June 25Three entities are competing to build a new psychiatric hospital in Spokane County that will help address a statewide shortage of inpatient mental health services.
Providence Health Care submitted an application for a 100-bed free-standing hospital with the Washington Department of Health earlier this month, following the submission of two other applications from for-profit companies in May.
Signature Healthcare Services, a California company that operates 13 psychiatric hospitals around the nation, and Springstone LLC of Kentucky, which has eight psychiatric facilities, also submitted applications to the state. Both are asking for approval to build 72-bed psych hospitals.
"We feel that psychiatric services are under-provided across the nation," said Eric Kim, vice president of development for Signature Healthcare Services. Spokane County needs more "psychiatric beds, and that's our sweet spot," he said.
With the Affordable Care Act, more people have insurance to pay for psychiatric services, the three applications said. Washington is also under court orders to improve treatment for the mentally ill.
Inpatient facilities are for individuals experiencing acute mental health episodes. A typical stay is five to eight days, while health care professionals work to stabilize individuals and connect them to outpatient services, Kim said.
All three applications cited state projects estimating the need for about 72 more beds for psychiatric patients in Spokane County and surrounding areas by 2030.
Providence Sacred Heart Medical Center currently operates the only inpatient psychiatric facility in Spokane, with 48 adult beds and 24 pediatric beds. It's the facility where police take individuals who pose an immediate threat to themselves or others.
The applications will go through a six- to nine-month review by the Department of Health's certificate of need program, which will assess how many beds the community needs and who gets to build them.
The state's process is designed to plan for health care expansion, while avoiding costly duplication of services, said Janis Sigman, the certificate of need's program manager. The review includes scrutiny of financial projections and past operating experience.
Sacred Heart is proposing a joint venture to build the hospital with Fairfax Behavioral Health, which operates inpatient psychiatric and chemical dependency facilities in Everett and Kirkland, Washington.
In Spokane County, 8 percent of residents have a mental illness or serious emotional disturbance, said Dr. Kirk Rowbotham, chief medical officer for Providence Medical Group in Spokane. That figure jumps to 20 to 25 percent for single, homeless adults.
"It's a growing industry. The resources are just starting to catch up with the need," said Kim, of Signature Health Care Services.
Washington is under court orders to improve treatment. Last year, the state Supreme Court banned the practice of "psychiatric boarding," where patients waited in emergency rooms for days until beds became available, but the shortage of beds statewide remains a problem.
Washington ranks last among Northwest states for the ratio of psychiatric care beds per 100,000 people, at about 8 per 100,000, according to American College of Emergency Physicians' 2014 report card. The state Department of Health estimates that the need is closer to 27 beds per 100,000 people.
Sacred Heart's application said it could have a new hospital in operation by 2017. If its application with Fairfax Behavioral Health is approved, a $37 million psych hospital would be built on its existing campus, at the site of the Fifth and Browne Medical Building. The structure would be razed to make room for the 100-bed hospital, officials said.
If the new psych hospital is built, Sacred Heart would scale back the number of beds in its existing facility, for a net gain of 72 psych beds, said spokeswoman Liz Deruyter.
Signature Healthcare Services has proposed a $22 million facility in Spokane Valley, and Springstone has proposed a $24 million facility, also in Spokane Valley. Both companies projected a 2018 opening date.
Medicare and Medicaid patients make up about 30 to 50 percent Signature Healthcare Services' clients at its other facilities, and would likely represent a significant part of Spokane business as well, Kim said.
Staffing whichever facility is built will be a challenge. Sacred Heart's staff of seven psychiatric doctors recently submitted letters of resignation, effective in August. Hospital officials declined to discuss the reasons for the pending departures. The hospital is working on ways to continue to provide inpatient psychiatric services. Rowbotham said those efforts include recruiting new psychiatrists, advertising for psychiatrists willing to fill in on a short-term basis and connecting patients with psychiatrists by phone or computer, which he said is an industry trend.
Nationally, there's a shortage of psychiatrists and competition for them is fierce.
"I get emails every day, with opportunities all over, and they're really good-paying jobs," said Dr. Matt Layton, a psychiatrist and faculty member at Washington State University's College of Medical Sciences.
At Eastern State Hospital, 15 beds in a unit for mentally ill patients 50 and older can't be filled because the hospital doesn't have enough staffing, a spokeswoman said.
Spokane County has 48 licensed, practicing psychiatrists, according to a 2012 Department of Health survey.
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