The Fresno Bee
Thursday, November 21, 2002
By Tracy Correa
The Fresno Bee
(Published Wednesday, November 20, 2002, 12:18 PM)
Fresno County health officials, pediatricians and mental health workers are struggling to develop a plan to help hundreds of troubled children now that the only psychiatric hospital in the Valley treating adolescents will eliminate the service in a few weeks.
A community task force is being formed to address the problem. Others are finger-pointing and laying blame.
"I think we have an ethical mandate to take care of these kids," said Dennis Lewis, a Fresno psychologist. "When you don't care for the children, you will be paying down the road."
Last week, Community Medical Centers announced it was moving forward on its purchase of Cedar Vista Hospital in Fresno. Many mental health officials were surprised by Community's decision to eliminate adolescent psychiatric treatment. Chemical dependency programs and outpatient services also are being cut.
Community hopes to own the hospital by Dec. 1.
Hundreds of troubled adolescents in the Valley are referred to the hospital each year and now will be sent to other counties away from their families for treatment.
It has been common to send some children away in recent years as a psychiatric bed shortage has plagued the Valley. Now there will be no local beds.
Privately owned Cedar Vista represented the only psychiatric hospital program for adolescents.
Fresno County, which last year had to find psychiatric hospital beds for 315 children, may be the county hardest hit by the loss of services. The county sent 192 children to Cedar Vista between July 2001 and June 2002. The majority of the children were in the Child Protective Services program.
Some of the children were sent out of the area when Cedar Vista, with 16 of its 61 beds reserved for children, ran out of room.
The problem increased in July when Cedar Vista, without warning, eliminated services for children younger than 13.
Many mental health officials suggest the county, legally mandated to provide mental health services for children in its programs or on Medi-Cal, should have a better plan for troubled children. They say the county should have been warned when Cedar Vista cut services for children in the summer.
"It's inescapable the county has a major role, they have the responsibility for many of these children who need care," said Nancy Richardson, chair of the county's Foster Care Standards and Oversight Committee.
Richardson is a former member of the Fresno County Mental Health Board, an advisory committee to the county. "This problem has been in the making for years."
The problem never has been adequately addressed, she said. "In a way, this really forces our hand."
Jerry Wengerd, the county's mental health director, defended criticism against the county, saying there was no way to predict Community would eliminate children's services.
"We didn't have an opportunity to do more, because we didn't have enough notice. This was all done without any kind of communication at all," Wengerd said.
Community officials said last week they would eliminate children's services and focus on adult inpatient programs when they take over Cedar Vista. The plan involves relocating a 32-bed adult psychiatric unit currently housed at its downtown Community Medical Center-Fresno campus to the Cedar Vista site near Cedar and Herndon avenues.
"That's where the volume is now," John D. Zelezny, Community's senior vice president of communications, said of the adult psychiatric program.
Concern had been simmering for months as Community and Cedar Vista discussed a deal that wasn't outlined until last week.
Wengerd said the county is working on a contract to send children to Stanislaus Behavioral Health Center, a county-run psychiatric hospital in Modesto with 18 beds for children under 18.
But there are no guarantees beds will be available when needed, and transporting the children, usually by ambulance, will be costly for taxpayers. Wengerd said children also will need to be sent to Los Angeles or Sacramento.
Lee Ann Parry, chair of the Fresno County Mental Health Board, said the deterioration of psychiatric hospital services for children prompted the board last month to look into starting a task force focused on children's mental health needs. Now, after Community's announcement, it's taken on a greater urgency.
"We do need to have a better plan," Parry said. "The whole community should be concerned. It affects us all."
The board is working closely with the Local Health Care Coalition, a public interest group that lobbies for health-care access, to establish the task force.
"We need to have leadership in the county," Parry said. "[The county] Board of Supervisors and leaders across the community need to get involved."
Fresno psychologist Kathy Sullivan, who owns the Sullivan Center for Children, said the elimination of children's services at Cedar Vista may help jump-start a foundation that she started to raise money for children's mental health needs.
Sullivan recently held a meeting where about 50 people attended. She hopes to raise community awareness about the plight of troubled children, enough to get people to fund programs, ideally a psychiatric hospital for children.
A Valley that once had 90 beds for troubled children in the late 1980s soon will be reduced to none, she said.
Sullivan said it's obvious people in the Valley care about children, and points to the community's financial support of Children's Hospital Central California in Madera.
"There's no objective reason we can't do the same for mental health care," she said. "Very sick young children can become sick adolescents and sick adults. This is something we can't ignore. The cost is way too high."
The reporter can be reached at firstname.lastname@example.org or 441-6378.