NEWS

Patient advocates seek openness on mental-hospital closures

Tony Leys
tleys@dmreg.com

Patient advocates and state regulators say they wish state administrators would be more forthcoming with information about what is happening with residents of two mental institutions that are being closed.

The patients' rights advocates are most concerned about what is happening with a small group of elderly people with mental illnesses, who are being moved out of the state mental institution at Clarinda before its looming closure. Although those patients number fewer than 20, they are considered among the hardest to place in private facilities.

Jane Hudson, executive director of the group Disability Rights Iowa, said her agency visited the Clarinda institution in early March and found that residents and their families had been given little solid information about the pending closure. "They were hearing about this on TV, and they had no idea what would happen to them," she said. "They had no idea what was going on."

Hudson's federally sanctioned group is responsible for protecting the rights of people with mental or physical disabilities. The group is supposed to be included in a state "closure team," which is called in a few times a year when long-term care facilities are being closed. The team is supposed to oversee and help coordinate transfers of residents to other appropriate settings.

Gov. Terry Branstad disclosed in January that his administration intends to close the mental institutions in Clarinda and Mount Pleasant by June 30. Branstad has said most of the residents of the two facilities could receive more effective and efficient care at private facilities or at the state's other two mental institutions, at Independence and Cherokee. Critics contend his administration is moving too quickly to close the institutions before proper alternatives are ready.

The Department of Human Services has said it is taking precautions to ensure safe placements for the institutions' residents. A spokeswoman said this week the agency has started transferring patients from the geriatric mental health program to private care facilities, although she wouldn't say how many. (The transfers do not include four sex offenders, who are expected to be moved to another state facility.)

Hudson said many of the patients from the Clarinda program might do well in private care centers. But she said it's important to make sure those facilities are equipped to handle people with serious mental illnesses.

Hudson said that as word spread that the Clarinda and Mount Pleasant mental institutions would be closed, Disability Rights Iowa repeatedly asked state officials when the closure team would be called in. The state long-term care ombudsman's office, which is supposed to look out for the rights of residents, also serves on the task force and asked that it be called into action, emails from that agency show.

The Department of Inspections and Appeals, which regulates nursing homes, is in charge of calling up the team. At first, it declined to do so because the Department of Human Services hadn't formally notified it that the institutions would be closed.

David Werning, an Inspections and Appeals spokesman, said his agency decided on Thursday to call up the closure team, after a DHS request. The team is to hold a conference call next week to get started.

Werning said Friday that his agency wants to help ensure that residents in the Clarinda program experience a smooth transition to other facilities. When asked about the communication his agency has received from DHS, which is located across the street, he replied: "There hasn't been quite the flow of information we would have liked."

Deanna Clingan-Fischer, the state's long-term care ombudsman, said she, too, feels the Department of Human Services has kept her agency at arm's length when it comes to the looming mental hospital closures. "Our office has had very minimal involvement, not that we haven't asked for involvement," she said Friday.

Clingan-Fischer's office is part of the Iowa Department on Aging, and it also participates in the closure team. She said she's received much of her information about the pending closures from the media. Although she's glad the closure team will meet next week, she said it should have been called in before the DHS started transferring patients from the Clarinda geriatric mental health program to private nursing homes.

DHS spokeswoman Amy McCoy said Friday that her agency is taking appropriate steps. "We'll follow the requirements for issuing formal notification, and we have been communicating with other state agencies about the realignment since January," she wrote in an email to the Register. "The department's focus is on patient safety and well-being, and we have plans to meet with the Department of Inspections and Appeals, Disability Rights Iowa, and the long-term care ombudsman as a facilities team next week. We are ready to come together, as we have in the past, to ensure Iowans get the services they need."

Werning said care facilities are required to give his department at least 30 days' notice before a closure, but he said administrators sometimes give more notice than that.

Mount Pleasant program empties

No patients are left in a general psychiatric wing of the Mount Pleasant Mental Health Institute as of this week, a state spokeswoman confirmed Friday.

The program had nine beds when the Department of Human Services announced in January that it intended to close the Mount Pleasant and Clarinda mental institutions by June 30. Department spokeswoman Amy McCoy said Friday the last five patients have been transferred to the state mental institution in Independence.

The department said earlier this month that no patients remained in the Mount Pleasant institution's "dual diagnosis" program, which treats people who have both addiction issues and serious mental illnesses. That program had 19 beds in January. The Mount Pleasant facility continues to run a 50-bed addiction-treatment program, but it is expected to close by June 30. Nearly half of the Mount Pleasant institution's workers received layoff notices on March 5, which are effective April 6.

As the programs are being emptied out, critics in the Iowa Legislature are pushing a pair of bills that would try to block the institutions' closures. The bills passed the Senate, but it's not clear whether the House will debate them.