is MSOP providing appropriate treatment to civilly committed sex
offenders? Why have there been no discharges from MSOP
facilities?
	 Could some of the civilly committed sex offenders be treated in the
community at a lower cost, while still providing significant
safeguards for the public?
To address these questions, we conducted interviews with MSOP employees,
Department of Corrections employees, prosecutors, defense attorneys,
psychologists, MSOP residents, and advocates for residents. We also attended
several civil commitment trials and hearings. Furthermore, we reviewed a large
body of literature on the risk assessment and treatment of sex offenders.
In conducting this evaluation, we used financial data from both MSOP and the
Department of Corrections (DOC). In addition, we used information on referrals
from DOC and on commitments from MSOP. We reviewed a substantial number
of treatment and other files on MSOP residents. We also collected information
on sex offenders from DOC files on sex offenders who DOC reviewed for
possible civil commitment from 2006 through 2008.

1

Background

M

innesota law calls for the civil commitment of people with “sexual
psychopathic personalities” as well as those who are “sexually dangerous
persons.” These types of commitments result in confinement to a secure facility
operated by the Department of Human Services (DHS). The commitment is for
an indeterminate time and usually follows the completion of a period of
incarceration at a Minnesota correctional facility.
In this chapter, we review the growth in the number of civilly committed sex
offenders in Minnesota over the last two decades, as well as the projected growth
in the next decade. Furthermore, we present information on the costs of civil
commitment and compare those costs to other types of state-operated residential
facilities. Finally, we examine how Minnesota compares with other states in the
number of civilly committed sex offenders and the average cost of confinement.

CIVIL COMMITMENT POPULATION
In this section, we discuss the growth that has occurred over the last two decades
in the number of sex offenders civilly committed in Minnesota, as well as the
projected growth over the next decade. We also present information on the age,
race, and education level of the civilly committed population. Finally, we
examine the number and type of felony convictions on the criminal records of
civilly committed sex offenders.

Past Growth
The total number
of civilly
committed sex
offenders has
nearly
quadrupled in the
last ten years.

As of July 1, 2010, there were 575 civilly committed sex offenders at DHS
facilities at Moose Lake and St. Peter. This figure does not include another 55 or
so civilly committed sex offenders who were serving time at a Minnesota
correctional facility. Most of these latter offenders were temporarily transferred
from DHS facilities to correctional facilities to serve new criminal sentences or to
serve out the remainder of a previous sentence due to violations of their
supervised release conditions. These offenders will be returned to DHS
following completion of their remaining prison sentence.
The 2010 figure of 575 civilly committed sex offenders is the result of significant
growth in the number of commitments that occurred in both of the last two
decades. Even though the Legislature first enacted the psychopathic personality
commitment law in 1939, the overall number of people committed was fairly low
until the 1990s. As Figure 1.1 illustrates:
	 The total number of civilly committed sex offenders has grown from
less than 30 in 1990 to 149 in 2000 and 575 in 2010.

4

CIVIL COMMITMENT OF SEX OFFENDERS

Figure 1.1: Total Number of Civilly Committed Sex 

Offenders in Minnesota, as of July 1 of 1990-2020 

1109

575

149
30 or
Less
1990
(Estimated)

2000

2010

2020
(Projected)

SOURCES: Minnesota Sex Offender Program, and Office of the Legislative Auditor, Psychopathic
Personality Commitment Law (St. Paul, February 1994), 11.

The growth was about fivefold from 1990 to 2000. From 2000 to 2010, the
civilly committed population grew 286 percent, or nearly fourfold. No civilly
committed sex offenders have been successfully discharged from these DHS
facilities since at least 1994 when the current program was created.1
Although there are a number of reasons for the growth in the number of civilly
committed sex offenders, several key policy changes have facilitated that growth.
In 1991, the Department of Corrections (DOC) began screening sex offenders in
its custody for possible referral to county attorneys for civil commitment. Prior
to that date, it was entirely up to county attorneys to identify candidates for
possible commitment proceedings. This change brought more cases to the
attention of county attorneys and resulted in a greater number of commitments
than in the past. In part, the decision to refer sex offenders to county attorneys
was a response to growing public concern about crimes committed by sex
offenders. After several rapes and murders in 1987 and 1988, the Attorney
General convened a task force to review current policies and practices and to
prevent sexual violence against women. Among other recommendations, the task
force recommended greater use of the civil commitment statute for sex offenders
1

One sex offender was provisionally discharged but was returned to a DHS facility due to technical
violations of the conditions of his release. He subsequently died while at a DHS facility.

BACKGROUND

The largest
growth in
commitments
came after a
heinous crime in
late 2003 and a
subsequent
change in referral
practices by the
Department of
Corrections.

5

released from prison and indeterminate prison sentences for dangerous sex
offenders convicted of new offenses.
Several legislative changes may also have contributed to the growth in the civilly
committed sex offender population. For example, the 1994 Legislature expanded
the standard for commitment by explicitly authorizing the commitment of sex
offenders whose offenses involved emotional harm to victims and not just
physical harm. The 1994 Legislature also allowed for the commitment of sex
offenders who were likely to engage in acts of harmful sexual conduct even if
they did not exhibit an utter lack of power to control their sexual impulses.
In late 2003, DOC significantly increased the number of sex offenders referred to
county attorneys for possible civil commitment. Over the 12 years prior to
December 2003, DOC had referred 333 sex offenders to county attorneys, or
about 26 per year. In response to the rape and murder of a college student in
northwestern Minnesota by an offender recently released from a Minnesota
correctional facility, DOC undertook an extensive review of sex offenders in
prison and the community. In December 2003, DOC referred another 236
offenders to county attorneys. From 2004 through 2008, DOC referred 786
offenders, or about 157 per year.
Most civilly committed sex offenders were admitted to DHS facilities in recent
years. As of June 2010, about two-thirds of civilly committed sex offenders were
first admitted to a DHS facility between 2004 and 2010.2 About one-third were
admitted from 1991 to 2003. Only 1 percent of the current population was first
admitted during the earlier period when DOC was not making referrals to county
attorneys.

Projected Growth
Strong growth in
the civilly
committed
population is
expected over the
next decade.

DHS projects that the population of civilly committed sex offenders will continue
to grow at a fast pace, although at a slower rate than in the last 20 years. The
department expects about 53 new commits each year through the year 2022.
Overall:
	 The number of civilly committed sex offenders is expected to nearly
double in the next ten years.
In making these projections, DHS assumes no change in current laws and
practices. For example, DHS is assuming that there are no discharges from their
facilities. The department is also assuming that the percentage of sex offenders
committed upon release from prison does not change.
As noted above, future growth—while considerable—is expected to be at a lower
rate than in the past. The number of civilly committed sex offenders doubled in
five years from 2000 to 2005, and will probably double in the six years between
2005 and 2011. Another doubling is expected in the twelve years between 2011

2

This calculation includes all civilly committed sex offenders, including those currently at DOC
facilities.

6

CIVIL COMMITMENT OF SEX OFFENDERS

and 2023. Expected growth from 2010 to 2020 is 93 percent under current law
and practices.

Demographic Characteristics
DHS maintains information on certain demographic characteristics of its civilly
committed population, including sex, race, age, and number of years of formal
education. As of the end of 2009, all civilly committed sex offenders were male
except for one. About three-fourths of the population were white/Caucasian,
while 13 percent were black/African American, 7 percent were Native American,
and 3 percent were Hispanic.
As of June 2010, the civilly committed population ranged in age from 19 to 84.
The average and median age of the population were both 44. About 14 percent
of the population were less than 30 years old, while 24 percent were in their
thirties and 28 percent were in their forties. About 20 percent were in their
fifties, with 10 percent in their sixties, and 4 percent in their seventies or eighties.
About 53 percent of the offenders at DHS facilities have had 12 years of formal
education, while 20 percent have had more than 12 years. Only 7 percent have
had eight or fewer years of formal education. However, there are offenders
whose reading and mathematics competencies have tested lower than would be
expected given their years of formal education. In addition, about one-sixth of
the civilly committed sex offenders are in an alternative program for lowfunctioning adults and generally have IQs below 80. Additional offenders with
lower than average IQs or other cognitive issues are in the general population at
DHS facilities.

Felony Convictions
DHS does not have an electronic database on its civilly committed population
that provides information on their sex convictions, psychological diagnoses, test
scores to predict the likelihood of recidivism, or other factors that were
considered in their civil commitment proceedings. However, information is
available from the Minnesota Sentencing Guidelines Commission (MSGC) on
the felony convictions of civilly committed sex offenders who were sentenced
between 1991 and 2008. In an analysis published in February 2010, MSGC staff
were able to obtain records for 486 of the 556 sex offenders in the Minnesota Sex
Offender Program (MSOP) as of January 2010. MSGC staff found that the
average number of felony convictions for offenders whose records were obtained
was 3.5, while the median number was 3. As Figure 1.2 indicates, about 13
percent of the civilly committed sex offenders had only one felony conviction,
and about 20 percent had two felony convictions. About 36 percent had four or
more felony convictions. The 70 individuals that MSGC staff could not match to
their records include those with no felony convictions, and possibly some

BACKGRO
OUND

7

Figure
e 1.2: Num
mber of Felony Co
onviction
ns for Civ
villy
Comm
mitted Sex
x Offende
ers in Min
nnesota
No convictions
or unknown
12%

Four or more
convic
ctions
36
6%

One
conv
viction
13
3%

Most civillly
committed
d sex
offenders have
multiple feelony
ns.
conviction

Three
conv
victions
19%

Two
conviction
ns
20%

NOTES: Th
his figure include
es felony convictions for sexual an
nd other offensess for the 556 civiilly
committed sex offenders wh
ho were at DHS facilities in Janua
ary 2010. Howevver, Minnesota
Sentencing Guidelines Commission could on
nly find felony reccords for 486 of these individualss. The
ons or unknown”” category include
es individuals without a felony co
onviction and ma
ay also
“no convictio
include som
me offenders who
ose only felony co
onvictions occurrred before 1991 or in other statess.
SOURCE: Minnesota Sente
encing Guidelines Commission, Information
I
on Pa
atients Committe
ed to
MSOP (St. Paul, February 2010).

offenders whose only felony convicctions occurreed prior to 19991 or in otherr
states.3
Table 1.1 shows the peercentage of offenders thatt had certain types of felonny
convictionns. About 422 percent of thhe offenders had at least onne convictionn for
first-degreee criminal seexual conductt, while 46 peercent had at least one convviction
minal sexual conduct. The analysis from
m MSGC staff
f also
for secondd-degree crim
includes felony convicctions for nonsexual offensses. About 299 percent of

3

MSGC staaff had records on offenders senttenced between 1991 and 2008. They were ablee to
match 424 offenders in MSOP with MSGC records, and goot information onn the records of 62
additional offenders from DOC microfilm. However, they could not find feelony convictionn records
for 70 of thee individuals in MSOP. This grooup includes: (11) individuals whho did not have a felony
conviction; (2) individuals whose only felonny convictions were in other stattes; and (3) indivviduals
whose only felony convictioons occurred priior to 1991, but whose records coould not be locatted using
DOC microofilm.

8

CIVIL COMMITMENT OF SEX OFFENDERS

Table 1.1: Type of Felony Convictions of Civilly
Committed Sex Offenders
Offense Type

Percentage of Offenders with at
Least One of These Convictions

First-Degree Criminal Sexual Conduct
Second-Degree Criminal Sexual Conduct
Third-Degree Criminal Sexual Conduct
Fourth-Degree Criminal Sexual Conduct
Criminal Sexual Conduct Unknown Degree
Failure to Register as a Sex Offendera
Child Pornographyb
Other Sex Offensec
Offense Against a Person (Other than a Sex Offense)
Property Offense
Drug Offense
Other Offense
Juvenile Sex Offensed
Misdemeanor Sex Offensed

42%
46
29
19
7
5
2
4
28
29
6
6
8
11

NOTES: The percentages in this table are based on the 486 civilly committed sex offenders whose
records could be matched by the Minnesota Sentencing Guidelines Commission. Another 70 civilly
committed offenders who were at DHS facilities in January 2010 could not be matched to MSGC
records. This latter group of offenders includes those without a felony conviction and those whose
only felony convictions were prior to 1991.
a

This offense has only been a felony for a first offense since 2000.

b

This offense has been in effect in its current form since 2001.

c

“Other Sex Offense” includes: felony fifth-degree criminal sexual conduct or indecent exposure,
solicitation of children to engage in sexual conduct, or use of minors in sexual performance.

d

Information on juvenile and misdemeanor sex offenses may not be complete.

SOURCE: Minnesota Sentencing Guidelines Commission, Information on Patients Committed to
MSOP (St. Paul, February 2010).

offenders had a conviction for a property offense, and 6 percent had a drug
conviction.

Many civilly
committed sex
offenders have
more offenses and
victims than
convictions.

However, many sex offenders have a greater number of sexual offenses and
victims than is represented by their number of felony convictions. In 2010,
MSOP collected information on a random sample of 50 MSOP residents. For
these 50 residents, the median number of sexual crime convictions was two, but
the median number of victims per resident was 11.5. The lowest number of
victims for any of the 50 residents was three. The number of sexual offenses
tends to exceed the number of convictions because many sex crimes are
unreported and some reported crimes do not result in convictions. However,
because the sample of residents was small, it is unclear how many MSOP
residents have a low number of victims, as well as a low number of convictions.

BACKGROUND

About 3 percent
of registered sex
offenders are
civilly committed.

9

It should be noted that the sex offenders at MSOP represent a relatively small
percentage of all registered sex offenders.4 MSOP has estimated that 3 percent of
registered sex offenders are at MSOP facilities and 16 percent are at correctional
facilities. But 81 percent of registered sex offenders are living in the community
on probation or a form of supervised release.
If the civil commitment process works appropriately, civilly committed sex
offenders in MSOP are those who are assessed to be more likely than most other
sex offenders to commit sexual offenses if they were living in the community.
Civilly committed sex offenders must be “highly likely” to commit harmful
sexual offenses in the future. In contrast, a 2007 study by the Minnesota
Department of Corrections found that, among all sex offenders released from
Minnesota correctional facilities between 1990 and 2002, only 10 percent were
reconvicted of a sexual offense and 7 percent were reincarcerated within an
average period of 8.4 years.5 The study also found that the sexual recidivism rate
for sex offenders released from Minnesota correctional facilities has declined
significantly. Reconviction rates three years after release from prison declined
from 19 percent for those released in 1990 to 3 percent for those released in
2002. The report attributes the decline in sexual recidivism rates to longer and
more intensive post-release supervision of sex offenders.

DHS FACILITIES
DHS has facilities for housing and treating civilly committed sex offenders in
both St. Peter and Moose Lake. The program started at St. Peter on the grounds
of the state hospital. Remodeled facilities at St. Peter now provide a licensed
capacity of about 197 beds and primarily house sex offenders in the most
advanced stages of treatment and sex offenders who are also low functioning in
their cognitive abilities.
A new facility was constructed in 1995 at Moose Lake and subsequently
expanded several times. The facility has a current licensed capacity of 550 beds
and houses newly admitted sex offenders, individuals in the first two stages of
treatment, and those who refuse treatment. The facility is currently being
expanded and remodeled to provide programming and other space that was not
included when the last addition of 400 beds was completed.6 No additional beds
are being built as part of the current expansion.

4

In Minnesota, certain sex offenders must provide their name, address, and other information to
authorities. The registration database is maintained by the Minnesota Bureau of Criminal
Apprehension. See Minnesota Statutes 2010, 243.166.

5

Minnesota Department of Corrections, Sex Offender Recidivism in Minnesota (St. Paul, April
2007).

6

The 2010 Legislature appropriated $47.5 million for the current project in Moose Lake.

10

CIVIL COMMITMENT OF SEX OFFENDERS

Overall, the DHS facilities for civilly committed sex offenders have a licensed
capacity of about 747 beds.7 However, as discussed earlier, DHS expects there to
be strong continued growth in new commitments. As Figure 1.3 shows:
	 The number of civilly committed sex offenders under DHS control is
expected to exceed the existing capacity at St. Peter and Moose Lake
beginning sometime in 2013.

Figure 1.3: Projected Growth in Civilly Committed 

Sex Offenders and Existing Bed Capacity, 2010-22 

1,216

1,250

State facilities for
civilly committed
sex offenders are
expected to be at
capacity in about
two years.

Projected Growth

1,055

1,000
894

735

750

Licensed Capacity = 747

575
500

250

0
2010
(Actual)

2013

2016

2019

2022

Year

NOTE: The number of civilly committed sex offenders is projected for July 1 of each year.
SOURCE: Minnesota Sex Offender Program.

7
In addition to its 550 licensed beds, the Moose Lake facility has an additional 26 high security
beds that are used if residents exhibit disruptive behavior. The St. Peter facility does not have any
additional beds specifically for this purpose. As a result, DHS officials consider the effective
operating capacity at St. Peter to be about 188 beds for planning purposes, or nine beds less than
the 197-bed licensed capacity. The nine beds provide a cushion in case there are behavioral issues
or problems with incompatibility between roommates.

BACKGROUND

11

DHS has developed options to meet the immediate and long-term bed space
needs. These options were presented in a January 2011 report that was mandated
by the 2010 Legislature.8
The facilities at St. Peter and Moose Lake are managed by the Minnesota Sex
Offender Program (MSOP), which is part of the Department of Human Services.
Prior to 2008, MSOP was part of the State Operated Services (SOS) Division
within DHS.9 Some of its staff and management had shared responsibilities
within both MSOP and the SOS Division. However, beginning in 2008, DHS
hired a new management team for MSOP and separated their functions and staff
from SOS. MSOP also began reporting directly to the commissioner of human
services rather than to the management of SOS.
In addition to its responsibility to operate the facilities at St. Peter and Moose
Lake, MSOP operates a sex offender treatment program at the Moose Lake
Correctional Facility. MSOP currently has about 10 staff assigned to that
program. From 2001 through 2009, about 236 men have been admitted to the
program. The primary purpose of the program is to provide treatment to sex
offenders who are likely candidates for civil commitment upon their release from
prison. The goals of treatment are to reduce the number of offenders who are
civilly committed and to reduce the length of stay at MSOP facilities for those
who are subsequently committed.

COSTS OF CIVIL COMMITMENT
The public costs of civil commitment include MSOP’s costs of operating
facilities, the Department of Corrections’ costs of screening offenders,
prosecuting attorneys’ costs of petitioning courts for civil commitment, and the
district courts’ costs of reviewing and deciding civil commitment cases. Our
focus in this report is on the costs of operating MSOP facilities. The lack of
centralized information on prosecution and court costs necessitates that focus.

MSOP Costs
The costs of operating MSOP are significant on a per resident basis.

The Minnesota
Sex Offender
Program (MSOP)
costs about
$120,000 per
resident annually.

	 For fiscal years 2010 and 2011, the Minnesota Sex Offender
Program had an estimated per diem cost of $328, or about $120,000
per resident annually.
As required by law, these estimates are based on legislative appropriations and
projected average daily counts of residents. The spending figures include

8

Department of Human Services, Options for Managing the Growth and Cost of the Minnesota Sex
Offender Program: Facility Study (St. Paul, January 2011). The report was required under
Minnesota Laws 2010, chapter 189, sec. 18, subd. 6. The DHS report also includes a review of
current civil commitment policies, sex offender treatment programs, and sex abuse prevention
efforts.

9

State Operated Services consists of an array of programs and facilities serving people with mental
illness, developmental disabilities, chemical dependency, and traumatic brain injury.

12

CIVIL COMMITMENT OF SEX OFFENDERS

operating expenditures, which were estimated to be $64.8 million in fiscal year
2010, and various indirect costs such as bond interest and building and capital
asset depreciation, which were estimated to be $5.2 million.10
Actual operating expenditures for fiscal year 2010 were $58.8 million. In
addition, facility population numbers were lower than projected earlier. As a
result, the actual per diem cost for fiscal year 2010, including indirect costs, was
about $320, or about $117,000 per resident annually. Based on the most recent
projections of the number of residents, the per diem cost will be $333 (or
$122,000 per resident) in fiscal year 2011, if MSOP spends its entire current
operating budget of $67.5 million for fiscal year 2011.11

MSOP Operating Expenditures
In the last six
years, MSOP’s
operating
expenditures have
nearly tripled.

MSOP operating expenditures have grown significantly over the last six years, in
large part due to the increase in the number of residents in MSOP. Between
fiscal years 2004 and 2010, spending grew from $20.4 million to $58.8 million,
while the average population at MSOP facilities increased from 217 to 548.
Future spending growth is expected due to the projected growth in the civilly
committed population. However, MSOP believes that additional residents can be
accommodated at a lower marginal cost than the current average per diem cost of
$328, particularly if they are housed in new or remodeled facilities at the existing
locations in Moose Lake and St. Peter. If so, the addition of residents will bring
down the overall average per diem cost.
MSOP’s operating expenditures are now lower than the peak of $75.0 million in
fiscal year 2008. When a new management team was hired beginning in 2008,
they were faced with a budget deficit. In response, management significantly
reduced staff positions, particularly in the security area. Another significant part
of the budget reductions since fiscal year 2008 was facilitated by the opening of a
400-bed building at Moose Lake in July 2009. MSOP had been spending about
$8 million annually to rent bed space and other services at the Moose Lake
Correctional Facility from the Department of Corrections. The opening of the
new MSOP building eliminated the need to rent DOC space.
The biggest portion of MSOP spending is for security. Table 1.2 shows that
about 45 percent of operating expenditures in fiscal year 2010 were for security.
About 19 percent of expenditures were for administration and support services.
This category not only includes salaries and benefits for MSOP administrative
and support service staff, but also includes the costs of services provided by the
Department of Human Services to MSOP, as well as equipment costs that are not
allocated to other areas.

10

For fiscal year 2011, MSOP used an operating budget of $67.5 million and indirect costs of $5.7
million to estimate its per diem costs.

11
Because of a carryover of funds from fiscal year 2010, MSOP had a spending authority of about
$73.5 million for fiscal year 2011. However, MSOP has allocated $2.4 million for capital projects
that will help increase the capacity of its St. Peter facility. In addition, as a result of an executive
order, MSOP is expected to reduce its fiscal year 2011 spending authority by about $3 million.

BACKGROUND

13

Table 1.2: Minnesota Sex Offender Program
Operating Expenditures and Staffing, by Type, FY
2010
In fiscal year
2010, about 45 	
percent of
MSOP’s
operating
expenditures were
for security, while
only 12 percent
were for sex
offender
treatment.

Function

Percentage of
Operating Expenditures

Percentage of Staffing

45%
19
11
8
8
3
3
2
1
1
100%

61%
11
11
6
3
1
2
2
1
1
100%

Security
Administrative and Support Servicesa
MSOP Clinical Treatment
Health Care
Physical Plant
Dietary	
Vocational
Recreational
Educational
DOC Clinical Treatment	
Total	
a

Expenditures include transfers to the Department of Human Services for services provided to the
Minnesota Sex Offender Program.
SOURCE: Minnesota Sex Offender Program.

The clinical treatment program at MSOP accounted for only about 11 percent of
operating expenditures in fiscal year 2010.12 In addition, the clinical treatment
provided by MSOP at the Moose Lake Correctional Facility accounted for a little
more than 1 percent of MSOP’s fiscal year 2010 spending.

MSOP Staffing
The biggest component of MSOP’s operating budget is salaries and benefits for
MSOP staff. In fiscal year 2010, about 83 percent of operating expenditures
were for the salaries and benefits paid to MSOP staff. Salaries and benefits
accounted for a somewhat lower share of spending (72 percent) in the previous
two fiscal years, largely due to the rent paid to DOC during those years.
In fiscal year 2010, MSOP had 714 full-time equivalent staff while it averaged
about 548 residents.13 In other words:
	 During fiscal year 2010, the Minnesota Sex Offender Program had
about 1.3 staff per resident.

12

For fiscal year 2011, the clinical treatment program at MSOP is expected to account for 11 to 12
percent of operating expenditures. The percentage was slightly lower in fiscal year 2010 due to a
significant number of vacant clinical positions, particularly at MSOP’s Moose Lake facility. We
discuss clinical staffing and vacancies in more detail in Chapter 3.
13
The calculation of full-time equivalent staff is based on the number of hours of work and paid
leave that actually occurred during fiscal year 2010. The total number of such hours is then divided
by 2088 hours to calculate the number of full-time equivalent staff. We did not include overtime
hours or shift differential pay when calculating the number of full-time equivalent staff.

14

CIVIL COMMITMENT OF SEX OFFENDERS

The number of MSOP staff has declined over the last three years, primarily due
to reductions in the number of security staff. The number of staff positions
declined from 1,029 in January 2008 to 731 in January 2010 due to the budget
cuts made in order to bring the budget in line with legislative appropriations.14
For fiscal year 2011, MSOP’s budget includes funding for 722 positions.
As Table 1.2 indicates:


A majority of MSOP staff provides security at MSOP’s facilities.

In fiscal year 2010, 61 percent of the full-time equivalent staff at MSOP was
security staff, while 11 percent were clinical treatment staff serving MSOP
clients. Another 11 percent of staff performed administrative or support services
functions. Six percent of MSOP staff provided health care services.

Cost Sharing
Not all of MSOP’s costs are ultimately paid by the state. Specifically:

The state pays 90
percent of
MSOP’s costs,
and counties pay
the remaining 10
percent.

	 For civilly committed sex offenders, the state pays 90 percent of
MSOP’s estimated per diem cost and recovers 10 percent from
counties.
This share of costs is recovered from the county with financial responsibility, as
defined in Minnesota Statutes 2010, 246B.01, subd. 1b, and deposited in the
state’s General Fund. About 95 percent of the time, the county with financial
responsibility is the county which filed the commitment petition for an offender.
In some cases, offenders finish serving their prison sentences before their
commitment cases have been completed. The courts may order these offenders
to be held at a secure facility pending the outcome of the commitment case. The
offenders may be held at an MSOP facility, a Department of Corrections facility,
or a county jail during that time. If an offender is held at an MSOP facility, the
responsible county pays the entire cost of confinement. If an offender is held at a
DOC facility or a county jail on a judicial hold, the county and the state each pay
50 percent of the costs.
For any committed offender residing at an MSOP facility during either fiscal year
2010 and 2011, a county’s responsibility is $32.80 per day. For any offender
held at an MSOP facility prior to commitment, the county is responsible for the
full $328 per diem cost.

Comparisons with Other Institutions
We compared the costs of operating MSOP facilities with the costs of certain
other state-run residential facilities. In particular, we examined the costs of

14

The number of staff positions is roughly equivalent to the number of full-time equivalent staff at
a particular point in time.

BACKGROUND

15

operating Minnesota’s state correctional facilities and the per diem rates charged
at various Department of Human Services facilities. We found that:
	 The cost per resident at Minnesota Sex Offender Program facilities
is considerably more than the cost at Minnesota correctional
facilities but significantly less than the cost at other Department of
Human Services facilities.

MSOP’s per diem
cost is about triple
the cost at
Minnesota’s
correctional
facilities, with
much of the
difference due to
higher staffing
ratios at MSOP
facilities.

In comparing MSOP’s per diem cost with Minnesota correctional facilities, we
excluded any capital-related expenditures.15 For fiscal year 2010, the average
cost at a Minnesota correctional facility was about $97 per day, or about $35,000
per year. This figure includes health care and treatment costs, as well as
institutional support services and 65 percent of operational support costs.16 Since
this correctional facility per diem cost does not include depreciation or bond
interest, those costs should be excluded from MSOP costs in order to make a fair
comparison. The comparable actual MSOP per diem cost was about $296 in
fiscal year 2010. In other words:
	 The cost per resident at Minnesota Sex Offender Program facilities
is about three times the average cost of incarceration at Minnesota
correctional facilities.
The main reason for this difference is that MSOP facilities have a staffing ratio
that is a little more than three times that at Minnesota’s correctional facilities. In
fiscal year 2010, MSOP facilities had 1.3 staff per resident, while DOC facilities
had a ratio of 0.4 staff per inmate in fiscal year 2009.17 Average salaries at
MSOP facilities were about 8 percent lower than at DOC facilities, but that
difference only offset a small portion of the cost difference caused by MSOP’s
higher staffing ratio.18
Much of the difference in staffing ratios can be attributed to differences in
security staff, since security accounts for a large portion of the staff complement
of both agencies. DOC facilities can have lower security staffing ratios than
15

We excluded capital costs because MSOP and DOC are required to calculate capital costs in
different ways when computing per diem rates. MSOP includes bond interest and depreciation in
its per diem rates, while DOC includes the actual repair, equipment, and capital costs that are
incurred in a particular year in its “statutory” per diem.
16

Operational support includes the central office functions of the Department of Corrections that
support both its correctional facilities and its probation function. The 65 percent allocation of
operational support costs to correctional facilities has been used in the past as a rough indication of
the share of these costs that can be attributed to support for correctional facilities. The per diem
figure we used for correctional facilities exceeds the facility operating cost per diem that DOC
publishes due to the inclusion of these support costs, as well as health care and behavioral health
costs. Our figure is equivalent to DOC’s “statutory per diem” minus capital costs.

17

The DOC figure includes staff at the correctional facilities, as well as institutional support
services staff and 65 percent of operations support services staff.

18

In fiscal year 2010, MSOP security salaries and other pay were about 10 percent lower than DOC
security salaries and other pay. Average salaries for other staff were about 3 percent lower at
MSOP than DOC. Some of the differences, particularly in the security area, can probably be
attributed to the fact that MSOP staff have less tenure in their jobs than their DOC counterparts. As
a result, DOC staff are probably at higher steps in their pay ranges.

16

CIVIL COMMITMENT OF SEX OFFENDERS

MSOP facilities because DOC facilities are generally much larger than MSOP
facilities. Five of DOC’s facilities have an average population ranging from
close to 1,000 to over 1,500. Lower security ratios are possible in correctional
facilities with large cell blocks.19 In addition, lower security ratios are possible
there because resident movement can be more restricted than it can be in a
facility for civilly committed individuals.
MSOP also has higher staffing ratios for treatment staff than does DOC.
However, the differences in treatment staff do not play a large role in explaining
the overall difference in staffing ratios, since treatment staff account for a
relatively small share of MSOP’s overall staff complement.
In contrast, MSOP’s per diem rate of $328 is much lower than those at other
DHS residential facilities. As of August 1, 2010, DHS set per diem rates for
mental health services that varied from $982 at the Anoka-Metro Regional
Treatment Center to $1,484 for child and adolescent behavioral health services.
Per diem rates for forensic services ranged from $425 for transition services to
$618 at the Minnesota Security Hospital. We did not examine the underlying
cost components for these services, but we suspect that these services involve
greater staffing ratios than at MSOP facilities. They may also involve greater
numbers of higher paid medical or psychiatric staff than employed at MSOP
facilities.

OTHER STATES
Nearly all the
states with civil
commitment
programs use
secure treatment
facilities for all
their residents,
except Texas and
New York.

Minnesota is one of 20 states with civil commitment programs for sex
offenders.20 Civil commitment programs are scattered throughout the nation, but
they are more common among the states with higher populations. Fourteen of
the 22 states with populations exceeding five million have civil commitment
programs for sex offenders. About 63 percent of the nation’s population lives in
states with civil commitment programs.
Nearly all of the programs confine the civilly committed population in secure
facilities. However, the program in Texas is exclusively an outpatient program.
The civilly committed population primarily lives under GPS surveillance in
halfway houses in four locations throughout Texas. Activities of the offenders
outside of the halfway house are greatly restricted. Violations of the conditions
of commitment—including failure to participate in treatment—are a felony in
Texas and may result in a lengthy prison sentence. However, according to those

19

We estimated the staffing ratio for the high security correctional facility in Oak Park Heights to
be about 0.67 staff per inmate in fiscal year 2009, including a prorated share of institutional support
staff and operations support staff. This facility had an average inmate population of 436 in fiscal
year 2009 and is much smaller than most other DOC facilities. This suggests that, even within
DOC, staffing ratios are affected by the size and function of the facilities.
20
In addition to Minnesota, the states with civil commitment programs include California, Florida,
New Jersey, Illinois, Wisconsin, Massachusetts, Washington, Virginia, New York, Kansas, Texas,
Missouri, Nebraska, South Carolina, Arizona, Iowa, North Dakota, Pennsylvania, and New
Hampshire. The program in Pennsylvania is only for juvenile offenders, while programs in other
states are primarily for adult offenders. The federal government also has a civil commitment
program for adult sex offenders.

BACKGROUND

17

managing the Texas program, no civilly committed sex offender has been
charged or convicted of a new sex offense.
The program in New York is unique in that it has two tracks. Some offenders are
committed to a secure facility, while others are managed in the community using
intensive supervision. In both settings, civilly committed offenders receive
treatment. Those committed to intensive supervision can be revoked for
violations and re-petitioned for commitment to a secure facility. One drawback
of the New York program is that it does not provide housing for the offenders,
and many of them have unstable housing situations. In New York, two persons
on intensive supervision have been convicted of sexual touching.

MSOP’s per diem
cost is close to the
average for other
states with high
security facilities
for civilly
committed sex
offenders.

Costs per Resident
In most states, civil commitment programs are fairly expensive and generally
cost more than incarcerating inmates at a prison. Based on available information,
it appears that:
	 Minnesota’s per diem cost for civilly committing sex offenders is
higher than the cost in some states but lower than that in other
states.
Minnesota’s per diem rate of $328 was the fifth highest of 12 states that
responded to a survey conducted by MSOP staff.21 The comparison was based
on the reported budget and number of clients as of June 30, 2009. Per diem costs
ranged from $98 to $493. The median cost was $284 per day, while the average
was $295 per day. Although Minnesota’s published per diem was about 11
percent above the average, its actual per diem ($296) without depreciation and
bond interest costs was close to the average. Because most of the states
responding to the survey did not include these expenses in their per diem costs, it
is appropriate to conclude that MSOP’s costs per resident are about average for
this group of states.

Costs in Texas are
significantly lower
because it does
not use high
security facilities.

Texas was not included in the survey conducted by MSOP staff because, unlike
programs in other states, it provides outpatient treatment and does not house its
participants in a high security setting. However, according to Texas officials, the
Texas program has an annual cost of about $27,000 per offender, or about $74
per day.

Number of Commitments
Roughly 5,300 sex offenders were in civil commitment programs throughout the
United States in 2010. Minnesota ranked third among the states—after

21

States calculate per diem costs in different ways. Minnesota’s per diem rate is a “fully loaded”
rate that includes building depreciation, bond interest costs, and indirect costs, as well as operating
expenditures. Other states typically include operating expenditures but do not always include some
or all of these other types of expenses. However, even if we include only operating expenditures in
Minnesota’s per diem rate, Minnesota’s rank remains at the fifth highest of 12 states.

18

CIVIL COMMITMENT OF SEX OFFENDERS

California and Florida—in the total number of civilly committed sex offenders.
Furthermore:
	 Minnesota had the highest number of civilly committed sex offenders
per capita in the nation in 2010.
As Figure 1.4 indicates, Minnesota had 110 civilly committed sex offenders for
each one million residents. Among other states with civil commitment programs,
the average is 27 offenders per million residents. Among all 49 states except
Minnesota, the average is 17 per million residents.

Figure 1.4: Number of Civilly Committed Sex
Offenders per Million Residents, 2010
Minnesota has
about four times
the number of
civilly committed
sex offenders per
capita as the
average for the
other 19 states
with civil
commitment
programs.

110

27
17

Minnesota

Other States with Civil
Commitment

All States Except Minnesota

SOURCES: Office of the Legislative Auditor, analysis of graphs from Rebecca Jackson, Jennifer
Schneider, and Tara Trattia, “SOCCPN Annual Survey of Sex Offender Civil Commitment Programs,”
presentation to the Sex Offender Civil Commitment Programs Network annual meeting, October 18,
2010. Information on Nebraska was for 2009 and was obtained from the Minnesota Sex Offender
Program.

Another perspective is that Minnesota has 1.7 percent of the nation’s population
and 2.7 percent of the population in states with civil commitment programs for
sex offenders. However, in 2010, Minnesota had almost 11 percent of the
nation’s civilly committed sex offenders.

Number of Conditional Releases
It is also noteworthy that:

BACKGROUND

While some other
states have
released offenders
from civil
commitment, no
sex offender has
ever been
discharged from
MSOP.

19

	 Minnesota has released no sex offenders from civil commitment and
conditionally released only one offender, while some other states
have made modest numbers of releases.
Only one civilly committed sex offender has been conditionally released in
Minnesota since at least 1994. That individual was returned to MSOP due to
technical violations of his release conditions. He subsequently died while at an
MSOP facility.
A report that examined states’ commitments and conditional releases as of
February 2004 found that the percentage of committed sex offenders that had
been conditionally released was between 8 and 17 percent depending on which
states were included in the analysis.22 Some states in that analysis were like
Minnesota in that very few civilly committed sex offenders had been
conditionally released. But other states had conditionally released modest
numbers of offenders. Wisconsin’s civil commitment population has stabilized
in the last several years as the number of releases has offset new commitments.

Commitment Laws
It is not entirely clear why Minnesota has so many more civilly committed sex
offenders than other states. Some may suggest that other states simply
incarcerate sex offenders longer. However, it is not possible to corroborate that
hypothesis. Minnesota does have the second lowest prison incarceration rate
among the states, but it is unclear whether this ranking applies to sex offenders.
It could be that other states incarcerate sex offenders for similar prison terms as
Minnesota but have higher incarceration rates than Minnesota for other types of
offenders. Data are not available to make such a comparison. Furthermore, a
comparison of state laws for sex offenses would provide insufficient information
because it would not account for any interstate differences in prosecution,
conviction, and sentencing practices.
Other possible explanations include interstate differences in: (1) referral,
petition, and court practices; (2) legal standards for commitments; (3) legal
requirements for commitment proceedings; and (4) differences in release
practices. Few studies have looked at these factors, and even fewer have
attempted to link the factors to differences in commitment rates.
In this section, we discuss some of the differences in commitment laws that may
explain Minnesota’s higher commitment rate. We do not attempt to examine
differences in referral, petition, or court practices because we do not have
detailed information from other states on the number of referrals, petitions, and
22

Dennis M. Doren, “The Model for Considering Release of Civilly Committed Sexual Offenders,”
The Sexual Predator: Law and Public Policy, Clinical Practice, ed. by Anita Schlank (Kingston,
New Jersey, 2006), 6-7 to 6-8. The analysis excluded Missouri and South Carolina because their
statutes did not allow for conditional release at that time. In addition, Pennsylvania was excluded
because no one had been committed at the time of the analysis. The range of results depends on
whether one includes Texas and Arizona. In Texas, all civilly committed sex offenders are on
conditional release and live in halfway houses in the community. In Arizona, most of the so-called
conditional releases were to a less restrictive, but locked facility on the grounds of the state
hospital.

20

CIVIL COMMITMENT OF SEX OFFENDERS

commitments per year. However, differences in practices may be as important
as, or even more important than, differences in state laws in explaining the
variation in commitment rates.
We found that:
	 Minnesota laws facilitate the civil commitment of sex offenders in a
number of ways, perhaps contributing to Minnesota’s relatively high
use of civil commitment for sex offenders.

It is difficult to
attribute
Minnesota’s high
commitment rates
to any single set of
factors.

As noted earlier, Minnesota laws specifically allow for commitment for offenses
that involve emotional harm, as well as those involving physical harm or
violence. In contrast, the statutes of most states require a violent offense for civil
commitment, although the statutes do not necessarily define what constitutes
violence. Minnesota requires two offenses while most states require only one.
However, unlike most states, Minnesota does not require that the offenses
resulted in convictions.
In several respects, Minnesota law makes it easier to civilly commit sex
offenders. Minnesota does not allow offenders to request a jury trial for a civil
commitment proceeding, while at least 15 of the other 19 states allow jury trials.
Minnesota also allows hearsay evidence and requires the commitment standard to
be met with “clear and convincing evidence” rather than proven “beyond a
reasonable doubt.”23 State laws in six states including Minnesota explicitly allow
hearsay evidence, while laws in five states explicitly prohibit hearsay evidence.
In other states with civil commitment programs for sex offenders, state
commitment laws do not appear to explicitly address the issue. About half of the
states with civil commitment programs have the “clear and convincing” standard
regarding evidence supporting commitment, while the others use the “beyond a
reasonable doubt” standard.
Another way in which Minnesota differs from most states is in its lack of a
required periodic report to the courts regarding each sex offender’s continuing
need to be committed. Most states require an annual report to be sent to the
courts on each committed person as to whether the person continues to meet the
commitment standard. Some states require mandatory court hearings, while
others may only have a hearing if necessary. In some states, the state is required
to reprove the commitment case in court periodically. Minnesota and
Massachusetts appear to be the only two states where an annual report to the
courts is not required.
Finally, in practice, Minnesota appears to have a release standard that is more
restrictive than those in most states. Release standards are a product of both state
laws and state agency policies and practices. Minnesota and other states with
few conditional releases like North Dakota were described in a 2006 analysis as
having a “treatment completion” standard.24 On the other hand, states with more
23

The “beyond a reasonable doubt” standard is a higher standard of proof than “clear and
convincing” evidence, which is the minimum of proof required by the United States Supreme Court
in civil commitment cases.
24

Doren, Model for Considering Release, 6-18.

BACKGROUND

21

conditional releases have a standard that indicates that someone should be
discharged when he no longer meets the statutory criteria for commitment.
Treatment completion states require offenders to fully complete the treatment
program, which does not simply mean completing a course or courses of study.
It generally means that offenders must demonstrate that treatment has had a
significant impact on their behavior and thoughts. In other words, offenders must
reduce their recidivism risk to very low levels. In contrast, other states allow for
conditional releases when an offender’s risk is reduced below the level required
for commitment, even if they do not fully complete treatment.
Overall, it is difficult to attribute Minnesota’s high commitment rates to any
particular factor or set of factors. However, it does appear that some of
Minnesota’s laws and practices may contribute to those high rates. Lower
incarceration rates may also be a factor, but it is hard to make interstate
comparisons of incarceration for sex offenders alone.

2

Civil Commitment
Process
A

s discussed in Chapter 1, Minnesota has committed more sex offenders per
capita than any other state. Furthermore, Minnesota continues to commit
offenders at a relatively high rate, while none have been released. Some
policymakers are concerned about the increasing costs of civil commitment.
While also concerned about public safety, they wonder whether all of those being
committed need to be confined in a high cost, high security setting.
This chapter reviews the civil commitment process for sex offenders and, in
particular, the decisions made to commit sex offenders. First, we discuss the
legal standards for commitment in Minnesota. Second, we provide background
information on the process used to civilly commit sex offenders in Minnesota.
Third, we examine the process used by the Department of Corrections to refer
sex offenders to county attorneys for possible commitment. Fourth, we examine
whether commitment decisions are being made on a consistent basis across the
state. Finally, we discuss options for legislative changes in the commitment
process and make some specific recommendations. We also consider whether
some of those offenders being civilly committed could be treated in a community
setting at a lower cost while still providing significant public safeguards.

STANDARDS FOR CIVIL COMMITMENT
Minnesota law
provides for the
civil commitment
of sexually
dangerous
persons and
individuals with
sexual
psychopathic
personalities.

Minnesota first enacted a law to provide for indefinite civil commitment of
certain dangerous sex offenders in 1939. That law provided for the civil
commitment of sex offenders with a “psychopathic personality.” In response to
court decisions, the 1994 Legislature modified the law to provide for the
commitment of people with a “sexual psychopathic personality.”1 Current law
defines a person with a sexual psychopathic personality as a person who:
	 is irresponsible for personal conduct with respect to sexual matters due to
emotional instability, impulsive behavior, lack of customary standards of
good judgment, or failure to appreciate the consequences of personal
acts;
	 has engaged in a habitual course of misconduct in sexual affairs;
	 exhibits an utter lack of power to control the person’s sexual impulses,
and;

1

Laws of Minnesota First Special Session 1994, chapter 1.

24

CIVIL COMMITMENT OF SEX OFFENDERS

	 as a result, is dangerous to others.2
In addition, the 1994 Legislature created an alternative path to civil commitment.
The Legislature defined a “sexually dangerous person” as a person who:
	 has engaged in a course of harmful sexual conduct;
	 has manifested a sexual, personality, or other mental disorder or 

dysfunction, and; 

	 as a result, is likely to engage in acts of harmful sexual conduct.3

It is not necessary
to establish that
an offender used
or threatened
physical harm
with his victims in
order to civilly
commit him.

The Legislature adopted the sexually dangerous person definition in response to
various court decisions. In particular, the Legislature allowed for the
commitment of persons who did not exhibit an “utter” lack of power to control
their sexual impulses. The new sexually dangerous person category also
removed the requirement that the offender’s history of sexual misconduct be
“habitual.” Finally, the new category allowed for civil commitment even if the
offender’s actions resulted in emotional harm only—rather than physical harm—
to a victim. This was accomplished by: (1) defining “harmful sexual conduct”
as sexual conduct that creates a substantial likelihood of serious physical or
emotional harm to another, and (2) linking the conduct associated with certain
offenses as creating a substantial likelihood that a victim will suffer serious
physical or emotional harm.4 The offenses directly linked with serious physical
or emotional harm include criminal sexual conduct in the first, second, third, or
fourth degree.5 Additional offenses are considered to be associated with physical
or emotional harm if the conduct was motivated by the person’s sexual impulses
or was part of a pattern of behavior that had criminal sexual conduct as a goal.
Those offenses include harassment and stalking, terroristic threats, burglary in
the first degree, arson in the first degree, tampering with a witness, incest, false
imprisonment, kidnapping, simple or aggravated robbery, and certain types of
assault, manslaughter, and murder.6

2

Minnesota Statutes 2010, 253B.02, subd. 18b.

3

Minnesota Statutes 2010, 253B.02, subd. 18c.

4

Minnesota Statutes 2010, 253B.02, subd. 7a. The law creates a presumption that the conduct
associated with certain offenses creates a substantial likelihood that a victim will suffer serious
physical or emotional harm. That presumption can be rebutted in court if a defendant provides
sufficient evidence to the contrary.
5

According to a Minnesota House of Representatives Research Department document, the firstdegree and third-degree offenses typically involve sexual penetration of the victim, while the
second-degree and fourth-degree crimes involve sexual contact without penetration. In addition,
the first-degree and second-degree crimes generally apply to offenses involving personal injury to
the victim; the use or threatened use of force, violence, or a dangerous weapon; or extremely young
victims. The third-degree and fourth-degree crimes involve less aggravated conduct and apply
when the victim did not consent, was relatively young, or was incapable of voluntarily consenting
to sexual conduct due to a particular vulnerability or a special relationship with the offender. See
Jeff Diebel, Overview of Criminal Sexual Conduct Crimes (St. Paul, July 2010).
6

Minnesota Statutes 2010, 253B.02, subd. 7a.

CIVIL COMMITMENT PROCESS

25

A court decision further clarified what is required for a civil commitment of a
sexually dangerous person. Specifically, the prosecution must prove with clear
and convincing evidence that a person:
	 has engaged in a course of harmful sexual conduct;
	 suffers from a current disorder or dysfunction; and
	 the disorder or dysfunction does not allow the person to adequately
control his or her behavior, thus making the person highly likely to
commit harmful sexual acts in the future.7
A “course of harmful sexual conduct” consists of at least two offenses, which do
not need to involve convictions and may involve the same victim. A “disorder”
or “dysfunction” is usually a diagnosis by a psychologist of a sexual disorder like
pedophilia or paraphilia, or a diagnosis of a personality disorder.
A majority of sex offender commitments in Minnesota are made under the
sexually dangerous person statute. Based on information received from the
Department of Human Services, we calculated that about 51 percent of those who
were committed as of June 2010 were committed under the sexually dangerous
person statute, while 11 percent were committed under the sexual psychopathic
personality statute.8 About 38 percent were committed under both statutes.

COMMITMENT PROCESS
The civil
commitment
process is initiated
by a county
attorney,
generally
following a
referral from the
Department of
Corrections
(DOC).

In Minnesota, the civil commitment process for sex offenders is initiated by any
of Minnesota’s 87 elected county attorneys. A county attorney that wants to
commit a sex offender must file a petition with the district court. A petition may
be filed by the county attorney from the county in which the offender is living. If
the offender is incarcerated, the petition may be filed in the county where the
conviction for which the offender is incarcerated was entered.9
Since 1991, the Department of Corrections (DOC) has assisted county attorneys
by evaluating sex offenders who are scheduled to be released from prison. Based
on its review, DOC forwards the names of sex offenders that the agency believes
meet the commitment standard to county attorneys for their consideration.
Although the vast majority of civilly committed sex offenders have been referred
by DOC to county attorneys, some have not been referred. County attorneys may
choose to file a civil commitment petition on an offender who has not been
referred by DOC. Also, a district court may identify an offender as a candidate
for commitment at the time of criminal sentencing. In that case, the court’s
determination is forwarded to the county attorney, who would consider whether
to file a petition for civil commitment.

7

Linehan IV, 594 N.W.2d 867, 876 (Minn. 1999).

8

The group committed under the sexual psychopathic personality statute also includes anyone
committed under the previous psychopathic personality statute.

9

Minnesota Statutes 2010, 253B.185, subd. 1(b).

26

CIVIL COMMITMENT OF SEX OFFENDERS

In seven Minnesota counties (Hennepin, Ramsey, Dakota, Anoka, Washington,
Olmsted, and St. Louis), county attorneys and their staff handle civil commitment
cases in their entirety. In 75 of Minnesota’s 87 counties, the Attorney General’s
Office (AGO) regularly handles civil commitment cases involving sex offenders
on behalf of county attorneys. Another five counties (Stearns, Wright, Winona,
Crow Wing, and Chisago) typically use the services provided by the AGO, but
sometimes process a civil commitment petition without AGO’s assistance.
Whenever AGO handles a civil commitment or assists a county attorney’s office,
the county attorney determines whether or not to pursue a civil commitment.
AGO provides services but leaves the higher-level decisions to the county
attorney.
Counties using the AGO’s services in civil commitment cases typically pay some
of the costs of litigation but not the costs associated with the time spent by
attorneys and other staff from AGO. Counties pay for litigation expenses such as
expert witness fees, travel expenses for witnesses and the AGO’s staff, and costs
related to the gathering of records. However, the state pays the salaries and
benefits of the AGO’s staff who work on civil commitment cases for the
counties.

Civil commitment
trials are subject
to different rules
than criminal
trials.

Those petitioned for commitment have the right to legal counsel at any
commitment-related hearing. The court will appoint an attorney if the sex
offender does not secure counsel on his own. However, as we noted in Chapter
1, there are a number of ways in which the rules and processes used in a
commitment trial in Minnesota are different than those in criminal trials. For
example, the person being considered for commitment does not have the right to
a jury trial in Minnesota. Instead, the commitment case is decided by a district
court judge. In addition, hearsay evidence is allowed in a commitment trial,
while it is not permitted in a criminal trial. The court may also hear testimony
about offenses that did not result in convictions and may consider evidence about
such offenses even if it is hearsay evidence. Furthermore, the prosecution must
demonstrate with “clear and convincing evidence” that the person meets the legal
standard for commitment rather than the “beyond a reasonable doubt” standard
that is used in criminal trials. If the person is found by the court to meet this
standard, the court must commit the person to a secure treatment facility like
those provided by the Minnesota Sex Offender Program (MSOP) unless the
committed person establishes by clear and convincing evidence that a less
restrictive treatment program is available and consistent with the person’s
treatment needs and public safety.
County attorneys often use experts to help them decide whether to file a petition.
In addition, the court will appoint its own forensic psychologist to assist the
court. This “examiner” assesses the recidivism risk posed by the sex offender
and determines whether the offender has any relevant mental disorder that limits
his ability to control his sexual actions. The sex offender has the right to have a
second examiner appointed by the court and paid by the county attorney’s office.
Some judges hear a large number of commitment cases while others may only
hear an occasional case. For example, the district court in Hennepin County
generally assigns one judge to hear sex offender commitment trials for a period
of several years. A judge with that assignment may develop an expertise in that

CIVIL COMMITMENT PROCESS

27

area. In some parts of the state, however, a judge may hear only one sex offender
commitment case in many years.
Minnesota law also requires the treatment facility to which the person is
committed to file a written treatment report within 60 days after initial
commitment. The court must hold a hearing to review the treatment report unless
both parties agree to waive the hearing. Following the hearing, the court must
make a determination as to whether the person should be committed indefinitely.
These hearings have rarely changed the results of an initial commitment.

Civil commitment
trials are heard in
district courts
across the state.

Although civil commitment cases are heard by district courts throughout the
state, Minnesota law authorizes the Supreme Court to establish a panel of district
judges with statewide authority to preside over all sex offender commitment
proceedings.10 This law was enacted as a result of a recommendation from a
2005 Governor’s task force on sex offenders.11 The Supreme Court has not
established such a panel.

REFERRALS
A key part of the commitment process is the identification of sex offenders who
are scheduled to be released from Minnesota’s correctional facilities and might
be appropriate for civil commitment. In this section, we review the history of the
referral process.
As noted earlier, in 1991 the Department of Corrections (DOC) began reviewing
sex offenders for possible civil commitment following their incarceration.
During the nearly 13 years up until December 2003, there was an annual average
of about 26 referrals from DOC to county attorneys. About 61 percent of the
referred offenders were committed.12
In December 2003, DOC made 236 additional referrals after an extensive review
of sex offenders either incarcerated in prison or living in the community after
release from prison. The number of referrals that month was more than 70
percent of the referrals that were made in the nearly 13 previous years. These
new referrals came in response to the rape and murder of a college student in
northwestern Minnesota by an offender recently released from a Minnesota
correctional facility. About 31 percent of those sex offenders referred in
December 2003 have been committed.
Since 2003, DOC has changed its review process. The pre-2003 review process
involved a more informal review by three staff. Beginning in 2004, the DOC
review became more formalized in terms of the criteria and process used to

10

Minnesota Statutes 2010, 253B.185, subd. 4.

11

Governor’s Commission on Sex Offender Policy, Final Report (St. Paul, January 2005).

12

In making this and subsequent calculations, we eliminated any duplicate referrals. Duplicate
referrals occur when DOC refers an offender to more than one county or in more than one year. In
addition, we did not include any offenders whose cases are still under review by county attorneys
or not finally decided by the courts. Over the 1991-2003 period, very few cases have not yet been
completed. However, there are significantly more uncompleted cases in more recent years.

28

CIVIL COMMITMENT OF SEX OFFENDERS

conduct the review. Under current policies, the screening of each offender is
done by a three-person team usually consisting of a DOC psychologist, a
correctional facility staff person, and a staff person from DOC probation
services. Their review consists of three stages. At the first stage, a computer
program developed by DOC eliminates offenders from consideration based on
their criminal history and other factors. Over the last four years (2006-09), about
17 percent of the sex offenders were eliminated at this stage. At the second
stage, the three-person screening committee reviews the files of offenders.
About 64 percent of the screened sex offenders were eliminated from
consideration at this stage over the past four years. The third stage of review
consists of a more detailed review of offenders, including interviews and the
development of a report on each offender. At this stage of review, independent
legal counsel under contract to DOC reviews the psychologist’s report on each
offender to see if the offender meets the legal standard for referral to a county
attorney.13 In addition, the Commissioner of the Department of Corrections
reviews the reports on those offenders who are assigned a risk level of three but
are not recommended for referral by the screening committee or legal counsel.14
If the screening committee or legal counsel recommends referral or if the
commissioner determines referral is appropriate, the department forwards the
offender’s name to the appropriate county attorney for possible civil
commitment. Over the last four years, about 5 percent of the screened offenders
were eliminated from consideration at this third stage of review. About 13
percent of screened offenders were referred to county attorneys for possible
commitment.
About 70 percent of the referrals made by DOC were jointly supported by the
three-person DOC staff review team and legal counsel over the last four years.
Another 22 percent of referrals were supported by either the review team or legal
counsel, but not both. Finally, 8 percent of the referrals came from the
commissioner without support from either the review team or legal counsel.

The number of
DOC referrals to
county attorneys
for possible
commitment
dramatically
increased in
December 2003.

With the implementation of this new process, there was a substantial increase in
the number of referrals. More specifically:
	 During the five-year period from 2004 through 2008, DOC made
about 157 referrals per year, or about six times the referral rate
from January 1991 through November 2003.
About 42 percent of the offenders referred during this five-year period have been
civilly committed.15
The increase in referrals that began in December 2003 reflects a significant
change in DOC’s philosophy regarding the purpose of the department’s review.

13

The use of legal counsel in the review process began in 2005.

14

A risk level of three is the highest level of risk assigned by DOC to sex offenders for community
notification purposes. The assignment of risk levels is a separate process from the screening
process for civil commitment.
15

During 2009, DOC referred 114 offenders to county attorneys. It is too early to calculate a
meaningful final commitment rate for offenders referred in 2009 and 2010.

CIVIL COMMITMENT PROCESS

29

Prior to December 2003, DOC focused more on narrowing the list of sex
offenders for possible civil commitment to those who were clearly dangerous.
However, DOC was severely criticized by some, including the Governor, for not
referring the sex offender who committed the rape and murder that occurred in
the fall of 2003 in northwestern Minnesota. In December 2003, DOC changed its
referral practices and began referring all sex offenders who qualified for
commitment based on the legal standard, as well as some others who DOC
believed might qualify. By referring more offenders, DOC reduced the chance of
not identifying someone for possible commitment who might later commit a
heinous sex crime.

DOC is required
to refer any sex
offender for
whom a petition
for commitment
“may be
appropriate.”

This revised policy essentially passed the commitment decision in more cases to
county attorneys. This policy makes sense if one believes that the legal system,
and not DOC, should make decisions about which cases merit the filing of a
petition and which offenders should be committed. DOC’s policy is also
consistent with state law, which requires the commissioner of DOC to refer those
for whom a petition “may be appropriate.”16 Furthermore, the revised policy
reduces the chance of failing to refer a sex offender who will later commit a
heinous sex crime.
However, as we discussed in Chapter 1, the standard for commitment is relatively
low, and many offenders qualify for commitment. As Figure 2.1 indicates:
	 A large increase in commitments has followed the substantial 

increase in DOC referrals since 2003. 

As of February 1, 2011, nearly 440 individuals, or about 68 percent of civilly
committed sex offenders, were committed after 2003. The increase in
commitments has not been as large as the increase in referrals. As noted above,
the rate of commitment has declined as referrals increased. But the number of
commitments has increased because the reduction in the commitment rate has
been small relative to the large increase in the referral rate.
DOC’s change in referral policy has two possible disadvantages. First, the
increase in commitments has had a very significant impact on the costs of
operating the Minnesota Sex Offender Program. Second, the revised referral
policy increases the chance of referring an offender who will not reoffend or
whose tendencies to reoffend could probably be managed through supervision
and treatment in the community at a lower public cost than civil commitment to a
high security MSOP facility.

16

Minnesota Statutes 2010, 244.05, subd. 7.

30

CIVIL COMMITMENT OF SEX OFFENDERS

Figure 2.1: Referrals by the Department of
Corrections and Numbers of Sex Offenders Entering
the Minnesota Sex Offender Program, 1985-2010
250

200

DOC Referrals

150

100

MSOP Entrants

50

2010

2005

2000

1995

1990

0
1985

The number of
civil commitments
increased
significantly
beginning in 2004.

Year
NOTES: DOC started making referrals to county attorneys in 1991. The number of MSOP entrants
was estimated using the date of admission for civilly committed offenders at MSOP or DOC facilities
as of the end of 2010. In addition, we included the date of admission for previous MSOP residents
who are now deceased.
SOURCES: Minnesota Sex Offender Program and the Department of Corrections.

VARIATION IN COMMITMENT
PRACTICES
Under Minnesota law, the decisions regarding commitment are made in a
decentralized manner. Even in counties where the Attorney General’s Office
handles commitment cases, county attorneys decide whether to file a petition to
commit sex offenders. In addition, district court judges across the state hear
commitment cases.
As a result, it is important to consider whether commitment decisions are being
made in a consistent manner across the state. Without consistency, some
offenders who would be committed in certain parts of the state would be released
to the community in other parts of the state. Such inconsistency could result in:
(1) the release of some offenders who are dangerous and should be committed,
and/or (2) the indeterminate commitment of other offenders who are not a

CIVIL COMMITMENT PROCESS

31

significant risk to the community, or who at least could be treated and supervised
in the community at a lower cost with a relatively small risk to the community.
In examining the variation in commitment practices across the state, we
conducted three types of analyses. First, we examined the variation in the
number of sex offender civil commitments per capita in Minnesota’s ten judicial
districts. Second, we considered the variation by judicial district in the
percentage of referred cases that resulted in commitments. We also reviewed the
percentage of referrals that did not result in a petition filed by a county attorney
and the percentage of cases in which a petition was filed but was either
withdrawn by the prosecution or dismissed by a district court judge. Finally, we
conducted a statistical analysis that isolates the impact of geographic location by
controlling for known differences in the sex offenders that were referred,
petitioned, or committed throughout the state. We discuss each one of these
analyses below.

Commitments per Capita
As of July 2010, there were 12.2 civilly committed sex offenders in Minnesota
per 100,000 residents.17 We found that:
	 The number of commitments per capita varies significantly across
the state.
There is wide variation by county. The commitment rates by county vary from
zero in a number of counties to nearly 61 per 100,000 residents.

There is
significant
variation across
judicial districts
in the number of
civil commitments
per capita.

In addition, there is significant variation across judicial districts. Figure 2.2
shows the location of Minnesota’s ten judicial districts, and Figure 2.3 provides
information on the commitments per capita for each judicial district. The latter
figure shows that the number of commitments per 100,000 residents is the
highest in the Third Judicial District (19.5) in southeastern Minnesota and the
Ninth Judicial District (19.1) in northwestern Minnesota. The number is also
well above the state average in the Fifth Judicial District (16.7) in southwestern
Minnesota and the Seventh (15.3) and Eighth (17.0) judicial districts, which are
both in west central Minnesota. The Second Judicial District in Ramsey County
(12.0) and the Fourth Judicial District in Hennepin County (12.1) both have
slightly below average numbers of commitments per capita. The numbers of
commitments per capita are further below average in the judicial districts
immediately north and south of Hennepin and Ramsey counties. The First
Judicial District has 6.7 commitments per 100,000 residents, and the Tenth
Judicial District has 7.9 commitments per 100,000 residents. The Sixth Judicial
District (8.5) in northeastern Minnesota also has a lower than average number of
commitments per capita.

17

This figure includes the 627 sex offenders held at MSOP and DOC facilities as of July 2010, as
well as 18 deceased MSOP residents. We included the deceased residents because we wanted the
commitments per capita to reflect all the commitments that have been made. We included nine
MSOP residents who are there on a judicial hold but have not been finally committed. Most
judicial holds result in a commitment.

32

CIVIL COMMITMENT OF SEX OFFENDERS

Figure 2.2: Minnesota Judicial Districts, 2010

--

-9
-,-- I ] ,,•
-~

\-

7

--

--'" _... _ - ..-.·1-

SOURCE: Minnesota State Court Administrator’s Office.

It should be noted that there is also considerable variation within each judicial
district with more than one county. For example, in the Third Judicial District,
the number of commitments per 100,000 residents ranges from zero in one
county to over 34 in another county. However, a majority of counties in the
district have above average numbers per capita, including all six of the most
populous counties in the district. As a result, despite this variation, the Third
Judicial District has the highest number of commitments per capita of any district
in the state.
Another way to look at this variation is to group the counties by population size.
For example, we compared the seven most populous counties in the state with all
the other counties. These “high population” counties—which include Hennepin,

CIVIL COMMITMENT PROCESS

33

Figure 2.3: Sex Offender Civil Commitments per
100,000 Residents by Judicial District, as of July 2010
20

The number of
civil commitments
per capita is the
highest in the
southeastern and
western parts of
the state.

15
Statewide
Average=12.2

10

5

0
1

2

3

4

5
6
Judicial District

7

8

9

10

NOTES: Commitments include 627 offenders held at MSOP and DOC facilities, including nine
offenders held at MSOP on a judicial hold and not yet committed. We also included 18 offenders who
died while residing at MSOP. Population estimates were for 2008.
SOURCE: Office of the Legislative Auditor, analysis of data from the Minnesota Sex Offender
Program and the State Demographer’s Office.

Ramsey, Dakota, Anoka, Washington, St. Louis, and Stearns counties—all have
below average numbers of commitments per capita. As a group, the “high
population” counties have 10.0 commitments per 100,000 residents, compared
with an average of 15.1 for the other 80 counties.
We also compared the counties based on the level of involvement of the Attorney
General’s Office (AGO) in civil commitment cases. For those counties in which
AGO handles all civil commitment cases, the number of commitments per
100,000 residents is 15.1, which is above the state average. In contrast, the
number is 10.6 in those seven counties not served by AGO and 10.7 in the five
counties that use AGO for most, but not all, cases. It is unclear that AGO’s
involvement is responsible for this variation, since county attorneys make the
decision about whether to submit a petition for commitment. However, counties
do not have to pay the salaries and benefits paid to AGO attorneys and other staff
working cases for them. It is possible, though unproven, that county attorneys
may be more inclined to file a petition when some of the prosecution costs are
paid by the state.

34

CIVIL COMMITMENT OF SEX OFFENDERS

Commitments as a Percentage of Referrals
We also examined the variation in commitment rates across the state. Since the
vast majority of commitments result from referrals, we defined a “commitment
rate” as the number of commitments as a percentage of referrals from the
Department of Corrections. We found that:
	 There is significant variation across the state in the percentage of
referrals that result in commitments, and that variation is somewhat
similar to the variation in commitments per capita.
From 1991 through 2008, 45 percent of DOC referrals resulted in the civil
commitment of a sex offender. Figure 2.4 shows that, among the ten judicial
districts, the commitment rates have varied from 34 percent to 67 percent.18 The
lowest rates, which range from 34 to 36 percent, are in Ramsey and Hennepin
counties and northeastern Minnesota. The highest commitment rates, which
range from 59 percent to 67 percent, are in southeastern, southwestern, west
central, and northwestern Minnesota. The commitment rates in the judicial
districts to the immediate north and south of Hennepin and Ramsey counties are
either average or slightly below average.

Figure 2.4: Percentage of Referrals Resulting in Civil
Commitments by Judicial District, 1991-2008
67%


Statewide Average=45%
63%


Across judicial
districts, the
percentage of
referrals that
result in civil
commitments
ranges from 34
percent to 67
percent.

60%


59%

59%

45%

43%
36%

34%

1

2

3

4

35%

5

6

7

8

9

10

Judicial District
SOURCE: Office of the Legislative Auditor, analysis of data from the Department of Corrections.

18

As with commitments per capita, these averages mask significant variation by county.

CIVIL COMMITMENT PROCESS

The lowest
commitment rates
are in Hennepin
and Ramsey
counties and
northeastern
Minnesota.

35

This pattern of variation is somewhat similar to the variation in commitments per
capita. All five judicial districts with above average commitments per capita
have above average commitment rates. In addition, all five districts with below
average commitments per capita have below average commitment rates.
However, Hennepin and Ramsey counties have slightly below average
commitments per capita, but they have commitment rates (commitments as a
percentage of referrals) that are well below average. The judicial districts
immediately north and south of Hennepin and Ramsey counties have
commitments per capita that are well below average, but they have commitment
rates that are slightly below the state average. These differences in the pattern of
variation can be explained by differences in referrals per capita. The first and
tenth judicial districts have slightly below average commitment rates and well
below average numbers of referrals per capita. As a result, their number of
commitments per capita are also well below average. Hennepin and Ramsey
counties have the highest referral rates per capita. When combined with lower
than average commitment rates, these two counties have slightly below average
numbers of commitments per capita.
As was the case for commitments per capita, “high population” counties also
have below average commitment rates. As Table 2.1 indicates, the seven most
populous counties have an average commitment rate of 36 percent compared
with an average of 56 percent for the other 80 counties. The table also shows
that the main reason for the lower commitment rate in the “high population”
counties is that:
	 On average, county attorneys in the seven most populous counties
file a petition for commitment in a smaller percentage of cases than
county attorneys in other counties.

Table 2.1: Outcome of Sex Offender Referrals by
Population of County, 1991-2008
Outcome
Committed
County Attorney did not file a petition
Petition dismissed or withdrawn
Total

Seven Highest
Population Countiesa

All Other Counties

36%
56
8
100%

59%
26
15
100%

a

These are the seven counties in Minnesota with the highest overall number of residents in 2008.
They include Hennepin, Ramsey, Dakota, Anoka, Washington, St. Louis, and Stearns counties.
SOURCE: Office of the Legislative Auditor, analysis of data from the Department of Corrections.

In other words, county attorneys in the “high population” counties generally
appear to be more selective in bringing commitment cases to court than their
counterparts elsewhere across the state. On average, the county attorneys in the
seven most populous counties filed a petition for commitment for 44 percent of
the referrals. In the other counties, county attorneys filed a petition for
commitment for 74 percent of the referrals.

36

CIVIL COMMITMENT OF SEX OFFENDERS

Among those cases brought to court, the two groups of counties do not differ
much in the percentage of cases that resulted in a civil commitment. In the seven
most populous counties, 82 percent of the referred cases in which a petition was
filed resulted in a commitment. About 80 percent of the petitions resulted in a
commitment in the other 80 counties.
Figure 2.5 illustrates the differences in petition rates by judicial district. Petition
rates—or the percentages of referrals which result in petitions filed for
commitment—vary from 40 to 80 percent. Petition rates are the lowest in
Hennepin and Ramsey counties and northeastern Minnesota. The rates in two
judicial districts immediately to the north and south of Hennepin and Ramsey
counties are a little above the statewide average of 56 percent. Petition rates in
the other five judicial districts range from 69 to 80 percent.

Figure 2.5: Percentage of Referrals Resulting in
Petitions for Civil Commitment by Judicial District,
1991-2008
Statewide Average=56%
80%

Much of the
variation in
commitment rates
is due to
differences in the
decisions made by
county attorneys
to bring referred
cases to court.

79%
74%

76%

69%
61%
57%

42%

40%

1

2

3

4

40%

5

6

7

8

9

10

Judicial District
SOURCE: Office of the Legislative Auditor, analysis of data from the Department of Corrections.

As Figure 2.6 indicates, court commitments as a percentage of petitions filed are
high and do not vary as much as petition rates. Commitments as a percentage of
petitions range from 71 to 91 percent and do not follow the same geographic
pattern as petition rates. The judicial districts with higher than average
commitments as a percentage of petitions include districts with lower than
average petition rates and districts with above average petition rates.

CIVIL COMMITMENT PROCESS

37

Figure 2.6: Percentage of Petitions Resulting in Civil
Commitment by Judicial District, 1991-2008
Statewide Average=81%

There is also some
variation across
district courts in
the percentage of
petitions that
result in civil
commitments.

91%
86%

85%

88%

85%
81%

73%

71%

1

79%
77%

2

3

4

5

6

7

8

9

10

Judicial District
SOURCE: Office of the Legislative Auditor, analysis of data from the Department of Corrections.

Statistical Analysis
The previous analyses strongly suggest that there are significant variations in
commitment practices across the state. However, the differences in commitment
rates could be the result of differences in the characteristics of the sex offenders
being referred across the state. For example, the lower commitment rates in
“high population” counties would be explainable if sex offenders being referred
in the “high population” counties were less dangerous on average than those
being referred in other counties. While there is no reason to believe that this is
true, we used a statistical analysis to determine if the county or judicial district in
which the referral was made had an impact on the outcome of a commitment
case.
More specifically, we used logistic regression analysis to examine the
relationship between the commitment outcome and various factors related to the
recidivism risk of the offender. These factors included the types and numbers of
an offender’s crimes, types of victims, scores on actuarial assessment
instruments, treatment history, prison disciplinary history, probation history,
diagnoses of mental disorders, reported sex abuse as a child, education, race, age,

38

CIVIL COMMITMENT OF SEX OFFENDERS

and geographic location.19 The purpose of using regression analysis was to
isolate the effect of location while controlling for the types of offenders being
considered for commitment throughout the state. In addition to examining the
decisions of courts on commitment, we also examined the decisions by county
attorneys to file petitions and the decisions by DOC to refer offenders.
In order to examine all three types of decisions—referral, petition, and
commitment—we used data from DOC. These data are in DOC computer and
paper files and are used by DOC during the referral process. Information on
referred offenders is then passed on to county attorneys.20 Our focus was on a
stratified random sample of offenders who had been reviewed by DOC during a
three-year period (2006-08). Overall, we gathered data on 474 offenders—
including 292 offenders who were referred to county attorneys and 112 offenders
who reached the final stage of DOC review but were not referred.21

Effect of Location
The geographic
variation in
petition and
commitment
practices cannot
be explained by
differences in the
characteristics of
offenders and
their crimes.

In this section, we examine whether the geographic variation we found in
commitment rates is substantiated by the logistic regression analyses. Our
analyses isolate the impact of geography while controlling for the impact of other
factors. The results of our analyses confirm that:
	 There is significant geographic variation in petition and commitment
rates across the state that is unexplained by the characteristics of
offenders and their crimes.
Furthermore:
	 The geographic variation in petition and commitment rates is similar
to the variation in commitment rates and commitments per capita.
For example, we found that the probability that a petition for commitment is filed
on an offender is significantly higher if the county attorney reviewing the case is

19

Actuarial assessment instruments are used to estimate the chances that an offender will commit
another crime in the future. The instruments included in our analysis were the Minnesota Sex
Offender Screening Tool – Revised (MnSOST-R) and the Static-99, since DOC generally utilizes
these tests in its review of offenders for possible civil commitment. Actuarial scores are considered
to be the best predictors of future recidivism, but are not perfect in their predictions. Offenders
with identical scores are, on average, expected to commit a future offense with equal likelihood, but
their chances of recidivism will vary to a certain extent. Existing literature suggests that clinical
judgment alone, or combined with actuarial scores, does not improve the predictability of
recidivism over that provided by actuarial scores alone.
20

Additional information is developed by prosecutors and the courts during the petition and
commitment process. However, this information is not generally computerized or stored in a
central location. As a result, it would have been difficult for us to review enough cases for a
statistical analysis. Furthermore, the information could not have been used to evaluate the referral
process.
21

We also gathered information on 70 offenders who reached the second level of DOC review but
did not progress beyond that stage. These offenders were not included in our analysis when we
compared referred offenders to those not referred.

CIVIL COMMITMENT PROCESS

39

from a county other than the seven most populous counties in Minnesota.22
Similarly, the probability that a petition is filed is significantly higher than in the
Fourth Judicial District (Hennepin County) if the petition is being considered by
a county attorney in any judicial district other than the Sixth Judicial District
(northeastern Minnesota). The probability is the highest in the same parts of the
state—southeastern, southwestern, west central, and northwestern Minnesota—
that we found had higher than average commitment rates and higher than average
numbers of commitments per capita.
Furthermore, the regression analysis of commitment decisions showed that the
probability that a sex offender who was referred by DOC was civilly committed
is significantly higher if the case is prosecuted by a county attorney from a
county other than the seven most populous counties in Minnesota. In addition,
the probability that an offender who was referred by DOC was committed was
significantly higher than in Hennepin County in all judicial districts except the
Second Judicial District (Ramsey County) and the Sixth Judicial District
(northeastern Minnesota).23 Again, these results are similar to the differences in
commitment rates discussed earlier.

The inconsistency
in commitment
practices suggests
that Minnesota is
committing sex
offenders in some
parts of the state
who would be
released from
prison in other
parts of the state.

This inconsistency in commitment decisions suggests that either Minnesota is
civilly committing too many sex offenders in some parts of the state, or is
committing too few sex offenders in other parts of the state, or both.
Alternatively, it suggests that Minnesota has a low bar to meet for civil
commitment. As a result, prosecutors have considerable discretion in
determining who to commit and who to release. In some parts of the state,
prosecutors choose to petition a greater percentage of those who meet the
requirements for commitment. The vast majority of those petitions result in civil
commitments. In any event, the inconsistency implies that:
	 Minnesota is committing some sex offenders who probably have a
lower risk of recidivism than some of those being released.
Or, alternatively, Minnesota is releasing some sex offenders who probably have a
higher risk of reoffending than some of those being committed.
Finally, we compared sex offenders referred by DOC with those who reached the
final level of DOC review but were not referred. We found that:


Geographic location generally does not affect referral decisions.

Our regression analysis showed that there was no significant difference in the
probability of an offender being referred between the seven most populous
22

More specifically, we compared offenders who were referred by DOC but not petitioned with
offenders who were referred by DOC and were the subject of a petition for commitment filed by a
county attorney.

23

In one of the two different regressions we ran, the probability of commitment in the Tenth
Judicial District was not significantly different from that in Hennepin County. One of these
regressions used various diagnoses such as pedophilia or personality disorders as independent
variables. The other regression did not use these diagnosis variables, but instead used alternative
variables such as intelligence impairments, brain injuries, major mental illnesses, mood disorders,
and post-traumatic syndrome as independent variables.

40

CIVIL COMMITMENT OF SEX OFFENDERS

counties and the other 80 counties. In addition, there was no significant
difference in the probability of an offender being referred between most judicial
districts and the Fourth Judicial District (Hennepin County). However, in both
regression analyses we conducted, offenders from the Second Judicial District
(Ramsey County) had a significantly lower chance of being referred than
offenders from Hennepin County. In one of the two regressions, offenders from
the Third Judicial District (southeastern Minnesota) and the Sixth Judicial
District (northeastern Minnesota) had a significantly higher chance of being
referred than offenders from Hennepin County. It is unclear why these
exceptions to the general findings for referrals occurred.

Effect of Other Factors
To some extent,
decisions made
during the
commitment
process are based
on assessments of
the recidivism
risks of offenders.

Some of the other results from the statistical analysis indicate that decisions made
by those involved in the commitment process are, at least in part, evidence-based.
For example, we found that:
	 Higher scores on actuarial assessment instruments that are
indicative of higher recidivism risks are associated with increased
probabilities of an offender being referred, petitioned, and
committed.
Higher scores on the MnSOST-R and the Static-99 are indicative of higher
recidivism risks. In each of four regressions, higher scores on one of the
actuarial instruments or both were associated with higher probabilities of an
offender being referred.24 Similar results were obtained for petition and
commitment decisions. These results are encouraging in that they suggest that
the most important information available to decision makers is being used.
However, the results for geographic location and some other variables suggest
that other factors that should not be considered are playing a role in these
decisions. A number of these other factors are discussed below.
We also found that:
	 Caucasians were more likely to be petitioned and committed than
minorities, but their chances of being referred were not different.
There was no significant difference in the odds of being referred for Caucasians
relative to minorities. However, all four regressions showed that Caucasians had
a significantly higher probability of being petitioned for commitment. Three of
four regressions indicated that Caucasians had a significantly higher probability
of being committed than minorities.
In addition:

24

The four regressions included two regressions using diagnosis variables. In one of these, the
geographic variable indicated whether a county was one of the seven most populous counties or
not. In the other, the geographic variables indicated the judicial district in which the county was
located. These two different sets of geographic variables were also used in regressions involving
the alternative variables such as brain injuries rather than the diagnosis variables.

CIVIL COMMITMENT PROCESS

41

	 Having an offense in which a weapon was used or the victim was
physically injured raised the odds of being referred but not the odds
of being petitioned or committed.

The effect of prior
treatment and
treatment failures
on decisions made
during the
commitment
process is
complicated.

We also examined the effect that prior treatment or a prior treatment failure had
on referral, petition, and commitment decisions. The effects of treatment were
mixed.25 For example, we found that:
	 Having been enrolled in any sex offender treatment program at any
point in time raised the odds of being referred, lowered the odds of
being committed, but generally did not affect the odds of being
petitioned.
Treatment participation may increase the odds of referral for two reasons. First,
more dangerous offenders may be more likely to have been enrolled in treatment
at least once. They may have a longer criminal history and may be more likely to
have been ordered to treatment than offenders with fewer offenses. In addition,
sex offender treatment at Minnesota’s correctional facilities is generally targeted
toward more serious offenders. Second, treatment professionals generally
encourage participants to reveal all of their offenses including those for which
they have not been convicted. Those admissions can be used to establish a case
for commitment. On the other hand, participation in treatment may be indicative
of progress in reducing the risks of recidivism. It is unclear why treatment
participation appears to affect referral and commitment decisions differently and
does not appear to affect petition decisions.
In addition, we analyzed the impact of treatment failures on decisions made
during the commitment process. A treatment failure occurred when the offender
left treatment before completion or was removed from treatment for lack of
progress, a sexual offense, or a violation of other rules. We found that:
	 Having had any failure in treatment increased the odds of
commitment, reduced the odds of referral, and did not generally
affect the odds of being petitioned.
Again, the reasons for these different results are not entirely clear. It makes some
sense that having experienced a treatment failure might increase the odds of
commitment, but it is less clear why a failure affects referral and petition
decisions differently. It is possible, however, that having a treatment failure
means that an offender did not discuss his past offenses during treatment
sessions, including offenses that were not reported, were not charged, or were
charged but did not result in convictions. The lack of disclosure could mean that
officials making the referral or petition decisions were aware of fewer offenses
for offenders with one or more treatment failures compared with offenders who
25

We examined the effect on referral, petition, and commitment decisions of: (1) having
participating in any sex offender treatment program and (2) having failed to complete any sex
offender treatment program. A potential problem with the treatment variables we used is that they
may not adequately summarize an offender’s entire treatment history. For example, an offender
could have had a treatment failure ten years ago, but successfully completed a treatment program
more recently. Alternatively, an offender could have successfully completed a short treatment
program ten years ago, but has failed in numerous treatment programs in subsequent years.

42

CIVIL COMMITMENT OF SEX OFFENDERS

participated in treatment successfully and disclosed past offenses. As a result, it
could be less likely for offenders with treatment failures to be referred or
petitioned.

COMMITMENT ALTERNATIVES
Minnesota lacks a
less costly
commitment
alternative to the
high security
facilities at Moose
Lake and St.
Peter.

One problem with Minnesota’s commitment process is that it results in an all-or­
nothing outcome. The decision that prosecutors and judges face is that either a
sex offender is civilly committed in an expensive, high security facility, or the
offender is released to the community, sometimes with no supervision if he has
served his complete prison sentence. In particular:


Minnesota lacks options for committing offenders and placing them
in less costly settings with adequate supervision and treatment.

Minnesota law allows judges to consider less restrictive settings to the secure
facilities operated by MSOP. A judge may commit the offender to a less
restrictive facility if the offender establishes by clear and convincing evidence
that a less restrictive treatment program is available and is consistent with
treatment needs and public safety.26 While some judges have been willing to
consider alternatives to committing certain offenders, there are no available
alternatives that provide adequate supervision. There is only one other
residential treatment program in Minnesota for sex offenders, but that program
will not accept any sex offenders who are being considered for civil commitment.
As a result, this provision in law is currently of virtually no practical use in
commitment decisions involving sex offenders. Prosecutors and judges thus face
a choice between release with no public safeguards and placement in the costly,
high security MSOP facilities. There are no lower-cost alternatives that would
provide needed treatment and adequate public protection.
One such alternative would be to place certain committed offenders in group
homes in the community under MSOP’s supervision, provided the courts
determined that they could be safely managed in that setting. The offenders
would be under constant supervision and GPS monitoring and would receive
treatment. If the offenders violate the terms of their commitment, they could be
moved to the secure facilities in Moose Lake or St. Peter. Alternatively, they
could be sent back to prison, as Texas does, if they fail to attend treatment or
violate the conditions of their commitment. As we noted in Chapter 1, the
outpatient civil commitment program in Texas provides treatment and housing in
four halfway houses specifically for civilly committed offenders. In addition, the
Texas program provides close supervision and monitoring of committed
individuals, all for an annual cost of about $27,000 per offender.
Another option would be to stay the commitment of an offender and allow the
offender to live in the community. A person under a stay of commitment could
also be subject to a treatment directive and be under intensive supervision.

26

Minnesota Statutes 2010, 253B.18, subd. 1. This subdivision specifically applies to the civil
commitment of mentally ill and dangerous individuals. However, it also applies to the civil
commitment of sex offenders due to the language in Minnesota Statutes 2010, 253B.185, subd. 1.

CIVIL COMMITMENT PROCESS

43

Offenses or violations of the conditions of the stay would result in a revocation of
the stay and commitment to a secure treatment facility.

The current stay
of commitment
option needs to be
modified in order
to be suitable for
use with sex
offenders.

Current law provides a stay of commitment option for sex offenders, and that
option has been used in a few instances.27 However, the stay provision was
designed primarily for mentally ill or chemically dependent populations and not
sex offenders. As a result, there are no provisions for MSOP, DOC, or county
community corrections agencies to supervise or monitor sex offenders who
receive a stay. Instead, supervision would be provided by a social service
agency. In addition, there are currently limited options for treatment in the
community for those on a stay of commitment. The lack of adequate funding for
supervision and treatment of those on a stay of commitment is also a concern.
Finally, the conditions that the offender must meet to avoid revocation of a stay
are not spelled out in statute but are completely left up to the court to determine.
Statutory provisions more appropriate to sex offenders would be needed to make
the stay of commitment a viable option for the courts and to ensure adequate
protection for the public.
It could also be argued that the financial incentives for counties, combined with
the lack of alternatives to MSOP, help to increase the number of commitments of
sex offenders in Minnesota. Counties pay $32.80 per day, or about $12,000 per
year, for each offender at MSOP facilities for which they are financially
responsible. Through commitment, county officials can remove an offender from
their jurisdiction at a reasonable cost, or at least a cost that may compare
favorably with the risks the county would face if the offender was released to the
community. However, the overall cost to the public is about $120,000 per year
for each offender, with the state paying 90 percent of the cost. If the counties
paid a higher share of the costs, county attorneys might commit fewer
individuals. If less costly alternatives were available and counties were required
to pay the same percentage of costs as they do for commitments to MSOP
facilities, county attorneys might also be amenable to those alternatives when
they are appropriate. Implementing alternatives to commitment could not only
save money for both the state and counties but could be done in a way that
provides adequate protection for the public if implemented properly.
A less restrictive setting may be appropriate not only for some of those being
considered for commitment in the future, but also for some of the existing
population at MSOP facilities. There is some reason to think that:
	 Minnesota may be committing some sex offenders who could be
treated and supervised in other less costly settings.
Professionals we interviewed—including MSOP clinicians and outside
psychologists who assess sex offenders for the courts—generally agreed that
some sex offenders at MSOP facilities could be treated in less secure community
settings, although they disagreed about what percentage of MSOP residents could
be successfully managed in other settings. In addition, as we will explore further
in Chapter 3, MSOP clinical management agreed that some low functioning

27

Minnesota Statutes 2010, 253B.095.

44

Some MSOP
residents,
particularly
certain low
functioning
individuals, could
be supervised in a
less costly setting.

CIVIL COMMITMENT OF SEX OFFENDERS

individuals in the MSOP alternative program in St. Peter could be managed in
group homes specifically designed for low functioning sex offenders. Elderly
individuals with numerous medical problems and physical disabilities are also
being committed and sent to MSOP facilities and placed in an assisted living unit
when appropriate. Most recently, an 88-year-old was committed and sent to an
MSOP facility. Some of these individuals may be suitable for an alternative
commitment setting.
In addition, some MSOP residents—beyond those mentioned above—may be
suitable for placement in a less costly community setting provided that there is
appropriate supervision and monitoring of their activities and that there are
appropriate consequences for violations of the rules. These individuals may not
meet Minnesota’s high standard for release, but their recidivism risk may be
significantly less than when they were admitted and less than the level required
for commitment. Professionals would have to assess their current risk levels to
see if they might be suitable for an alternative commitment setting.
It should also be recognized that Minnesota has the highest number of civilly
committed sex offenders per capita in the nation and has not released any
offenders from MSOP facilities. In contrast, some other states are releasing
offenders from their facilities, and others such as Texas and New York have
some or all of their civilly committed sex offenders living in community settings.
It appears that these practices in Texas and New York are successful in managing
costs and in preventing sexual recidivism, provided that offenders have stable
housing arrangements and that authorities maintain intense supervision and
monitoring.
As we noted earlier in this chapter, Minnesota is also releasing some sex
offenders from prison who are probably more dangerous than some of the
offenders being committed. Instead of committing these less dangerous
offenders to the secure facilities at Moose Lake and St. Peter, Minnesota could
establish less expensive commitment alternatives for them and the more
dangerous offenders who are being released. By doing so, Minnesota could
control its costs and provide protection for the public from a larger number of
offenders.
Finally, utilizing alternatives to civil commitment could help stretch the available
resources so that intensive supervision of sex offenders released from prison
could be extended beyond the usual one-year period where necessary. Since
many sex crimes are committed by offenders without a prior conviction for a sex
crime, investments in cost-effective prevention efforts could also be considered.

RECOMMENDATIONS
Without changes to the civil commitment process, the number of sex offenders
housed at MSOP facilities is expected to nearly double in ten years. MSOP’s
budget will also grow significantly although it need not grow as fast as the
population due to cost efficiencies associated with larger populations. While
MSOP provides a safer alternative than community placements, community
placements can be effective from a public safety standpoint provided that

CIVIL COMMITMENT PROCESS

45

appropriate safeguards are taken and intensive supervision of offenders is
provided on a continuing basis. In addition, the Legislature could provide
additional safeguards for the public by increasing the length or intensity of
supervision of other sex offenders released from prison or increasing prevention
efforts. As a result, there are opportunities for the Legislature to reduce the costs
of civil commitment over time. The following recommendations are options that
the Legislature could use in pursuing that goal.
First, we recommend that the Legislature consider implementing a continuum of
options. In addition to the current option of commitment at a secure MSOP
facility, these options might include: (1) commitment to a less restrictive facility,
and (2) stays of commitment. In either of these cases, treatment should be a
required activity. In addition, intensive supervision and monitoring should be
required. Finally, there should be consequences if an offender violates the
conditions of his commitment or stay of commitment, including transfer to a
secure MSOP facility.

As an alternative
to a significant
expansion of
existing facilities,
MSOP should
present a plan to
the 2012
Legislature for
alternative
facilities and an
enhanced stay of
commitment
option.

The costs of MSOP have grown significantly in the past and will likely grow
more in the future due to the expected increase in the civilly committed
population. The expected population growth will require a significant increase in
the bed capacity of MSOP’s facilities and additional staff and other resources.
Implementing a continuum of options will require some additional funding from
the Legislature. However, by using less costly facilities and stays for some
individuals, the Legislature can probably lower the overall costs of the program
below projected costs under current law.
In addition, MSOP would need appropriate statutory language to ensure adequate
supervision and monitoring and to spell out the process to be followed if
offenders in less restrictive facilities or on stays of commitment fail to comply
with the conditions of their commitment or stay of commitment. However, we
think the first step in this process is to get a better idea of how these options
would work and how they might affect the costs of MSOP in the future.

RECOMMENDATION
The Legislature should require MSOP to develop a plan for alternative
facilities for use by certain sex offenders currently at MSOP, as well as for
certain newly committed individuals. The plan should provide details about
funding and needed statutory changes to ensure adequate supervision,
monitoring, and treatment of these sex offenders. The plan should also
address the funding and statutory changes needed to address a stay of
commitment option. The cost impact of these options should be compared
with the costs of expected growth at MSOP without any change in policy.
The plan should be presented to the 2012 Legislature.
In preparing this plan, MSOP will also need to reassess its existing residents to
see which residents would be suitable for placement in an alternative setting.

46

CIVIL COMMITMENT OF SEX OFFENDERS

RECOMMENDATION 

MSOP should reassess its existing residents to determine which residents
would be suitable for placement in an alternative setting. The plan
presented to the 2012 Legislature should provide information on this
reassessment, including the rationale for determining why certain types of
residents would be suitable for an alternative commitment setting and a
detailed description of the alternative settings being proposed for various
groups.

Changes in
sentencing
policies for sex
offenders could be
considered but
will not affect the
number of civilly
committed sex
offenders for
many years.

Some might argue that outside experts should be used to do this assessment,
since they might be more objective in their assessments. However, as an initial
step in developing this plan, we suggest that MSOP staff conduct this
reassessment. In the future, if the Legislature required transfers from the high
security MSOP facilities to community options to be approved by the Supreme
Court Appeal Panel, outside examiners could be used by the panel.
Another option for the Legislature to consider is indeterminate sentencing for
certain sex offenders. In order to reduce costs, the system of indeterminate
sentencing would need to be designed so that it does not increase overall prison
sentences for sex offenders by threefold or more. In addition, it should be
recognized that the implementation of indeterminate sentencing will not begin to
address the current costs at MSOP and their expected growth for many years.
The expected growth in MSOP’s population over the next decade is largely
expected to come from current prison inmates who were sentenced under existing
laws.

RECOMMENDATION
The Legislature should consider providing for indeterminate sentencing for
some sex offenders. As a condition of their release, offenders could be
required to successfully complete treatment in prison.
Another sentencing option would be to increase the length of sentences for
certain sex offenders, such as those convicted of first-degree criminal sexual
conduct. Such an option would take a considerable time before it would affect
the number of civil commitments. In addition, it might significantly increase
correctional costs. Finally, it might not be effective in preventing the civil
commitment of some dangerous sex offenders, since only about 42 percent of
those who have been committed had a first-degree criminal sexual conduct
conviction.
In addition to these recommendations, there are other options the Legislature
could consider to increase the consistency of commitment decisions and reduce
expensive commitments, while continuing to maintain public safeguards. We
offer no explicit recommendations on these options, but we think they deserve
the Legislature’s consideration.

CIVIL COMMITMENT PROCESS

47

For example:
	 The Legislature could consider providing funding for a centralized
commitment court and a centralized prosecution and assessment
unit.

In light of the
inconsistencies in
commitment
practices, changes
in the
commitment
process and
structure are
worth
considering.

The Legislature has authorized the Supreme Court to create a centralized court
for processing commitment cases, but the court has not created one. Because the
court system has experienced budget problems in recent years, fully funding a
centralized commitment court would provide an incentive for the Supreme Court
to establish such a court. However, we are not sure that centralizing the court
decisions will increase consistency in commitment decisions or reduce the
number of commitments without additional changes. If prosecutors in some parts
of the state are more inclined to bring commitment cases than in other parts of
the state, a centralized court might not by itself bring about more consistency.
The court would have to commit any offender petitioned by a county attorney
who meets the legal standard. Creating a centralized prosecution and assessment
unit might also help, but it will also be helpful to implement alternatives to
MSOP commitment—like stays of commitment and commitments to a less
restrictive alternative—so that the court and prosecutors have alternatives to
consider.
In addition:
	 It may be useful for the Legislature to consider raising the legal
standard for commitment to require at least one or two convictions
or more than two total offenses.
	 The Legislature could also consider assuring offenders the same level
of procedural protections—such as jury trials, the inadmissibility of
hearsay evidence, and the “beyond a reasonable doubt” standard for
evidence—in commitment trials as are required in criminal trials.
However, if the Legislature changes the commitment standard, it might lose the
ability to supervise and monitor certain sex offenders who could be committed to
less restrictive settings or whose commitment could be stayed. Changing the
commitment standard could also affect existing commitments if the Legislature
also changes the release standard to match the commitment standard as is
suggested in Chapter 3.
The large increase in DOC referrals that began in December 2003 appears to
have had a significant impact on the number of commitments. Some increase in
referrals was needed because DOC was not previously referring some potentially
dangerous sex offenders. However, the six-fold increase in referrals may not
have been necessary and served to increase commitment rates. As a result:
	 The Legislature could consider changing state law to provide the
Department of Corrections with more explicit direction on referrals.
It is unclear, however, exactly what specific direction would be appropriate to put
into state law to get the DOC to be more selective in who it refers to county

48

CIVIL COMMITMENT OF SEX OFFENDERS

attorneys. Current law directs DOC to refer those sex offenders who are
appropriate for a petition for commitment. DOC refers those who meet and
might meet the commitment standard and leaves it up to prosecutors to decide
which offenders should be the subject of petitions for commitment. The real
issue is whether the commitment standard is too low.
Finally:

The Legislature
should also
consider the
incentives to
counties under
the current
system of
financing MSOP
and prosecution
costs.

	 The Legislature could consider changes to the system of financing
the costs of MSOP and civil commitment prosecution.
Changes would be of particular interest as long as county attorneys are still
responsible for filing petitions for commitment and there are no alternatives to
commitment at the secure facilities in Moose Lake and St. Peter. The Legislature
could increase the county’s share of the cost of commitment, or alternatively
increase the county’s share substantially but only for additional commitments
beyond the number of commitments for which the county is currently financially
responsible. If the Legislature provides for alternatives to commitment at Moose
Lake and St. Peter, the county’s share could be maintained at 10 percent for any
placement including those at Moose Lake and St. Peter. Counties would then
pay a lower rate for alternatives than they do for Moose Lake and St. Peter.
Alternatively, the Legislature could increase the county’s share for new
commitments at Moose Lake and St. Peter and reduce the county’s share for less
costly alternatives. That would create an even greater incentive for counties to
look seriously at alternatives. Finally, the Legislature could consider making
counties using the services of the Attorney General’s Office pay for a portion of
the salaries and benefits of the AGO staff working on civil commitment cases.
Because there are many possible changes to consider, we suggest that alternatives
to the existing commitment process and commitment standard be studied by a
stakeholder group during the interim.

RECOMMENDATION
The Legislature should direct the Department of Human Services to
convene a task force to consider the need for changes in the sex offender
commitment standard and process, including the advisability of
establishing a centralized prosecution structure and a single commitment
court for sex offenders. The Legislature could also direct the department to
have the task force examine the referral process. The task force should be
required to report its findings and recommendations to the 2012
Legislature.
The members of the task force should include prosecutors, judges, defense
attorneys, and others with a specialized knowledge and interest in these issues.
Legislators should also be represented on the task force.
Regardless of the recommendations of the task force, we think that the statutes
governing the civil commitment of sex offenders should be separated from those

CIVIL COMMITMENT PROCESS

49

governing the civil commitment of others, including mentally ill and dangerous,
mentally ill, chemically dependent, and developmentally disabled populations.

RECOMMENDATION
The Legislature should direct the Department of Human Services to work
with stakeholders and the Office of the Revisor of Statutes to develop a
proposal for separating the civil commitment statutes for sex offenders
from those governing the civil commitment of other populations.
In most states with civil commitment programs for sex offenders, the statutes
governing the civil commitment of sex offenders were developed independently
of their general civil commitment statutes. As a result, the civil commitment
statutes for sex offenders in most other states are probably clearer and better
tailored to the sex offender population than in Minnesota.

Further study is
needed of the
recidivism rates
of sex offenders
who have been
referred or
petitioned for civil
commitment but
not civilly
committed.

It is also important to consider the implications of the variation across the state in
petition and commitment rates. As mentioned earlier, the variation is significant
and suggests that some offenders being released from prison in some parts of
Minnesota have a higher risk of recidivism than some offenders being civilly
committed in other parts of the state. While it is not possible to measure the
recidivism rates of those who have been civilly committed, the Department of
Corrections could study the recidivism rates of those who have been referred or
petitioned for civil commitment but not committed.

RECOMMENDATION
The Legislature should direct the Department of Corrections to study the
recidivism rates of sex offenders who have been referred or petitioned for
civil commitment and not civilly committed and report back to the 2012
Legislature. The department should also analyze whether there are
geographical differences in the recidivism rates for these populations.
These recidivism rates could also be compared to the rates experienced by
other sex offenders who have been released from prison but not referred for
civil commitment.
By examining geographical differences in recidivism rates, the department may
be able to shed some light on the impact of the current variation in petition and
commitment practices.
Finally, we think it is important for the Legislature to consider the importance of
funding treatment in Minnesota correctional facilities and community settings as
a tool in reducing the need for more costly civil commitment options. To the
extent that programs are effective, they may diminish the need for civil
commitment. In particular, the treatment program operated by MSOP at the
Moose Lake Correctional Facility is designed to treat inmates who are the most
likely candidates for civil commitment. The program attempts to reduce the
costs of civil commitment by reducing the number of offenders who need to be

50

CIVIL COMMITMENT OF SEX OFFENDERS

civilly committed and reducing the length of their stay at MSOP facilities if they
are committed. Although MSOP has operated the program for about ten years, it
has been under different management in the last three years. It is difficult to
determine whether this program has reduced the need for civil commitment or
will reduce the need in the future as a result of recent management changes. Of
those who have participated in the program in the past ten years, about 66 percent
have been civilly committed.28 It is uncertain, however, what percentage of
participants would have been committed in the absence of their participation in
the MSOP treatment program or whether the length of the stay of those
committed to MSOP facilities has been reduced. It is also unclear, at this point,
what effect changes made three years ago will have on the program’s
effectiveness.

28

In calculating the percentage committed, we excluded 49 offenders who are still in the program
and whose final status is unknown because their commitment cases are pending or they have not
yet been reviewed for possible commitment.

3

MSOP Treatment

S

uccessfully treating clients by reducing their risk of reoffending and safely
releasing them or moving them to less costly settings is essential to
controlling the population growth and costs of the Minnesota Sex Offender
Program (MSOP). Offering adequate treatment to these clients is also important
for maintaining the constitutionality of the program. However, no client has ever
been permanently discharged from MSOP, and there are currently few clients
nearing completion of the program.
In this chapter, we focus on those aspects of the treatment program that may
contribute to clients’ failure to progress and be released from treatment. We first
discuss the legal requirement to provide treatment. We then review what is
known about the effectiveness of sex offender treatment and the best treatment
models for sex offender treatment. We examine the type and amount of
treatment delivered to clients at MSOP facilities, the adequacy of clinical staffing
at MSOP facilities, and the therapeutic environment at MSOP facilities. We also
discuss how client progress is evaluated, as well as how the program meets the
special needs of some clients. Finally, we discuss the process and standard for
releasing clients from MSOP.
To address these topics, we reviewed relevant literature on sex offender treatment
and risk assessment. We examined in detail the records of a stratified random
sample of 41 clients who had been committed for at least four years. In addition,
we reviewed material contained in two Special Review Board hearing files and
two additional complete client files which were not part of our sample. We
interviewed clinicians at both St. Peter and Moose Lake, conducted four focus
groups with clients at both locations, and interviewed experts and advocates
outside of MSOP. We also visited the Sand Ridge facility for civilly committed
sex offenders in Wisconsin, and we interviewed officials and reviewed material
about programs in other states.

LEGAL REQUIREMENT FOR TREATMENT 

Civilly committed sex offenders retain certain rights. In particular, they have a
right to receive treatment or other training that will give them an opportunity to
regain some or all of their rights to liberty.1 Providing treatment is evidence that

1
In Youngberg v. Romeo, 457 U.S. 307, 322 (1982), the United States Supreme Court held that
civilly committed persons retain a right to minimally adequate treatment or training that will allow
them to exercise some or all of their liberty rights. While this case did not explicitly apply this
holding to civilly committed sex offenders, other courts have found the right to treatment to exist
for civilly committed sex offenders as well. For example, see Turay v. Seling et al., 108 F.Supp.2d
1148 (W.D. Wash. 2000).

52

CIVIL COMMITMENT OF SEX OFFENDERS

the purpose of civil commitment is not to punish the committed individual, but
rather is to address the conditions that led to a person’s commitment.2

Civilly committed
sex offenders have
a right to
treatment.

The Minnesota Supreme Court has held that Minnesota’s civil commitment laws
do not violate offenders’ fundamental rights to liberty and due process so long as
treatment and periodic review is provided.3 While civilly committed sex
offenders in Minnesota, therefore, have a right to adequate treatment, the United
States Supreme Court has held that courts should defer to the judgment of
treatment professionals in judging what treatment is constitutionally adequate in
the context of civil commitment programs.4 The standard for reviewing whether
treatment is adequate is whether treatment professionals exercised their
professional judgment in running the treatment program.5
While this may be a low bar for judging treatment programs, a federal court
found that the program administrators in the state of Washington failed to
exercise their professional judgment in running their civil commitment program,
resulting in a 13-year injunction while the program corrected the treatment
program. In that case, the court found that the treatment program had so departed
from minimal professional standards that the treatment professionals must not
have based their treatment decisions on their professional judgment. Some of the
conditions which led to the injunction included: inadequate staffing, inadequate
training of staff regarding the clinical mission of the facility, the lack of
individualized treatment, the absence of arrangements for clients to transition to
being released, inadequate provisions to allow clients’ families to participate in
treatment, and a punitive treatment environment.6
As a result:
	 It is important that any civil commitment program for sex offenders
offer adequate treatment to those in the program.
A court could consider failure to release offenders from civil commitment as
evidence that inadequate treatment is being provided or that the purpose of the
program is punitive rather than rehabilitative. It should be noted, however, that
participation in treatment is voluntary. Residents at a civil commitment facility
may decline treatment, but a facility must at least offer each resident the
opportunity to participate in treatment.

2

Kansas v. Hendricks, 521 U.S. 346, 367-369 (1997). Providing treatment also assures that the
conditions and duration of confinement bear a reasonable relation to the purpose for which persons
are confined, another requirement of due process. See Seling v. Young, 531 U.S. 250, 265 (2001)
citing Foucha v. Louisiana, 504 U.S. 71, 79 (1992), Youngberg v. Romeo, 457 U.S. 307, 324
(1982), and Jackson v. Indiana, 406 U.S. 715, 738 (1972).

3

In re Blodgett, 510 N.W.2d 911, 916 (Minn. 1994) established this principle for sex offenders
committed under the sexually psychopathic personality statute. The Minnesota Court of Appeals
explicitly applied this holding to those committed under the sexually dangerous person statute. See
In re Harrison, No. A07-1181, 2007 WL 4305377, at 7.

4

Youngberg v. Romeo, 457 U.S. 307, 323 (1982).

5

Ibid.

6

Turay v. Seling et al., 108 F.Supp.2d 1148 (W.D. Wash. 2000).

MSOP TREATMENT

53

EFFECTIVENESS OF SEX OFFENDER
TREATMENT
Most research
suggests that
certain types of
sex offender
treatment can
reduce recidivism.

The purpose of treating sex offenders is to reduce their risk of reoffending so that
they may be safely released. We reviewed the literature on effectiveness of sex
offender treatment in reducing sexual recidivism. We found that:
	 Most research suggests some positive impacts from sex offender
treatment.
Several meta-analyses of sex offender treatment studies have found lower rates
of recidivism among treated offenders compared to untreated offenders.7 These
studies are often cited in the treatment community as evidence that sex offender
treatment reduces recidivism. For example, a 2002 meta-analysis found that
cognitive behavioral treatments resulted in a reduction of sexual recidivism from
17.4 percent to 9.9 percent.8
Another meta-analysis from 2005 found a 6 percentage point, or 37 percent,
reduction in sexual recidivism for offenders that had participated in treatment.9
While these studies showed significant reductions in sexual recidivism, a sex
offender’s risk of reoffending will never be zero.
We also found that:
	 Existing research suggests that cognitive behavioral therapy that
adheres to the principles of risk, need, and responsivity is most
effective for reducing sex offender recidivism.
Cognitive behavioral treatment targets attitudes, beliefs, and behaviors that are
believed to increase the likelihood of sexual offenses.10 The principles of risk,
need, and responsivity require that the intensity of treatment conforms to the risk
posed by the individual needing treatment (risk), that treatment targets behaviors
and ways of thinking that are linked to reoffending (need), and that treatment be
adapted to an individual’s learning style and needs (responsivity).

7

A meta-analysis is a study which reviews and summarizes the results from existing studies in a
particular area of interest.

8

Karl Hanson et al., “First Report of the Collaborative Outcome Data Project on the Effectiveness
of Psychological Treatment for Sex Offenders,” Sexual Abuse: A Journal of Research and
Treatment 14, no. 2 (April 2002): 169-194.

9

Friedrich Losel and Martin Schmucker, “The Effectiveness of Treatment for Sexual Offenders: A
Comprehensive Meta-Analysis,” Journal of Experimental Criminology 1 (2005): 117-146.

10

Studies supporting the use of cognitive behavioral therapy for sex offenders include Hanson et
al., “First Report of the Collaborative Outcome Data Project on the Effectiveness of Psychological
Treatment for Sex Offenders;” Karl Hanson et al., “The Principles of Effective Correctional
Treatment Also Apply to Sexual Offenders,” Criminal Justice and Behavior 36, no. 9 (September
2009): 865-890; and Steve Aos, Marna Miller, and Elizabeth Drake, Evidence-Based Adult
Corrections Programs: What Works and What Does Not (Olympia, WA: Washington State
Institute for Public Policy, 2006).

54

CIVIL COMMITMENT OF SEX OFFENDERS

However, there is some disagreement about the effectiveness of sex offender
treatment in general. It has been argued that:
	 Many studies of the effectiveness of sex offender treatment do not
use the best research methods for isolating and measuring the
impact of treatment.

However, some
questions remain
about the
effectiveness of
sex offender
treatment.

For example, the vast majority of studies do not use random assignment or other
matching techniques to assure that the group of sex offenders who received
treatment is similar in its characteristics and risks to the group of sex offenders
who did not receive treatment. Without such assurance, it is not possible to tell
for certain whether a difference in recidivism rates is due to the treatment or
inherent differences in the groups. For example, the group of offenders who did
not receive treatment may be higher risk or less willing to change than the
offenders who did receive treatment. These differences, rather than treatment’s
effects, may explain the differences in recidivism. Meta-analyses have also
included studies of treatment programs that were very different or outdated,
studies with differing definitions of recidivism, studies with small numbers of
participants, and studies with short follow-up times.
Two recent, well-designed studies came to opposite conclusions about the
effectiveness of sex offender treatment. One widely cited study by Marques and
others used strong research methods, a long follow-up period, and a relatively
large sample.11 The authors randomly assigned offenders in a California prison
who volunteered for treatment to either receive two years of inpatient cognitive
behavioral treatment and relapse prevention treatment or to remain in prison and
receive no treatment. The study also randomly selected an additional
nonvolunteer control group that did not receive treatment. After release,
offenders were tracked for eight years to collect data on any sexual or violent
recidivism. The study found no significant differences between the three groups
in their rates of sexual and violent offending over the follow-up period.
The Minnesota Department of Corrections (DOC) recently published a study of
recidivism of sex offenders who received treatment in DOC facilities.12 The
study looked at the recidivism of 2,040 offenders who were followed for an
average of 9.3 years. Offenders who received treatment were statistically
matched with offenders who did not receive treatment in order to assure that
differences in recidivism between the groups were due to treatment. Offenders in
the treatment group received DOC’s one to three-year intensive cognitive
behavioral treatment program for sex offenders. The study showed that the
sexual recidivism rate was 27 percent lower for offenders who entered treatment
than those who did not participate in treatment.

11

Janice Marques et al., “Effects of a Relapse Prevention Program on Sexual Recidivism: Final
Results from California’s Sex Offender Treatment and Evaluation Project (SOTEP),” Sexual
Abuse: A Journal of Research and Treatment, 17 no. 1 (January 2005): 79-107.
12

Grant Duwe and Robin Goldman, “The Impact of Prison-Based Treatment on Sex Offender
Recidivism: Evidence from Minnesota,” Sexual Abuse: A Journal of Research and Treatment, 21
no. 3 (September 2009): 279-307.

MSOP TREATMENT

55

The studies discussed above used different methods of matching untreated and
treated groups of offenders and came up with different results. While the DOC
study and the earlier meta-analyses results are promising, until more studies like
the Marques study are completed, it is impossible to offer more definitive
conclusions about sex offender treatment’s effect on recidivism.
In addition:
	 Another unresolved issue in sex offender treatment research is
whether treatment is effective for the type of high-risk offenders who
are civilly committed.
We are not aware of any studies that have attempted to address this question. In
fact, it would be difficult to assess the effects of treatment for a population that,
for the most part, has not been released. There is some evidence, however, that
the highest risk offenders—psychopaths—may actually have an increased risk of
reoffending following treatment.13

MSOP’S TREATMENT PROGRAM
Although there is no definitive research demonstrating the effectiveness of sex
offender treatment in reducing recidivism, sex offender civil commitment
programs must offer adequate treatment to civilly committed persons in order to
survive constitutional scrutiny. In this section, we describe the treatment
program at MSOP facilities. In particular, we focus on whether the type and
amount of treatment is appropriate for civilly committed individuals at MSOP
facilities. We also discuss the adequacy of clinical staffing, the impact of
changes in clinical leadership on the treatment program, and the therapeutic
environment at MSOP facilities.

Background
Treatment at
MSOP facilities
consists of three
phases of
indeterminate
length.

MSOP delivers sex offender treatment in therapy groups and psychoeducational
classes. As the program is designed to be residential and intensive, clients are
also expected to learn and demonstrate behavior change in daily life.
Therapeutic goals are laid out in a “treatment matrix,” which is divided into three
phases. There are no timelines associated with completion of any of the phases
or the treatment program as a whole. In Phase One, clients are expected to learn
how to comply with facility rules and learn basic treatment concepts. In Phase
Two, clients are expected to disclose their sexual offenses and understand their
patterns of sexual abuse. The first two phases of treatment are delivered at the
Moose Lake facility. Phase Three of treatment is provided at the St. Peter facility
and focuses on community reintegration. The St. Peter facility also houses the
alternative program, a modified program for cognitively disabled clients.

13

For a discussion on these studies, see Howard Barbaree, Calvin Langton, and Edward Peacock,
“Sexual Offender Treatment for Psychopaths: Is It Harmful?” in Sexual Offender Treatment:
Controversial Issues, eds. William Marshall, et al. (West Sussex: John Wiley & Sons Ltd., 2006),
159. Due to concerns regarding the treatment of psychopaths, MSOP has a separate unit for clients
with high psychopathy with unique programming.

56

CIVIIL COMMIT
TMENT OF SEX OFFEN
NDERS


Phase Thrree is further divided into two phases—
—MSOP Superrvised Integraation
(MSI) andd Communityy Preparation Services (CP
PS). In MSI, clients continnue to
live withiin a secure areea, but they gradually gainn privileges too take accomppanied
outings onn and off cam
mpus and evenntually unaccoompanied outtings on camppus. In
CPS, cliennts live on caampus in a house and anothher facility that is not within the
secure perrimeter. Clieents make unaaccompanied on-campus trrips and
accompannied off-camppus trips. Thee movement of both MSI and CPS cliennts is
electroniccally monitoreed.14
As shownn in Figure 3.1, as of June 30, 2010, aboout 50 percentt of clients weere in
Phase Onne, 21 percent were in Phasse Two, and 7 percent weree in Phase Thhree.
About 21 percent had declined treattment. Of thee 40 clients inn Phase Threee, 5
were in CPS.

Figure
e 3.1: Min
nnesota Sex Offen
nder Prog
gram Clie
ent
Popula
ation by Treatmen
nt Phase, 2010
Ph
hase One

51%


Close to 800
percent off MSOP
clients aree
participating in
treatmentt.

Declining
Treatme
ent
21%


Phase Tw
wo
21%
Phase Three

7%


NOTES: Re
epresents 542 clients as of June 30, 2010, and exxcludes clients in
n the MSOP adm
missions
unit, clients being held prior to commitment, and committed clients being held
d at the Departm
ment of
Corrections or in local jails. This chart includ
des clients in all phases of the altternative program
m.
SOURCE: Department of Human Services, Minnesota Sex Offender Program
m (MSOP) Quarterly
r
nd
oose Lake, St. Pa
aul, and St. Peterr, 2 Quarter, 20
010.
Report: Mo

14

MSOP also runs a treatm
ment program at DOC’s Moose Lake Correctionaal Facility for inm
mates
who have not been committted, but face a hiigh likelihood off being committeed. The DOC prrogram
also uses the matrix and phaase system, but does not have thhe MSI and CPS components. We did
P/DOC program
m. When we refeer to MSOP, we are referring to the
not evaluatee the joint MSOP
program thaat operates at thee Department off Human Services sites in Moosee Lake and St. Peeter.

MSOP TREATMENT

57

Clients of the program are indefinitely committed. Decisions to move the client
to CPS or to grant provisional or final discharge are made by a three-member
judicial panel called the Supreme Court Appeals Panel (SCAP) following a
recommendation by a Special Review Board (SRB). The SRB is an independent
three-member panel made up of a mental health professional, a psychiatrist, and
an attorney. SRB decisions may be appealed to the SCAP. In 2003, the governor
issued an Executive Order barring the release of any MSOP clients unless
required by law or ordered by a court.
Prior to 2008, the SRB would make recommendations on transfers, provisional
discharges, and discharges directly to the Commissioner of Human Services.
The commissioner’s decision was appealable to SCAP. In 2008, the Legislature
enacted a law which removed the commissioner from the SRB process and made
SCAP the decision maker.15 To date, no clients have been discharged from the
program.

Type of Treatment at MSOP
MSOP delivers a
type of treatment
that is
recommended by
existing research.

One of the important issues about sex offender treatment at MSOP facilities
concerns the type of treatment provided. We examined whether the type of
treatment delivered at MSOP facilities is what current research suggests is most
effective for reducing recidivism among sex offenders. We found that:
	 MSOP’s current model of treatment conforms to what current
research suggests is most effective in reducing recidivism in sex
offenders.
MSOP’s current approach to treatment is based on cognitive behavioral therapy
and the treatment principles of risk, need, and responsivity. As noted earlier,
current research suggests that cognitive behavioral therapy, which adheres to the
principles of the risk, need, and responsivity, is most effective for reducing sex
offender recidivism.
Cognitive behavioral treatment at MSOP facilities seeks to promote changes in
offenders’ thinking and behavior through group therapy and psychoeducational
classes. This therapy aims to help offenders learn about their ways of thinking
and behaviors that led to committing their offenses. In addition, the residential
program seeks to provide a 24-hour therapeutic environment where clients are
expected to demonstrate that they have changed through their behaviors on the
living unit, in recreation, at work, and in education classes.
Treatment at MSOP facilities consists primarily of six hours of group therapy.
Group therapy is commonly used in sex offender treatment programs. Individual
therapy is provided only in special circumstances in Moose Lake. Individual
therapy is available to clients in Phase Three of the program at St. Peter.

15

Minnesota Statutes 2010, 253B.185, subd. 9.

58

CIVIL COMMITMENT OF SEX OFFENDERS

Staffing
In order for meaningful and intensive treatment to take place, MSOP must have
leaders and supervisors to develop and implement a treatment program as well as
clinicians to deliver treatment to clients. In this section, we discuss some of the
challenges the program has faced in staffing clinical positions and establishing
consistent clinical leadership. Clinical staffing has been more of a problem at
Moose Lake than in St. Peter.

Clinical Leadership
MSOP has had
four clinical
directors in the
last seven years.

Clinical leaders should develop a treatment program based on research, literature,
and theory. They should develop the model of treatment and treatment
expectations, and direct clinicians on how to deliver treatment. Stable leadership
and a consistent treatment program supports clients in progressing through a
long-term treatment program. We found that:
	 Frequent leadership changes have contributed to a lack of continuity
in MSOP’s treatment program.
The program has had three executive directors and four executive clinical
directors in the last seven years. Due to these many leadership changes, the
content of the treatment program at MSOP facilities has changed multiple times
since 2003. With each change in leadership and the treatment program,
clinicians and clients have needed to learn the new program. Also, clients have
had to be reassessed according to new program requirements. At times,
clinicians have lacked supervision to help them make good clinical decisions.
Because of changes in MSOP’s leadership and the treatment program, the
program has not been able to deliver consistent treatment to its residents.
The current executive director of MSOP took the position in March 2008. At
that time, there was no executive clinical director of the program and there had
been no executive clinical director since May 2007. The current executive
clinical director was hired in July 2008. We found that:
	 The current MSOP administration is working to stabilize the clinical
program after years of inconsistent and unstable clinical leadership.
Figure 3.2 shows the clinical leadership structure of the program. The executive
clinical director quickly established two new positions – clinical directors for
both the Moose Lake and St. Peter facilities. The executive clinical director,
along with these facility clinical directors, established the new treatment
program, including the phase system and treatment matrix currently in use. This
program will be discussed in more detail later in this chapter.
The St. Peter facility clinical director has been in place since December 2008.
The Moose Lake facility has had two clinical directors since this position was
first filled in September 2008. Maintaining consistent clinical leadership is
essential to filling current vacancies, retaining existing clinical staff, maintaining
a long-term treatment program, establishing consistent treatment expectations,

MSOP TREATMENT

59

Figure 3.2: Clinical Organizational Structure of
Minnesota Sex Offender Program, 2010
MSOP Executive
Director

Executive Clinical
Director

Moose Lake Facility
Clinical Director

St. Peter Facility
Clinical Director

8 clinical supervisor
positions

3 clinical supervisor
positions

48 clinician positions

20 clinician positions

NOTES: Figure represents MSOP organizational structure related to clinical staffing only, and
excludes rehabilitation department staff providing education, vocation, and recreation services.
“Clinicians” include clinicians running groups and treatment psychologists. Figure shows the number
of positions, including all vacant positions.
SOURCE: Minnesota Sex Offender Program.

While clinical
supervisors are
essential to ensure
consistency of
treatment, MSOP
has had
difficulties filling
supervisory
positions in
Moose Lake.

and giving clients the hope of release that is essential to maintaining motivation
to complete treatment.

Clinical Supervision
Clinical supervision is an essential part of creating a cohesive and effective
treatment program. Clinical supervisors are responsible for assuring that
clinicians are following best practices when conducting treatment groups,
training new clinicians, making final decisions regarding whether a client
progresses or is moved to another unit, and assuring that the treatment program is
implemented in a consistent manner. We found that:
	 MSOP has had difficulty filling clinical supervisor positions at the
Moose Lake facility.

60

CIVIL COMMITMENT OF SEX OFFENDERS

At one point, the facility had only two clinical supervisors and six clinical
supervisor vacancies. When we interviewed one of these two supervisors, her
caseload had recently decreased to 224 clients because a third clinical supervisor
had just been hired. As of January 2011, four of eight clinical supervisor
positions were filled.
With a dearth of clinical supervisors, MSOP has been unable to assure that all
clinicians are implementing a therapeutic style consistent with best practices or
applying the treatment model in the way the clinical directors envision.
Clinicians we interviewed at Moose Lake stated that they did not feel that
everyone was “on the same page” in terms of administering the treatment model
established by the current administration. The executive clinical director told us
that MSOP has actively taken steps to recruit and retain qualified staff. In
addition, she has taken steps to introduce videotaping of treatment groups in
order to assure that all clinicians are delivering therapy in appropriate and
effective ways.

Clinician Staffing

Clinical vacancies
in Moose Lake
have hampered
the ability of
clinicians to
deliver treatment.

The program has had continuing problems maintaining clinical staffing levels
and keeping pace with growth in the client population. As of November 2010, 17
of 68 nonsupervisory clinical positions were vacant. Sixteen of these vacancies
were at the Moose Lake facility. Since then, MSOP has worked rapidly to hire
clinicians. As of January 2011, five clinical vacancies remained at Moose Lake.
Overall, we found that:
	 Clinician caseloads at Moose Lake have been too high due to 

clinician turnover and many clinical vacancies. 

Clinical understaffing has been a very serious problem, which has affected the
ability of the program to deliver treatment to clients. The executive clinical
director said the goal—with a fully staffed program—is to have eight clients per
clinician. This would be in line with caseloads at the facility for civilly
committed sex offenders in Wisconsin, which many of our interviewees
considered to be a model program. However, the clinical director stated that
clinicians at Moose Lake have sometimes had up to 25 clients on their caseloads.
When caseloads are too high, clinicians may be less able to properly document
progress in client files, submit necessary paperwork to advance a client (such as
referrals for polygraphs), provide individual therapy, or observe and assist clients
in their daily behaviors. High caseloads may also lead to delayed assessments of
clients who are not progressing due to a learning disability or other cognitive
difficulty. When clinicians are overworked, those who have the most trouble or
who speak the loudest may get the most attention. Clients who are well behaved
and may be progressing nicely in treatment may not be noticed.
In addition, we observed weak documentation in some clinicians’ files, perhaps
reflecting high caseloads. Some files were missing quarterly or annual reviews
of client progress in 2008, 2009, or 2010. In general, we observed that files in
recent years (since 2008) tended to have much less detail than those from
previous years, suggesting that clinicians either did not have time to fully

MSOP TREATMENT

61

document client behaviors or be fully aware of client behaviors relevant to
treatment.

Clinicians at DOC
facilities and some
other civil
commitment
programs can
receive higher pay
than MSOP
clinicians.

Clinical vacancies have been caused by: (1) staff turnover and (2) growth in the
program, which continually creates a need for more clinicians. MSOP has had
difficulty attracting and retaining clinicians for a variety of reasons. First, MSOP
clinicians have a different employee classification than DOC clinicians within
their union, putting them at a competitive disadvantage. Maximum annual
salaries for DOC’s clinicians can be up to about $10,000 more than MSOP
maximum clinician salaries. Second, the federal and Wisconsin civil
commitment facilities pay more than MSOP. Third, it is sometimes challenging
to attract clinicians to work and live outside of the Twin Cities metropolitan area
(or for clinicians’ spouses to find work in these areas). Fourth, clinicians may
not want to work for MSOP because of its reputation for program instability and
not releasing any clients.
In addition, working at a treatment center for sex offenders can be emotionally
difficult. Staff told us it is hard to treat people who are often reviled in the
community. One clinician said that some staff vacancies are due to normal
“burn out” that is common in many social service professions. It can be difficult
to find clinicians who are willing to work with sex offenders. Inevitably, some
clinicians who are hired to positions in MSOP facilities will discover that they do
not want to work with this population. Despite their challenging work, the
treatment staff we interviewed were committed to the work being done at MSOP
and believed in clients’ ability to change.
Despite these challenges, the program has recently had success in filling many
clinical vacancies. However, having many new clinical staff presents its own set
of difficulties, as these staff are often inexperienced. Clinical staff learn to do
their job through on-the-job training and mentoring by other clinical staff. This
adds to the already large workload of existing clinical staff. It also takes time for
new clinicians to develop the skills of more seasoned therapists.
Due to clinician turnover, clients often have not had the benefit of consistent
clinical care. It is difficult for clinicians who are new to their clients to know
whether a client has improved over time or whether a learning disability,
cognitive problem, or mental illness is hindering the client’s treatment.
In filling clinical vacancies, we found that:
	 Since 2008, MSOP administrators have required new clinicians to
have master’s degrees and be licensed or licensed-eligible in contrast
to past practices.
The current administration inherited some clinical staff who had been promoted
into clinical positions even though they lacked a background in therapy. For
example, some clinicians were formerly security staff, with backgrounds in
criminal justice. Some have only a high school diploma. The administration’s
focus on staffing the program with master’s level clinicians should promote
professionalization in the clinical area and assure that clinicians have a clinical

62

CIVIL COMMITMENT OF SEX OFFENDERS

background that equips them to do the intensive treatment required in the
program.

Amount of Treatment
While MSOP administrators assert that every organized activity at MSOP is part
of treatment, group therapy and psychoeducational modules specifically focus on
delivering sex offender treatment. We examined the amount of treatment
delivered to clients as shown in the schedules of the 41 clients whom we selected
to review.
When comparing the amount of treatment received by clients at MSOP facilities
to clients in other sex offender programs in Minnesota, we found that:
	 The amount of treatment delivered at MSOP facilities is lower than
at any other adult inpatient sex offender treatment program in the
state.
As of November 2010, clients who were participating in treatment at Moose
Lake received six hours of group therapy per week.16 In addition, about half of
the clients in our Moose Lake sample received psychoeducational modules for
generally an hour and a half per week. Clients from the alternative program (the
program for clients with cognitive disabilities located in St. Peter) received six
hours of group therapy per week, plus two hours of additional psychoeducational
modules.17

Unlike other
residential sex
offender
treatment
programs, MSOP
is not required to
comply with a
rule requiring a
minimum
number of
treatment hours.

MSOP delivers less treatment hours to its clients than either of the two other
residential adult treatment programs in the state: the Department of Corrections
(DOC) Sex Offender Treatment Program and the privately operated Alpha
Human Services. With the exception of MSOP, all adult residential sex offender
treatment programs in the state are governed by Minnesota Rules 2010, chapter
2965. The rule requires that clients in these programs receive an average of 12
hours per week of sex offender treatment in the primary phases of treatment.18
The head of the DOC Sex Offender Treatment Program confirmed that clients in
the program receive an average of 12 hours of treatment per week, including
group therapy, individual therapy, psychoeducational programming, and
therapeutic community meetings. Inpatient clients at Alpha Human Services
receive 20.5 hours of scheduled group therapy per week in addition to at least a

16

There was one client in our Moose Lake sample who did not receive six hours of group therapy
per week. This client resided in the Young Adults unit and received additional psychoeducational
modules and therapy in lieu of the entire six hours of group therapy.

17

Clients in Phase Three in St. Peter have generally completed work needed in psychoeducational
modules and therefore received six hours of group therapy, as well as programming (such as
community outings and transitions group) to assist them in preparing for release.

18

Minnesota Rules 2010, 2965.0150, subp. 1. The rule also applies to the joint MSOP/DOC
program in the Minnesota Correctional Facility at Moose Lake.

MSOP TREATMENT

63

half an hour of individual therapy.19 Both the DOC program and Alpha Human
Services have established environments with similar therapeutic expectations as
MSOP for clients to demonstrate and learn behaviors during their daily lives.
MSOP is not governed by Minnesota Rules 2010, chapter 2965 and is not
accredited by any agency outside of DHS. MSOP is governed by a Department
of Human Services administrative rule which does not specify a minimum
number of treatment hours.20 In our sample, the most sex offender treatment
received by a client in the primary phase of treatment (a Moose Lake client) was
eight hours and fifty minutes per week.

Clients at Moose
Lake generally
received between
6 and 7.5 hours of
treatment per
week, while DOC
and a private
residential facility
provided more
hours of
treatment to their
clients.

Programs operating under the DOC rule may count treatment hours differently
than MSOP counts treatment hours. MSOP counts only group therapy and
psychoeducational classes as part of their total treatment hours. Therefore, we
specifically examined the number of hours of group therapy and
psychoeducational classes Alpha Human Services and DOC deliver per week and
compared that to the number of hours per week delivered at MSOP facilities.
MSOP clients at Moose Lake in our sample generally received between 6 and 7.5
hours per week of group therapy and psychoeducational classes. In contrast,
DOC provides between 9 and 10.5 hours per week of group therapy and
psychoeducational classes.21 Alpha Human Services delivers 8 hours per week
of group therapy focusing on general therapeutic issues which affect sexual
recidivism in addition to 7.5 hours per week of group therapy focusing
specifically on sexual behaviors of clients. Clients at Alpha Human Services also
must attend at least a half an hour of individual therapy per week.
Psychoeducational classes are provided periodically on a rotating basis and are in
addition to the hours of therapy described above.22 Therefore, treatment hours at
Alpha Human Services, which are comparable in type of treatment to MSOP
treatment hours, total at least 16 hours per week – or more than double what
MSOP offers.23
The “risk principle” of sex offender treatment literature suggests that the highest
risk offenders should receive the highest intensity treatment. MSOP was
designed to hold and treat the highest risk offenders in the state. However, it
appears that offenders who are lower risk (in the DOC program or Alpha Human
19

Alpha Human Services’ policy is to provide a minimum of 60 minutes of individual therapy per
week. Due to short staffing for four months, they began providing a minimum of 30 minutes of
individual therapy per week. However, some clients received far more than 60 minutes of
individual therapy per week. In addition, Alpha Human Services expects to resume requiring 60
minutes of individual therapy per week in March 2011.
20

Minnesota Rules 2010, 9515.3000-9515.3110.

21

DOC counts between 1.5 and 3 hours per week of therapeutic community meetings towards the
12 hours of treatment they provide. Since MSOP does not count this type of meeting in their tally
of treatment, we excluded that treatment here.
22

We did not include hours of psychoeducational programming in the above tally because classes
are not always provided. However, these classes are offered once a quarter for six to eight weeks
for one and a half to two hours per week.
23

Alpha Human Services also provides five hours of “Behavior Group,” which is similar to DOC’s
therapeutic community meetings. We do not count these hours here because MSOP does not count
this type of therapy as treatment.

64

CIVIL COMMITMENT OF SEX OFFENDERS

Services) receive more intensive treatment as measured by hours of sex offender
treatment per week.

MSOP also has
generally
delivered less
treatment than
civil commitment
programs in other
states.

We also compared the amount of treatment delivered at MSOP facilities to “best
practices” nationally. We found that:


MSOP is at the low end of the range of treatment hours considered
to be best practices for sex offender civil commitment programs.

Outside experts who have been hired annually by MSOP to evaluate the
treatment program have noted that the number of treatment hours provided per
week is on the low end of the range of hours provided by other facilities for
civilly committed sex offenders. They have noted that other programs typically
provide between 6 and 12 hours of treatment programming per week. In 2009,
they recommended that MSOP conform to best practices by increasing the
number of treatment hours provided. It has been difficult for MSOP to schedule
treatment hours due to clinical staffing shortages. In 2009, psychoeducational
modules at Moose Lake were completely suspended for three quarters due to
staff vacancies. While MSOP has increased weekly treatment hours for some
clients from 6 hours to 7.5, the amount of treatment still remains on the low end
of the spectrum as outlined by these experts. MSOP treatment staff told us that
they anticipate increasing treatment hours once the Moose Lake facility is fully
staffed.
We also looked at the percentage of clients who were actually receiving sex
offender treatment. While about 80 percent of MSOP clients are participating in
the treatment program, only about one-fourth are receiving treatment specifically
related to sexual offenses. As of June 30, 2010, about 50 percent of MSOP
clients are in Phase One of the treatment program.24 Phase One of the program
does not focus directly on the behaviors that led to offenders’ commitments.
Rather, Phase One is focused on preparing clients for treatment by asking clients
to demonstrate that they can follow rules and learn how to participate in
treatment groups. Phase One treatment does not explore the reason for
offenders’ sexual offending or help offenders develop tools to prevent
offending.25
Some clients may be “stuck” in Phase One because they lack motivation.
However, some clients may also be in Phase One because the program has not
been sufficiently staffed or because the environment at Moose Lake has not
promoted positive treatment participation. Many clients who are in Phase One
have been at an MSOP facility for years and have participated in a lot of sex
offender specific treatment at MSOP previously. Some of these clients have
expressed frustration that they are no longer in treatment specifically focused on
their sexual offenses.

24
25

With a growing population, there is also a constant influx into Phase One.

MSOP administration noted that addressing behaviors that interfere with treatment is standard in
the early stages of contemporary sex offender treatment programs.

MSOP TREATMENT

65

We also looked at client schedules to determine what they do with their time.
We found that:


Current clients at
Moose Lake
appear to have
less time in
treatment and
scheduled
activities than
clients at MSOP
facilities before
2004.

Most of Moose Lake clients’ time is unstructured.

As discussed above, treatment hours are limited partly by the fact that there have
been persistent clinical vacancies. In addition, there are limited work
opportunities for clients. Therefore, clients who do not participate in treatment
are allowed to work only up to eight hours per two-week pay period; Phase One
clients can work up to 14 hours; Phase Two clients can work up to 24 hours; and
Phase 3 clients can work up to 30 hours. Few, if any, clients are scheduled the
maximum amount of work hours. One clinician at Moose Lake expressed
concern that clients do not even approach having a full forty hours per week of
scheduled activity. In our file review, one client participating in treatment
documented that he had watched 77 hours of television in one week in 2010.
While recreation is available to clients from 8:00 a.m. to 9:00 p.m., client
schedules showed very few scheduled recreation activities. The use of the
gymnasium in Moose Lake is very limited by its current use as a dining hall.26
For Moose Lake clients whose files we reviewed, weekly structured client time
(including treatment, scheduled recreation, work, and education) ranged between
0 and 22.5 hours. In contrast, our file reviews showed that, prior to 2004, some
clients complained about having too many classes, too many groups, and too
many assignments.

RECOMMENDATION
The Department of Human Services should require MSOP to provide more
treatment hours per week.
We believe that high risk sex offenders held at MSOP facilities should receive at
least as much treatment as some lower risk offenders receive at other residential
sex offender treatment programs in the state. DHS should consider promulgating
a rule requiring a minimum number of treatment hours to assure that MSOP
clients receive as much treatment as they would receive at other residential
programs. Delivering additional treatment hours at MSOP facilities will be
challenging while staffing vacancies remain.

The Therapeutic Environment
Many sex offenders have antisocial attitudes, poor interpersonal skills, and
distorted thinking about others that contributed to their sexual offenses. To
create behavior change that will reduce clients’ risk of reoffending, MSOP is
designed to be a 24-hour intensive treatment environment. While formal
treatment takes place in group therapy and psychoeducational modules, clients
receive behavioral guidance in education classes, work programs, recreational
settings, and living units. Clients are observed in all aspects of daily living to

26

Construction due to be completed in 2012 will include a dining hall.

66

CIVIL COMMITMENT OF SEX OFFENDERS

assess whether they apply what they have learned in treatment to their daily
behaviors.
We examined the therapeutic environment at MSOP facilities and found that:

MSOP is designed
to be a 24-hour
treatment
environment, but
faces many
challenges in
creating an
atmosphere
conducive to
treatment.

	 Historically and currently, the program has struggled to create an
environment that fosters client rehabilitation.
Outside advocates and experts, MSOP clients, and some MSOP staff have
complained that, historically and currently: (1) some MSOP staff held
disrespectful, negative, punitive, and untherapeutic attitudes towards clients; and
(2) that the culture at the facilities was counter-therapeutic. In our review of the
records of clients who had been in the program for at least four years, we found
evidence that clients were sometimes treated with suspicion, their reasonable
frustrations were considered treatment problems, and they were sometimes
punished for behavior that appeared to be normal. Under some past MSOP
administrations, the program focused so much on client behaviors that any
infraction could result in a client failing to progress or being sent backwards in
treatment. The program still struggles with staff who are overly suspicious of
clients or who expect impossible perfection. This can make progress in treatment
difficult.
In the sections below, we address several additional specific issues that have
contributed to the challenge of creating and maintaining a therapeutic
environment. These include: (1) the physical design of the facilities, (2) the
balance between security and therapy, (3) changes in the role of MSOP security
counselors, and (4) the difficulty of motivating civilly committed offenders to
meaningfully participate in treatment.

Physical Design of Moose Lake Facilities
The physical environment at MSOP facilities also affects the therapeutic
environment. We found that:
	 The physical structure of Complex One at Moose Lake has made it
difficult to create a therapeutic environment.
Creating a therapeutic environment has been challenging because the newly
constructed “Complex One” was not designed primarily for therapeutic goals.
The structure has two 98-bed living units and three 68-bed units. This design is
more typical of correctional facilities and assures that the building is safe and the
highest number of clients can be efficiently monitored with the smallest number
of staff. However, these units are much larger than the other Moose Lake
building units, all units in St. Peter, and the units of the joint DOC/MSOP facility
located in the Moose Lake Correctional Facility. In addition, units in Complex
One are larger than any unit at the Sand Ridge facility in Wisconsin. Small units
are important because behaviors can more readily be observed and addressed by
staff. Also, it is easier to create a culture among clients of holding each other
accountable when units are small.

MSOP TREATMENT

67

In addition, Complex One units lack any clinician offices. Clinicians for these
units are housed outside the living units in a “bullpen.” The executive clinical
director feels that housing clinicians off the units undermines the residential
nature of the treatment and follows a less intensive outpatient model which
requires clinicians to come to the unit to do treatment.
MSOP’s executive clinical director told us that creating a therapeutic climate on
such large units is very challenging but still possible. Administrators said that,
with renovations due to be completed in 2012, they will be able to create a more
therapeutic environment by placing clinician offices on the units. Despite
acknowledging that the large units in Complex One are less than ideal for
creating therapeutic environments, MSOP is currently planning an expansion
which would create a second building identical to Complex One.

RECOMMENDATION
In evaluating designs for the construction of new living units for MSOP,
the Legislature and DHS should consider the tradeoffs between the
efficiency of staffing large units and the effect of larger units on the
therapeutic environment.
MSOP was able to decrease costs partly because of increased efficiency of
staffing in Complex One. Large units constructed with clear lines of sight allow
the program to use fewer security staff to monitor more clients. However, as
discussed above, using such large units presents difficulties in creating and
maintaining an environment that is suitable for promoting therapeutic change.
Both the security benefits and the therapeutic drawbacks should be considered as
MSOP evaluates its options for additional bed space.

The Security/Therapy Balance
Current MSOP
administrators
inherited a
program with
significant safety
and security
issues.

Current administrators told us that MSOP devoted substantial resources to safety
and security concerns prior to 2008 due to staff assaults and two different
escapes. In addition, some practices at MSOP made security difficult. For
example, clients were allowed so much property that it could take two staff
members eight hours to search a single room. Clients were also allowed to order
food from outside vendors, potentially allowing contraband to be smuggled
inside the food. As a result, the current administration took immediate actions to
address these safety and security concerns.
We evaluated the current administration’s response to previous conditions in the
program. We found that:
	 Starting in 2008, MSOP administrators took significant steps to
address safety and security weaknesses at MSOP facilities and
develop written policies.
Administrators made the perimeter more secure by changing the way food was
distributed to clients. They limited the amount of property clients could have,

68

CIVIL COMMITMENT OF SEX OFFENDERS

established a trained team of first responders, wrote protocols for responding to
emergencies, limited client movement outside of the living units, and trained
security staff in the use of chemical irritants.
In addition, they decided that client living units were overstaffed for the purposes
of security and reduced security staffing on the largest living units from 16
security staff per shift to 2 staff per shift. MSOP’s new management team
believed that a reduction in security staff could be made without sacrificing staff
and client safety. For example, by locking clients in their rooms at night and
establishing a team of first responders, administrators concluded they no longer
needed as many security staff.
Current administrators told us that when they first took over, MSOP did not have
consistent or organized written rules and policies. The absence of written
policies prior to 2008 resulted in inconsistency. Staff on each unit developed
their own rules and there were no policies to hold staff accountable or maintain a
therapeutic environment. The current administration wrote many new policies in
cases where no policy existed before or where generic DHS policies had
previously been used. One of the first tasks of the current administration was to
establish MSOP-specific policies and procedures.
We found that:

Some security
changes made by
the current
MSOP
administration
have adversely
affected the
therapeutic
environment.

	 While the current MSOP administration made needed security
changes, some security changes have adversely affected the
therapeutic environment, particularly at Moose Lake.
In our interviews, we heard widespread agreement among clinicians, clients,
outside advocates, experts, and some MSOP administrators that the program has
recently focused on security to the detriment of therapy. In the absence of
clinical leadership when the current administration took over MSOP in 2008,
some policies were put into place without adequate consideration for the effect
those policies would have upon the therapeutic environment.
Clinicians and clients described how isolated incidents resulted in general
policies which took away privileges from all clients. For example, MSOP
prohibited clients from sharing food with each other. Because of concerns about
inappropriate touching, clients are no longer allowed to shake hands with each
other or staff. Clients who were once allowed to move within the facility on their
own schedule are now required to move together at specifically set times.
Clinicians told us that these types of restrictions undermined their efforts to
promote client independence and prosocial behaviors. Also, they said the new
rules and policies contributed to an “us versus them” attitude between clients and
staff.
Program managers now recognize that some security changes they thought were
necessary in 2008 may be out of balance with therapeutic concerns and told us
they are considering changes. A policy review committee established in
September 2008 includes the executive clinical director and other clinical leaders
to ensure consideration of treatment and the therapeutic environment during the
adoption of program policies. The executive clinical director stated that many

MSOP TREATMENT

69

security policies established early on in the current administration’s tenure were
necessary to create a safe environment for treatment.

Role of Security Counselors
The role of
security
counselors has
changed
significantly.

Perhaps the biggest change to the therapeutic environment was the
administration’s decision to dramatically cut security staff in 2008. Security staff
at MSOP facilities are called “security counselors” as a reflection of the dual role
they hold in both assuring security in the facility and helping clients make
behavioral change in their daily lives. Security counselors are taught to observe
client behavior and report behaviors to clinical staff. They are also supposed to
model good behavior and help clients solve problems.
Security counselors and clinical staff told us that security staffing levels are not
sufficient to perform the therapeutic and observational functions they once had.
In the past, the largest living units had up to 16 security counselors per unit.
These staff documented client behaviors in clients’ records. They also helped
clients complete treatment assignments, intervened to address client behaviors in
a therapeutic manner, listened to clients’ problems and concerns, and checked in
with clients regarding their quarterly treatment goals. Security counselors
participated in MSOP quarterly meetings regarding client progress and also sat in
on treatment groups. Other secure residential facilities, such as the Minnesota
Security Hospital, the Leo Hoffman Center (for juveniles with sex offending
histories), and the Sand Ridge facility in Wisconsin, also utilize security
counselors as a way to maintain a therapeutic presence in living units.
Around-the-clock behavioral information is essential for MSOP to be intensive
enough to create behavior change. This is especially true because MSOP has
many clients with high psychopathy or who are talented at appearing good while
behaving badly. Since clinicians work Mondays through Fridays from 8:00 a.m.
to 4:30 p.m., using security staff as part of the treatment team allows therapeutic
monitoring of clients when clinicians are not in the facility. Input from security
counselors also provides clinicians much needed information about whether
clients have internalized treatment concepts.
While security counselors are no longer allowed to write in clients’ records or sit
in on treatment groups, they are expected to report relevant client behaviors to
clinicians during unit meetings at the beginning and end of each day. In addition,
they are expected to use a communication log to document client behavior.
However:
	 Clinicians we interviewed do not believe that the current level of
communication and security counselor staffing is sufficient for them
to get all the relevant information needed regarding client behavior.
In our review of clients’ records, there was noticeably less information about
client behavior in the most recent years than in earlier years. In the past, many
behaviors were noted by security and then referenced by clinicians in their
quarterly and annual reviews of progress; more recent reviews were less specific
and rarely referenced these behaviors. Lack of documentation in client records
does not necessarily mean that clinicians did not take those behaviors into

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CIVIL COMMITMENT OF SEX OFFENDERS

consideration when making assessments of clients. However, we believe that
when such information is absent from the chart, it is hard for clinicians with very
high caseloads to remember and apply what they have heard from security
counselors in making assessments of client progress.
Outside experts hired by MSOP to evaluate their treatment program commented
in past years on the important role that security counselors played in assisting
clients. The most recent evaluation stated that these favorable therapeutic
components had been reduced with the reduction of security counselor staff,
especially on larger units, and that the program needed to find a way to
compensate for the loss of these staff.
We recognize that there are legitimate reasons for limiting the relationships
between security and clients. When clients and security staff become too close, it
can result in introduction of contraband into the facility and inappropriate
relationships between staff and clients. In addition, our file review suggested that
some security counselors documented irrelevant behaviors of clients and were
overly concerned regarding minor violations.
The executive clinical director stated that security counselors need more clinical
training to know what to document, and that she does not believe that it is proper
for security staff to sit in on group therapy sessions. She also stated that filling
all clinical vacancies and locating clinician offices in living units will help
improve the therapeutic environment. Finally, MSOP will be converting its
documentation systems to an electronic system which will make information
sharing easier, more accessible, and more centralized.

RECOMMENDATION
As clinician positions become fully staffed and clinician offices are located
in living units, MSOP should closely monitor whether staffing in living
units is sufficient to improve the therapeutic environment.

Changing the role
of security
counselors and
reducing their
staffing levels has
affected how
treatment is
delivered.

Reducing security staffing levels and changing the role of security staff has
affected how treatment is delivered, how information is collected on clients, and
the therapeutic environment in MSOP facilities. Since these changes took place,
the Moose Lake facility has not been fully staffed with clinicians. In addition,
remodeling living units to provide clinician offices in the units has not yet been
completed. It is too early to tell whether filling clinical staff vacancies at Moose
Lake and putting clinician offices in living units will improve the therapeutic
environment in the facility. However, MSOP should monitor whether the
changes they have made improve the therapeutic environment at the Moose Lake
facility.

Client Motivation
Client motivation is a prerequisite to successful and meaningful treatment
participation. Clients may not challenge thinking patterns and behaviors they
have held for a lifetime without feeling that the program is there to help them
make those changes. However, we found:

MSOP TREATMENT

71

	 Lack of client motivation has been a barrier to progression in
treatment.

Client motivation
is key to
successful
treatment
participation.

In our focus groups, clients at Moose Lake expressed a great amount of
hopelessness regarding the possibility of their release. Clients cited a 2003
executive order prohibiting the release of anyone from MSOP without a court
order as evidence that the program does not truly seek to rehabilitate them. They
described living at Moose Lake as so stressful under the new administration that
some have sought revocation of their supervision so that they may return to
correctional facilities where they at least saw people being released. Many
clients also struggled with motivation because of the frequent changes in the
treatment programming and in the MSOP administration.
MSOP has taken steps to address client motivation. The former Moose Lake
clinical director conducted a program-wide training on motivational
interviewing, teaching all staff with clinical interactions methods of reaching out
to clients to encourage them to participate more fully in treatment. Motivational
interviewing is also now a part of clinicians’ orientation and continuing training
at MSOP. The executive clinical director stated that the motivational
interviewing training was good for bringing more empathy to the program and a
start in balancing therapeutic and security perspectives.
Perhaps the most important motivator for clients is the prospect of release back to
the community. We found that:
	 The current administration has taken steps toward provisionally
discharging some clients.
MSOP administrators hope that releases from the program will encourage clients
to work hard in treatment and combat some hopelessness. Under the current
administration, MSOP has supported six client transfers to Community
Preparation Services (CPS) residences located outside of the secure perimeter.
MSOP has also opened a second CPS residence outside of the secure perimeter.
The current administration has re-evaluated all Phase Three clients and
administered detailed personality tests to assure that those clients nearing release
have truly internalized their treatment. MSOP has supported six petitions to the
Special Review Board for clients to transfer from the MSOP Supervised
Integration program within the perimeter to the CPS program. MSOP has also
supported two petitions for provisional discharge of CPS clients. In order to help
motivate both clients and clinicians at Moose Lake, the administration brought
some CPS clients to Moose Lake to talk about the treatment program at St. Peter
and the reintegration program.
While we found that the administration is taking client releases seriously, it is
important to note that:
	 Only 7 percent of MSOP clients are in the last of the program’s
three phases of treatment.
As of February 1, 2011, there were 7 residents at CPS and another 30 clients in
Phase Three of treatment. Clinicians we interviewed at St. Peter expressed

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CIVIL COMMITMENT OF SEX OFFENDERS

concern that there was a “clogged drain” in Moose Lake, but the executive
clinical director stated that there were not clients in Moose Lake who were ready
to move to St. Peter. She noted that changing clients’ behaviors can take many
years. To make progress in treatment and be considered for release, she said
clients need to demonstrate that they have changed.
However, some clients are unwilling to change and are not participating in
treatment. About 20 percent of MSOP clients do not participate in treatment.
This is consistent with the levels of nonparticipation at other civil commitment
programs nationally. Even in Wisconsin, where clients are routinely released,
some clients are pessimistic about treatment or refuse to participate.
We recognize that some clients will never be able to complete the treatment
program because they are unwilling or unable to change their behaviors.
However, for clients who want to change, MSOP should consider additional
ways to provide motivation.

Few privileges
exist to motivate
Moose Lake
clients.

For example, there are few privileges at Moose Lake to motivate clients, and
some clients refuse to believe that clients in St. Peter are allowed to live outside
the secure perimeter or go on outings off campus. Currently, the only motivating
privileges for Moose Lake clients are being eligible for additional work hours
and having the chance to have their own room in a smaller unit when they reach
Phase Two of treatment. Clients at Moose Lake formerly had incremental
privileges associated with their treatment participation and progress, but new
rules have curtailed privileges such as ordering food from outside or using the
barbecue grill. Officials at the Sand Ridge facility in Wisconsin told us that
privileges, however small, are essential to keeping clients motivated. Moose
Lake clinicians also told us that they viewed privileges as an important
therapeutic tool.

RECOMMENDATION
MSOP should consider creating an incremental privilege system for clients
in the early phases of treatment in order to increase client motivation.
Increasing client motivation to participate in treatment is essential to helping
clients progress through the treatment program. From a security standpoint, it
may be difficult to monitor clients with different privilege levels. However, in
order to balance therapeutic and security concerns as well as to encourage clients
to participate in treatment, we believe that MSOP should consider using some
privileges to motivate clients.

ASSESSMENTS OF NEED AND
TREATMENT PROGRESS
Sex offender treatment literature generally suggests that treatment should address
areas which are linked to reoffending for each individual (the need principle).
MSOP identifies each client’s “dynamic” risk factors for recidivism and seeks to
address these factors in each phase of treatment. Dynamic risk factors are those

MSOP TREATMENT

73

risk factors which are changeable by the client. For example, many offenders
have hostility toward women or emotionally identify with children.
In this section, we discuss how MSOP assesses the changeable risk factors that
clients possess, as well as how MSOP evaluates clients’ progress in addressing
these risk factors. Whether clients have clear goals and expectations in treatment
affects how well they can progress and complete the treatment program.

Treatment Assessments and Planning
Upon admission to MSOP, clinicians assess which dynamic risk factors affect the
client. Individual treatment plans are prepared showing which dynamic risk
factors the client needs to address to reduce their risk of offense and how those
risk factors will be addressed. Clients’ progress is reviewed quarterly by the
client’s primary therapist and that therapist’s clinical supervisor. A more
thorough review with the client’s entire treatment team is performed annually.
This annual review is used to create annual individual treatment plans.
We examined whether treatment plans and reviews were individualized and
specific enough to give meaningful information about treatment expectations.
We found that:
	 MSOP treatment plans and reviews are individualized and set
meaningful goals, but do not provide the level of detail as past plans
and reviews, nor are they as explicit about how clients can advance
in treatment.

Some periodic
reviews of client
progress
contained
insufficient detail.

Treatment goals are individualized in that each offender is expected to make
behavioral changes related to the specific dynamic risk factors that have been
identified for him. Treatment plans and quarterly reviews make specific
references to the challenges individual clients face and their successes in
treatment. However, it is not always clear from these reviews what the client
needs to do to advance in treatment, especially when the client is meeting all
their goals and doing well in treatment. Clinicians also do not always explain or
discuss how they came to their conclusions about client progress.
The amount of detail included in both annual and quarterly reviews varied among
clinicians. Some clinicians made summary conclusions without providing
evidence or specific events that led them to their conclusions. Others provided
examples of things that the client did or said that supported their conclusions
about the client’s progress. For example, in one file we reviewed, the clinician
stated only that the client “can deploy prosocial problem solving skills in place of
emotion focused or avoidant responses to stress or problems.” Another client
whose file we reviewed also did well in the area of prosocial problem solving.
However, the clinicians writing the review discussed specific examples of how
the way he solved specific problems over the course of the quarter demonstrated
this skill.
We believe that detailed feedback, regarding both positive and negative
behaviors, is more helpful for clients. It is also helpful to outside reviewers, such

74

CIVIL COMMITMENT OF SEX OFFENDERS

as the Special Review Board, county attorneys, defense attorneys, and county
social workers. The detail provided in some reviews provides more specific
guidance on what behaviors a client needs to continue or to change.

Reviews of client
progress under
past
administrations
contained far
more detail.

Quarterly reviews and treatment plans written under some past administrations
often involved much more specific detail about client behaviors that related to his
goals and his progress in treatment. In addition, reviews included reports from
all staff including security staff, recreation staff, medical staff, vocational staff,
and clinical staff. Accordingly, observations related to treatment goals were less
likely to be confined to observations from treatment groups.
The executive clinical director acknowledged that past plans and reviews
contained more and diverse specific detail. She noted that the program did not
deliver treatment for eight to ten working days between trimesters so that staff
could do all the documentation required. This resulted in the program not
delivering treatment for one month out of the year, which she found
unacceptable. In addition, she pointed out that she and the facility clinical
directors made a decision in July 2009 to make quarterly reviews less detailed
and formal than they had been in the past. Instead, they chose to make annual
reviews a more comprehensive review process.
Based on our observations, annual reviews conducted since the policy changed in
July 2009 do give more information than quarterly reviews. However, they still
often rely heavily on summary statements without providing specific details
regarding why a client advanced (or not) and how he was meeting his treatment
expectations. In addition, while annual reviews involve the entire treatment
team, they still do not reflect the input of vocational, recreational, education, and
security staff to the extent that past reviews did. These staff are ostensibly part of
the client’s treatment in the inpatient environment at MSOP, but they are not part
of the treatment review process that they once were.
Some of the differences between the level of detail in treatment plans and
reviews may be due to being understaffed and having newer, less seasoned
clinicians who are continually being hired to keep up with the program’s growth.

RECOMMENDATION
MSOP should train and supervise clinical staff to assure that quarterly and
annual reviews contain enough specific detail to provide meaningful
feedback to clients and others regarding treatment progress.
Lack of detail in reviews of client progress can be a result of clinicians being
overworked. In addition, MSOP may not currently have sufficient clinical
supervisors to assure that all clinicians are consistently documenting sufficient
relevant detail to be helpful to clients, outside reviewers of client progress, and
clinicians who may treat clients in the future. As MSOP continues to hire new
clinical staff as well as clinical supervisors, the program should assure that staff
are trained to write reviews with a meaningful amount of detail. The program
should also monitor whether information on client behavior is being effectively

MSOP TREATMENT

75

shared between clinical staff and security, vocation, education, and recreation
staff.

The “Matrix” and Measures of Progress
A “treatment matrix” is the main tool used by MSOP to assess clients’ treatment
needs and progress. This matrix was developed by MSOP, and clinicians began
using it in the spring of 2009. As shown in Table 3.1, the treatment matrix
focuses on ten behavioral areas which are linked to dynamic risk factors
identified in the recidivism literature.27 The matrix outlines specific behaviors
that clients must demonstrate to address their risk factors and progress through
treatment. Table 3.2 shows an example of one behavioral area and the specific
expectations for each phase of treatment. In our interviews, we found that:
	 MSOP’s treatment matrix is highly regarded by MSOP clinicians
and professionals outside of MSOP.
MSOP clinicians said the matrix is empirically sound and provides clients with
specific behavioral targets. The matrix outlines a clear progression in treatment
for clients which did not exist before 2010. Outside experts hired by MSOP
found that the matrix was clearly linked to empirically based risk factors that
clients can change through treatment. Officials at the Sand Ridge facility in
Wisconsin told us the matrix closely resembles the tool they use to evaluate
clients’ progress in treatment.
While the matrix is clearly rooted in the literature,28 we found that:
	 Treatment matrix standards are somewhat undefined and overly
subjective.

The main tool
used by MSOP to
assess treatment
progress needs to
be applied more
consistently.

MSOP clinicians were trained on the matrix when it was introduced in the spring
of 2009. However, many clinicians told us the matrix was not uniformly applied
and suggested that MSOP set standards for interpreting the tool. Some clinicians
stated that some MSOP therapists were too rigid in their interpretations, requiring
impossible perfection from clients, while others imposed a more lenient standard.
Clinicians and outside reviewers alike felt that the program needs to take actions
to improve consistency between clinicians in applying the matrix. Outside
reviewers recommended developing a treatment manual or providing further
training in order to establish more objective standards for interpreting client
progress according to the matrix. The MSOP clinical director stated she is
working on a treatment manual which will include a clinician guide on the
matrix.

27

See Karl Hanson and Kelly Morton-Bourgon, “The Characteristics of Persistent Sexual
Offenders: A Meta-Analysis of Recidivism Studies” 12 no. 6 (2005): 1154-1163; and Karl Hanson,
“Risk Assessment” (Beaverton, OR: Association for the Treatment of Sexual Abusers, 2000).
28

Ibid.

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CIVIL COMMITMENT OF SEX OFFENDERS

Table 3.1: Dynamic Risk Factors and Their
Corresponding Behavioral Areas on MSOP’s
Treatment Matrix
Treatment Matrix Behavioral Area
Group Behavior

Attitude Toward Change	
Self Monitoring

Thinking Errors	

Prosocial Problem Solving
Emotional Regulation
Interpersonal Skills

Cooperation with Rules	
Sexual Functioning

Productive Use of Time 	

Dynamic Risk Factors






























Resistance to rules or supervision
Negative social influences
Poor self-regulation
General hostility
Hostility toward women
Offense supportive attitudes
Antisocial attitudes and behavior
Poor self-regulation
Antisocial attitudes and behavior
Impulsivity
Sexual preoccupation
Deviant sexual interests
Sexualized coping
Offense supportive attitudes
General hostility
Hostility toward women
Antisocial attitudes and behavior
Negative social influences
Poor self-regulation
Impulsivity
Emotional congruence with children
Poor adult attachment
Negative social influences
Resistance to rules or supervision
Antisocial attitudes and behavior
Sexual preoccupation
Deviant sexual interests
Sexualized coping
Unstable Work History

SOURCE: Minnesota Sex Offender Program (MSOP) Program Manual, (St. Paul, September 2010),
23-24.

The current
clinical director
has also
introduced some
objective
measures of
treatment
progress.

While the matrix is the main tool used to assess client progress, the current
executive clinical director has also introduced the regular use of objective
measures of sexual interest and behavioral compliance. These objective
measures are commonly used in other sex offender treatment programs. They
include the penile plesmograph (PPG), polygraph testing, and the Able
assessment of sexual interest. The PPG and Able tests measure clients’ sexual
interests. The polygraph is used to determine whether clients are telling the truth
about what they are doing in treatment. For example, the tester may ask the
client if he has broken any facility rules. In addition, clinicians record elements
of client behavior in therapy groups. For example, therapists track the number of
times per quarter that a client references their offense pattern in group.

MSOP TREATMENT

77

Table 3.2: Sample Matrix Behavioral Area (Emotional
Regulation)
Phase	

Treatment Goals

Phase One	

(a) Express emotional responses proportionate to situations (neither
excessive nor flattened).
(b) Maintain safe, responsible behavior when experiencing strong
emotions.
(c) Recover from difficult or intense emotions appropriately, asking for
help as needed (rather than shutting down or thinking about them
angrily for a long time).

Phase Two	

(a) Develop a healthy awareness of emotions (neither denying nor
suppressing them).
(b) Expand range and repertoire of emotional responses.
(c) Refrain from dwelling on emotions in a way that interferes with
healthy functioning.

Phase Three	

(a) Increase self-reliance when it comes to managing emotional
responses.
(b) Manage lifestyle and cope with events in a way that demonstrates
a healthy range of appropriate emotions.
(c) Recognize the link between dysfunctional emotional reactions and
activation of maladaptive schemas.
(d) When maladaptive schemas have been triggered, use effective
coping strategies to restore healthy emotional regulation relatively
rapidly and without self-injurious, hostile, or impulsive behavior.
(e) Apply mindfulness skills to assist in regulating emotions and
focusing attention.
(f) Practice and generalize emotional regulation skills to environments
that offer more freedom, choices and different temptations.

SOURCE: Minnesota Sex Offender Program (MSOP) Program Manual, (St. Paul, September 2010),
21.

RECOMMENDATION
MSOP should complete the treatment manual. This manual should
include clear clinical guidance on the interpretation of the matrix.
With many clinical and supervisory vacancies and turnover, the program cannot
rely solely on mentoring and clinical supervision to assure that the matrix is
consistently applied. Clinical judgment of clients’ behavior change will always
be somewhat subjective. However, the program can establish clearer parameters
for client behavior in each phase. Completing the treatment manual and
including clear guidance on matrix terms and phase expectations should help
create consistency in clinical decisions.

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CIVIL COMMITMENT OF SEX OFFENDERS

CLIENTS WITH SPECIAL NEEDS
MSOP is intended to serve the needs of any individual who is committed as a
sexually dangerous person or sexual psychopathic personality. Whether the
program can meet the unique needs of its clients affects how well clients can
progress through treatment. To meet the diverse needs of MSOP clients, we
found that:


The program has created specialized living units and programs.

As shown in Table 3.3, MSOP has created specialty units for clients needing
assisted living care, clients who have disruptive or threatening behavior, clients
with high psychopathy, clients with significant mental health diagnoses, clients

Table 3.3: MSOP Programming Units
Programming Unit	

Description of Activities

Admissions 	

Clients newly admitted to MSOP and/or going through
commitment proceedings. Clients participate in assessments
required by licensing.

Assisted Living Unit 	

Clients who are medically compromised to the extent of
requiring specialized care.

Behavior Therapy Unit 	 Clients who demonstrate behaviors that are disruptive to the
general population and/or affect the safety of the facility (i.e.,
assaults on staff/peers, thefts, predatory-type behaviors, etc.)
are treated in this unit with the goal of mainstreaming once the
interfering behaviors have been successfully addressed.
Corrective Thinking
Unit

Clients with high and very high levels of psychopathic traits.
Traits include: Grandiosity, instrumental emotions, impulsivity,
need to dominate, callousness, irresponsibility,
conning/deception, not accountable, belligerent, and lack of
sustained effort.

Skill Building Unit 	

Clients with significant mental health diagnoses, Axis I
diagnoses that do not meet the requirements for a transfer to
the Minnesota Security Hospital, and/or significant personality
disorders that result in persistent emotional instability and/or
potential self harm.

Therapeutic Concepts
Unit

Clients actively choosing not to participate in sexual offender
specific programming.

Young Adult Unit 	

Clients who are between the ages of 18 and 25 and do not
meet criteria for the Alternative Program or CTU programming.

Alternative
Programming

The alternative program in St. Peter currently houses clients
who have “compromised executive functioning” and who could
not be successful in the conventional programming track.
Phases One, Two, and Three for the alternative program and
the reintegration stages of treatment are all based in St. Peter.
Alternative program clients address the same matrix factors as
conventional clients, though approaches to treatment differ in
particular ways to ensure needs are effectively addressed.

SOURCE: Minnesota Sex Offender Program (MSOP) Program Manual, (St. Paul, September 2010),
31.

MSOP TREATMENT

79

who are 25 years or younger, and clients with cognitive difficulties or with low
IQs. In addition, the program has conventional treatment units where most
clients receive treatment. Because of the limitations of our sample size for our
file review, we were unable to specifically evaluate treatment on specialty units,
with the exception of the alternative program.
Generally in our file reviews and interviews, we found that there were concerns
that some clients with cognitive deficits and those with psychiatric issues did not
have their needs met by the program. In this section, we first discuss clients in
the alternative program who are very low functioning. We next discuss higher
functioning clients who have some cognitive deficits but are not being treated in
the alternative program. Finally, we discuss the availability of psychiatric care in
MSOP facilities.

Clients with Cognitive Deficits
There are three groups of clients at MSOP who have some cognitive deficits
which may affect their treatment progress. Some clients are diagnosed as
mentally retarded due to having IQs less than 70 or other profound deficits in
their cognitive functioning. Prior to their civil commitment, these lowest
functioning clients likely did not ever live independently or have a job. The
second group of clients is higher functioning and often has IQs between 71 and
80. These two groups of clients have been found by MSOP clinicians to have
compromised executive functioning, as evidenced by low IQs, profound learning
disabilities, traumatic brain injury, or neurological impairment. Cognitive
difficulties make it difficult for these clients to succeed in conventional
programming. These two groups of clients are treated in the alternative program.
A final group of clients with cognitive deficits is higher functioning than
alternative program clients, but still struggles with low intelligence, learning
disabilities, memory problems, or other cognitive deficits that can affect their
ability to do treatment. These clients are in the conventional treatment program
in Moose Lake and St. Peter.

The Alternative Program
MSOP’s lowest
functioning clients
may not be able to
complete the
treatment
program.

The alternative program is located in a MSOP building on the St. Peter campus.
Alternative program treatment follows the same “treatment matrix” as
conventional MSOP treatment and clients advance through the same three phases
of treatment. As of May 2010, there were 98 clients in the alternative program.
Figure 3.3 shows alternative program clients by phase of treatment.
We evaluated how the alternative program meets the needs of the two groups of
lowest functioning MSOP clients it serves. We found that:
	 The lowest functioning alternative program clients may not have the
cognitive skills to complete the MSOP treatment program.

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CIVIIL COMMIT
TMENT OF SEX OFFEN
NDERS


Figure
e 3.3: Alte
ernative Program Client Po
opulation
n by
Treatm
ment Phas
se, 2010
Phase One
47%

Decliining
Treattment
10
0%

Phase Two
30%
%

Phase Thrree
13%

NOTE: Figu
ure shows alternative program clients by phase as of May 20, 201
10.
m.
SOURCE: Minnesota Sex Offender Program

Historicallly, civilly committed sex offenders whho were diagnosed as mentaally
retarded were sent by MSOP to a seeparate DHS treatment proogram called Special
Needs Serrvices. This program is deesigned speciffically for low
w functioningg,
SOP
cognitivelly impaired persons with sexually danggerous behavioor. Some MS
clients whho were sent to Special Neeeds Services were assessed by that proggram
to not havve the ability to complete a cognitively based treatmeent program.
Special Needs Services treated these clients to thhe extent that they could bee
treated.
OP administraation separatedd from DHS’s State Operaated Services
The MSO
division inn 2008, and low functioninng MSOP clieents who had been treated at
Special Needs Services were movedd back to MSOP in the new
wly created
alternative program. The decision to move thesee clients back to MSOP waas
made withhout executivve level cliniccal input. Thee decision was made by thee

MSOP TREATMENT

81

MSOP executive director during a time when there was neither an executive
clinical director for the program nor a clinical director on the St. Peter campus.29
These lowest functioning alternative program clients are now expected to
complete the same, cognitively based treatment program that all MSOP clients
are expected to complete. While the alternative program provides some support
to help clients learn and retain treatment concepts, alternative program clients are
expected to complete all three phases of treatment and master all aspects of the
treatment matrix. In order to complete treatment, clients must be able to
understand their own thinking patterns and sustain changes in behavior and
thinking that could lead to reoffending. As past assessments of MSOP clients
treated at Special Needs Services show, some current alternative program clients
are not cognitively able to complete MSOP treatment.
The executive clinical director of MSOP stated that she is considering supporting
provisional discharge or transfer to another treatment setting for clients in the
alternative program who have been assessed to have learned the most they can
from sex offender treatment. The program is currently assessing the cognitive
function of some clients. The executive clinical director believes that there are
some clients in the program nearing the point where they can learn no more from
MSOP treatment.
While some alternative program clients cannot complete the program, these
clients can be assisted to learn certain parts of the treatment program. In
addition, some higher functioning alternative program clients have the cognitive
ability to complete MSOP treatment in its entirety. To assist both these groups of
clients, the alternative program uses treatment tools specifically designed to help
those with cognitive deficits understand treatment concepts and expectations.
These tools include: pictorial representations to help clients understand their
feelings, schedules, individualized treatment plans, and risk factors; art therapy;
shorter group therapy meetings to accommodate the shorter attention span of
some clients; and cue cards to help clients manage their risk factors. The
program recently created a relaxation room which provides an opportunity for
alternative program clients to calm themselves in a quiet environment. The
schedules of alternative program clients appear to be more structured than those
of conventional program clients, with more activities and classes regularly
scheduled. The St. Peter clinical director is also working on developing an
alternative matrix which uses language that is easier for alternative program
clients to understand.
Some alternative program clients are close to: (1) completing their treatment or
(2) being determined to have received the maximum benefit they can receive
from treatment. However, we found that:

29
MSOP management stated that this decision was made in part to protect clients from mentally ill
and dangerous clients who were also being treated at SNS as well as to consolidate all civilly
committed sex offenders at MSOP. MSOP management also expressed concern that SNS did not
provide adequate sex offender treatment to MSOP clients who were placed there.

82

Currently, there
is no clear release
path for low
functioning
MSOP clients.

CIVIL COMMITMENT OF SEX OFFENDERS

	 The program has not yet developed and implemented an alternative
release path for low functioning alternative program clients.
The release path established by MSOP consists of a client first moving to the
CPS facility outside of the secure perimeter and then being provisionally
discharged to a halfway house in the community. However, the release path for
some alternative program clients will probably have to be very different since
many of these clients will never be able to live independently in the community.
Several clinicians at St. Peter expressed concern that program officials have
focused on releasing conventional program clients, but have not developed
suitable release plans for some alternative program clients. Some of the lowest
functioning alternative program clients will need lifelong support, both with daily
living and with continuing to apply the treatment concepts they have learned.
However, few group homes exist that would accept these clients and be able to
help them adhere to their relapse prevention plans. MSOP administrators
acknowledge that they face unique difficulties in releasing these developmentally
disabled sex offenders from the program.
In addition, we found that:
	 Some low functioning alternative program clients likely do not need
the same level of security as other MSOP clients.

Some low
functioning clients
do not need to be
in a high security
facility, but will
continue to need
support with
treatment and
daily living skills.

We conducted a focus group with alternative program clients who were
previously in Special Needs Services, and we also reviewed several clients’
Special Needs Services files and alternative program files. We learned that many
of these clients had successfully managed significantly more freedoms and
privileges at Special Needs Services than they are currently allowed at MSOP
facilities. For example, these clients had been allowed use of the Minnesota
Security Hospital pool and had taken supervised on-campus walks. These are
privileges now reserved for clients in Phase Three of MSOP.
Security at MSOP is designed to contain clients who are highly intelligent
criminals. Although alternative program clients have also committed criminal
offenses, some of these clients likely do not have the planning and reasoning
ability to get beyond basic security measures. One clinician at MSOP stated that
she felt that some clients could be managed without razor wire by simply placing
alarms on the windows so that the clients knew they should not leave.

MSOP TREATMENT

83

RECOMMENDATIONS

MSOP should develop and implement a plan for identifying when certain
low functioning alternative program clients who are not cognitively able to
complete treatment can be managed in a less restrictive setting. MSOP
should petition the Special Review Board (SRB) for transfer or provisional
discharge of these clients to an alternative setting.
MSOP should develop and implement a plan for managing transferred or
provisionally discharged low functioning alternative program clients in an
alternative setting.
Some low functioning MSOP clients lack the capacity to complete MSOP’s
cognitively based treatment program. Keeping these clients, some of whom can
be managed without being kept in a high security facility, at an MSOP facility is
counterproductive. MSOP should treat these individuals to the extent that their
cognitive abilities allow and then petition the SRB for transfer or provisional
discharge of these clients to an alternative setting that can provide individualized
support to these clients.
MSOP has the capacity to evaluate whether certain alternative program clients
have received the maximum benefit from sex offender treatment and can manage
their risk with continued support. MSOP also has the legal authority to petition
the SRB for placement of these clients in either another treatment center or
provisionally discharging these clients.30 These clients can likely be safely
managed in a group home or facility that is focused on helping them maintain
daily living skills and retaining the sex offender treatment behaviors and
concepts they have learned. MSOP should develop and implement a plan so that
these clients can reside at a facility or in a group home that is more appropriate to
their needs while at the same time protecting public safety.

Clients with Cognitive Deficits in the General MSOP Population

Some clients
struggle in the
conventional
program due to
cognitive
difficulties.

Clients with severe disabilities are placed in the alternative program. However,
according to our file reviews and interviews with clinicians, many clients in the
conventional program also struggle with cognitive difficulties. We found that:
	 MSOP has had difficulty identifying and meeting the needs of some
clients with low IQs, learning disabilities, memory problems, and
certain less obvious cognitive problems.
Identifying clients with low IQs, learning disabilities, and other cognitive
disabilities can be very difficult in any context. Failing to identify and meet the
special needs of clients at MSOP facilities can result in a client not participating

30

Minnesota Statutes 2010, 253B.185B, subd. 9(c), provides that the head of the treatment facility
may petition the SRB for a reduction in custody. This includes transfer to another treatment facility
as well as provisional discharge and discharge.

84

CIVIL COMMITMENT OF SEX OFFENDERS

in treatment (for example, because they cannot read), not progressing in
treatment, or progressing very slowly in treatment. Clients with learning
disabilities or other special needs at MSOP facilities have often developed ways
to mask their disabilities through more advanced social skills. Masking their
disabilities can be a form of survival for clients who do not want to be perceived
as vulnerable or “slow” by other clients. In addition, it may be hard to identify
some clients with cognitive issues because they refuse to participate in treatment,
so there is no opportunity to observe the client struggling.
Suspicions that clients are malingering can also affect whether clients’ special
needs are identified in a timely way. Treatment is hard for many clients and
clinicians sometimes suspect that a client is unwilling to put in the hard work
required rather than being unable to do the work.
We saw evidence in client files that some clients’ progress was delayed because
clinicians suspected they were malingering or not trying when, in fact, they had
cognitive or learning disabilities that hindered their treatment. For example, a
MSOP psychologist concluded in one file that a client was faking his memory
problems and inability to understand treatment. Four years later, a
neuropsychological assessment was ordered, and it showed that the client’s
working memory was poor and affected his ability to learn treatment concepts.
We also found that:
	 MSOP adapts materials and provides supplemental education to
clients who need extra help, although clinicians said some clients’
needs are still unmet.
Clients with low IQs, learning disabilities, and other cognitive difficulties who do
not meet the criteria for the alternative program are assisted in conventional
treatment groups through individual tutoring, treatment assignment
modifications, and supplemental education classes. Treatment at MSOP facilities
is based on critical thinking, reading, and writing. Failure to address learning
disabilities or academic deficits can hold clients back. We found evidence in
some clients’ files that learning disabilities and academic deficits were identified,
and that the program worked with clients individually to help them in their
treatment. For example, MSOP facilitators simplified handouts and made
audiotapes for one client. Another client was identified as having academic
deficits and was given supplemental education.
Clinicians expressed concern that some client needs continue to be unmet. One
clinician described how some clients struggling in the conventional program
were referred, but not accepted, to the alternative program. There are no firm
criteria for clients to be admitted to the alternative program. Rather, clients are
assessed on an individual basis to see if the alternative program is appropriate for
them. Another clinician stated that Moose Lake had once established a group for
individuals with cognitive difficulties, but running the group was too exhausting
for already overworked staff. In addition, clinicians felt that ad hoc supports
offered to clients have sometimes been insufficient.

MSOP TREATMENT

85

Clients with Psychiatric Needs
MSOP is required by a Department of Human Services (DHS) rule to have a
psychiatrist perform evaluations, prescribe medications, and monitor clients
needing psychiatric care. In the past, State Operated Services provided all
psychiatric care for MSOP clients. Since 2008 when MSOP separated from State
Operated Services, MSOP has had to find alternate psychiatric services. We
found that:
	 MSOP does not have a staff psychiatrist and has had difficulty
contracting with an outside psychiatrist.

Professionals we
interviewed
expressed concern
that the
psychiatric needs
of some clients are
not fully met, thus
making treatment
difficult.

MSOP employs psychologists trained in general mental health issues, as well as a
physician and psychiatric nurse practitioner. MSOP receives a variance from
DHS which allows licensed mental health professionals (such as a licensed
psychologist or a psychiatric nurse practitioner) to perform some of the functions
of a psychiatrist. These functions include evaluations of clients and prescribing
and monitoring the use of psychotropic medication. The variance requires a
psychiatrist to review new medications and medication changes. Clients
receiving psychotropic medications must be seen in person or via internet
conferencing every 12 months. While the program currently has a psychiatrist on
contract to see clients via internet conferencing and is currently in compliance
with the variance, MSOP has had difficulty in the past retaining a contract
psychiatrist. As a result, clinical staff, outside advocates, and clients expressed
concern that some clients’ psychiatric needs have not been fully met. Failure to
address the psychiatric problems of some clients may interfere with the clients’
ability to receive sex offender treatment. Further, it can be difficult to discern
whether clients with behavioral problems suffer from a mental illness that
interferes with their treatment or are purposefully misbehaving.

RECOMMENDATION
MSOP should assure that clients have access to psychiatric care.

CLIENT RELEASES
To date, MSOP has not had any “successes” in releasing clients. In this chapter,
we discussed how inconsistency in clinical leadership, clinical vacancies, a
problematic treatment environment, vague standards for assessing treatment
progress, and the challenges of meetings clients’ special needs have likely
contributed to the lack of releases. In this section, we discuss how Minnesota’s
standards for release may also contribute to the lack of client releases from
MSOP.
Minnesota statutes spell out the process for reductions in custody that may occur
after a sex offender receives treatment at an MSOP facility. A reduction in
custody means a provisional discharge or a discharge from commitment. It also
includes a transfer out of a secure treatment facility and into another treatment
facility, with the only option currently used being MSOP’s Community

86

CIVIL COMMITMENT OF SEX OFFENDERS

Preparation Services, a transitional residence located on the St. Peter campus
outside the secured area.
Minnesota law requires the Commissioner of the Department of Human Services
(DHS) to establish one or more panels of a special review board (SRB) which
consists of three members. One panel member must be an attorney and one must
be a psychiatrist. All members must be experienced in the field of mental illness.
No member can be affiliated with DHS. Petitions for reductions in custody or an
appeal of a revocation of provisional discharge may be filed with SRB by the
committed person or the head of MSOP.31

The courts make
final decisions
regarding client
releases.

SRB must hold a hearing on each petition and consider any statements from
victims. Within 30 days of the hearing, SRB must issue written findings and
recommend denial or approval of any petition to a judicial appeal panel. The
commissioner must forward the recommendation to the panel. The judicial
appeal panel (also known as the Supreme Court Appeal Panel, or SCAP) is a
panel established by the Supreme Court. It consists of three judges and four
alternate judges appointed from the acting judges in the state. Each member
serves for one year. Three judges from the panel hear petitions for a rehearing
and reconsideration of SRB recommendations.
Following SRB’s decision, the committed person, county attorney from the
county of commitment, or commissioner may file a petition for rehearing and
reconsideration by SCAP.32 If no party petitions SCAP, SCAP may either adopt
SRB recommendations or set the matter for a hearing. Any person may oppose
the petition to SCAP. SCAP decisions may be appealed to the Minnesota Court
of Appeals within 60 days of the SCAP decision.

Treatment
progress is one of
the factors
considered by the
courts in release
decisions.

No civilly committed sex offender may be transferred, discharged, or
provisionally discharged without majority approval of SCAP. Upon approval by
SCAP, the commissioner may transfer a civilly committed sex offender out of the
secure treatment center to another treatment center when a transfer is appropriate.
In determining whether a transfer is appropriate, the following factors must be
considered: (1) the person’s clinical progress and present treatment needs, (2)
the need for security to accomplish continuing treatment, (3) the need for
continued institutionalization, (4) which facility can best meet the person’s needs,
and (5) whether the transfer can be accomplished with a reasonable degree of
safety for the public.
Factors to be considered in determining whether a committed person may be
provisionally discharged include: (1) “whether the patient’s course of treatment
and present mental status indicate that there is no longer a need for treatment and
supervision in the patient’s current treatment setting; and (2) whether the
31
The committed person may not petition the SRB sooner than six months following the issuance
of the commitment order and exhaustion of appeal rights. The committed person may petition SRB
every six months after an SRB recommendation or after appeals of the SRB recommendation have
been exhausted.
32

The petition must be filed with the Supreme Court within 30 days of when the commissioner
forwarded the SRB decision to SCAP. The hearing must be held within 180 days of the filing of
the petition.

MSOP TREATMENT

87

conditions of the provisional discharge plan will provide a reasonable degree of
protection to the public and will enable the patient to adjust successfully to the
community.”33 A provisional discharge plan must be developed, implemented,
and monitored by the head of MSOP.34
A civilly committed sex offender may be fully discharged only after a
determination is made by SRB and SCAP that the person “is capable of making
an acceptable adjustment to open society, is no longer dangerous to the public,
and is no longer in need of inpatient treatment and supervision.” In making a
determination regarding discharge, SCAP and SRB must consider whether
“specific conditions exist to provide a reasonable degree of protection to the
public and to assist the patient in adjusting to the community.”35 If those
conditions do not exist, the discharge cannot be granted. A 1995 Minnesota
Supreme Court case established that solely proving that a committed person no
longer meets the commitment standard was not sufficient to justify discharge of
that individual.36
MSOP must provide supervision, aftercare, and case management services for
civilly committed sex offenders who have been discharged. Prior to discharge,
the head of the treatment facility shall establish a continuing plan of aftercare
services, including assisting the client in finding employment, shelter, and
adequate health care services.
As discussed above, Minnesota law currently allows civilly committed sex
offenders to be transferred, provisionally discharged, and discharged if they can
be treated in alternative settings in a way that protects public safety. However, as
discussed in Chapter 2, there are currently few options for treating and
supervising these offenders in the community.
In addition, we found that:
	 Release decisions have been made with a conservative approach to
public safety.
There is generally a high level of public concern about releasing sex offenders
into the community. When we asked MSOP clinicians why clients had not been
released from the program, they stated that they felt that there is public pressure
on SRB and on judges making release decisions to be extraordinarily
conservative in releasing clients. They felt that it was difficult for any individual
to take the risk to release a sex offender because sex offenders are so reviled in
the community and because there is always some risk that the sex offender will
reoffend. Clinicians, clients, and outside treatment providers we interviewed also
pointed to the Governor’s 2003 executive order not to release any sex offenders
from commitment without a court order as evidence of the lack of support for
33

Minnesota Statutes 2010, 253B.185, subd. 12.

34

The head of MSOP may revoke a provisional discharge if the client violates the conditions of the
provisional discharge plan or the client exhibits behavior that may be dangerous to self or others.
35

Minnesota Statutes 2010, 253B.185, subd. 18.

36

Call v. Gomez, 535 N.W.2d 312 (Minn. 1995).

88

CIVIL COMMITMENT OF SEX OFFENDERS

releasing these clients. In addition, despite support of the MSOP for provisional
discharge of two clients, the Commissioner of Human Services recently
petitioned SCAP for reconsideration and rehearing of two SRB recommendations
to grant MSOP clients provisional discharge.

MSOP makes
treatment
progression
decisions
conservatively
and only supports
those who have
completed
treatment for
release.

MSOP also takes a very conservative approach to progression and release
decisions. Although clinicians told us they felt no pressure from within the
program to either hold clients back or advance them in treatment, they stated that
they have an obligation to public safety and are therefore very careful in making
recommendations. This was consistent with what we saw in our file reviews.
In addition, we found that:


MSOP does not support clients for provisional or final discharge
unless they have completed the MSOP treatment program.

It is MSOP policy to not support clients for release, provisional discharge, or
transfers to CPS unless they have completed all three phases of the MSOP
treatment program. MSOP clients’ course of treatment and need for continued
treatment at MSOP facilities are two factors considered by SRB and SCAP in
making release decisions. SRB relies on MSOP treatment team reports and an
MSOP risk assessment in making their recommendations to SCAP. Clients who
appeal cases to SCAP have an opportunity to have an outside expert review their
treatment status and current risk as well. However, both SRB and SCAP
probably rely greatly on MSOP’s assessments of their clients.
While MSOP as an institution does not support the provisional or final discharge
of clients without first finishing MSOP treatment, many MSOP clinicians we
interviewed felt that some MSOP clients could be treated and supervised in the
community without first completing treatment in MSOP’s secure facilities. We
found that:
	 There are clients who, due to age or disability, could likely be 

managed in alternative settings to MSOP facilities. 

For example, in the previous section, we reported that some low functioning
clients in the MSOP alternative program may not ever be able to complete MSOP
treatment. However, some of these clients would likely be manageable in group
homes because they do not need to be in a highly secure environment (although
ongoing security precautions may be needed). There are also clients at MSOP
facilities who have become physically and/or mentally handicapped due to
strokes, old age, or accidents. While some of these offenders may continue to be
high risk and have already sexually offended late into their lives, some of these
clients do not necessarily need the type of high security provided at MSOP
facilities. These clients would not be released into open society, but could be
managed (with extra safeguards) in a nursing home (possibly the forensic nursing
home at the Minnesota Security Hospital) or a specialized assisted living facility.
In evaluating release criteria, we compared Minnesota’s standard for releasing
civilly committed sex offenders to other states’ standards for release and found
that:

MSOP TREATMENT

89

	 Unlike most other states, Minnesota does not allow offenders to be
released from commitment when they no longer meet commitment
criteria.

Minnesota is one
of three states
that do not release
offenders once
they no longer
meet commitment
criteria.

Minnesota is one of three states that do not expressly allow the release of
committed sex offenders once they no longer meet commitment criteria. The
standards used in Minnesota for reduction of custody decisions are quite different
from standards used to make commitment decisions. For example, in order to be
committed as a sexually dangerous person, a person must: (1) have engaged in a
course of harmful conduct; (2) suffer from a current disorder or dysfunction; and
(3) be unable to adequately control his or her behavior, such that the person is
highly likely to commit additional harmful sexual acts.
The effect of having different standards for commitment and reduction of
custody is that clients are not automatically granted a reduction in custody when
they no longer meet commitment criteria. Therefore, a client’s progress in the
treatment program continues to be a factor in considering a reduction in custody,
even if the client no longer has a mental disorder or is no longer highly likely to
commit additional acts of sexual harm.
For example, MSOP clients’ diagnoses can change. A client who no longer has a
disorder that could result in inadequate control of his behavior would no longer
meet the commitment standard. We read some files of clients whose crimes were
exclusively against other children when they themselves were juveniles. These
clients were sometimes originally given diagnoses of pedophilia. Some clients in
this situation have had their diagnoses changed because, as adults, they do not
have a persistent attraction to children.

Some MSOP
clients may no
longer meet the
standard for
commitment.

Some clients may no longer be considered “highly likely” to commit additional
acts of sexual harm. For example, some clients were committed prior to
development of actuarial risk assessment tools or after scoring norms on actuarial
tools were changed. Courts often rely on these tools to help them determine
whether or not someone is highly likely to commit additional sexual harm. Prior
to the development of actuarial tools, courts had to more heavily rely on experts’
clinical judgment, which research has shown to be the least reliable predictor of
risk.37 If assessed with current actuarial tools, some of these clients could no
longer be found to be high risk. Scoring norms have also changed on some of
these tools. Some clients at MSOP facilities may no longer be considered high
risk if scored under new scoring norms based on the newest research.38
The Legislature may want to consider changing the standard for releasing civilly
committed sex offenders. For example:

37

For example, see Karl Hanson, Risk Assessment (Beaverton, OR: Association for the Treatment
of Sexual Abusers, 2000).

38
In particular, the developers of the Static-99, a widely used tool to assess static risk, recently
changed the scoring norms to account for offender age in calculating risk. New research on this
tool also indicates that the tool may not accurately predict risk without taking into account the
offender’s dynamic risk factors.

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CIVIL COMMITMENT OF SEX OFFENDERS

	 The Legislature could consider amending provisional discharge
criteria to allow for the provisional discharge of offenders who no
longer meet commitment criteria.
This change would make Minnesota’s release standard conform more closely to
that of most other states. We are specifically suggesting consideration of
amending the provisional discharge standard. Allowing those offenders who no
longer meet commitment criteria to be provisionally (rather than fully)
discharged would give MSOP the ability to assure that these offenders receive
treatment and are supervised in the community. It would also assure that
offenders receive support in finding housing and adjusting back to community
life.
It is unclear, however, how many existing MSOP clients would qualify for
provisional discharge under a new release standard. Changing the release
standard could potentially result in a large number of clients petitioning for, and
being granted, provisional discharge. One alternative to changing the provisional
discharge standard would be to consider alternatives to commitment at a high
security facility as discussed in Chapter 2. If options exist for treating and
supervising offenders in alternative settings, SRB and SCAP may find that some
currently committed offenders can be safely transferred to these alternative
settings rather than remain at the MSOP high security facility.
Whether the Legislature changes the provisional discharge standard or provides
alternatives to commitment, there will likely be many clients who will seek to be
reassessed to determine whether they can be treated and supervised in settings
outside of MSOP’s secure facilities. We looked at how other states reassess their
civilly committed sex offenders. In most states that reevaluate whether civilly
committed offenders have fallen below the commitment threshold, reports are
made periodically to the courts to determine whether the offender can be safely
released or placed in a less restrictive alternative. If Minnesota changes its
release standard or creates alternatives to commitment, the state would need to
develop a way to periodically and independently review clients at MSOP
facilities to determine whether provisional discharge or an alternative to the
secure facility is appropriate.
Requiring an independent body to review client cases would allow MSOP to
share responsibility for making release decisions. This would shelter both MSOP
and the decision-making entity from unpopular decisions. Further, independent
reviews would assure that decisions on provisional discharges or placement in
alternatives to the secure facility are based on risk, not treatment performance. A
2006 study of states’ release processes found that when a treatment program has
a policy of not recommending release until treatment is completed (as is the case
in Minnesota) and the program must make decisions regarding provisional
releases, provisional releases are unlikely.39
The Legislature could require SRB to periodically reevaluate MSOP clients to
determine whether they continue to meet the commitment standard or can be
39

Dennis Doren, The Model for Considering Release of Civilly Committed Sexual Offenders in The
Sexual Predator: Law and Public Policy; Clinical Practice ed. Anita Schlank (New Jersey: 2006).

MSOP TREATMENT

91

managed in a less restrictive alternative to MSOP facilities. This would require
the Legislature to amend state statute to require periodic reviews rather than
waiting for clients to petition SRB. In the alternative, the Legislature could use
SCAP or another court to review clients at MSOP facilities.

The Legislature
could consider
establishing an
independent
periodic review of
MSOP clients to
determine if they
are manageable in
alternative
settings.

The Legislature should also decide what evidence SRB or the reviewing court
receives as part of their review process. Some states rely exclusively on a report
from the treatment program to make release decisions. Other states use
independent forensic experts as witnesses. In its current reviews of client
petitions, SRB relies on a report from the MSOP treatment team and MSOP’s
risk assessment department. The client does not have a right to a risk assessment
and forensic examination from an expert independent of MSOP unless he
petitions his case to SCAP. The Legislature may want to consider allowing
expert testimony independent of MSOP in reviews of whether clients can be
managed in the community or no longer meet commitment criteria.
If the Legislature amends the provisional discharge standard or develops less
restrictive alternatives to MSOP secure confinement, then:


The Legislature could consider amending state law to require a
periodic review of clients by an entity independent of MSOP.

Currently, there is one occasion where Minnesota law allows the courts to
reevaluate whether an offender continues to meet the commitment standard.
Sixty days after an initial commitment is ordered, the committing court must
review the case to determine whether commitment continues to be necessary.
However, this provision in the law was originally designed for mentally ill and
dangerous patients whose condition can be quickly stabilized with psychiatric
medication. The 60-day review in the context of civil commitment of sex
offenders is not useful because the risk these offenders present to the community
would rarely change after 60 days. After the 60-day review and final
commitment, the committing court can no longer review the client to see if the
commitment criteria continues to be met.

RECOMMENDATION
The Legislature should amend Minnesota law to eliminate the 60-day
review of initial commitments of sex offenders as required in Minnesota
Statutes 253B.18, subd. 2.
As discussed above, we believe that there are more meaningful ways to review
whether MSOP clients continue to need to be committed in a highly secure
treatment program. The 60-day review does not amount to a meaningful review
of the need for commitment.

List of Recommendations 



The Legislature should require MSOP to develop a plan for alternative
facilities for use by certain sex offenders currently at MSOP, as well as for
certain newly committed individuals. The plan should provide details about
funding and needed statutory changes to ensure adequate supervision,
monitoring, and treatment of these sex offenders. The plan should also
address the funding and statutory changes needed to address a stay of
commitment option. The cost impact of these options should be compared
with the costs of expected growth at MSOP without any change in policy.
The plan should be presented to the 2012 Legislature. (p. 45)



MSOP should reassess its existing residents to determine which residents
would be suitable for placement in an alternative setting. The plan presented
to the 2012 Legislature should provide information on this reassessment,
including the rationale for determining why certain types of residents would
be suitable for an alternative commitment setting and a detailed description
of the alternative settings being proposed for various groups. (p. 46)



The Legislature should consider providing for indeterminate sentencing for
some sex offenders. As a condition of their release, offenders could be
required to successfully complete treatment in prison. (p. 46)



The Legislature should direct the Department of Human Services to convene
a task force to consider the need for changes in the sex offender commitment
standard and process, including the advisability of establishing a centralized
prosecution structure and a single commitment court for sex offenders. The
Legislature could also direct the department to have the task force examine
the referral process. The task force should be required to report its findings
and recommendations to the 2012 Legislature. (p. 48)



The Legislature should direct the Department of Human Services to work
with stakeholders and the Office of the Revisor of Statutes to develop a
proposal for separating the civil commitment statutes for sex offenders from
those governing the civil commitment of other populations. (p. 49)



The Legislature should direct the Department of Corrections to study the
recidivism rates of sex offenders who have been referred or petitioned for
civil commitment and not civilly committed and report back to the 2012
Legislature. The department should also analyze whether there are
geographical differences in the recidivism rates for these populations. These
recidivism rates could also be compared to the rates experienced by other sex
offenders who have been released from prison but not referred for civil
commitment. (p. 49)



The Department of Human Services should require MSOP to provide more
treatment hours per week. (p. 65)



In evaluating designs for the construction of new living units for MSOP, the
Legislature and DHS should consider the tradeoffs between the efficiency of

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CIVIL COMMITMENT OF SEX OFFENDERS

staffing large units and the effect of larger units on the therapeutic 

environment. (p. 67)




As clinician positions become fully staffed and clinician offices are located
in living units, MSOP should closely monitor whether staffing in living units
is sufficient to improve the therapeutic environment. (p. 70)



MSOP should consider creating an incremental privilege system for clients in
the early phases of treatment in order to increase client motivation. (p. 72)



MSOP should train and supervise clinical staff to assure that quarterly and
annual reviews contain enough specific detail to provide meaningful
feedback to clients and others regarding treatment progress. (p. 74)



MSOP should complete the treatment manual. This manual should include
clear clinical guidance on the interpretation of the matrix. (p. 77)



MSOP should develop and implement a plan for identifying when certain
low functioning alternative program clients who are not cognitively able to
complete treatment can be managed in a less restrictive setting. MSOP
should petition the Special Review Board (SRB) for transfer or provisional
discharge of these clients to an alternative setting. (p. 83)



MSOP should develop and implement a plan for managing transferred or
provisionally discharged low functioning alternative program clients in an
alternative setting. (p. 83)



MSOP should assure that clients have access to psychiatric care. (p. 85)



The Legislature should amend Minnesota law to eliminate the 60-day review
of initial commitments of sex offenders as required in Minnesota Statutes
253B.18, subd. 2. (p. 91)

Minnesota Department of Human Services - - - - - - - - - - - - - -

March 3, 2011

James R. Nobles, Legislative Auditor
Office of the Legislative Auditor
Centennial Office Building
658 Cedar Street
St. Paul, MN 55155
Dear Mr. Nobles:
Thank you for the opportunity to review and respond to your program evaluation report “Civil
Commitment of Sex Offenders.” The Department of Human Services (DHS) appreciates the time and
effort of the Office of the Legislative Auditor in reviewing the civil commitment process for sex
offenders. This report confirms the complexity of the sex offender civil commitment process and
validates the significant work of the Minnesota Sex Offender Program (MSOP).
Your team did a thorough review and analysis of the civil comment process for sex offenders. We
believe this report reflects that hard work and objectivity. It is our hope that this report serves as a
practical tool for policy makers in analyzing our current statutes and processes around the civil
commitment of individuals with histories of sexual offenses.
The Department supports the majority of the recommendations made in the report. Many of the findings
and recommendations are consistent with current objectives and goals to continue to provide sex
offender treatment in a safe and secure facility. As you are aware, MSOP is in the process of
implementing many enhancements to the program and has several pending policy changes which are
consistent with the report’s recommendations. The Department provided the Legislature with a report
late last year with recommendations which are in accord with those of the report.
The following are a few recommendations that DHS would like to specifically address:
•	 The report outlines several recommendations to the Legislature requiring DHS to take the lead in
coordinating major policy discussions around sex offender civil commitment. The Department is
committed to working with the Legislature to provide leadership, expertise, and information on
sex offender civil commitment to help implement these recommendations. We support getting
the key stakeholders together and jointly discussing changes that will improve the overall civil
commitment process.
•	 We agree with the recommendation that MSOP should be increase treatment hours and are
taking active steps to reach that goal.
PO Box 64998 • St. Paul, MN • 55164-0998 • An Equal Opportunity Employer and veteran-friendly employer

•	 MSOP is responsible for providing health care services to all clients. External licensing authorities
provide requirements for MSOP regarding client access to medical care including all psychiatric
services. MSOP continues to streamline and develop internal processes for these services, which
were previously provided by State Operated Services (DHS). MSOP currently has contracts, and
will continue to contract, with community-based psychiatric providers who are experienced in
treating sexual offenders.
•	 MSOP is committed to balancing the demands of treating civilly committed sex offenders in a
secure setting. Creating a therapeutic environment in a secure setting while maintaining fiscal
responsibility can be challenging. MSOP will continue to consider the tradeoff between
efficiency of staffing large units and the effect of larger units on the therapeutic environment
when presenting the Legislature with options of expansion.
•	 As in all civil commitment programs, MSOP recognizes the importance of identifying and
articulating client progress in treatment (i.e. dynamic risk factors). MSOP is committed to
improving the professional competency of clinical staff through trainings and regularly
scheduled clinical supervision. MSOP will have a completed program manual to accompany the
theory manual, by the end of the calendar year, providing a further foundation for clinicians
regarding treatment design and program philosophy.
•	 MSOP recognizes the unique treatment needs of lower-functioning sex offenders and is committed to
assisting these clients in decreasing their risk to the best of their abilities. Treatment progress is
reviewed quarterly and individual plans are adjusted accordingly. MSOP is currently seeking
alternative settings for the lower-functioning clients, in preparation for when a court approves a
transfer or a provisional discharge.
Thank you again for the hard work of your office conducting this evaluation and addressing important
issues regarding civilly committed sex offenders.
Sincerely,

Lucinda E. Jesson
Commissioner

PO Box 64998 • St. Paul, MN • 55164-0998 • An Equal Opportunity Employer

MINNESOTA DEPARTMENT OF CORREcnONS

OFFICE OF THE COMMISSIONER

March 2, 20 I I

James R. Nobles, Legislative Auditor
Office of the legislative Auditor
140 Centennial Office Building
658 Cedar Street
St. Paul Minnesota 55 I55-4708
Dear Mr. Nobles:
Thank you for the opportunity to review and comment on your report on Civil Commitment of
Sex Offenders. As noted in your report the Department of Corrections screens the sex offender
population prior to release from incarceration and forwards to county attorneys those cases that
may be appropriate for a civil commitment petition. As noted in your report the Department's
refen'al policy and practice is consistent with state law, is empirically based, and is not
influenced by the racial or geographical background of offenders.
The Department recognizes the concerns regarding the sustainability ofthe current size and rate
of growth of the Minnesota Sex Offender Program. We recognize the important role our referral
process plays in the commitment process. We are prepared to readily implement any changes in
our procedures as legislatively directed.

Tom Roy
Commissioner

WWW.dOC.5tate.mn.U5
1450 Energv ParK Drive. suite 200 St. paUl, Minnesota S5108 PH 651.361.7226 FAX 651.642.0414 TTY 800.627.3529
EOUAL OPPORTUNITY EMPlOYER

Recent Evaluations	
Agriculture
“Green Acres” and Agricultural Land Preservation
Programs, February 2008
Pesticide Regulation, March 2006
Criminal Justice
Public Defender System, February 2010
MINNCOR Industries, February 2009
Substance Abuse Treatment, February 2006
Community Supervision of Sex Offenders, January 2005
CriMNet, March 2004
Education, K-12, and Preschool
Alternative Education Programs, February 2010
Q Comp: Quality Compensation for Teachers,
February 2009
Charter Schools, June 2008
School District Student Transportation, January 2008
School District Integration Revenue, November 2005
No Child Left Behind, February/March 2004
Charter School Financial Accountability, June 2003
Teacher Recruitment and Retention: Summary of Major
Studies, March 2002
Education, Postsecondary
MnSCU System Office, February 2010
MnSCU Occupational Programs, March 2009
Compensation at the University of Minnesota, February 2004
Higher Education Tuition Reciprocity, September 2003
Energy
Renewable Energy Development Fund, October 2010
Biofuel Policies and Programs, April 2009
Energy Conservation Improvement Program, January 2005
Environment and Natural Resources
Environmental Review and Permitting, March 2011
Natural Resource Land, March 2010
Watershed Management, January 2007
State-Funded Trails for Motorized Recreation, January 2003
Water Quality: Permitting and Compliance Monitoring,
January 2002
Minnesota Pollution Control Agency Funding, January 2002
Recycling and Waste Reduction, January 2002
Financial Institutions, Insurance, and Regulated Industries
Liquor Regulation, March 2006
Directory of Regulated Occupations in Minnesota,
February 1999
Occupational Regulation, February 1999
Government Operations
Capitol Complex Security, May 2009
County Veterans Service Offices, January 2008
Pensions for Volunteer Firefighters, January 2007
Postemployment Benefits for Public Employees,
January 2007

Government Operations (continued)
State Grants to Nonprofit Organizations, January 2007
Tax Compliance, March 2006
Professional/Technical Contracting, January 2003
State Employee Health Insurance, February 2002
Health
Financial Management of Health Care Programs,
February 2008
Nursing Home Inspections, February 2005
MinnesotaCare, January 2003
Human Services
Civil Commitment of Sex Offenders, March 2011
Medical Nonemergency Transportation, February 2011
Personal Care Assistance, January 2009
Human Services Administration, January 2007
Public Health Care Eligibility Determination for
Noncitizens, April 2006
Substance Abuse Treatment, February 2006
Child Support Enforcement, February 2006
Child Care Reimbursement Rates, January 2005
Medicaid Home and Community-Based Waiver Services for
Persons with Mental Retardation or Related Conditions,
February 2004
Controlling Improper Payments in the Medicaid Assistance
Program, August 2003
Economic Status of Welfare Recipients, January 2002
Housing and Local Government
Preserving Housing: A Best Practices Review, April 2003
Managing Local Government Computer Systems: A Best
Practices Review, April 2002
Local E-Government: A Best Practices Review, April 2002
Affordable Housing, January 2001
Jobs, Training, and Labor
Workforce Programs, February 2010
E-Verify, June 2009
Oversight of Workers’ Compensation, February 2009
JOBZ Program, February 2008
Misclassification of Employees as Independent Contractors,
November 2007
Prevailing Wages, February 2007
Workforce Development Services, February 2005
Financing Unemployment Insurance, January 2002
Miscellaneous
Public Libraries, March 2010
Economic Impact of Immigrants, May 2006
Gambling Regulation and Oversight, January 2005
Minnesota State Lottery, February 2004
Transportation
Governance of Transit in the Twin Cities Region,
January 2011
State Highways and Bridges, February 2008
Metropolitan Airports Commission, January 2003

Evaluation reports can be obtained free of charge from the Legislative Auditor’s Office, Program Evaluation Division,
Room 140 Centennial Building, 658 Cedar Street, Saint Paul, Minnesota 55155, 651-296-4708. Full text versions of recent reports are
also available at the OLA Web site: http://www.auditor.leg.state.mn.us