Hospitals in the region say the potential closure of two inpatient behavioral psychiatric facilities could create a "crisis" situation for both patients and other providers.
Medina Memorial Medical Center this week filed plans to close its 7-bed behavioral health unit. The plan follows a decision last month to close Lake Shore Health Center this January, an Irving hospital that includes a 20-bed inpatient behavioral health unit.
Compounding the problem are closures in neighboring counties, including the shutdown in September of inpatient adult and adolescent psychiatric care services at St. James Mercy Hospital in Hornell.
"There's a huge transition going on in inpatient mental health and it's certainly a concern for the community in the number of patients that are going to need to be transferred long distances," said Donald Eichenauer, CEO at Wyoming County Community Health System.
Wyoming County Community operates a 12-bed unit in Warsaw, one of the three closest hospital-based inpatient units to Medina and all located at least 40 miles away: Rochester General Medical Center has a 30-bed unit to the east; while 40 miles to the west, Great Lakes Health is building a 160-bed inpatient psychiatric program as part of its Regional Behavioral Health Center of Excellence on the campus of Erie County Medical Center.
The Great Lakes center consolidates services from ECMC's existing 132-bed inpatient psych program, its 57 inpatient rehabilitation/detoxification unit; as well as a 91-bed program from Buffalo General Medical Center that closed earlier this summer. It is slated to open in January.
Eichenauer said his program has an average census of 10-11 patients from the five-county region it serves, leaving little availability for patients from the Medina and Irving areas.
"It's getting to a crisis level, probably more so for the counties who no longer have this service," he said. "Their police and emergency service providers who come into a situation where someone needs an emergency placement are going to have to transfer them somewhere, and it's going to become very difficult."
Lake Shore Health's problems are also financial, with the hospital projected to lose $7 million this year. That's what led the Lake Erie Regional Health System of New York to approve a shut-down by January. There's still a chance the hospital could remain open, however, as board members are soliciting buyers to take over operations.
But Medina Memorial's leaders told state health officials its behavioral health unit has been experiencing shrinking reimbursement, decreasing census, stricter admission criteria and rising internal expenses, all leading to a projected loss for 2013 of $321,000. The state health department rarely turns down requests for program closures, Eichenauer said.
"When someone comes to you and says they don't have the money to do it, what is the real choice?" he said.
ECMC officials said the hospital is already serving the eight-county region through its state designation as a regional center. The new regional center of excellence was built with an emergency department three times the typical size partly for that reason, said Tom Quatroche, vice president of marketing, planning and business development.
"We're obviously concerned with the lack of access in those communities," he said. "We get many of the referrals from those communities for higher levels of mental health care."
While the regional center will be able to handle additional demand, the hospital also hopes to help communities with strategies such as outpatient care, Quatroche said.
Both the Medina Memorial and Lake Shore Health plans still require approvals for their closure plans by the State Department of Health and the Office of Mental Health.