NAMI Minnesota is deeply concerned with the changes being proposed by Fairview Health Services. The loss of 18 inpatient psychiatric beds at Fairview Southdale Hospital is not offset by opening an intensive mental health ER. While mental health ERs can triage and stabilize some people, there are far too many people already languishing in Emergency Departments who need inpatient psychiatric care – and this number continues to grow. If people are in need of hospital level of care, they need to be able to access it.
It is clear that the 100 inpatient psychiatric beds at St. Joseph’s Hospital will be closed in about one year. The loss of these beds will be devastating to the metro area and will greatly decrease access to inpatient psychiatric care across the state. Fairview has stated that they are looking for partners to build a new free-standing psychiatric hospital. It’s important to note that the federal Medicaid law includes an “Institution for Mental Disease (IMD)” clause that prevents Medicaid funding being used in any facility with more than 16 beds where over half of the patients are being treated for a mental illness or substance use disorder. Without Medicaid funding, the hospital cannot be built.
“NAMI Minnesota is not placated by promises to build a new free standing psychiatric hospital – knowing that federal Medicaid law would prevent payments to care provided in a psychiatric only hospital and that there is little possibility of changing the law in the near future due to the enormous fiscal note,” said Sue Abderholden, NAMI Minnesota’s executive director. “Additionally, at a time when advocates, providers and health care systems are pushing for integrated care – between health and mental health – why would we support a psychiatric only hospital?”
Many psychiatrists report that the percentage of people in an inpatient psychiatric unit with serious medical comorbidities who require ongoing specialty medical consultation and management is steadily increasing.
While Fairview has stated that it’s the largest mental health provider in the Midwest, this is not a reason to decrease access to mental health treatment at a time when the pandemic has increased the need for mental health care. It doesn’t matter how big a provider you are, closing beds decreases access. NAMI Minnesota urges community members to speak up against these closures.
Editor’s note: Fairview Health, now M Health Fairview, has announced a dramatic downsizing of hospital and clinic operations on to stem financial losses, to prepare for a $250 million operating loss. This includes the shutdown of the 90- bed Bethesda Hospital in St. Paul that had been previously converted to treat COVID-19 patients. Bethesda will become a Ramsey County homeless shelter.
St. Joseph’s Hospital will become Fairview’s new flagship for COVID-19 care. It will no longer be a general hospital, as its emergency room will close by year’s end. Specialties such as neurology and bariatrics will be relocated. Inpatient mental health care will continue at the downtown St. Paul hospital at least through 2021.
Sixteen clinics in Minnesota and western Wisconsin will close, and 900 jobs will be eliminated.
The announcement formalizes plans for the closures of Bethesda and St. Joseph’s that were raised in November 2019.
The fate of St. Joseph’s remains less clear, but it could be converted into permanent housing, outpatient clinics and potentially a psychiatric hospital that will maintain inpatient capacity. St. Joseph’s is Minnesota’s first hospital, which was converted from a school by the Sisters of St. Joseph of Carondelet in 1853 to address a cholera epidemic.
Primary care clinics are closing in Columbia Heights, Farmington, Hugo, Lino Lakes, Milaca, Pine City, Roseville, Savage and Zimmerman in Minnesota, as well as select sites in Minneapolis, St. Paul and Bloomington. Clinics also will close in Ellsworth and Spring Valley in Wisconsin. Eleven of the 16 had temporarily closed due to the pandemic.