In the past six months alone, Sonoma County has sent 319 adult and 60 adolescent psychiatric patients to acute psychiatric hospitals in other counties because no inpatient care exists locally -- and there hasn't been any for nearly four years.
But that will change in May.
In west Santa Rosa, hard-hat construction workers are steadily resurrecting a Fulton Road building that once housed a psychiatric unit operated by Santa Rosa Memorial Hospital.
The building is being fully converted into a 93-bed psychiatric hospital with inpatient geriatrics and adult units. It also will offer inpatient psychiatric services for adolescents, services that have been absent in the county for about a quarter-century.
"That's going to be really a huge benefit to have a local program for teens," said Michael Kennedy, the county's director of mental health services. "We're really excited about having that option."
Since the loss of the inpatient psychiatric facility, the county has tried to bolster its outpatient mental health services and improve follow-up care for those sent to hospitals outside the county.
But for several years, the missing piece of the puzzle has been a North Coast inpatient hospital for those in severe psychiatric crisis. These patients have been sent to facilities in other counties, including Marin, Napa and Sacramento.
"There have not been an adequate number of beds in the county for a number of years," said Deborah, a North Coast mother who asked that her last name not be used.
Her two sons, diagnosed with schizo-affective disorder, have been sent to psychiatric facilities outside the county.
The oldest son has been sent to a hospital in Oakland and Modesto. The distance creates barriers for both mental health patients and their family members, she said.
"It isolates you even further ... it traumatizes you even further," she said. "I'm grateful that one is opening up."
Aurora Behavioral Health Care, based in Southern California, will operate the facility. Aurora's parent company, Signature Health Care, bought the property and has invested almost $4 million in construction and renovation of the building, work that began in June.
Aurora is a private, for-profit company with four facilities in Southern California, one in Chicago and two in Arizona.
The 1970s-era building on Fulton Road is being gutted as part of the process bringing it up to state and federal health care facilities standards.
About the only thing left of the old facility will be the single-story structure's walls, said Ken Meibert, CEO of the new hospital, which will be called Aurora Santa Rosa Hospital.
Aurora had hoped to have the hospital open early this year, but construction delays have pushed the opening date to about mid-May, he said.
The hospital also will have a specialized outpatient program for those who don't require 24-hour inpatient care. The program can accommodate up to 40 outpatients, Meibert said.
"I expect it to be very successful," Meibert said.
Since the closure of Memorial's psychiatric unit in April 2008, the county has sought to retool its psychiatric services to make up for the loss, while focusing on outpatient care.
The county operates an around-the-clock psychiatric emergency services unit on Chanate Road, near Sutter Medical Center, that provides crisis intervention. The unit, known as PES, can hold patients for a maximum of 24 hours.
During that time, patients are stabilized while mental health staff determine whether they should be treated on an outpatient basis or sent to a secure psychiatric facility outside the county. A new program launched two years ago provides home-visit interventions that take place within the first week of a county resident returning from a psychiatric hospitalization.
Kennedy said that in the first year of the program, the county experienced a 11.6 percent drop in the number of clients who were re-admitted to a psychiatric inpatient hospital. The second year showed a decline of nearly 14 percent.
The county also operates a 10-bed, crisis residential program on Montgomery Drive that accepts voluntary patients who require psychiatric treatment in a non-hospital setting. People can stay there for up to 30 days, Kennedy said.
"It's really an option to help us prevent hospitalization," he said. "Or if someone is in a hospital and shows enough improvement, we can step them down to that program and then work with them to stabilize them a little more before they return either to their home or their family."
The county's model works for the roughly 1,600 people who have passed through PES in the past six months, but not for the 319 adult and 60 adolescent patients that have been sent to psychiatric hospitals in Marin, Sacramento and Napa counties.
Aurora's new hospital "makes it easier for families to visit their loved ones," Kennedy said, adding that "being local, it's going to be easier for us to coordinate their care."
It also will help reduce delays in referring people to secure psychiatric facilities.
"Sometimes it takes us a while to find a hospital bed," he said. "Some people will have to sit either at an ER or at PES. It can be anywhere from that same day to three to four days ... This is not only a great benefit to Sonoma County but our local region, the surrounding counties, too."
Meibert said the hospital officials plan to accept most forms of health care payment, including private insurance, Medicare and Medi-Cal for adolescents.
Medi-Cal -- California's version of the federal Medicaid program -- does not cover adult mental health services at a private free-standing facility, he said. A free-standing facility is one with a license not tied to a medical hospital.
It could be up to a month before the mental hospital begins accepting Medicare or Medi-Cal patients. The new facility first must be certified by the Centers for Medicare and Medicaid Services, or CMS, before it can bill the federal programs.
Such certification requires a site visit and review of substantial patient documents.
You can reach Staff Writer Martin Espinoza at 521-5213 or firstname.lastname@example.org.