Mentally ill seniors shifted out of state institution

Administrators at the state Mental Health Institute at Clarinda have started transferring mentally ill senior citizens from the institution to private nursing homes, a spokeswoman confirmed Wednesday.

The transfers will affect only about a dozen patients in a geriatric mental health program, but they are considered some of the toughest cases among the residents of two mental institutions that the state plans to close by July 1.

The brother of one of the Clarinda program's patients said he is worried about what will happen to her. Richard Jansen said his sister, Patricia, 66, has several psychiatric issues, including schizophrenia. He fears that a nursing home might accept her, then determine she is too disruptive. "What's going to keep them from throwing her out?" he asked. "Where would she go then?"

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Patient advocates say most of the program's residents wound up at the Clarinda institution after private facilities found them too difficult to handle. The Department of Human Servics says it is now finding safe placements for them in nursing homes. But critics contend the transfers are part of a hasty effort to shutter mental institutions at Clarinda and Mount Pleasant before proper alternatives are ready.

The transfers do not include four elderly sex offenders who live at the Clarinda institution. The human services department has said those four are likely to wind up in a different state facility instead of at a private nursing home.

Department spokeswoman Amy McCoy said most of the other patients in Clarinda's program have conditions that are equivalent to the kinds of mental illnesses or dementia that private nursing homes deal with routinely. "With more than 400 nursing facilities in Iowa, there are appropriate placements that are available and equipped to serve this type of resident," McCoy wrote in an email to the Register.

McCoy confirmed that some transfers have already taken place, though she declined to comment on how many or where the residents have been sent.

Richard Jansen said his sister, Patricia, has been in the Clarinda program about six years. He said she has been in and out of institutions and halfway houses for decades. A judge sent her to Clarinda after she was found wandering in traffic in Ames, where she had lived in a group home, he said. She's become so debilitated that she can't feed herself, he said, but the Clarinda staff takes good care of her. "They do an excellent job."

Richard Jansen, who lives in Florida, said he and his sister grew up in Marshalltown. He said he understands that with modern medications, far fewer people these days need institutional care for mental illness. But his sister is among the relatively few people who still need such care, he said. "What are we going to do with them, sweep them under the rug?"

He expressed concern that in seeking to place such residents in private nursing homes, state administrators won't fully disclose the difficult issues residents of the program have. "If they're trying to get rid of them, they might gloss over a lot of those details," he said. He worries his sister will be placed in a private facility that won't be capable of handling her. But he has no say over where she goes, because she's been a ward of the state for many years.

State Sen. Amanda Ragan said staff at the state institution have told her that some residents in the geriatric mental health program had failed in 13 or more other facilities before winding up in Clarinda. "It's a place of last resort," said Ragan, a Mason City Democrat who is co-chairwoman of the Legislature's main health care financing committee.

Ragan said she's willing to consider establishment of a private program for such residents. The idea has been discussed for several years, but it hasn't happened yet because of financial concerns, she said. The current residents of the Clarinda program aren't the only ones with a stake in the discussion, she said. "We'll always have new patients with the same issues."

McCoy, the Department of Human Services spokeswoman, said her agency is being careful in seeking alternatives for the Clarinda program's residents.

"Our experts work hard to find the best placements so that there aren't more transitions, and so that the resident finds the right level of care to meet their needs," she wrote. "Our process includes inquiring about services and availability at facilities, and when a match looks promising, sharing the specifics so that the patient, their guardian and the facility are all ready to make a successful transition."