Clark County’s for-profit mental health services provider Telecare is set to close Aug. 30, leaving the county with fewer available beds for inpatient mental and behavioral health services.
The closure will affect beds devoted to evaluation and treatment as part of the Involuntary Treatment Act, which allows people to be civilly committed to hospitals or treatment settings if a judge finds they pose a threat to themselves or others.
Telecare’s Clark County location has 11 beds available for evaluation and treatment; however, it has only been using seven of those beds.
Telecare Vice President of Operations Linda Reese said the Clark County location lost about $1 million over the last 18 months after the funding structure was changed in the state and made it so Medicaid dollars were awarded based on Telecare’s daily census.
Reese said Telecare’s 16-bed facilities in other areas have coped with that change, but the Clark County location has struggled because it’s smaller.
There’s not much difference in staffing and costs between the Clark County location and other locations, Reese said, yet Clark County pulls in less funding because it has fewer patients. Telecare, based in Alameda, Calif., would return to the area, if possible, Reese said, but there are currently no plans for that.
“We have valued being in Clark County,” Reese said. “We have lots of staff who live in Clark County. If there’s an opportunity of a program that’s financially viable we would love to be there.”
Vanishing beds
Telecare’s impending closure comes after PeaceHealth Southwest suspended its own inpatient behavioral health unit in November at the Memorial Campus on Main Street in Vancouver.
The unit was suspended because it no longer met “the physical environment requirements to best ensure the safety of patients and caregivers,” according to a PeaceHealth press release. A required annual survey by DNV GL, which accredits and certifies hospitals nationwide, discovered those shortcomings.
PeaceHealth spokesman Randy Querin said in an email the unit is scheduled to reopen in the future, but the company wouldn’t have more details or a timeline for that for at least another month.
The suspension of PeaceHealth’s unit and Telecare’s imminent closure have created questions about how mental health services can be sustainable in Clark County when many patients are indigent or on Medicaid.
Clark County is planning a short-term mental health triage center that will open in 2020, according to Jared Sanford, the executive director for Lifeline Connections. The crisis and stabilization program there will have 20 beds and six observation chairs, which are “comfortable” chairs people can stay in for up to 23 hours while stabilizing, Sanford said. It will be housed on Lower River Road.
“Most larger communities, particularly the size of Clark County, have these programs,” Sanford said. “This will fill a void.”
Director of Clark County Community Services Vanessa Gaston said Telecare averaged between four to six patients at a time, and the loss might be felt by the county having to send more patients to places such as Yakima and Tacoma for evaluation and treatment.
“It’s a statewide problem,” Gaston said. “It’s not just our county. You are fighting for beds across the state.”
‘Always about money’
Creating more regional treatment centers for mental health has been a goal of Gov. Jay Inslee’s as the state tries to transition away from relying too much on Western State Hospital, a large inpatient psychiatric facility in Lakewood. Gaston and Schneiderman said it’s important for people stabilizing or recovering to be near their community.
Vancouver’s new behavioral health hospital, Rainier Springs, has 48 beds available in two psychiatric units — and another 24 beds at the facility dedicated to detox for substance use, CEO David Jones said. Rainier Springs, which is licensed for evaluation and treatment, can help fill the void, he added. Patients can stay at Rainier Springs for seven to 10 days.
However, Jones did not have statistics on whether Rainier Springs generally sees more private insurance or Medicaid patients; beds are not dedicated to one or the other, and the aim is to “accept everybody,” he said.
Kim Schneiderman, the executive director for the National Alliance on Mental Illness Southwest Washington, said she is pleased people are attempting to find solutions for the lack of beds but still has concerns about the loss of Telecare and future of PeaceHealth’s unit.
“We’re just barely holding even with services for folks, and losing any of them hurts,” Schneiderman said.
A certified nursing assistant and registered nurse, who both worked at PeaceHealth’s unit and requested anonymity, told The Columbian there wasn’t any money to be made in running the unit. They said they have great concerns about the long-term viability of any mental health care facility in Clark County, especially while serving indigent populations or people on Medicaid.
“It’s a disconnect. We need more mental health beds. We need more mental health units. But here they are closing more units,” one of the nurses said. “But it’s always about money. No matter what anyone says, it’s always about money.”
