Mat-Su Regional seeks Certificate of Need in securing behavioral health beds

PALMER — Just five years ago, the two specialty rooms the Mat-Su Regional Medical Center had set aside for behavioral health and drug abuse patients was plenty.

In fact, just five times in 2012 did the hospital have to find space for an overflow of those patients. But with the Valley’s meteoric rise in population, and as crucially, the on-rush of its opioid epidemic, those two beds failed to suffice 234 times in 2016.

Fast forward to Tuesday of last week, and there were 27 behavioral health patients in need of those few slots.

“We have to hold these people because Alaska Psychiatric Institute can’t see them,” explained Jared Kosin, Business Development Director for the hospital. “It’s a detriment to them, to us, our staff — no one wins.”

Chief Nursing Officer Emily Stevens said emergency departments aren’t typically designed for mental and behavioral health care with rooms that include specially trained sitters, stripped down rooms and no breakable glass for patients who may be a threat to themselves.

“The ER is geared for trauma or crisis — heart attack, broken bones, things like that,” Stevens said. “We have 20 beds and eight have been taken over by psychiatric patients since last Tuesday.”

Stevens said the number of committed beds for mental health needs is now 11, which puts a strain on the rest of the ED.

“It’s very stressed,” she said. “(Tuesday) we had 100-some patients in the ED. You take that many beds down (for behavioral health) and you have to become resourceful in how you see patients. The less acute patients you see in hallway beds.”

As the problem at MSMRC grew larger and larger, the hospital decided to do something proactive about it, and on June 27, a long study culminated in the filing of a Certificate of Need with the State of Alaska to add 36 beds directed at treating behavioral health and substance abuse issues.

“This is just the tip of the iceberg for what the community needs,” hospital CEO David Wallace said. “If there’s a waiting list get in the only inpatient beds in the state — and we know yesterday we had at least 27 — the need for a 36-bed unit is more than justified.”

On Thursday, the hospital received confirmation that the state had accepted its application for a Certificate of Need public hearing, which is expected to be scheduled in early-to-mid August.

In the meantime, hospital staff is making sure to galvanize and ask for help from a Mat-Su community already well aware of the problem.

“I think it’s almost therapeutic for the people who work here to be involved with gathering community support in that this is such a crisis we’re going through,” Wallace said. “We just want to make sure that when the time comes for the state to consider our Certificate of Need, they’ve heard from our community.”

Hospital staff has been out in the community circulating forms explaining the situation. These forms include a text box inviting people to write their personal testimony about the importance of mental health or substance abuse treatments in the Mat-Su Borough.

“Hospital services (for drug abuse/behavioral health in Alaska) are used over four times the national average,” Kosin said. “We’re completely under-bedded. So when someone comes here and has nowhere to go, they just keep coming back and back and back… “We don’t have a choice; these people have nowhere else to go. We just do what we do.”

Kosin said that in the long run, having dedicated behavioral health amenities in hospitals would not only deliver more effective care, but also be more economical.

“When people need behavioral health services in the emergency department, a lot of them are in crisis and often times need inpatient services for 4 to 7 or 10 days,” Kosin said. “We have to hold these people because Alaska Psychiatric can’t see them.”

While few would could doubt the validity of the need, Kosin pointed out that the process could be complicated by what could be seen as a rivalling effort.

“There’s a proposal that just went in from Alaska Regional Hospital in Anchorage,” he said. “The state has a habit, when there’s two things that are similar to almost think we’re competing for the same thing, even when they’re not. That can change the timeline. But we’ve been very clear that Alaska Regional is not designed to serve our population… We don’t view ours as competition.”

If all goes well and MSRMC gets its Certificate of Need, building would begin soon after and that additional wing would be fully up and running no later than December of 2020. The total cost is projected at $19,250,756.

“When you’re in crisis, you need a place to go to be stabilized and treated and get adequate outpatient care to live a happier, more fulfilling life,” Kosin said. “That way you’re not forced back into the hospital over and over again.”

To contact the Department of Health and Social Services, Office Rate of Review, contact Alexandria Hicks, Certificate of Need Coordinator at alexandria.hicks@alaska.gov.