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Sailer speaks on CBHH's future

A low census at Minnesota's Community Behavioral Health Hospitals and the availability of qualified health care workers is causing the state to re-examine the care level for its 16-bed hospitals, and local human services officials would like the Wadena facility to remain at least partially for acute care.

The CBHH in Cold Spring was temporarily closed in October and will be reopened as a subacute facility, said Paul Sailer, Wadena County's human services director. Subacute facilities require less staff and psychiatric services with longer stays such as 90 days possible. The average length of stay for patients in the Wadena facility is 15 days.

Sailer expects the Wadena facility to remain open, but would like to see it continue with acute care, he told the social services board at its October meeting. Another option they are talking with the state about is to have eight beds for acute care and eight beds for those with a dual diagnosis, which involves both mental illness and chemical dependency.

"We want to keep the best program we can at our local facility," Sailer said.

The Wadena facility opened in June 2006 as part of a statewide effort to replace large mental health institutions such as the Regional Treatment Center in Fergus Falls with smaller hospitals closer to the homes of patients.

The state is three and a half years into a five-year plan for the facilities, Wadena CBHH Administrator Richard Slieter said in an interview. The demand has not been what was predicted. There's been a consistent decline in census numbers over the past three years, he said.

The hospitals are staffed for full capacity, but as of Wednesday morning, there were 60 people in all of the state's nine open facilities, he said. The capacity was 125 people. If the hospitals were at 100 percent capacity, which is dependent on the availability of psychiatrists and other specialized care, there would be 144 beds available.

While Slieter doesn't know all of the factors for the decline, he said, one thing he does know is there are more community-based services than there were three to five years ago, which allows people with mental illness to remain in their homes or in group homes.

The state hasn't made any decisions yet regarding the future of the CBHHs, he said. The Minnesota Department of Human Services assistant commissioner has been meeting with various stake holders, such as health care providers, social services offices and law enforcement, to find out what their opinions are before a plan is decided. They want to be good stewards of precious state resources, he said.

"I do not believe we will see closure," Slieter said.

Closing is a possibility, but he doesn't see that happening, he said. He does believe the state has an obligation to make some changes and some CBHHs will be converted to lesser care facilities.

The availability of psychiatric services will play a role in what level is offered at the each of the hospitals, he said.

Dr. Aaron Larson of Tri-County Hospital in Wadena is pursuing a doctorate of psychiatry and having a local psychiatrist will be one of the things that makes the Wadena hospital unique, Sailer said.