Private Company May Save One South

By Patrick Brendel, Victoria Advocate, Texas

Apr. 5–The situation surrounding One South looked a lot clearer Tuesday after an early morning meeting between all parties concerned with the mental health unit.

The future of the unit, also known as Evaluation and Stabilization Unit at Citizens Medical Center brightened a little with the first proposal from a private company to keep One South’s doors from closing forever.

Convening were the board of directors of Citizens, the Gulf Bend Center board, psychiatrists Robert Lyman and Bob Creager, and elected county officials.

Gulf Bend contracts with Lyman and Creager to provide care to the patients in One South, also called the Evaluation and Stabilization Unit, but has said the current agreement constitutes an improper use of public money because, although Gulf Bend is designated by law as a “payer of last resort,” some ESU patients are covered by Medicaid or private insurance.

If the psychiatrists, hospital, and Gulf Bend do not come to an agreement by May 1, Lyman and Creager will no longer be available to treat ESU patients.

With no attendant psychiatrists, the unit would have to close and patients diverted to hospitals out of the region, most likely to San Antonio State Hospital.

The new contract submitted by Gulf Bend calls for the psychiatrists to be paid according to services performed, not hours billed, and would pay the psychiatrists less money for more work, when compared to the old contract, Lyman and Creager have said.

David Way, Gulf Bend’s director of operations, said that the psychiatrists’ main issue concerning the new contract Tuesday was not about the number of dollars earned, but the number of hours worked.

“What I heard today is, if the community could bring in two other psychiatrists to work the inpatient unit, then the money then, wasn’t so important,” Way said.

Neither Lyman nor Creager could be reached for comment Tuesday afternoon.

As the only two psychiatrists with hospital privileges, Lyman and Creager’s on-call schedule is every other night and every other weekend. Citizens staff and physicians have said that Lyman and Creager are extremely dedicated to caring for their patients.

It is worth noting that, if additional psychiatrists were brought to Victoria and added to Gulf Bend’s contract (per the psychiatrists’ request), Lyman and Creager would have a much more manageable call schedule but would earn less money from Gulf Bend than they do now.

County commissioner Gary Burns, who is also on Gulf Bend’s board, said that Continuum Holdings Company has approached Gulf Bend about working something out to keep One South open.

Continuum representatives could not be reached for comment on Tuesday afternoon.

Continuum provides inpatient psychiatric care for Padre Behavioral Healthcare System in Corpus Christi and already does business with Gulf Bend, Burns said.

“They’re in the business of providing psychiatric services in other communities,” Gulf Bend Executive Director Don Polzin said.

Polzin added that he wanted to clarify that Gulf Bend’s outpatient services are in no way involved with any of these negotiations and will continue to be provided, regardless of what happens with inpatient services.

Citizens CEO David Brown said he has scheduled a meeting with Continuum representatives today and that there will be a presentation Monday by Continuum to the Citizens board.

However, he said that, although Continuum is the first company to announce its interest in One South, this does not lend it competitive advantage over other companies that might approach Citizens and Gulf Bend at a later date.

“There needs to be a certain amount of caution exercised in any business relationship,” Brown said.

Brown said he is looking at a spectrum of future possibilities for One South, including enhancing and broadening the facility’s services to draw in patients from counties outside Victoria.

Although the future of One South is still not clear after Tuesday’s meeting, a few things are for certain: Lyman and Creager will continue to provide services to ESU patients until at least May 1; Gulf Bend Center will not continue to cover inpatient services for patients who have health coverage; and, the shortage of psychiatrists in Victoria is a community problem and must be addressed by the entire community, not by a single organization like Gulf Bend or Citizens.

And if negotiations continue to go as well as parties say they did on Tuesday, then hopefully the statement “One South will stay open” can be added to this list of certainties.

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