County says no to sub-acute unit

Supervisor:?‘I don’t believe that’s the type of service we want to be delivering there’

— Daily Freeman-Journal file photo The former Webster City Medical Clinic was gifted to Hamilton County by Van Diest Medical Center last summer. The intent is to create a campus with mental health and health care services, according to the Board of Supervisors.

The Hamilton County Board of Supervisors Tuesday morning voted to turn down a proposal to potentially place a sub-acute residential recovery center in a portion of the former Webster City Medical Clinic building.

The clinic building was obtained by Van Diest Medical Center with the acquisition of Webster City Medical Clinic. Last summer, the hospital gifted the building to the county to develop a campus featuring health care and mental health services. The original plan for the facility was to develop respite rooms and transitional living recovery services, according to Supervisor Doug Bailey.

The supervisors hoped to bring Central Iowa Recovery on board to provide the services. CIR provides psychiatric rehabilitation service to individuals in 15 counties of Central Iowa, including Hamilton.

The supervisors received notice that the proposed service plan for CIR to be offered in the former clinic building was denied by the regional staff. The notice also said the staff would be recommending to the governance board to deny the request. But the regional staff offered a counter proposal for the facility.

“They did propose that they would offer to hire a consultant for CIR to look at creating a subacute mental health unit in the facility,” Supervisor Doug Bailey said.

Bailey said the subacute unit would be a higher level of care than what was originally planned and would cost much more to operate.

“There is also a higher level of risk and a higher level of liability,” he said.

“I don’t believe that is the type of service we want to be delivering there. That’s never been the intention,” he said.

He explained that acute services are provided by state-operated inpatient residential facilities such as Cherokee Mental Health Institute. Sub-acute services are just below the acute level. In a sub-acute unit the patient is admitted for a 10-day inpatient stay with an evaluation following the 10 days. Bailey said the patient’s stay could be extended if deemed necessary.

“The intent is that it’s short term and recovery. But it is also a facility that would need to be able to be locked down,” he said. “It’s just totally the opposite of what we had been looking for.”

Recently, the county announced that two other agencies will be moving into the former clinic building. HeadStart and Hamilton County Public Health will be the first two tenants and both plan to move in this spring.

“Neither of those entities were advised that that would be the level of service in the building. I don’t feel it’s an appropriate location for that type of service,” he said.

Hamilton County Public Health Administrator Shelby Kroona said she was in favor of the original plans for the clinic building.

“I would have serious concerns having public health in a sub-acute setting,” she said.

The supervisors passed a motion to inform Central Iowa Recovery and the mental health region that the county would not be interested in developing the sub-acute unit in the former clinic building.

“In the essence of time, I think we need to let them know where we stand,” Bailey said.

Bailey said the county would be looking at other options, including the possibility of changing regions.

“That’s fairly extreme, but there has been a great deal of interest all around us,” he said. “Not all regions have developed the same services and so what we had originally been looking at is not really available in the region to our north,” he said.

“We’ve always wanted to do something that would benefit the 75 to 80 percent of those individuals who have mental health diagnoses, but who don’t need to be treated at the sub-acute level.”

Bailey said he hoped the county could continue to work with the regional staff.

“We need to be able to develop a variety of services that is appropriate for that setting and for the region,” he said.