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Erlanger, Parkridge battle over need for new mental health hospital

Chattanooga Times Free Press - 8/23/2016

Aug. 23--Erlanger and Parkridge, two of the area's three largest hospitals, will go public this week with their dispute over whether there is need for a new mental health hospital in the area.

Erlanger is asking state officials for permission to build a new $25 million, 88-bed behavioral health hospital about a mile away from the current Erlanger main campus. Parkridge already operates two mental health facilities that combined have more patients than anyone else, and hospital officials there say a new facility is not needed.

Both sides will make their case Wednesday in Nashville in a presentation to the Tennessee Health Services and Development Agency, the state group that must give its permission before any major new medical facility can be built.

Erlanger's Joe Winick, senior vice president for planning, analytics and business development, will argue that the metro area particularly needs a short-term care facility serving vulnerable patients with little or no insurance.

"They are your next-door neighbors," he said. "They could be someone who is depressed, schizophrenic, bipolar, a young kid who goes to the emergency room because he has attempted suicide. The list is long, and it is sad to see that these folks cannot get access to timely health care."

But officials at Parkridge, which operates the Parkridge Valley mental health facilities serving both adults and juveniles, have argued there are plenty of beds already to serve the mentally ill.

Parkridge officials declined a request to be interviewed, but in a letter to the health development agency argued, "The Erlanger project fails to meet the applicable criteria of need, economic feasibility and contribution to the orderly development of health care facilities and services" and should be denied.

While Parkridge officials have not commented on it, one issue of concern to them may be that Erlanger plans to build the hospital as a for-profit joint venture with Franklin, Tenn.-based Acadia Healthcare, which owns the nation's largest network of mental health facilities and is a rival of Parkridge's owner, Hospital Corporation of America. The new facility would give Acadia a foothold in the Chattanooga market, and a powerful partner in Erlanger. Now Acadia's only local facility is the Volunteer Comprehensive Treatment Center on Rossville Boulevard that treats patients addicted to opioids.

Erlanger's proposal allocates 24 beds for geriatric patients, 24 for adults, 18 for children and adolescents, and 22 for adult substance abuse patients.

The hospital would be built on the corner of North Holtzclaw Avenue and Citico Avenue. Erlanger would move its current 12-bed geriatric behavioral health unit from Erlanger North to the new hospital.

The two-story, 69,000- square-foot hospital would employ about 100 staffers if it is built, according to Erlanger's projections.

While Erlanger and Acadia will jointly own the facility, Acadia will probably end up as the majority owner, Winick said. The letter of agreement between the two calls for Acadia to pay Erlanger 2 percent of net revenue from the hospital for its support services, and for use of the Erlanger name.

In addition, Erlanger is working with the University of Tennessee Medical School in Chattanooga to start a psychiatric residency program that would use the hospital to train medical students, Winick said.

Besides Parkridge, the hospital is also opposed by CADAS, the Council for Alcohol and Drug Abuse Services. CADAS has 96 inpatient and detoxification beds in Chattanooga aimed at patients with drug and alcohol problems. CADAS officials have argued there are already a total of 342 beds in Chattanooga to provide help to people with substance abuse problems.

"CADAS believes these beds are sufficient for the substance abuse/chemical dependency needs of the community," executive director Paul Fuchcar wrote in a letter to the state. He added that there is a shortage of nurses, psychiatrists and other health care personnel that would be worsened by adding the new facility.

But Erlanger officials insist their emergency room is frequently flooded with patients with mental health issues who have no place to go.

"They are in our examination room and we have extra people watching them to keep them safe," Winick said. "But our emergency patients get delayed, so it really complicates our ability to deliver medical care."

"We are not taking patients going to Parkridge or wherever -- they are already at Erlanger," he said.

Erlanger said that in one 12-month period, some 11,500 of its patients had a mental health condition that needed treating, and of those patients, 6,468 were admitted through the emergency room.

Moccasin Bend has 150 beds for people with the most serious mental health problems who are likely to need permanent or long-term care, but those beds are in high demand.

"Moccasin Bend is often full, and last week, we were 76th on the waiting list to get patients into Moccasin Bend," Winick said.

Parkridge provides 172 beds at its two facilities, Parkridge Valley Child and Adolescent Services and Parkridge Valley Adult and Senior Services, but in general only accepts involuntary admissions from patients who have health insurance, according to the state analysis.

Erlanger ends up taking the patients no one else wants to see, Winick said. No matter whether another hospital or clinic has in-patient or outpatient services, "When they close down at 5 p.m. and people have not been admitted, what do they say? They say go to Erlanger," he said.

"The system of care that is available for those with mental health and substance abuse problems in this region is not working," Winick said. "If patients are staying in our emergency department, then something is wrong."

Contact staff writer Steve Johnson at 423-757-6673, sjohnson@timesfree press.com, on Twitter @stevejohnsonTFP and on Facebook, www.facebook.com/noogahealth.

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