Orchids from around the world
Beavercreek Popcorn Festival
.JPG)
2008 MTV VMA show
Twin Valley closing will have massive impact on area
Local officials scramble to figure out how to handle the closing of the region's only public psychiatric facility.
Sunday, April 20, 2008
DAYTON — When Gov. Ted Strickland announced Jan. 31 he was closing Twin Valley Behavioral Healthcare in a budget-saving move, it came as a surprise to local public and health care leaders who immediately decried the decision as ill-conceived, short-sighted and potentially disastrous for the region, the mentally ill and their families.
Nearly four months later and about two months before Twin Valley's June 30 closing, local officials are scrambling to figure out how they will handle the fallout from losing the Dayton region's only public psychiatric facility.
Extras
Photos
"The impact has been immediate and it's going to be long-term," said Bryan Bucklew, president of the Greater Dayton Area Hospital Association.
The state also is closing a psychiatric hospital in Cambridge to help plug a $733 million deficit in the 2009-2010 budget cycle, which begins July 1. Those who use Twin Valley will have to travel to Cincinnati, Columbus or Toledo for treatment.
By closing the former Dayton State Hospital and consolidating services, the state expects to save $13 million next year.
"I wish I had more resources, quite frankly, but the reality is we've got a very serious set of budget conditions that make it necessary to make decisions that I find painful," Strickland, a Democrat and a former prison psychologist, said in a March interview.
State leaders told local officials they could keep Twin Valley open after June 30 but the Dayton community would have to pay for it.
Local leaders immediately rejected the idea.
"I don't know why Dayton should be the only major urban area in the state where the (Ohio) Department of Mental Health isn't paying for its own facilities," said Tom Breitenbach, president and chief executive of Premier Health Partners, parent corporation to several hospitals in the region, including Miami Valley and Good Samaritan.
"The state is looking for answers that won't cost them money, and there really is no answer that won't cost them money. The only answer is for them to keep it open."
By all indications, that's not going to happen. The state began moving patients out of Twin Valley on April 3.
Here's a look at the impact area residents and leaders expect from Twin Valley's closing.
Patients and families
Twin Valley treats hundreds of civil and so-called forensic patients — the mentally ill caught up in the criminal justice system — at its 110-bed facility on Wayne Avenue.
For area families, having their relatives close by for treatment can mean the difference between a fast or slow recovery, said Walt Lichtenberg, past president of the Montgomery County chapter of the National Alliance for the Mentally Ill.
"It's part of the healing process," said Lichtenberg, who has a family member who's been hospitalized at Twin Valley. "If (the patient) knows that you accept his illness and still love him and deal with him, it's going to affect his attitude. If he's out in the middle of nowhere — you know, 'Why was I shipped here instead of being close to my loved ones?' — how would you feel? You're dealing with a person's emotions and they're very fragile when they're hospitalized."
Add in the time, distance and fuel costs involved with a trip to Cincinnati and, "it really becomes a burden," Lichtenberg said. "You have some people who are really going to be financially strapped to see their loved one."
ODMH spokeswoman Amy Cooper said the state is exploring "creative solutions" to mitigate any of the negative impact, including travel issues, the Twin Valley closing will have on the Dayton region.
Wright State's medical school
"Twin Valley's closure is going to be a major hit to the training of our residents and students," said Dr. Howard Part, dean of the Wright State University Boonshoft School of Medicine.
"We're going to lose nine high quality faculty based at Twin Valley, which has been an outstanding training site for our students and residents," Part said.
Twin Valley won't close until June, but the school's already feeling the loss, Part said. None of Boonshoft's graduating students this year sought a psychiatry residency in Dayton, breaking a proud tradition for the medical school.
Dayton will feel the loss, he said, because many of the school's psychiatry residents who train at Twin Valley go on to work in the public sector.
"These are individuals who are going to play an important role in public mental health," Part said.
He said the closure will "destabilize" Boonshoft's psychiatry program and jeopardize the school's relationship with Wright-Patterson Air Force Base Medical Center, which provides 20 psychiatry residents to the Dayton community.
"If the Air Force feels the psychiatry program is weakened, or there's been a substantial change, they could take those residency slots and take them to San Antonio," site of the Air Force's only other training ground for psychiatric residents, Part said.
Earlier this month Strickland dispatched Eric Fingerhut, chancellor of the Ohio Board of Regents, and ODMH Director Sandra Stephenson to discuss with Wright State possible solutions to the quandary.
The leaders proposed that state and local officials form two workgroups: One would focus on mitigating the impact on Wright State's training programs; the other would study alternative uses for the land and buildings at Twin Valley.
Part said he appreciates the state's offer to help; he just wishes it would have come long ago, not 12 weeks before Twin Valley's scheduled closing.
"This isn't even close to being figured out yet," he said.
Local hospitals
About half of Twin Valley's patients are civil cases, those not ordered into care through the criminal justice system, according to ODMH.
Hospital leaders fear a shuttered Twin Valley could mean more patients seeking care at local hospitals, emergency rooms and mental health floors that are already overcrowded and ill-equipped to handle critical psychiatric cases.
"You can't put a patient with a serious mental illness, one who is potentially violent, next to an elderly patient with Alzheimer's disease," said Dr. Jerome J. Schulte Jr., medical director of psychiatry at Good Samaritan Hospital.
Hospital officials have a similar concern at Upper Valley Medical Center in Troy, where residents in Miami, Darke and Shelby counties use UVMC's Dettmer Behavioral Health Services for psychiatric care.
"We don't have a locked inpatient unit that would be appropriate to serve these clients in the tri-county," said Keith Achor, a nurse and vice president of UVMC patient services.
With Twin Valley closing, the state has told judges in Miami County to send its forensic cases 125 miles away to Northcoast Behavioral Healthcare Organization in Toledo, five times the distance to Dayton.
"We think that's a pretty huge injustice to those individuals," Achor said. "These patients desperately need their families with them."
County budgets
Nearly three-quarters, or 72 percent, of Montgomery County's budget supports criminal justice services, County Commissioner Judy Dodge said.
"Right now we're spending approximately half a million to a million dollars a year just putting (inmates) in different counties because we don't have space at the jail," Dodge said. "It's breaking our backs."
Toss in a soft economy, declining revenues and the estimated $89,000 per year it will cost the county to transport inmates to Summit Behavioral Healthcare in Cincinnati. "We don't know how we're going to do it," she said.
In Miami County, Sheriff's Capt. Dave Duchak said a trip to Northcoast in Toledo will require two deputies and at least six hours out of service. "It's a tremendous, tremendous hardship," Duchak said.
State law doesn't require sheriff's deputies to transport mental health cases to psychiatric hospitals unless a judge orders it, Duchak explained. But law enforcement usually accepts the task in the interest of public safety and the welfare of the inmate or person arrested, he said.
"The sheriff's office, the Troy police, the Piqua police, we can't take two officers off of a shift on a Friday or Saturday night for a six-hour trip to Toledo. We just can't do that from a personnel standpoint," Duchak said. "That's why we're trying to work together locally to come up with the best possible solution for the safety of the community and those needing mental health services."
One idea floated so far includes using off-duty sheriff's deputies for the transport. The Tri-County Alcohol, Drug Addiction and Mental Health Services Board would pay a negotiated hourly rate with the deputies and cover fuel costs, Duchak said.
"For not a whole lot of savings, (state leaders) have created an extremely large mess," said Duchak, echoing the sentiment of many. "The sad part is the people who are going to pay are the people who need mental health assistance."
Contact this reporter at (937) 225-7408 or agottschlich@DaytonDailyNews.com.
