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Fairview and Acadia highlight construction of 144-bed mental health hospital in St. Paul without governor, mayor or county

Saint Paul Pioneer Press - 6/5/2024

Officials with Fairview Health Services and Acadia Healthcare gathered a few blocks north of the Minnesota State Capitol in St. Paul on Wednesday for a ceremonial beam signing — a way to highlight of the ongoing construction of what will soon be one of the state’s largest purpose-built inpatient mental health hospitals.

The future hospital’s steel girders form a commanding sight at 559 N. Capitol Blvd, but given the project’s politically sensitive history, the absence of public health and state, city or county elected officials from the symbolic signing was notable.

Located at the former site of Bethesda Hospital, the 144-bed Capitol Park Mental Health Hospital will offer inpatient, intensive outpatient and “partial hospitalization” mental health treatment, including services for patients who are ready to leave an acute care setting but who may still need in-hospital services for three to six hours per day, three to five days per week.

“We are all pioneers in this work,” said Jeffrey Woods, an Acadia operations executive and former psychiatric nurse, noting that the Franklin, Tenn.-based healthcare and hospital chain operates 260 hospitals and treatment centers nationally and is now the largest provider of mental health treatment in the country.

“We are literally in the beginning phase of what we expect to be many, many generations … of (innovation) and reducing stigma,” Woods added, addressing a crowd of officials from the two healthcare networks and general contractor J.E. Dunn Construction Group.

Fairview officials said the three-level facility will open next summer at a time when inpatient mental health services are in high demand statewide and many youth and adults have been unable to access needed services.

That said, the hospital — which will not have ambulance bays for emergency transport — has not been without controversy. Citing the need for new mental health beds, the Minnesota Department of Health approved the facility in September 2022 while acknowledging at the time “significant concerns” with its lack of an emergency room.

The Minnesota Psychiatric Society and other mental health experts have raised concerns that many patients will be transferred from other in-network hospitals, allowing for-profit Acadia to effectively cherry pick the wealthiest patients, leaving poorer, uninsured and harder-to-treat crisis cases to emergency rooms at outside hospitals.

Notably absent from the beam signing on Wednesday were officials from the governor’s office, the Ramsey County Board and Ramsey County Social Services, the St. Paul mayor’s office and the St. Paul City Council, as well as the National Alliance on Mental Illness and other vocal advocates for the mentally ill.

Reached shortly after the gathering, Ramsey County Board Chair Trista Martinson, St. Paul City Council Member Rebecca Noecker and Sue Abderholden, executive director of NAMI Minnesota, said they were unaware of the event and had not received invitations.

“We opposed this from the beginning,” said Abderholden, in a brief interview. “It’s a psychiatric-only hospital, as opposed to a psych-unit within a regular hospital, such as Region’s or Hennepin County Medical Center. They won’t have an emergency room, so they get to choose who they take into their hospital. They call it an ‘institute for mental disease,’ or an IMD, which means you can’t use Medicaid.”

“Because people with the most serious mental illnesses are on Medicaid, (surrounding) hospitals are going to serve people with higher needs, and they’re going to get a higher percentage of the Medicaid patients, which doesn’t pay as much,” Abderholden added. “Somebody who is homeless and has gangrene in their feet — are they going to take that person in their psych-only hospital? I don’t think so.”

Fairview and Acadia officials on Wednesday said there will be some primary care doctors located on site, offering what Woods called “care for the whole person, mind, body and spirit.”

Martinson said she had once approached the Acadia-Fairview joint venture with an open mind, but walked away from initial meetings a few years ago frustrated.

“It might be located in St. Paul, but it became pretty clear it is only for their clients,” Martinson said. “It was very clear to me from the beginning, despite our outreach and us trying to touch base with them, they were not here to serve our community. It was a for-profit entity that bought a building.”

Also among the Department of Health’s stated concerns in 2022, the state found that the new facility will operate under a “leaner staffing model than is the norm nationally and in Minnesota.” The state review noted the 144 new beds would partially — but not fully — offset mental health beds lost when Fairview gradually shuttered St. Joseph’s Hospital in downtown St Paul from 2020 to 2022.

And while the increased patient load from the closure of St. Joe’s had been absorbed by surrounding downtown hospitals, the state found “it is placing a strain on emergency rooms and inpatient mental health units.”

Fairview officials on Wednesday noted that some of their services had actually expanded in downtown St. Paul. St. Joe’s has since been converted into the Fairview Community Health and Wellness Hub. Bethesda Hospital, which had for many years offered 15 long-term acute care rehabilitation beds for the severely disabled, was demolished in 2023, but a new long-term acute care unit opened at the downtown Wellness Hub with 24 beds.

With an eye toward the economics of maintaining hospital systems, the state of Minnesota maintains a moratorium on adding new hospital beds without state approval.

Woods, in his remarks, acknowledged that getting state legislative approval for the Capitol Park Mental Health Hospital had been an extensive process.

Ultimately, however, “the Legislature, in their wisdom, waived the moratorium,” he said.

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