Update on the New Psychiatric Facility Planned for Dane County

By: Lindsay Wallace, Executive Director

*Reprinted from the March/April Pioneer Newsletter, Executive Director's Corner

Bret Morschauser - a clinical liaison with Willowcreek Behavioral Health in Green Bay, Wisconsin-came and presented to the Recovery Coalition of Dane County (RCDC) and NAMI membership in February. Willowcreek is a psychiatric facility run by Strategic Behavioral Health (SBH), the same company that plans to build a facility here in Dane County.

While the facility in Dane County will not mirror Willowcreeks exactly, there are some common features we can expect to see. We know that all rooms are double occupancy and inpatient units are locked and billable.

For the 72-bed facility in Green Bay, the adult wing has 28 beds, which includes beds for medically managed detox. There are 16 beds in the geriatric wing and 28 beds for adolescents 12-17 years old. While the exact number of beds in the Dane County facility has yet to be decided, we can count on having at least 72.

In addition to the inpatient unit, SBH facilities provide intensive outpatient treatment and partial hospitalization programs, as well as a free, 24/7 crisis assessment unit. At Willowcreek, roughly 30% of assessments and calls are admitted, while 70% are referred to community-based services.

Most admissions to Willowcreek are voluntary, however, they do take involuntary commitments. This means police officers or law enforcement may be able to transport directly to WCBH instead of Winnebago. This is an attractive feature of the new psychiatric facility in Dane County because in 2017, of the 580 involuntary admissions, only 246 were served by local
hospitals. The 334 individuals that went to Winnebago accounted for more than $300,000 in additional costs to law enforcement and the Sheriff's Office.

Another feature of SBH facilities is that most medical clearance can be provided on site, preventing long wait times at emergency rooms. However, patients whose medical condition supersedes their psychiatric one would likely be better served at the emergency room. Examples of such circumstances could include a patient with extremely high blood pressure or a patient in withdrawal and at risk for convulsions.

Important to note is that SBH has an abstinence policy when it comes to treating substance use disorders. While SBH facilities will do an initial dose of vivitrol for detox, they will not do methodone or suboxone treatments. Patients requiring the latter two treatments would be better served at other hospitals in the community. All Dane County hospitals currently
offer methodone and suboxone treatments.

For the 72-bed facility in Green Bay, full staffing is 250 employees, including psychiatrists, psychologists, nurse practitioners, nurses, therapists, and mental health technicians. Staff are recruited from all over the country and compensation is usually slightly higher than the local average. Of course, this creates some anxiety as our community service providers already
struggle to offer competitive wages for qualified mental health professionals.

When asked about their HMO contracts, Willowcreek said they have four to five contracts with Wisconsin HMO's. For the HMO's they are not contracted with, they have successfully entered into single case agreements without a problem. 

A recent news report in the Green Bay Gazette stated that Willowcreek wings within the hospital have been vacant. Bret shared that there have been times the geriatric wing has been vacant because there were no geriatric patients during that particular week. He also shared that the adolescent wing will not open until this Fall, resulting in a lower bed utilization rate. This rate was 75% in January 2018 and is expected to increase to 85% once the adolescent wing opens.

SBH provided clinical outcomes for all their facilities across the nation (10 in total) from 2012 to April 2017. The study was completed by a third party and the results showed clinically significant changes from pre to post, maintained at 1 and 6 month marks. The adult population showed an overall 55% reduction of total acuity after 1 month and 57% reduction after 6 months. For adolescents, total acuity was reduced by 56% at the 1 and 6 month marks. The percent of adult patients re-hospitalized within 1 month for mental health reasons was 11.6% for
adults and 18% for adolescents. Seclusion and restraints data also show low utilization rates.

At the time of publication, SBH had not announced where the Dane County facility would be built, but they are looking at property in Middleton and Madison. Other items to note: the interim CEO will be Teena Johnson and SBH will host a public forum in late Spring. We will share details regarding the public forum as soon as that information is made available.

NAMI Dane County has not taken a position in support or opposition of the new facility, however, we are cautiously optimistic about some of the features of the facility (i.e. potentially decreasing the number of transports to Winnebago). Stay up-to-date on this topic by signing up for our monthly e-newsletter online at www.namidanecounty.org.