Some fear Marshall Pickens Hospital changes could hurt adults seeking in-patient mental health care

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As Greenville Health System and Acadia Healthcare seek to transfer existing licensed psychiatric beds at Marshall I. Pickens to a new hospital planned on the main GHS campus, there’s concern that the move could further strain a state system that already struggles to provide timely access to inpatient psychiatric care to some adults.

GHS announced plans in November 2016 for a new 120-bed psychiatric hospital on its main campus in partnership with Acadia Healthcare, a national health care giant that has 579 facilities in 39 states, the United Kingdom, and Puerto Rico. Acadia would manage day-to-day operations of the hospital, while GHS would provide clinical oversight.

Greenville Behavioral Health LLC, the company formed by GHS and Acadia, has applied for a certificate of need with the state Department of Health and Environmental Control for the transfer.

Because the new facility would be a freestanding hospital, it would be unable to bill Medicaid for any care provided to eligible adult patients between the ages of 22 and 64. Currently, Marshall Pickens may bill Medicaid for treatment of eligible adults because it is part of the Greenville Health System.

That has created concern among state lawmakers and mental health officials, who say the change will only further worsen the problem of providing timely inpatient care for the state’s vulnerable adults.

State mental health hospitals have had significant decreases in the number of adult inpatient psychiatric beds over the past 18 years, although the number of beds has been stable for several years, said Mark W. Binkley, deputy director of the division of administrative services at the state Department of Mental Health in a letter to Louis Eubank, director of DHEC’s certificate of need program. At the same time, the state’s population has continued to increase.

“As a result, the problem of timely access to adult inpatient psychiatric care has become a significant problem in some areas of the state,” Binkley said. While the Department of Mental Health supports efforts to increase the number of available adult psychiatric hospital beds, Binkley said in his letter the transfer would likely result in increased demand for hospitalization in a state-operated hospital, and the state’s psychiatric hospitals are already unable to timely admit individuals referred for admission.

“Because of financial and workforce limitations, it is extremely unlikely the state alone will ever be able to meet the increasing demand for adult psychiatric beds,” he wrote, saying that is why it is vital for the current capacity in community hospitals to be preserved. “Those in need of hospitalization for treatment of an acute episode of mental illness are as much members of their communities as those in need of emergent treatment for heart disease, diabetes, or injuries from an automobile accident.”

State Reps. Garry Smith, Mike Burns, and Dwight Loftis and State Sen. Tom Corbin also wrote a letter voicing the same concern.

GHS said the new hospital will provide inpatient and outpatient services to adult Medicaid patients even though it won’t receive reimbursement for those services.

“We committed to this in our application; we will continue to serve the patients requiring these services regardless of reimbursement,” said Sandy Dees, GHS spokeswoman. “In fact, under the projection for the new partnered hospital, services provide to adult Medicaid patients are expected to increase over what GHS can currently provide by itself. Our partnership with Acadia to jointly build and operate a psychiatric hospital allows GHS to advance its mission to improve the health and wellbeing of the people and the communities we serve. GHS could not do this on our own.”

DHEC is expected to make a decision on the certificate of need by the end of the year.

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