Drs. Kevin Caldwell and Greg Duncan resurrected a discussion about a crisis stabilization unit Tuesday when their colleague, Healthcare District Director Elizabeth Austen reported back on a collaborative group's efforts to bring a psychiatrist to Del Norte County.

Caldwell described the crisis stabilization unit as a necessity local emergency room doctors wanted but Sutter Coast Hospital abandoned because "they said the county couldn't afford it."

At the district's monthly meeting, Caldwell said Sutter Coast Hospital, one of four entities working to enhance mental health services in the community, should pay for the crisis stabilization unit.

"Sutter is the public benefit charity that doesn't have to pay taxes and makes tons of profits," Caldwell said. "It's like there's no reason they shouldn't be the ones that fund the crisis stabilization unit."

During her report, Austen said working group members, which include Sutter Coast Hospital CEO Mitch Hanna and Department of Health and Human Services Director Heather Snow, requested that she ask her colleagues on the Healthcare District board if they would be willing to contribute money toward recruiting and paying for a psychiatrist.

Austen said she wouldn't be comfortable committing money toward the effort without seeing a written proposal. Ellie Popadic, Sutter Coast Hospital's director of ancillary services and business development, would research the "fair market value" for a psychiatrist's salary. Though a provider who lives in Brookings and has worked at Pelican Bay State Prison has expressed interest in providing services locally, the working group has yet to find a specific candidate for the job, according to Austen.

"We also talked about is it even realistic for somebody to open a private practice here," she said, adding the working group has also discussed recruiting a psychiatric technician, a professional who would work under the supervision of a psychiatrist, rather than an actual psychiatrist. "There's just so much we don't know right now."

The mental health working group is a five-member group that also includes Hilda Ypres Contreras of Open Door Clinic in addition to Austen, Popadic, Hanna and Snow. In a report to her colleagues at the district's March 26 meeting, Austen said she and her colleagues determined the community needs a psychiatrist who would accept all insurances, not just MediCal.

In March, Healthcare District directors discussed using a physician recruitment loan repayment fund through the Wild Rivers Community Foundation to help recruit a psychiatrist to Del Norte County. On Tuesday, Austen said the request she was asked to take back to her colleagues would be for money from the Healthcare District in addition to dollars from the WRCF

Duncan and Caldwell asked Austen to bring up resurrecting the crisis stabilization unit at the next mental health working group meeting.

According to Duncan, a crisis stabilization unit would be housed in the Sutter Coast Hospital emergency room and would allow patients with "an acute psychiatric need" to be treated locally. Currently, those in crisis are transported by ambulance, generally to Santa Rosa, for a 24-hour hold before returning to Del Norte County the next day, Duncan said.

The crisis stabilization unit would be a significant benefit to the patient and patient's family and fulfills a goal "of treating people in the community wherever possible," Duncan said.

"I spoke to Rose Corcoran at a medical staff meeting and Rose Corcoran stated there were insufficient funds available for the crisis stabilization unit," Duncan said, referring to the hospital's chief nurse executive. "And we asked for more specifics and we didn't get anything."

When it comes to recruiting a psychiatrist to the area, Duncan said a written proposal is necessary. The Healthcare District would also need to know what impact he or she would have on existing practitioners.

"In other words, are we going to use tax dollars to subsidize a competitor?" Duncan asked. "How is that going to impact the psychologists that are here? There's no psychiatrist here, so presumably that would be OK, but it's something we would want to reach out..."

Duncan said he'd also want to know what the employment relationship of the psychiatrist would be, asking if another source of income would subsidize his or her practice.

"It's a lot more complicated than just hiring a psychiatrist or paying for part of his salary," Duncan said.

At a Healthcare District meeting Nov. 27, in response to questions about the crisis stabilization unit, Popadic said the unit was a county service and the county didn't have the funds to support it sustainably long term.

"It is something that we would have liked to see happen, but there (are) some challenges around it," Popadic told Healthcare District directors in November.

Reach Jessica Cejnar at jcejnar@triplicate.com .

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