Mental health crises on rise, Stanislaus County staff says

Stanislaus County staff revealed some alarming statistics Tuesday about the rising number of people being hospitalized for mental health crises.

In some recent months, the number of patients admitted for emergency psychiatric care averaged 40 per day, double the historic average in Stanislaus County.

The county's costs to hospitalize the uninsured and Medi-Cal recipients at the 67-bed Doctors Behavioral Health Center or facilities outside the county is expected to hit $10.3 million this year, a $5 million increase over the previous year's budget.

County supervisors unanimously approved a plan to rein in those costs. It includes a 16-bed psychiatric health facility to provide a less intensive — and less costly — level of care for people who are contemplating suicide or having symptoms of psychosis.

In addition, the county will create crisis stabilization units to evaluate and stabilize people who may not need to be hospitalized at DBHC on Claus Road. Officials hope that better case management will ensure that people released from inpatient care take medication and keep their appointments, so they are not hospitalized again.

Officials, who have found no single reason for the increase in patients, are aiming for $1.5 million in annual cost savings. The strategy could improve care for county residents who struggle with mental disorders.

'After care' a problem

Jack Waldorf, vice president of the county Mental Health Board, said that gaps in "after care" for patients have been a problem. He said his grown daughter didn't receive follow-up care after three stays at DBHC this year.

After the third time, "she attacked my wife and I, and our daughter had to be hospitalized for two weeks," Waldorf said. His daughter is now in a board and care home and doing fine, he said.

The county still will need a contract with the privately operated DBHC to handle severe adult cases. Younger children and adolescents are sent outside the county because there are no licensed facilities for them here.

Officials have spoken with local hospital officials about helping to fund crisis stabilization services, which could cost $545,000 to $750,000 a year.

Patients in crisis are first evaluated in hospital emergency rooms. Often, there are no beds available at DBHC, so they are transferred to facilities in other counties or wait in emergency room beds, officials said.

Psychiatric patients sometimes fill so many ER beds that ambulances carrying medical patients are diverted to other hospitals, staff said.

Mike King, chief operations officer of Doctors Medical Center in Modesto, said the hospital has not committed any funding for crisis stabilization services. He said details are being worked out, such as whether to locate the crisis units near hospitals or DBHC.

County Supervisor Vito Chiesa asked if the county will receive payments from insurers for patient care at the 16-bed psychiatric health facility. Patty Hill Thomas, assistant chief executive officer, said the county has not wanted to compete with DBHC for insured patients; it's mainly responsible for the uninsured and Medi-Cal recipients.

The new facility is expected to open in January 2014, when insurance coverage will become mandatory under national health care reforms.

The county will seek proposals from private firms to design a remodel of the former Stanislaus Recovery Center in Ceres for the 16-bed care facility. The center will be managed and operated through a contract with a private service.

To pay for the $2.1 million remodel, the county has $5.9 million in remaining proceeds from the 2007 sale of the Claus Road center to Tenet Healthcare Corp., the parent company of DBHC and Doctors Medical Center.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.

SUPERVISORS WATCH

The Stanislaus County Board of Supervisors also took the following action Tuesday:

• Approved designs for the coroner and public administration project in downtown Modesto. In a $6.2 million project to replace the undersized coroner’s office on Oakdale Road, the county will remodel the former Medical Arts Building on 17th Street. The building will house a larger coroner’s facility, a video center to visit with jail inmates and Health Services Agency medical records.

• Approved an agreement to provide dial-a-ride service in Riverbank and Oakdale

• Heard an annual report from the county Mental Health Board. One highlight was community-based programs that support county residents who struggle with mental illness.