Imagine rushing to the emergency room with heart attack symptoms or a major injury and having hospital staff greet you with some variation on this: "Sorry, we don't have any rooms available for that type of care."
For Minnesota families with loved ones battling a serious mental illness, this is too often a reality when a crisis strikes and hospital care is not just urgent but potentially lifesaving.
Hospitals have a limited number of inpatient mental health beds, and they're often filled, leaving patients to try to find another hospital or wait in emergency rooms, sometimes for days, until a bed opens up. One Twin Cities family contacted by an editorial writer once was relegated to an emergency room's hallway for hours.
The current difficulty of finding care is why reports about St. Joseph's Hospital's financial losses and uncertain future are so alarming. The venerable St. Paul institution has 105 inpatient mental health beds, a significant percentage of the roughly 1,300 such beds in the state. The system simply can't take a hit this size to care capacity.
"We can't lose these beds,'' said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness.
On Friday, James Hereford, president and chief executive of Fairview Health, called reports from last fall about St. Joseph's closure "overblown." More recent reports that Fairview is seeking out "partnerships" to preserve mental health care there are encouraging, though the move also raises broader questions. Among them: Why is mental health care reimbursed so meagerly compared with other medical care?
And, what do Minnesotans get in return for the special tax treatment provided to the state's medical centers? Generally, these institutions operate as nonprofit hospitals, and with that comes a valuable property tax exemption. In return, they're expected to provide a community benefit. Does that mean continuing to provide a critical but unprofitable type of care in an area with poor, vulnerable patients?
State Rep. Tina Liebling, DFL-Rochester, deserves credit for bringing up these expectations at a Minnesota House hearing on Thursday. Hopefully, her committee will continue to explore this issue. From testimony provided, there are few expectations outlined for what constitutes community benefit. Nor is there adequate information about whether taxpayers are getting a good return on their investment in these institutions.
