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Since Twin Valley's closing, battle rages over care of mentally ill

Margaret Gerken with one of the cats that survived a Sept. 4 fire at her Trotwood home, allegedly set by her son two days after his released from Grandview Hospital's psychiatric unit. Gerken said there's nowhere for unstable mental patients to go since the 2008 closing of Dayton's state hospital.

Jim Witmer/Staff photographer Margaret Gerken with one of the cats that survived a Sept. 4 fire at her Trotwood home, allegedly set by her son two days after his released from Grandview Hospital's psychiatric unit. Gerken said there's nowhere for unstable mental patients to go since the 2008 closing of Dayton's state hospital.

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Patients with mental illness face difficulties gaining access to state hospitals

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By Mary McCarty and Tom Beyerlein
Staff Writers Updated 10:24 PM Saturday, November 21, 2009

TROTWOOD — In early September, doctors at Grandview Hospital discharged Margaret Gerken’s mentally-ill son after they determined he was stable and his bed was needed for another patient.

Two days later, police say, Craig “Rob” Gerken set fire to the family home, causing major damage.

“He said the voices (in his head) told him the house couldn’t be there any more,” said Margaret Gerken, 79. “He was sitting on the couch with the curtains behind him and he just turned and flicked the lighter.”

Everybody agrees it’s harder for people like Rob Gerken to get long-term psychiatric care since the June 2008 closing of Dayton’s state mental hospital and subsequent funding cuts for mental health treatment. The battle that’s heating up is over what to do about it.

Montgomery County’s mental health board proposes a “step-down” facility called Morningstar to provide short-term housing and treatment for mental patients discharged from local general hospitals. The board could bill Medicare and Medicaid for the patients’ care.

But general-hospital psychiatrists say Morningstar isn’t the answer for acutely psychotic people. They say they are referring patients to a state hospital in Cincinnati, but the mental health board, which is responsible for paying for state hospitalizations, too often won’t approve their recommendations. Consequently, they say, psychotic patients are either being discharged before they’re ready or kept for weeks in local hospitals that aren’t set up to handle them.

Natalie Harris, chief executive of Miami Valley Housing Opportunities, said too many of her agency’s mentally ill tenants are relapsing, being evicted and becoming homeless because of a lack of longer-term care.

“I don’t know (exactly what’s needed),” Harris said, “but what we have now isn’t working.”

Keep reading: Patients with mental illness denied access to state hospital

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Here is a link to a 2007 DDN article, when ADAMHS's Executive Director only made $288,625/ year:

http://www.daytondailynews.com/loca...

Who's interest is he serving as ADAMHS continues to cut funds to providers?

follow the money
2:10 PM, 11/23/2009

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Don’t forget number four!

TELL NAMI, THE ADAMHS BOARD MEMBERS, AND ODMH THAT YOU SUPPORT CLIENTS BEING TREATED IN THEIR HOME COMMUNITY AT AREA HOSPITALS, SECURE THE MONEY FROM THE STATE TO FACILITATE THIS, THEN USE THE $1 MILLION (OVER TWO YEARS) FOR YOURSELF: Oh, wait you already did that! I smell FRAUD!

one more
12:58 PM, 11/23/2009

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3. LET YOUR PROVIDERS DO THEIR JOBS: If ADAMHS would stop hand-picking who should get into every program, they could probably eliminate at least 2 staff positions. This is not only a waste of taxpayer money, it is another way ADAMHS delays patients getting the care they need. Let Eastway screen admissions to the Lodge, CAM screen for New Hope Villa, Crisis Care screen for admission to Summit, and Morningstar to screen for admission to their residential program—they are the clinicians!

here's an idea
12:47 PM, 11/23/2009

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2. TAKE A GOOD, HARD LOOK AT HOW MANY STAFF POSITIONS ADAMHS NEEDS: The Ohio Department of Mental Health re-allocated the responsibility of performing the Ohio Medicaid Audits at the Community Mental Health Centers to the state, yet ADAMHS has maintained the same level of staffing, trying to justify their positions with a new “evidence-based practice audit.” Isn’t that why ADAMHS already pays contracted consultants to do fidelity reviews? Paying for the same service twice—that makes sense!

here's an idea
12:33 PM, 11/23/2009

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Top Three Ways ADAMHS can Raise the Money to cover the Operating Expenses of Morningstar without Making Further Cuts to State Hospital Beds:

1. CUT TWO OF YOUR THREE DIRECTOR POSITIONS: At any given time, one of them is MIA, one is busy impeding access to care, and the third one is engaging in some combination of the two activities. Think of all the services that could be provided to mental health patients, if ADAMHS was willing to be less top-heavy. Too many chiefs!

here's an idea
12:30 PM, 11/23/2009

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