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Psychiatric care faces cutbacks

Budget woes will derail relationship between county, RVMC ' with patients stuck in limbo

State budget cuts will force Jackson County and Rogue Valley Medical Center to make new financing arrangements for treating low-income patients with severe mental illness.

As of March 1, the county will end its long-term agreement to pay for 12 hospital beds per day in the hospital's psychiatric ward, commonly known as Two North. County public-health officials have been meeting with hospital administrators to discuss new financing arrangements for mental health care, but what will emerge on March — has yet to be determined, said Becky Martin, the county's mental-health manager.

We're trying to leverage our resources to make the most of what we have, Martin said Thursday.

The hospital will continue to provide psychiatric care, said Scott Sonenshine, RVMC's clinical manager for mental health services. There are significant cuts, but we don't want to create a sense of panic. We're still open.

The psychiatric ward treats people who are acutely mentally ill ' such as those who have lost contact with reality, or are overwhelmed with depression, or suicidal.

General spending cuts and reductions in Oregon Health Plan funding have left the county with far less money to care for the mentally ill, said Hank Collins, Jackson County's director of Health and Human Services.

It's a fact of life we don't have the money we used to, Collins said. Psychiatric services for folks are going to suffer. Certain people will not be able to be treated the way they used to be.

All told, spending cutbacks cost the county &

36;2.5 million ' more than the nearly &

36;2 million it paid RVMC last year to hospitalize mentally ill patients.

We've lost 29 staff and cut 10 vacant positions, Collins said. It's natural for us to look at that &

36;2 million, and it's timely for us to talk to the hospital about restructuring our agreement.

The state-supported health insurance plan will no longer provide mental-health services for at least 5,000 of the 20,000 Jackson County residents who are enrolled in the Oregon Health Plan. What's still unclear is how frequently those people were admitted to the psychiatric ward and, by extension, how much state support will be lost, Martin said.

As funds dwindle, the hospital may have to be more selective when admitting people for psychiatric care, said Dr. Richard Phillips, RVMC's medical director for psychiatry. Some people who are probably able to manage in the community will be expected to remain in the community.

Collins said county officials and hospital managers have been looking for less expensive ways to provide psychiatric care, such as a conflict resolution center that could provide many of the same services outside a hospital setting. But he noted that such alternatives have disadvantages, too. Moving acute psychiatric care outside the hospital, for example, would also mean the loss of federal medical reimbursement, like Medicare.

We're trying to put our heads together and figure out a way to do this in a less expensive setting, he said.

Dr. Richard Phillips, medical director for psychiatry, left, and Scott Sonenshine, clinical manager of mental health services at Rogue Valley Medical Center, are working with health officials to keep cuts in mental health programs from going too deep. Mail Tribune / Jim Craven - Mail Tribune Jim Craven