A five-member mental health working group of local healthcare representatives, including the Sutter Coast Hospital CEO and an elected official with the Del Norte Healthcare District, have concluded that the community needs a psychiatrist.

But where that person would work and how they would be paid has yet to be determined.

In a report to her colleagues on Tuesday, Healthcare District Director Elizabeth Austen said the mental health working group, consisting of Hilda Ypres Contreras, of Open Door Clinic, Ellie Popadic and Mitch Hanna of Sutter Coast Hospital, and Heather Snow, director of the county Department of Health and Human Services, determined the community needs a psychiatrist that would accept all insurances, not just MediCal.

Austen said the group asked her to obtain a consensus from her colleagues on the Healthcare District board that they would continue to work with Sutter Coast Hospital on the issue and broached the possibility of the district subsidizing the costs of recruiting a psychiatrist to the area.

Austen asked her colleagues if it would be appropriate to use dollars in a physician recruitment loan repayment fund through the Wild Rivers Community Foundation toward bringing a mental health professional to Del Norte.

Popadic said while the group has agreed that the community needs a psychiatrist, she reiterated Austen's comment about just how the group could recruit an individual to the area.

"We're looking at how that group would be funded, where that individual would work, whether it's some kind of an income-guarantee set up where they'd be working at Open Door or work at Sutter Coast or would they have a private practice," Popadic said.

The mental health working group also discussed working with Allied Health Professionals about the possibility of a physician assistant or nurse practitioner meeting the community's mental health needs, Popadic said. She noted that for many in the community, meeting with a mental health professional typically happens via telemedicine.

"Interestingly, (county) Mental Health is doing a very good job, comparatively, with the Medicaid population or the underserved population," Popadic said. "There are still gaps, but compared to the total population in our community, that population of patients are being served better with their mental health needs than probably any other population."

Citing statistics Snow provided the working group, Austen said the county Mental Health branch calculated that its clients received 152.5 hours of psychiatry via telemedicine. Mental Health provides 30 hours of in-person psychiatry at the Del Norte County Jail, Austen said.

Austen's colleague on the Healthcare District Board, Dr. Kevin Caldwell, said using dollars from Wild Rivers Community Foundation's physician recruitment loan repayment fund would be appropriate for recruiting a psychiatrist or any other doctor to the community.

The fund currently has $350,000, according to Caldwell. The Wild Rivers Community Foundation has collected donations over the years for the physician recruitment loan repayment fund and is currently developing guidelines on how to distribute those dollars, he said.

After speaking with a member of the WRCF board, Caldwell said the foundation may award $25,000 stipends to physicians who commit to serving the community for two years and, following that timeframe, an additional $25,000 if they commit to an additional two years of serving the community.

Dohn Henion, another Healthcare District director, asked if the WRCF fund could be used to help offset travel expenses for a psychiatrist or doctor that chooses to relocate to Del Norte County.

Caldwell said that would be at the discretion of the Sutter Coast Community Clinic or Open Door Clinic if the psychiatrist practices there.

"I doubt there'd be a psychiatrist that comes as a private practitioner," Caldwell said. "It could happen, but I doubt it."

In other matters, the Del Norte Healthcare District approved a joint resolution in support of Assembly Bill 204, which would establish a uniform set of standards for how nonprofit hospitals calculate and report the value of community benefits. Introduced by Assemblyman Jim Wood, if approved the bill would also require health systems to report the information for each of its hospitals.

Duncan noted the Del Norte County Board of Supervisors on March 12 unanimously approved a resolution supporting Wood's bill. The Crescent City Council is also set to weigh in on the resolution, Duncan said.

Duncan said he also wrote a letter to go to State Sen. Mike McGuire supporting Wood's legislation and took out language that was specific to Sutter Health.

"They wanted to have a resolution that's general for all health care systems, not specific to Sutter," Duncan said, "the wording of which also encompasses the community benefit aspect."

AB 204 would prohibit a hospital from including certain costs such as fundraising and compliance expenses in the calculation of its community benefit costs. It would also grant regulators the ability to assess fines against hospitals failing to provide community benefit plans and reports.

Nonprofit hospitals have been required to develop community benefit plans since 1996, describing how they meet the needs of its community. However, Wood has argued because there is no standard, it's difficult for communities to assess an accurate value of the benefits nonprofit hospitals provide in exchange for their tax-exempt status.

Reach Jessica Cejnar at jcejnar@triplicate.com .

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