Psych Care at Risk in Cedars Shutdown

Cedars Sinai says it will to close most of its mental health services, worrying providers and patients.

The decision by Cedars Sinai Medical Center to phase out most of its mental health services will rip a hole an already tenuous network of care, rattled providers said Thursday.

The news that within a year the non-profit hospital system would shut down its 51 psychiatric beds and release the 1,800 people who come for outpatient counseling and medication ripped through the region’s mental health community.

Free clinics braced for an onslaught of new patients, and doctors in nearby neighborhoods wondered where they would refer people in need of care.

“It’s devastating news,” said Sheila Forman, who practices in Santa Monica and is also a spokeswoman for the Los Angeles County Psychological Association. “The idea that a big facility like Cedars Sinai would close its doors is a very big deal. A lot of people are in crisis right now, and they need services.”

The hospital is a major player in the region, Forman and others said. Its medical school trained hundreds of psychiatrists, and its facilities have provided internship opportunities for therapists and other professionals.

The institution accepted both Medi-Cal and most health insurance, and also offered a sliding scale for payment. That’s significant in the mental health care today, because many clinicians do not accept insurance, instead expecting patients to pay cash.

Cedars’ policy meant that not only the poor but middle class families as well were able to get in to see a psychiatrist or psychologist when they needed one.

The medical center has said that it will phase out all services not directly related to another specialty, such as cancer treatment or veterans services, within a year.

Hospital officials said the shutdown was prompted by changes in the health care system – including recent reductions in reimbursements for care provided to people who rely on Medi-Cal and Medicaid.

“At a time when the healthcare delivery system in our country is undergoing a massive transformation, every medical center has a responsibility to examine what it should focus on to ensure that it is strong over the long term to serve the community,” said Thomas M. Priselac, Cedars-Sinai’s president and CEO. “In looking at where our core strengths are in a variety of clinical and research areas, how we can best serve the community … this difficult decision needed to be made.”

The cutbacks at one of the region’s premiere medical centers can be seen against a backdrop of difficulties faced by hospitals throughout the state, said Jan Emerson-Shea, spokeswoman for the California Hospital Assn.

Earlier this fall, the administration of Gov. Jerry Brown said it would slash payments for many services covered by Medi-Cal by 10 percent. That move comes on top of expected multi-billion-dollar cuts in Medicare and Medicaid at the federal level once health reform kicks in. At the same time, many employers and insurance companies have been reducing the amount that they are willing to pay for medical services – particularly those provided by mental health professionals.

“Hospitals across California are having to really make some difficult decisions about what types of services they’re going to be able to offer in the future,” Emerson-Shea said.

In Los Angeles County, the clinics that serve the poorest residents are bracing for an onslaught of psychiatric patients, said Louise McCarthy, president of the Community Clinic Association of Los Angeles County.

“It’s expected that there will be some increase in demand,” McCarthy said.

Clinics in the mid-Wilshire and West Los Angeles areas that typically refer psychiatric patients to Cedars Sinai will have to scramble to find care for them, she said.

Many clinics are planning to ramp up the low-level mental health services they can provide on site, but with Cedars Sinai gone, it will be more difficult for them to find care for patients who need more attention.

“They may get them in, but they’re going to have to send the person ten miles further or two more bus rides,” McCarthy said.

To ease the transition, Cedars Sinai plans to make a $1.5 million in grants to local agencies and clinics to help pay for mental health care, the hospital said in a press release. Officials also said that mental health workers at the hospital would try to find new doctors and therapists for existing patients.

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