Tri-City Medical Center in North County has agreed to negotiate with the County to open more beds to treat people with mental health crises. But taking that on could put the hospital in a crisis of its own.
Some San Diego County supervisors berated Tri-City for closing its crisis stabilization beds last year, while other hospitals kept theirs open. But health care consultant Nathan Kaufman says some hospitals, like UCSD, have revenue sources —like specialty cancer treatments — they can use to subsidize psychiatric crisis care. He says currently, Tri-City is just breaking even financially.
“I just looked at the general numbers. It could have a huge impact on its overall ability to provide general acute care because it could generate deficits that would impact the overall care provided to other patients,” Kaufman said. "It’s barely breaking even, so if it operates like a typical behavioral health program around the country then it’s going to lose money, so Tri-City is maybe protecting its other programs.”
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Kaufman said reimbursement rates for psychiatric care are typically 60 to 70 cents on the dollar. He said even if the County contributed $14 million to build a new crisis care facility at Tri-City, the costs of operating it would likely run into many more millions every year. That could threaten the hospital’s ability to keep providing other services to the North County coastal community.
Responding to the county supervisors’ decision to negotiate with any hospital willing to partner on developing new crisis stabilization beds, Tri-City spokesman Aaron Bysak said in a statement:
“It is important to have psychiatric facilities that are geographically distributed throughout the region. The County can negotiate with any provider they choose."
Tri-City serves Oceanside, Vista and Carlsbad. Like Palomar Healthcare in Escondido which also serves North County, Tri-City is a district hospital with a publicly elected board. Most of the other healthcare systems in San Diego County are private non-profits.