Collaboration Solution To Mental Health Care Void

Mental health advocates in Northwest Arkansas are finally seeing the result of years of pushing for more psychiatric services in the region.

After four years of dealing with a void in mental health care, a task force formed to address the issue has received about $2 million in General Improvement Fund money from the state legislature. The money is to cover the cost of renovating a floor at Northwest Medical Center-Springdale to serve as a psychiatric unit.

Construction will begin in November on the 29-bed acute mental health unit in the hospital’s north tower that will be operated by the University of Arkansas for Medical Sciences in partnership with Northwest Med.

Since Highland Hall, the psychiatric unit at Northwest Medical Center-Springdale, closed in 2002, health care professionals have been hard pressed to find a place for patients in need of acute inpatient psychiatric care.

Tom Petrizzo, CEO of Ozark Guidance in Springdale, said the Northwest Arkansas region ranks among the lowest in the state in patient beds per capita. According to 2006 data, Northwest Arkansas has 5.5 beds per 100,000 people compared to 48 beds per 100,000 in central Arkansas. The southwest region has 27 beds per capita and the northeast region has 8.4 beds per capita. The southeast part of the state ranks the lowest, with 4.4 beds per 100,000 people.

Adding 29 beds to the area will double the availability of beds, Petrizzo said, bringing the number to 11 beds per capita.

The private Vista Health in Fayetteville leases five public beds to the facility for indigent patients, but those beds are full at least a third of the time.

In that case, he said, patients have to be sent out of state to facilities in Joplin, Springfield, Tulsa or wait for a bed to become available at the state hospital in Little Rock.

In psychiatric emergencies, sometimes the patients end up in the emergency departments or intensive care units of local hospitals, Petrizzo said.

In September, Universal Health Services, a publicly traded hospital management company out of King of Prussia, Pa., broke ground on an 80-bed facility in Fayetteville called Springwoods Behavioral Health.

While the facility will add treatment options to the area, including substance abuse treatment, Petrizzo said it doesn’t address the needs of low-income or uninsured patients.

Since the facility is freestanding, and not associated with a general hospital, it can’t receive Medicaid reimbursements for acute psychiatric care.

There have been several attempts since 2002 to replace the 20 beds that were lost when Highland Hall closed.

In the months following the closure, Washington County Judge Jerry Hunton chaired a task force to find a replacement for the beds and a funding system to support it.

The group secured $500,000 from the legislature in 2005 in order to renovate a floor of the former Washington Regional Medical Center campus in Fayetteville for a 16-bed unit.

The plan was derailed, however, when Washington Regional decided not to participate in the plan.

A new task force was quickly formed to continue the group’s efforts.

The result is a six-partner collaboration between Northwest Medical Center, UAMS, Ozark Guidance, the Care Foundation Inc., Washington Regional and Mercy Health System of Northwest Arkansas.

Hunton said the effort gained momentum when UAMS decided in 2006 to open a satellite campus in Northwest Arkansas.

When UAMS started looking at the area as a location for its satellite campus, Hunton made sure that mental health would be included in the plans.

“They promised to make that one of their priorities,” he said.

Collaboration

UAMS will staff the unit with psychiatrists and provide program oversight. The school will use the unit as a teaching site for residents, expanding its psychiatry program in Little Rock, in hopes of addressing a statewide psychiatrist shortage.

UAMS will also establish an outpatient clinic, which will serve patients once they are discharged from the unit.

Northwest, besides providing the space for the unit, will staff the unit’s nurses and support personnel.

The Care Foundation is providing $415,000 in start-up costs for the first two years, which will include the initial hiring of psychiatrists and nurses.

Washington Regional Medical Center and Mercy Health System of Northwest Arkansas will each contribute $65,000 to take care of the primary care needs of the patients in the unit.

Ozark Guidance will serve as the fiscal agent for all of the funds and will also provide screening services for patients as well as outpatient services.

Washington Regional CEO Bill Bradley said the unit will eliminate some of the burden on the emergency departments at hospitals.

“Like all area hospitals we are caring for the patients with psychiatric issues in our emergency room, and for those requiring admission, primarily in our ICU,” he said. “This unit will allow more optimal care for these patients’ unique needs.”

Bradley said the unit will provide a better solution than the proposal of a 16-bed unit, which Washington Regional’s board of directors considered and eventually declined in 2005.

The board had concerns that the unit was undersized and that the funding for the unit was inadequate.

“This would have surely resulted in Washington Regional turning away other patients, something we were unwilling to do,” he said. “It did not seem to be a solution to the area’s need and placed an exclusive burden on one hospital versus a collective solution as we have forthcoming.”

Lee Christenson, COO of Northwest Medical Center-Springdale, agreed that the new arrangement, which he called a “blending of public dollars,” will make a unit more financially viable this time around.

In addition to getting Medicaid reimbursements, the unit will receive money from the state’s department of human services budget.

“In the past, a high percentage of patients had no ability to pay. Over time that erodes your ability to provide the service,” he said. “Through this partnership, it makes it viable once again to provide that service for the community.”