FARGO (AP) - Social workers in Minnesota's Clay County say mental health care providers in North Dakota are unethically moving patients to their state to take advantage of better public health care.

North Dakota providers including the State Hospital in Jamestown deny they deliberately discharge patients across the border, saying it only happens when a patient requests it.

Clay County social workers say they are worried about the cost to Minnesota taxpayers and the strain on housing for the state's own patients.

"The end result is that Minnesota taxpayers end up paying thousands and thousands of dollars to pay for the care," said social worker Gregg Feigum. "It is very frustrating and I believe unethical."

Dave Hallman, foster care licenser for Clay County, estimated that up to 10 North Dakota patients resettle each year in his territory.

"Most of the people who came, they just didn't happen to show up on our door," he said. "Somebody gave them the hint that we could provide what they need."

A patient in adult foster care can cost Minnesota as much as $300 a day, Feigum said.

Alex Schweitzer, superintendent of the North Dakota State Hospital, said about 3 percent of the 900 people admitted each year come from Minnesota. When those patients leave, many want to return to their home state, he said.

"Certainly we're not looking at taking advantage of any Minnesota programs," Schweitzer said.

A discharge summary released by the hospital said it had placed three North Dakota residents in Minnesota in 2005. One of the patients had requested to be placed there, the report said.

JoAnne Hoesel, director of North Dakota's Division of Mental Health and Substance Abuse, said community placement plans always are patient-driven. Nancy McKenzie, regional director of the Southeast Human Service Center in Fargo, said it is unusual for patients who need supervision upon their release to go anywhere other than from where they came.

"We certainly don't deliberately direct people to live out of state," she said.

Cyndy Skorick, managing partner of MeritCare hospital's Department of Psychiatry in Fargo, said mental health care providers are seeing a "dramatic increase" in Minnesota patients. She said she does not know of any social workers pushing patients into Minnesota. She attributed the complaints from Clay County to the heavy demand on the mental health system in both states.

Pat Boyer, a Clay County Social Services supervisor, said she did not have enough data to comment on the complaints of her social workers.

"We've had a few incidents," she said. "I'm thinking maybe we need to start tracking it."

Kathy Hogan, director of Cass County Social Services, said there is a need for more housing options for mentally ill adults. Cass County has about four or five adult foster care providers, and those are generally used for the elderly or for people with physical disabilities, she said.

In contrast, Clay County has 73 adult foster care programs with a capacity for 183 people, according to the Minnesota Department of Human Services. That is more than the entire state of North Dakota, which had 72 adult foster care homes as of February, said Linda Wright, director of the state's Aging Services Division.

Janet Sabol, North Dakota coordinator for the National Alliance on Mental Illness, an advocacy and support group, said she is not aware of any North Dakota social workers moving patients into Minnesota.

However, she said North Dakota's infrastructure for the mentally ill is lacking.

"There is no place for them to go in North Dakota," she said. "The housing is very, very limited."

Hoesel, director of North Dakota's Division of Mental Health and Substance Abuse, said her agency is working on a plan to address care needs, including housing.