Hospitals may step in to run Four Winds Syracuse

[Families Together in NYS]

      Hospitals may step in to run Four Winds
      Some youths stuck in psychiatric emergency room or shipped out of
town.
      April 28, 2004

      By James T. Mulder
      Staff writer

      Syracuse's four major hospitals hope to stave off the shutdown of Four
Winds psychiatric hospital by finding a temporary operator, if necessary, to
keep the facility open.

      The community cannot afford to lose the services of the 107-bed
private hospital and its staff, said Ron Lagoe of the Hospital Executive
Council, a local hospital planning agency. Four Winds caters primarily to
children and adolescents.
      "We didn't have a lot of treatment capability for this population to
start with and we have a lot less now," he said. "If Four Winds can't
continue, it's a big problem for the community."

      The closing of Four Winds will wipe out 33 percent of Syracuse's
psychiatric beds and 80 percent of psychiatric beds earmarked for children
and adolescents.

      The state Office of Mental Health notified Four Winds Monday it will
revoke the hospital's operating certificate unless it voluntarily surrenders
it.

      The state took the action after its inspectors turned up a long list
of serious deficiencies last month at the hospital, 650 S. Salina St. The
state ordered the hospital to stop accepting new patients March 26. The
deficiencies are similar to problems identified at the hospital two years
ago. Given the hospital's history, the state agency said it doubts Four
Winds can fix the problems and ensure basic patient rights.


      It's not clear when the state intends to close the hospital. The state
instructed Four Winds to notify it by Friday if the hospital will surrender
its license.

      As of Tuesday, Four Winds officials hadn't decided what to do. "We are
exploring all avenues open to us regarding this very unexpected action by
OMH," said Ken Courage, the hospital's chief executive officer.

      Having University Hospital step in as a temporary operator is one
possibility being explored.

      "We would be willing to help," said Ben Moore, the hospital's
executive director. "We would be willing to entertain discussions with the
state on how we might be helpful."

      Syracuse's fourmajor hospitals are worried because they only have 80
beds reserved for adult psychiatric patients. Without Four Winds, the only
inpatient psychiatric services for young people in the Syracuse area are at
the state's Hutchings Psychiatric Center, which has 16 beds for children and
adolescents.

      Since Four Winds stopped admitting new patients March 26, Syracuse's
psychiatric emergency room has seen 95 young patients, 22 of whom had to be
hospitalized, said Kristin Riley, Onondaga County's deputy commissioner of
mental health. Most of them were hospitalized at Hutchings and the state's
Mohawk Valley Psychiatric Center in Utica, she said. Others had to be sent
to hospitals in Buffalo, Saratoga and other out-of-town facilities.

      "We are trying to keep kids out of the hospital, but when they do need
to be hospitalized we want them to remain in the community," Riley said.

      The Office of Mental Health has been closely monitoring the situation
here since admissions were shut off at Four Winds March 26, according to
Roger Klingman, a spokesman for the agency. "We are confident sufficient
capacity exists to meet the region's needs," he said.

      Lagoe doubts facilities in other counties will continue to accept
young patients from Syracuse over the long term. "People elsewhere in the
state have been helping us through this crisis," he said. "But we can't keep
outplacing people forever."

      Sending youngstersout of town for care is not the best option, said
Dr. David Keith, chief of child and adolescent psychiatry at SUNY Upstate
Medical University. "It has limited therapeutic benefit in that it's hard
for families to travel . . . and be involved in the treatment of their
child," he said. "It just produces a massive lack of coordination."

      The problems at Four Winds are causing bottlenecks at Syracuse's
psychiatric emergency room, known as the Comprehensive Psychiatric Emergency
Room, CPEP for short. CPEP evaluates patients and refers them to inpatient
or outpatient services. Some days it's difficult to find facilities
elsewhere in the state with beds available for youngsters, said Mary Bishop,
CPEP's executive director. When that happens, some youngsters have to stay
at CPEP for three days or more.

      To keep Four Winds operating, its 226-person staff needs to be
preserved, Lagoe said. "If we don't have staff, it's hard to re-create one,"
he said.


      © 2004 The Post-Standard. Used with permission.

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