Consolidating mental health services, new center at ECMC offers more, better care - The Buffalo News
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Consolidating mental health services, new center at ECMC offers more, better care

A new $25 million behavioral health center will open today at Erie County Medical Center, the culmination of a major project to consolidate mental health services at ECMC and Kaleida Health.

One of the significant features is a near-tripling of the often-overcrowded Comprehensive Psychiatric Emergency Program, a 24-hour-a-day regional service known as CPEP, from 6,500 square feet to 18,000 square feet.

Officials also committed to match the new facilities of the Behavioral Health Center of Excellence with efforts to achieve medical excellence, saying they will work toward improved service and access to care, innovative programs, more coordinated care after hospitalization, and better value.

“We have had two fractured programs delivering care in a fragmented way, and we have had a CPEP in dire need of updating and expansion,” said Jody L. Lomeo, CEO of the medical center.

“We needed to do better not just with our facilities, but with our programs,” he said.

Mental illness is much more common than many people realize, and the demand for services great.

One in five American adults, or 45.6 million people, experienced a mental illness in 2011, and only about 60 percent received treatment, according to a report last year from the Substance Abuse and Mental Health Services Administration.

Patients in a behavioral health center receive therapy for a range of psychiatric illnesses, including depression and mood and psychotic disorders, as well as alcohol and drug abuse. The care is provided in the hospital, on an outpatient basis, and in emergency rooms that specialize in mental and substance-abuse disorders.

Behavioral health currently accounts for about 16 percent of ECMC’s hospitalized patients. With the consolidation, the program will be among the largest in the state and will represent nearly one-quarter of the hospital’s inpatient business.

“We have a robust mental health system in Buffalo, but it is not very coordinated,” said Dr. Michael R. Cummings, executive director of the new center. “We’ve also acted as more of a safety net instead of being more proactive.”

Among other things, Cummings said, ECMC is looking to identify and help patients to reduce their use of the facility, especially those with multiple readmissions, develop a psychiatric intensive-care unit and offer a transitional level of care for patients who no longer require hospitalization but need more structured therapy than typical outpatient treatment.

He also anticipates greater involvement with the University at Buffalo School of Medicine and Biomedical Sciences.

“Each patient should get the same experience with enough space and staff so that we can separate people by diagnosis and level of need,” Cummings said.

A better experience

Karen A. Ziemianski, director of nursing, characterized the new center as “putting the puzzle pieces together” for facilities, programs, health care providers and administrative support to provide a better experience for patients and their families.

For example, she said, ECMC wants to push for more nurse certification, a growing trend in which a national agency validates a nurse’s qualifications based on certain standards.

Kaleida Health operated a 91-bed inpatient psychiatric program at its Buffalo General Medical Center, as well as a partial hospitalization program at 1010 Main St.

ECMC operated 92 inpatient psychiatric beds, although it was licensed for 132 beds.

Increase to 172 beds

The new center, when fully operational in the spring, will have 172 beds, including those dedicated for adolescents, geriatrics, forensic psychiatry and a psychiatric intensive-care unit. ECMC also will continue to operate its existing 18 detoxification beds and 20 inpatient chemical dependency rehabilitation beds.

The partial hospitalization program moved to ECMC, which also will manage three chemical dependency treatment sites in Buffalo, Depew and Kenmore.

The center will combine annual outpatient behavioral visits of 44,300 at ECMC and 69,000 at Kaleida Health, as well as annual psychiatric hospitalizations of about 2,300 each at ECMC and Kaleida Health.

The transition did not go smoothly at times.

In June, Kaleida Health closed ahead of schedule what was left of Buffalo General Medical Center’s behavioral unit, as staff moved to other departments. The decision led to a major backup at ECMC’s psychiatric emergency room and criticism from advocates for the mentally ill.

Now, advocates offer praise for the new center and guarded optimism about the future of mental health services here.

“It’s a positive” and “an opportunity to step up and improve,” said Marcy Rose, president of the Erie County chapter of the National Alliance on Mental Illness.

Aiming for innovations

“To the good, we have a physically larger facility and an opportunity to study what is working elsewhere and integrate those elements,” said Kenneth P. Houseknecht, executive director of the Mental Health Association of Erie County.

He characterized Cummings as a physician with progressive ideas and said ECMC officials appear willing to partner with patient organizations to improve services.

But Rose and others also cautioned that the mental health system is big, complex and fraught with quality and access-to-treatment issues.

The shortage of psychiatric hospital beds that existed before the new center opened still exists, Rose said. And while the new center offers the possibility of more coordinated care, it also lessens choice of care providers in the community, Rose said.

“The potential is there for true excellence. But if you are going to be a center of excellence, you have to act like one,” she said.

Under a state-ordered agreement in 2008, the medical center and Kaleida Health remain separate institutions but operate under a unified governing organization known as Great Lakes Health. The restructuring was designed to reduce duplication of services, establish stronger specialty programs and control costs.

New York State provided $15 million for the project through a Healthcare Efficiency and Affordability Law grant, with ECMC funding the remaining $10 million.

3rd big consolidation

This is the third major medical program consolidation between the institutions.

A new regional transplant and kidney care center opened in 2011 at ECMC, combining once-competitive programs. In 2012, the Gates Vascular Institute opened at the Buffalo Niagara Medical Campus, consolidating Kaleida Health’s heart, stroke and vascular care services, as well as ECMC’s cardiac program.

“It should be clear by now that we need to find a fundamentally new strategy in health care,” said Robert D. Gioia, chairman of the Great Lakes board of directors.

Gioia said Great Lakes’ goals for the behavioral consolidation included improved quality, expanded access, performance measurement and better-controlled costs.

“Anyone can combine two programs,” he said. “But you also have to raise the bar on the level and quality of care. You have to drive value. It is not a choice in today’s competitive market.”


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