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Supervisor, Assemblywoman demand Tri-City action on inpatient psych units

Above: A letter sent by Asm. Tasha Boerner Horvath and Supervisor Nathan Fletcher to Tri-City Medical Center demanding it re-open a number of inpatient psychiatric facilities was met with a strong rebuke from Supervisor Kristin Gaspar and the hospital itself. Photo via Facebook

REGION — A war of words erupted this week over a letter from State Assemblywoman Tasha Boerner Horvath and San Diego County Supervisor Nathan Fletcher demanding Tri-City Medical Center take action to re-open its shuttered inpatient psychiatric facilities.

The letter, dated June 10 and addressed to Tri-City Chief Executive Officer Steve Dietlin, accused the North County public hospital of failing “to show substantive progress towards reinstating emergency behavioral health services at the Tri-City Medical Center,” despite ongoing talks between the county and the hospital executive staff.

It calls on the hospital to deliver a plan to the county within 30 days, and threatens legislative action against the hospital, including a state financial audit.

Nathan Fletcher
Tasha Boerner Horvath

“We understand that ‘conversations’ are taking place, but we have sat patiently for six months waiting for movement and it is time for conversations to turn into a specific, realistic and achievable action plan,” Fletcher wrote in the letter.

Fletcher and Boerner Horvath’s letter comes on the eve of a meeting that Tri-City officials said would have culminated negotiations between the county and North County health care officials.

The letter was met with a strong rebuke from Fletcher’s fellow Supervisor Kristin Gaspar and the hospital itself, whose officials said they were disappointed by the turn of events.

“Tri-City has been actively engaged with public and private stakeholders for the past year working towards real solutions,” the hospital said in a prepared statement. “We were disappointed to receive the Supervisor and Assemblywoman’s letter on the eve of what we anticipated to be a positive meeting to further advance a cooperative and collaborative regional plan within the County of San Diego and other healthcare providers.”

Gaspar took it further, calling the statement “self-serving” and politically motivated.

“This is an all-too-familiar tactic from two Sacramento politicians who make grandiose threats to create the allusion that they are the reason for the change,” Gaspar said. “My friends in Sacramento who claim to ‘prefer an environment of collaboration and cooperation’ have instead abandoned the famous words of Ronald Reagan who said ‘There’s no limit to what a man can do or where he can go if he doesn’t mind who gets the credit.’”

Tri-City’s board of directors voted last year in August to suspend the hospital’s 18-bed behavioral health unit and 12-person crisis stabilization unit, which had already shut down with the county’s approval. The closure went into effect Oct. 2.

Tri-City Healthcare District originally voted in June 2018 to shut down the units, citing a recent change in federal regulations requiring hospitals to remove from rooms all features that patients. They also cited a $5 million budget shortfall within the department that oversees the unit, as well as a shortage of psychiatrists to staff the unit.

District officials said after Tuesday’s meeting that as long as the hospital operated the units without fixing the ligature risks — which would require a $7.9 million renovation — it exposed the hospital and patients of the facility to undue risks.

“Your decisions have created an untenable deficit of services in North County exasperating a mental health emergency system that was already overwhelmed,” Fletcher wrote.

Fletcher’s letter contrasted Tri-City’s supposed lack of action to the county’s recent decisions to add 20 beds to its psychological hospital (with 20 additional beds to be added shortly) as well as increase the budget toward behavioral health services.

“In the six months since you suspended operations of your Behavioral Health and Crisis Stabilization Units, citing new federal guidelines requiring capital improvements as a significant obstacle, the County has made those same capital upgrades at the San Diego Psychological Hospital and obtained accreditation from Joint Commission this past February,” Fletcher wrote. “This compliance is not insurmountable … Despite this significant achievement, the closure of psychiatric beds at Tri-City during this same time frame ensured no true regional progress as the gain was cancelled out by your deficit.”

Fletcher, a Democrat, further responded to Gaspar, a Republican, saying that she has been “more interested in standing with Donald Trump than solving our regional health problems.”

“This is why Assemblywoman Boerner Horvath and I had to demand action and give Tri-City 30 days to provide their plan,” Fletcher wrote.