The county of Marin’s top health official has risen to the defense of Marin General Hospital, saying that a recommendation by a local mental health advocate — that voters reject the hospital’s bond measure — is a “misguided position.”
“I just think this is an unfortunate position,” said Larry Meredith, director of the Marin County Department of Health and Human Services. “I think it is counter to the best interests of the county.”
The hospital is seeking voter support in Tuesday’s election for Measure F, a $394 million general obligation bond measure to help cover the cost of a major rebuild of Marin General Hospital. Under state law, Marin General Hospital has until 2030 to make its facilities earthquake safe. Two-thirds of voters in the election must vote yes on Measure F for it to pass.
Rick Roose, vice president of the National Alliance on Mental Illness’ Marin affiliate, advised voters in a recent Independent Journal opinion column to reject Measure F because the hospital’s building plans don’t include any additional beds for mental health patients. Currently, the hospital has a locked psychiatric unit with 17 beds. They are the only mental health beds available in the county.
In his opinion piece, Roose noted that among the 10 Bay Area counties, Marin County ranks close to the bottom in providing psychiatric beds. Roose said that by the hospital’s own estimate, 105 mental health patients were turned away from the hospital in 2012 due to a lack of beds. And, Roose said, given its population, Marin County should have at least 125 psychiatric beds.
Meredith, however, said adding more psychiatric beds at Marin General is not necessarily the solution. In fact, Meredith said there is reason to believe that if the hospital added psychiatric beds that they would be filled by patients from other California counties.
That is because psychiatric beds in general hospitals such as Marin General are in short supply and high demand. Across the nation, hospitals have been reducing the number of psychiatric beds they have, due to the low reimbursement rates available for mental health services versus medical procedures such as cardiology or orthopedics.
This has led to a growth in “freestanding” mental health facilities; due to federal law, however, adults on Medi-Cal are not covered for psychiatric services in “freestanding” facilities.
Jon Friedenberg, Marin General’s chief fund and business development officer, said, “It’s very costly for the hospital to provide inpatient mental health beds, particularly for Medi-Cal patients. A majority of our psychiatric patients are Medi-Cal patients and indigent. In fact, a majority of our psychiatric patients are from outside the county.
“Even in counties where they do have some inpatient psych beds, they frequently don’t have any inpatient psych beds for Medi-Cal or indigent patients,” Friedenberg added, “so they send them all to us.”
Roose said Wednesday, “The National Alliance on Mental Illness doesn’t take a position on whether the beds should be at the hospital or a freestanding facility; we’re just looking for beds because we’ve been ignored for decades.”
One Marin County member of the alliance, whose son is struggling with schizophrenia, recounted his experience with the system on the condition that his name not be used to protect his son’s identity. The man said his son has needed to be in a locked unit about 10 times since 2010. In all but two or three of those occasions, his son was sent out of the county — to San Francisco, Alameda, Fremont and Sacramento. The father recalled driving to Fremont to visit his son only to be told that visiting hours were limited to 7 p.m. to 8 p.m.
Nevertheless, Meredith said Marin County does not need 125 psychiatric beds.
“I can’t even imagine what the cost would be,” Meredith said. “It would mean we would have no other mental health services. We would be a crisis-oriented county.”
Over the summer, Southern California-based Aurora Behavioral Health Care opened a 95-bed psychiatric hospital in Santa Rosa. The facility is located in the same building where St. Joseph Health formerly operated a psychiatric unit. That unit was closed by Santa Rosa Memorial Hospital five years ago. In the interim, Sonoma County had no inpatient psychiatric services, and patients were sent to Marin General or St. Helena Hospital in Vallejo.
But Rita Scardaci, director of Sonoma County’s Department of Public Health, said the 95 beds at the Aurora facility will outstrip the needs of Sonoma County residents.
“It was always designed to be a regional resource,” Scardaci said. “They’ll be looking for clients from throughout the northern part of the state.”
David Drumm, a spokesman for Aurora, said his company has already signed a contract with the county of Sonoma and is in talks with the county of Marin.
Drumm said, “We’re going to be able to service Marin and all the surrounding counties.”
Contact Richard Halstead via e-mail at rhalstead@marinij.com
