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Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2010 > February > 23 > Entry
Editorial: Twin Valley sale won’t fill void
A for-profit company is buying the old Twin Valley state mental hospital on Dayton’s Wayne Avenue, but it’s too soon to know whether that’s a good or a bad thing for people who need mental health care and can’t get it in the Dayton community.
The state closed Twin Valley in June 2008 as part of a cost-saving move.
Now individuals who need inpatient mental health care are being sent to a state facility in Cincinnati; admitted to local hospitals, which aren’t designed to keep psychiatric patients beyond a few days; or they’re given their meds and sent on their way.
It’s not a good situation, and the problem is compounded by the fact that psychiatrists at the county mental health agency and psychiatrists at local hospitals are at each others’ throats.
Psychiatrists at ADAMHS — the Alcohol, Drug Addiction and Mental Health Services agency — get to decide who’s admitted to the Cincinnati state hospital. In the case of people without insurance, this means they decide who will get treatment at state expense.
When that agency won’t OK treatment at a state facility, a local hospital often is in the position of keeping a patient who may not belong in a general hospital. More than likely, the hospital also will take a financial hit for providing the treatment.
A local study is being done by area hospitals that shows a small number of chronically mentally ill patients — many of whom also have drug or alcohol addictions — are responsible for big bills that the hospitals turn around and submit to Montgomery County for repayment under the Human Services Levy.
Amamata LLC is the newly created company that is buying the old Twin Valley from the state for $1.7 million. The state is eager to trumpet the sale because there is still much bitterness aimed at the Strickland administration for closing Twin Valley in the first place.
But the sale itself is not what matters. What counts are the services that will be offered and for whom. If the facility only takes those who have insurance, that’ll leave area hospitals caring for those patients who can’t pay and possibly losing those who can pay.
Some psychiatrists say that what’s needed locally are psychiatric services for children, developmentally disabled individuals, older adults and those who are both mentally ill and addicted to drugs or alcohol. These are subspecialities that general psychiatrists may not be expert enough at dealing with.
There’s some understandable local skepticism about a for-profit business model being viable. A for-profit operation was slated to go into Elizabeth Place, but that effort fizzled.
Generally speaking, it’s hard to turn a profit at psychiatric facilities because Medicaid and Medicare reimbursements are low, and reimbursements by traditional insurers aren’t exactly lucrative either. That’s why states so often end up running psych facilities or why they’re non-profit.
Dr. John A. Johnson, who is president of Amamata, told reporters he wants to offer speciality services, the sort Dayton needs. He has big plans, including putting $6 million into the aged Twin Valley facility, and he imagines hiring 150 people.
There is no doubt that there are gaps in the local psychiatric offerings. Whether Amamata can help fill them remains to be seen. What’s certain is that Twin Valley’s absence is still being felt.
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