Closing the Cherokee Mental Health Institute (MHI) would be damaging for Plymouth County, according to area mental health professionals.
Transportation costs for both the county and patients having to travel greater distances to other facilities to receive treatment and related agencies that rent space on the institution's campus could face hardships.
Cherokee's MHI and those in Independence, Clarinda and Mount Pleasant are currently under scrutiny of a task force, formed by the Iowa Legislature, to study the facilities' programs and services.
That information will be used by the Iowa Department of Human Services (DHS) to recommend to state government leaders whether one of the MHIs should close and if so which one.
If one of the MHIs was closed, its services would be distributed among the three remaining institutions, said Roger Munns, spokesman for the Iowa DHS.
"The directions to us were not to serve any fewer people," Munns said. "It was just to have the same number served at fewer places."
If Cherokee's MHI closes, that would mean children and adolescents from Plymouth County and surrounding areas would have to go to private hospitals or travel to Independence -- more than 200 miles away.
"Cherokee is the only Acute Inpatient Treatment facility for children and adolescents in the region," said Patrick Schmitz, executive director of Plains Area Mental Health Center, in Le Mars.
"Even on the adult side, our Sioux City hospitals are inundated with the indigent care people and if we lost CMHI it would get even worse," Schmitz said.
If Cherokee's MHI closed, it would also have a direct effect on Plains Area's services, as it would lose the expertise of the five psychiatrists employed by Cherokee, Schmitz said.
Plains Area utilizes those professionals for help with its outpatient care, he said.
"We will start having a significant waiting list for people to receive outpatient services," Schmitz said.
Another area that would take a direct hit if Cherokee's MHI was to close would be other treatment agencies like Pride Group that are stationed on the institute's campus.
Mike Porter, CEO of Pride Group, said its program West Cedar provides a PMI (persons with mental illness) level of care.
"It's a 24-hour residential program," Porter said. "It's a step down from the hospital setting for chronically mentally ill and a step up from what we provide in Le Mars."
Porter said Pride Group rents its space on the MHI campus from the State of Iowa and he's concerned what it would mean for the agency if Cherokee MHI closed.
"The State of Iowa provides meals, housekeeping, maintenance," Porter said.
If the MHI closes, his question would be who would provide those services.
Porter said he's also concerned about the relationship Pride Group currently has with the hospital, which in addition to other things also provides medical staff for West Cedar.
"We have a hand-in-hand relationship," Porter said. "As an agency, we don't want them to close."
Not only would services be affected, but Pride Group and Plymouth County would also see an increase in transportation costs if patients had to be taken to one of the other MHIs in the state.
"It would very fiscally be an impact on the mental health budget to have them not there," said Sharon Nieman, central point coordinator for mental health and disabilities services in Plymouth County.
"The ones that go there from Plymouth County are indigent folks that have no insurance," Nieman said.
More than 30 people from Plymouth County went to Cherokee throughout the last three years, she said.
"The numbers don't sound huge until you put it into perspective," Nieman said.
For example, when an individual is court-ordered into state hospitalization the county has to pay a portion of it, she said.
The county also has to pay any transportation costs to take the individual to the MHI and back for court hearings and the like, Nieman said.
That cost could increase greatly if someone had to go to Independence in eastern Iowa compared to Cherokee, about 30 miles away, for treatment, she said.
"It would be a huge detriment if we lost Cherokee," Nieman said.
Like Plymouth County officials, Dr. Dan Gillette, Cherokee MHI's superintendent and clinical director, is also concerned about possible closure.
But, he said, Cherokee MHI's merits speak for themselves.
"Our county billing peridium cost is substantially lower than the other MHIs. We're probably less than one-half the cost of a private hospital," Gillette said. "The care we provide is a bargain."
The hospital currently provides care for adults in 41 counties and children and adolescents in 56 counties in northwest Iowa, Gillette said.
"We also provide clinical training for students in 20 different schools (universities) in a four-state region," Gillette said.
In addition to Pride Group's West Cedar program, seven other agencies' rent space on the hospital's grounds, he said.
Cherokee MHI also offers the Civil Commitment Unit for Sex Offenders, a long-term residential treatment for repeat sex offenders who have been judged more likely to re-offend, Gillette said.
"The big thing is the task force very explicitly is looking at the facilities' economic impact and the community benefits," Gillette said. "Ultimately the closure comes down to a political decision and that means nothing is more important than the input of citizens."
People will have a chance to meet with the task force, ask questions and share concerns about the possible closure of the Cherokee MHI from 4-5 p.m. today (Tuesday) in the hospital's auditorium.
Cherokee is the first of the four MHIs to receive a visit from the task force.
Next it will be in Independence Sept. 28, Clarinda Oct. 12 and Mount Pleasant Oct. 26.