After Del Norte Healthcare District directors resurrected a discussion last week about a crisis stabilization unit, Heather Snow, director of the Del Norte Department of Health and Human Services, offered more information as to why it didn't pan out.

The crisis stabilization unit — initially explored as a joint effort with the county and Sutter Coast Hospital — was a place a person experiencing a joint mental health crisis could be treated without having to leave Del Norte, Snow told the Triplicate on Monday. It would also have been more appropriate for someone experiencing a mental health crisis than being housed at the jail or in the medical part of the hospital's emergency room, Snow said.

But as of January 2018, both the county and the hospital decided a crisis stabilization unit in Del Norte County wasn't viable, she said.

"It's really old news that was really talked about thoroughly between, at the time, county mental health and Sutter Coast," Snow said, adding that no other county the size of Del Norte that she knows of has a crisis stabilization unit. "Between the county and the hospital we could have made it happen but it was determined that it was not a financially sustainable project and you can't build something and require a level of staffing without knowing that it's going to pan out 20 years from now. It would have been irresponsible for me to have spent county funds building the thing if we knew we could not guarantee it would be fiscally viable 20 years from now."

In making a decision whether or not to move forward with the crisis stabilization unit, Snow said county mental health representatives and the hospital looked at emergency room visitations. They found days would go by without anyone in a mental health crisis showing up at the ER, she said, and a crisis stabilization unit would have to be staffed 24-7.

Snow noted if the crisis stabilization unit were sitting empty, the county and hospital couldn't bill MediCal for reimbursement.

When asked if Mental Health Branch and hospital representatives discussed how the crisis stabilization unit would be staffed, Snow said they discussed using a licensed vocational nurse.

"The hospital was very committed to this idea and very agreeable to do what they could to make it work," Snow said. "We agreed together at the end of it that it didn't seem fiscally viable."

In a written statement to the Triplicate, Sutter Health spokeswoman Erin Shaw said though the hospital system recognizes Del Norte's need for more mental health services, "sustainability issues were identified in the most recent assessment" of the crisis stabilization unit's feasibility.

During a discussion of a collaborative effort between the hospital, county and Healthcare District to recruit a psychiatrist, Healthcare District directors Drs. Kevin Caldwell and Greg Duncan brought up the crisis stabilization unit as a necessity local emergency room doctors wanted.

Caldwell said Sutter Coast Hospital should pay for the crisis stabilization unit.

Snow said one of the issues the mental health working group is looking at with regards to recruiting a psychiatrist to the area is what percentage of time that person would see the MediCal population. Currently, there's not a local psychiatrist serving the general public, she said, and it's those whose mental health services would be reimbursed through MediCal that the county mental health branch primarily works with.

"There are psychiatric needs outside of the MediCal population that are not being met," Snow said.

Snow added the Del Norte County Department of Health and Human Services regularly works with Sutter Coast Hospital about psychiatric emergencies.

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