Recommendation to close MHI in Mount Pleasant, move services to Independence

DES MOINES – A top state official submitted a proposal Monday to close the mental health institution in Mount Pleasant and move its services to another institution in Independence.

Lawmakers required the Iowa Department of Human Services to recommend closing one of the four state facilities as they looked to cut costs.

DHS Director Charles Krogmeier said they decided to propose closing the 79-bed facility in Mount Pleasant because it would cause the least economic fallout for staff and the community and the least disruption for families of patients.

“The quality of service at the MHI in Mount Pleasant is beyond question, and I want everyone to know that this recommendation is no reflection whatsoever on the dedication and expertise of our staff, which is outstanding,” Krogmeier said in a statement announcing the proposal.

Built in 1861, the Mount Pleasant mental health institution is Iowa's oldest. It employees 108 and has an operational budget of $8.8 million, the second-smallest of the institutes. Mount Pleasant also has the smallest unit for adult psychiatric services with 14 beds.

Lawmakers ultimately must make the decision if one of the state's mental health institutions, or MHIs, were to close.

Krogmeier said if lawmakers were to approve a closure by May 1, the department could start remodeling at the MHI in Independence in order to accommodate programs moving there. Key lawmakers have indicated a possible closure could take more than a year.

Krogmeier called the estimated annual savings of $1.7 million from relocating Mount Pleasant to Independence “slight” and said it actually would cost money in the beginning to relocate employees.

Rep. Dave Heaton, R-Mount Pleasant, notes that DHS officials were required by lawmakers to propose the closure of a facility. He notes the possible loss of jobs in Mount Pleasant if the institute were to close.

“Our town, right now, is not doing the best. We've lost 2,000 jobs here in the last year and a half,” Heaton said.

Heaton wants lawmakers to closely consider the recommendations of a task force that no institution be closed until more community mental health services are available. Heaton cited a need to develop mental health crisis centers and places that provide “sub-acute” care before people return to the community.

Tammy Rasmussen, executive director of the Independence Area Chamber of Commerce, expressed excitement and relief with the recommendation to grow the institute there.

“It's like we've been spared,” Rasmussen said. She cited the potential to increase the economic impact of the Independence institute by adding jobs. But she also acknowledges the decision is still up to the Iowa Legislature.

“It's not really over until it's over,” she said.

State Sen. Ron Wieck, R-Sioux City, also expressed relief that the Cherokee institute was not recommended for closure.

“It obviously is a good sign,” said Wieck, whose district includes the institute and all of Cherokee County.

Krogmeier said they were able to eliminate the MHIs at Cherokee and Independence early on while formulating a closure recommendation. He said they felt it did not make sense to relocate child or juvenile psychiatric services offered at Cherokee and Independence to either the Clarinda or Mount Pleasant campuses, which also are home to state prisons.

Clarinda's treatment of geriatric patients helped figure into the DHS's proposal not to close that facility, as did the sex offender unit located at the Cherokee MHI.

Krogmeier said the biggest need now is for outpatient and community-based services, which are how most psychiatric mental illnesses are treated today.

Krogmeier cited the example of Minnesota, which closed institutions and created a number of smaller acute-care facilities around the state closer to where people live.

Members of a special task force to study the closure of Iowa MHIs have said they do not believe any institution should be closed until community-based mental health services are beefed up around the state.

State Sen. Jack Hatch, D-Des Moines, leads a legislative committee that oversees spending on health and human services. He said the decision on whether to close a facility would be based on more than just the DHS recommendation. Other factors lawmakers will look at are the task force's recommendation, Gov. Chet Culver's recommendation, as well as budget considerations.

A consulting firm hired by Culver's administration recommends closing both the Mount Pleasant and Clarinda institutions and consolidating services at two facilities that would remain in Independence and Cherokee.

Hatch stresses that lawmakers will consider whether the state can increase the quality of services for those who have mental illness and whether people housed at one of the institutions could be moved to other facilities or community-based services of the same or higher quality.

The economic impact will also play into lawmakers' decision, Hatch said.

“Everyone is serious about closing a facility, but now it's up to the Legislature to put all the pieces together,” Hatch said.