Fresno County negotiating for adolescent psychiatric hospital

The Fresno BeeFebruary 7, 2014 

Fresno County could have an adolescent psychiatric hospital by the end of the year that would keep teens with severe mental illnesses close to home instead of being sent far away for care.

The county is negotiating with a private company to run a 16-bed inpatient unit for adolescents in Fresno, said Dawan Utecht, director of the Fresno County Department of Behavioral Health.

Stars Behavioral Health Group, based in Long Beach, would provide staffing and run the hospital, Utecht said. The county would provide space on Kings Canyon Road in a building now housing an adult day-treatment program. The building is on the campus of the former University Medical Center.

The psychiatric hospital would accept children ages 12 to 17.

The hospital would be called Central Star Behavioral Health and would have a staff of about 35, including psychiatrists, nurses, a primary-care doctor and social workers. It would cost about $3.7 million a year to operate. Funding for the hospital would come from state, federal and private insurance sources, Utecht said.

A county contract with Stars Behavioral will need the approval of the county Board of Supervisors.

Supervisor Henry R. Perea, a proponent of expanded mental-health services, said an adolescent psychiatric hospital is long overdue. "We'll see what the board does," he said, "but I think we absolutely need inpatient services."

Fresno County is one of 47 counties in California -- and the second-largest in the state -- without a psychiatric hospital for youths, according to the California Hospital Association. The nearest child/adolescent psychiatric hospital is in Bakersfield.

A psychiatric hospital for adolescents would end the expensive -- and heart-wrenching -- practice of sending children out of the area who are experiencing mental-health breakdowns. Last year, Fresno County sent 199 children to hospitals out of the area at a cost of $1.3 million.

A Fresno County crisis center now offers only short-term help, and hospital emergency rooms struggle to stabilize children and adolescents so they can be strapped in the back of ambulances or restrained in family cars for trips to hospitals out of the area.

Valley parents said it's devastating to leave a child who is suicidal or experiencing a psychotic break and not be able to visit daily because of the distance to the hospital.

"The first time my child was hospitalized, he was 12. He was falling apart -- he wanted to kill himself," said Linda Graves of Clovis. "They sent him someplace that was four hours away. I'm trying as a parent to support him, but I'm not close enough." Her son, now 17, has been diagnosed with bipolar disorder and over the past five years has been hospitalized seven times.

"What a difference it would make not having to go out of town," Graves said.

Fresno County has tried for years to open a child/adolescent psychiatric hospital, but with no luck. Area hospitals would not agree to devote space and staff for the care, which is more expensive to provide than adult psychiatric hospitalization.

Utecht, who took over directorship of the county's mental-health services in May 2013, said the solution came when she found the county space and Stars Behavioral responded to a request for bids to run the hospital. Prior to coming to the county, Utecht had managed Community Behavioral Health Center, an adult psychiatric hospital in northeast Fresno.

Fresno County has applied for $1.8 million from the state under the Investment and Mental Health Wellness Act of 2013 to pay for start-up costs at the adolescent psychiatric hospital. The act has nearly $200 million to expand and improve services, including crisis stabilization, intervention, residential treatment and mobile mental-health response teams.

Money now budgeted for out-of-county juvenile hospitalizations would go toward day-to-day operating costs, Utecht said. But reimbursements from private insurance companies and other counties could help support the hospital.

Stars Behavioral Health Group would seek contracts with insurance companies in the Valley for children with private coverage and would approach surrounding counties so children from those jurisdictions could have access to the hospital, said Kent Dunlap, senior vice president and chief operating officer.

The Fresno hospital would be the first in the Valley operated by the 25-year-old company. Stars provides programs in behavioral health, child welfare, juvenile probation and special education schools in primarily five counties -- Los Angeles, Riverside, San Bernardino, Alameda and Santa Clara.

The company operates a psychiatric hospital in Riverside County for adults and a hospital in Los Angeles County for children. It also runs one of only two -- and the largest -- locked residential treatment programs for children in California, Dunlap said.

"We're one of the few agencies that really have the experience to do a children's (psychiatric hospital)," he said. "We're dedicated to this work and serving children. It's what we do."

Read The Bee's April 2012 series, "Young and far from help":

Fresno County children face agonizing wait for psychiatrists

Fresno County parents must travel far to save their mentally-ill children

The reporter can be reached at (559) 441-6310, or @beehealthwriter on Twitter.

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