Article from the Des Moines Register:
By Jennifer Jacobs • jejacobs@dmreg.com • December 14, 2009
If lawmakers must close a state mental health institute, Mount Pleasant is the one that could be closed or consolidated most readily, Department of Human Services Director Charles Krogmeier said today.
In a report to state lawmakers, Krogmeier said the state could move all of the services provided at Mount Pleasant to the institute at Independence.
Independence would grow by 79 beds, the current number at Mount Pleasant.
Krogmeier spelled out two scenarios.
Under scenario No. 1, Mount Pleasant would “close” and all 92 DHS personnel would be laid off. None would be reassigned to work at Independence. But those laid off could apply for one of the 94.5 full-time-equivalent jobs at Independence. Some could be eligible for hire there by choosing Independence on their recall list.
Under scenario No. 2, Mount Pleasant would be “consolidated” and personnel would be administratively reassigned to Independence.
Closing Clarinda could be an option if another location could be identified for treatment services for elderly Iowans with mental illness or if the state stops operating such beds, the report says.
Today’s report is in response to a mandate approved by the Legislature last spring requiring Krogmeier to recommend closing one of the four institutes without loss of services.
“The quality of service at the MHI in Mount Pleasant is beyond question,” Krogmeier said in a news release, “and I want everyone to know that this recommendation is no reflection whatsoever on the dedication and expertise of our staff, which is outstanding.”
Krogmeier said shutting down Mount Pleasant would cause the least economic fallout for staff and the community, the least disruption for families of patients, and the most opportunities for improving the mental health system.
The net savings or cost next budget year, fiscal 2011 would, depend on whether employees were offered moving expenses to relocate to comparable jobs in Independence.
Two years from now, in fiscal 2012, the annual general fund net savings would be about $1.7 million, Krogmeier said.
Mount Pleasant has 108 employees, compared to 100 at Clarinda, 201 at Cherokee, and 267 at Independence.
DHS officials said analysis showed some MHIs were less suitable for closure and consolidation than others.
Mount Pleasant shares a campus with a state prison, and DHS decided children and adolescents currently treated at Independence and Cherokee should not be relocated to a facility on a prison campus.
Closing Cherokee wouldn’t save as much money because of the impact on shared services with the Civil Commitment Unit for Sex Offenders at Cherokee, the report says.
Independence has so many beds in use it wouldn’t be cost effective to close that facility, DHS concluded.
And it would be expensive to close Clarinda because one of the other three MHIs would have to be renovated to meet nursing home licensure standards. Clarinda houses that state’s only geropsychiatric unit for elderly Iowans with mental illness.
When DHS officials compared Clarinda and Mount Pleasant, they looked at availability of space for new programs, cost impact on other campus services, impact on clients and counties within the geographical proximity, and the economic impact of the closure.
“Given all the factors considered, the determination was made to recommend closure of the Mount Pleasant MHI and consolidation with the Independence MHI,” the report states.
Mount Pleasant has an operational budget of $8.8 million, the second smallest of the four MHIs. Clarinda’s budget is $8.6 million; Independence has a budget of $21 million and Cherokee’s is $16 million.
All four institutes offer acute adult psychiatric services, with Mount Pleasant’s being the smallest unit at 14 beds. There are 40 at Independence, 46 at Cherokee, and 20 at Clarinda, spokesman Roger Munns said.
But Mount Pleasant also offers a 15-bed treatment program for people who suffer from both addiction and mental illness, as well as a 50-bed substance abuse treatment program.
Nearly half the patients at the substance abuse program come from Polk County, records show.
Krogmeier said he understands closing the institute at Mount Pleasant will have a negative impact on the community, but said part of the loss could be offset if the Legislature decides to use the vacated space to expand the prison there.
The Iowa Legislature may decide to close one and possibly two MHIs, but only if residents would be well cared for in other settings, such as the remaining MHIs or other facilities, key Democratic lawmakers said earlier this month.
Lawmakers have said both a tight budget and a desire to switch from institutional care to community-based care for mentally ill Iowans is driving the discussion to close a mental health institute.
Iowa has four MHIs, in Mount Pleasant, Independence, Clarinda and Cherokee.
Capacity peaked in the 1940s when there were about 6,500 people at the institutes on an average day. Last budget year, the four institutes admitted 1,976 individuals throughout the year.
Today, the four institutes together have 267 beds.
A task force of 11 citizens, most of whom with a background in mental health or criminal justice, toured all four MHIs, listened to an overview from staff and held public hearings this fall. Hundreds of Iowans attended each public hearing to beg lawmakers not to close their particular facility.
The task force concluded that all four MHIs should remain open until community-based services are in place.
“If we move toward a closure of a facility, it’s not something that would occur in a short period,” state Rep. Lisa Heddens, who shares leadership with Sen. Jack Hatch over the human services budget, said Dec. 3.
Hatch said lawmakers may also consider closing one of the state’s two resource center for people with mental retardation. The report DHS releases today did not address the resource centers.
A consulting firm hired by Iowa Gov. Chet Culver recommends the closure of two MHIs: Clarinda and Mount Pleasant.
The report says the state could move Clarinda’s adult psychiatric unit to the state mental health institute at Cherokee, and its gero-psychiatric patients could go to nursing homes.
The adult psychiatric unit and the dual diagnosis units at Mount Pleasant could go to the Independence institute.
Also, the child and adolescent units at Cherokee could go to Independence, leaving only adult patients at Cherokee.
This would save the state about $1.9 million during the first year, and about $27 million in a five-year period, according to the report from Pennsylvania-based Public Works LLC.
It would likely take about a year to accomplish, Public Works consultants said. Today’s DHS report said it could be accomplished in about six months.
A new study by Iowa State University shows that closing the Mount Pleasant and Clarinda institutes would have the least economic impact compared with closing the other institutions.
Mount Pleasant’s MHI has eight buildings on a campus owned by the state prison system.
Patient restrooms and showers at Mount Pleasant are about to be remodeled for $1.2 million. But today’s DHS report said design and construction has not yet started and could be deferred.
None of the four MHIs can close without action from state lawmakers, who begin an 80-day legislative session on Jan. 11.
HISTORY OF MOUNT PLEASANT MENTAL HEALTH INSTITUTE:
A building of rough gray stone opened as the Iowa Hospital for the Insane in 1861 — the first state mental health hospital in Iowa and the second west of the Mississippi River.
Alcoholics, as well as “morphine and cocaine fiends,” started seeking treatment there, and in 1902, the facility was referred to as the Hospital for Inebriates.
The event known as “the flip-flop” occurred in 1981. The prison moved into the gray stone building, including new additions built after a 1936 fire, all surrounded by a double row of fencing and razor wire.
The mental health institute moved into a building the corrections system established in 1976 as a 144-bed medium-security prison.
The prison next door to the mental health institute, located on the same grassy campus, has a population of about 1,100 and costs about $27 million a year to run.
MUD’s
To All Local 2995 Members,
I have received some calls and e-mails expressing some concerns over the memo issued by personnel setting some ground rules for taking the MUD’s. I will attempt to answer and clarify some of these issues.
Members must keep in mind that when the statement was made: “MUD’s will be just like vacation”, it was never meant to be that every single issue would be exactly like vacation. Every institution is different on how they approve vacations. We chose many years ago to go to a 60 day out rule. Some places have to have their vacations in by November for the entire next year. This type of scheduling is normally called block vacations. We agreed to allow this type of scheduling for MUD’s for reasons I will list in a minute.
The intentions of the statement was to mean that each day of unpaid leave will be approved by seniority, will not wipe out overtime computation for that pay period, and will be considered as if at work if taken the day before or the day after a holiday, so you would not lose your holiday pay. It also allows you to take your MUD’s in hour increments, like vacation.
By agreeing to schedule the MUD’s 5 months in advance it allows management to ensure that everyone does take their MUD’s as per our agreement with the Governor. It also ensures that they are taken with equal amounts of staff off so we have adequate staffing here at all times. If we allowed the 60 day rule what would happen if everyone waited until the last 60 days? Along with this agreement, management will continue to grant vacations. Under the 60 day rule vacations would have been suspended.
The members of AFSCME Iowa made an agreement, with the Governor. It is our responsibility to live up to our end of it. We have all known for some time that we would be required to take 40 hours of unpaid leave. The way this is being implemented should give each and every member an opportunity to choose their days instead of them being assigned. In most cases this will happen.
We don’t agree with every item listed in the ground rules as well. I believe, in some cases, MUD’s CAN be turned back in. If we have inclement weather or EL, I believe we should be able to take these days as MUD. We will talk to management on this. However if we are allowed to turn back in scheduled MUD’s like vacation then that defeats the purpose of scheduling them to ensure we have adequate staffing. We have to keep our mission intact of protecting the public, Inmates and ourselves.
Keep in mind that the ground rule memo came out on Friday after we had left work for the weekend. We did not get an opportunity to proof read the final draft prior to it coming out. If you have any questions or concerns please contact me.
Kenton C Cole
President AFSCME Local 2995
Iowa Department of Corrections (MPCF)