Hillcrest seeking grants, creative solutions to stay open in HC

Hillcrest Family Services in Mt. Pleasant is working tirelessly to attempt to continue operations after the Hillcrest board of trustees voted on March 7 to close the mental health facility, citing financial instability.

Chris Betsworth, southeast Iowa mental health division director, said if Hillcrest does close they will not do so before July 1, and they will give patients at least 30 days notice.

Betsworth said he is remaining 'cautiously optimistic,” however, that they will be able to keep Hillcrest open in Mt. Pleasant.

'There's been a very strong community response that acknowledges the importance of mental health services and a desire to see us be successful and remain here in this community,” Betsworth said. 'We're committed to attempting to do so.”

Betsworth said they will keep the community updated as they move forward, and they will work as quickly as possible to come to a conclusion on what direction they will be going, Betsworth said.

During a Board of Supervisors meeting on Thursday, March 29, Betsworth asked supervisors to consider reducing the cost of rent or rent forgiveness for fiscal year 2020. Hillcrest Family Services is located in a county-owned building at 106 N. Jackson Street in Mt. Pleasant.

Hillcrest's monthly rental fee is $1,200. Rent forgiveness could possibly save Hillcrest $14,400 during FY20, which begins July 1, 2019.

'It's a potential pathway to assist us among the others we're looking into,” Betsworth said.

Betsworth asked for an answer from supervisors by April 25.

Hillcrest is also applying for several grants including Enhance Henry County and HRSA.

'We're looking to a multitude of sources to see if we would be able to shore up current budgetary shortfall as well as look at options that would improve future sustainability outlook,” Betsworth said.

Betsworth said they are communicating with their patients and will provide a minimum of 30 days notice of closure. During that time, Hillcrest will offer options to transition care to other Hillcrest facilities in Washington County or elsewhere or refer them to other mental health providers in Henry County.

Transportation and access is a barrier to continued care if Hillcrest in Mt. Pleasant does close, Betsworth said.

'There unfortunately are not a lot of other providers, but certainly those in this area we'll work with,” Betsworth said.

If Hillcrest does close in Henry County, they will continue to provide services to the Emergency Room at Henry County Health Center, Betsworth said. They would dispatch a clinician from Hillcrest in Washington, which already happens some days as Hillcrest serves three Emergency Room departments in southeast Iowa.

Betsworth said that having Hillcrest in Mt. Pleasant to follow up with those patients they see in the Emergency Room, however, is critical to continuity of care.

'If we pull out of Henry County, even though I can continue Emergency Room services, I don't have that same level of follow-up service to provide,” Betsworth said. 'We will work and collaborate with any other service provider to provide that continuity, but as we've already acknowledged, there's not enough service providers to absorb those patients.”

At a legislative briefing in Washington County on March 16, Sen. Rich Taylor (R-Mt. Pleasant), said that Hillcrest believes they are owed $1.3 million from the Managed Care Organization (MCO) AmeriHealth, and AmeriHealth believed they owned Hillcrest $0. AmeriHealth paid Hillcrest $450,000 at the beginning of March.

'I believe us getting involved (AmeriHealth) is going, ‘We don't really want the Legislature coming down on us,' so they gave them a little bit of money, about one-third of it,” Taylor said during the briefing, adding that closing Hillcrest would 'devastate” Henry County and the 600 patients it serves.

Betsworth said their primary concern is the ability to negotiate for a better rate with the MCOs.

'What saddens me is my staff doesn't ask to make a lot of money. We ask for simply enough to come back and do it tomorrow, and the system is set up in a way that disallows (that),” Betsworth said.

There are seven Hillcrest employees in Henry County, excluding Betsworth.

Betsworth said he was aware of the financial difficulties facing Hillcrest, and the Mt. Pleasant facility has continued despite operating 'in the red” for several years.

'We cannot continue as we are and we have to make tough decisions,” Betsworth said. 'I'm not surprised, but I'm certainly saddened the decision has come (to close the facility in Mt. Pleasant) and now it's time to do something different.”

Sarah Berndt, coordinator of disability services in Henry County, said it's critical to maintain Hillcrest in Henry County.

'It's going to be a significant loss to your community,” Berndt said to supervisors Thursday. 'People on Medicaid and Medicare primary paying sources do not have access to transportation to get to Louisa or Jefferson counties or Burlington. I'm not sure Optimae (Life Services in Mt. Pleasant) can absorb all of them. The number of patients we're talking about are not easily absorbed into the resources we have left.”