State redesign of mental health services means changes for Willmar hospital as well as closures statewide, 200 job losses

Changes to Minnesota's mental health services will mean eliminating 200 full-time jobs, closing several community mental health hospitals and revamping the psychiatric hospital in Willmar.

The changes will occur over the next 15 months and save $17 million from the state Department of Human Services' operating budget.

The timing of the changes is linked to state budget pressures, said Dr. Read Sulik, assistant commissioner for Chemical and Mental Health Services in an interview Wednesday.

But the changes will also result in better access to care for people with mental illness and will make better uses of facilities and resources, including the 16-bed Community Behavioral Health Hospital in Willmar, he said.

Kandiyohi County Administrator Larry Kleindl said he's "cautiously optimistic" the changes will improve the current system.

Kleindl, who had served as the county's family services director when the state made its initial transition from regional treatment centers to community-based hospitals, said the need to fill gaps in the current system has long been discussed on the county and regional level.

"I think it's OK to make adjustments as long as they keep in mind who you're serving and what the mission is," said Kleindl.

Some parts of the plan, including the permanent closure of the psychiatric hospital in Cold Spring, will happen immediately, according to Sulik.

Sometime this spring, before the fiscal year ends, the Willmar hospital will temporarily change from being an acute-care mental health hospital to a new type of a step-down hospital called Psychiatric Extensive Recovery Treatment Services.

Sulik said the change will mean elimination of some jobs at the Willmar facility.

A Psychiatric Extensive Recovery Treatment hospital won't have the tight, locked-door security or the high level of psychiatric care that's currently available at the Willmar hospital. Instead, it will provide a lower level of supervised care with lodging and clinical support that patients might need after they are discharged from an acute-care psychiatric hospital.

Sulik said the care offered with Psychiatric Extensive Recovery Treatment Services would fill a gap in existing services.

Since opening two years ago, the census at the Willmar hospital has been below expectations, in part because parameters for admittance had been "so tightly defined" and people weren't being served, said Kleindl.

While beds in Willmar were being left open, there were clients who needed less acute care that had no place to go.

Kleindl said creating a "seamless, step-down system" will provide needed follow-up care and prevent people from "cycling in and out of hospitals."

These new changes, meant to address that void, are a "natural evolution" to the state's mental health care delivery system, said Sulik.

During the temporary transition period, members of the 18-county consortium which has been studying the mental health delivery system in this region will be asked to work with public and private providers, like Rice Hospital, to create a new business and clinical care model for Level 1 or Level 2 psychiatric care that meets community needs.

Level 1 care is 24-hour psychiatric coverage for the most acute needs, and Level 2 is also in-patient care but a lower level of care than Level 1. Psychiatric Extensive Recovery Treatment Services is a third type of care.

Rice currently has acute-care psychiatric services.

There are state and federal financial incentives for such partnerships, Sulik said.

Another part of the plan is a new 24-hour psychiatric access service for comprehensive assessments, consultations, triage and referrals.

Kleindl said he's glad to see that the current centralized admission process is being eliminated and that more control will be given to local entities. "I see that as an exciting benefit to this change," he said.