Do the Quad Cities need a new psychiatric hospital?

A national company wants to build a large psychiatric hospital in eastern Iowa, but it must overcome opposition from current hospitals and the state’s largest health-insurance company.

The argument will come to a head Wednesday in a hearing before state regulators.

Strategic Behavioral Health has proposed a $14 million, 72-bed psychiatric hospital in Bettendorf. The Tennessee-based company owns or is building 11 mental hospitals across the country. Its owners note that Iowa, like most of the rest of the nation, faces a severe shortage of psychiatric services. But local hospitals contend the real shortage is of mental-health professionals, not beds. They’re asking the State Health Facilities Council to deny a permit for the proposal.

UnityPoint Health, which runs the Trinity hospital system, called the proposal “the wrong plan at the wrong time to meet the needs of mental health patients in the Quad Cities.”

In a letter to the state council, UnityPoint lawyer Doug Gross predicted the new, for-profit hospital would damage existing, nonprofit organizations. The new hospital "would cherry pick the least complicated and most profitable patients, leaving the existing facilities with fewer resources to care for the patients with the greatest need,” Gross wrote. Trinity, which has 54 psychiatric beds in the Quad Cities area, plans to expand and reorganize its mental-health efforts, he added.

Ken Croken, a vice president of the Genesis health system, said Monday that his system and UnityPoint announced in 2013 that they planned to significantly expand their inpatient mental-health services in the area. He said Genesis was recently down to 12 psychiatric beds, but plans to have 60 by the end of 2017. On Monday, five of its 18 adult psychiatric beds and one of its five pediatric beds were open, he said. “Does it really make sense to add a 72-bed hospital to the mix?” he said.

Strategic Behavioral Health leaders deny that they would focus only on lucrative patients. They note that hospitals are barred from denying service to patients in need, and they included supportive letters from mental-health agencies in other states where they’ve set up.

The company is urging Iowa regulators to consider the value of competition. “Where there are more providers to compare approaches and results, there is greater opportunity for finding best practices,” it wrote in a letter to the board. “When consumers have greater choice, particularly in a patient-centered environment, health care providers offer care and services that is more effective and provides greater satisfaction and therefore, very likely, better outcomes.”

The company also denies allegations that it would poach staff members from existing Quad Cities facilities. Instead, it contends it could recruit new professionals to the area.

The Health Facilities Council is to decide the matter Wednesday. The council’s role is to decide whether large health-care projects are economical or whether they would drive up costs by duplicating what already is available.

Croken denied that the existing hospitals are trying to use the process as a shield from competition. “Competition is a good thing, but redundancy isn’t a good thing,” he said.

The state’s dominant health insurer, Wellmark Blue Cross & Blue Shield, also opposes the new facility, saying the current hospitals’ planned expansions would be more efficient.

Local health agencies and government officials are split. Some, such as Scott County Supervisors Chairman Tom Sunderbruch, have written letters of support. Sunderbruch said there are too few options for people in psychiatric crises. “Unfortunately, our jail continues to be the largest mental health facility in the county in number of inmates receiving services,” he wrote to the state council.

The president of the local chapter of the National Alliance on Mental Illness, Michael Freda, wrote a letter opposing the project. Freda noted that the modern emphasis is supposed to be on the “least restrictive” treatment that can help a patient. He praised local agencies for adding alternatives to inpatient hospitalization. He also questioned the likelihood that a new hospital could attract enough new mental-health professionals when there aren’t enough for current facilities. “Planning to add additional beds without adding a corresponding number of providers will not assure a high level quality of care,” he wrote.

Council meeting

A proposed 72-bed psychiatric hospital is to be the first topic of discussion in a two-day meeting of the Iowa Health Facilities Council. The meeting is to start at 9 a.m. Wednesday at the state laboratory complex at the Des Moines Area Community College in Ankeny. After hearing arguments, the council is to vote on whether to issue a "certificate of need" for the project.