Hoag Plans to Close County’s 2nd Largest Mental Health Ward

Hoag Hospital has decided to close its mental health unit, one of the largest in Orange County, prompting an outcry from psychiatrists across the county who are negotiating to save the Newport Beach hospital’s 36-bed program.

Hospital administrators say the space is needed for expanding heart and cancer programs.

A year ago, Hoag became the first hospital in the county to launch a heart transplant program. Next month, ground-breaking ceremonies will be held for Hoag’s $15-million Cancer Center.

Larry Ainsworth, Hoag executive vice president, acknowledged Thursday that the March 1 decision by the hospital’s board of directors has met strong opposition from many of the estimated 230 psychiatrists in Orange County.

The psychiatrists say the move will hurt the county’s mentally ill, especially the indigent, because Hoag is one of the few hospitals in the county that treats psychiatric patients covered by Medi-Cal.

Ainsworth and other hospital administrators are negotiating with representatives of the 50 psychiatrists on the hospital’s staff who are attempting to save the 36-bed ward. In Orange County, only St. Joseph Hospital in Orange, with 37 beds in its mental health ward, is larger, county mental health experts said.

Ainsworth declined to disclose the details of these talks, saying they occurred at meetings that were “closed and legally confidential” because they were held by the executive medical staff, the hospital’s governing board of doctors.

The head of the negotiating team for staff psychiatrists, Dr. Barton Blinder, also would not provide details about the talks.

But Blinder, chairman of the department of psychiatry, said, “We are now in delicate negotiations. We are attempting to get the board of directors to reconsider their decision.

“We hope that a proposal we are developing to restructure the mental health unit will win approval.”

Blinder would not discuss the proposal, but another staff psychiatrist familiar with the plan said it involved opening the ward to some patients that Hoag administrators say cannot now be served because of a scarcity of beds.

“The unit would be opened up to people with head injuries who could benefit from psychiatric care,” Dr. Jordan Weiss said. “The unit also would serve people who are (medically) ill who have made suicide attempts and could benefit from a ward where they could receive both psychiatric and (medical) care.”

The round of intense negotiations was set off by a March 1 unanimous vote by Hoag’s board to phase out the psychiatric ward over the next seven months.

The mental health ward was selected for elimination rather than another hospital program because “it is autonomous and it stands alone,” Ainsworth said.

“It’s absence is not going to have a significant negative impact on operation of the rest of the hospital,” he said. “The mission of Hoag is to take care of (medical) patients. In the mental health unit, they take care of individuals who may need medical care, but for the most part they are primarily suffering from a mental illness.”

Other hospitals could serve these patients, he said.

Dr. Douglas Kahn, president of the 230-member Orange County Psychiatry Society, disagreed. “Not a single one of our members who I’ve talked to favors closing the unit,” he said.

Dr. William L. Kelly, a staff psychiatrist, noted that Hoag is one of only seven general hospitals in the county and that “it is one of the few that will admit Medi-Cal patients.”

“If it closes,” he said, “the only place where I’ll be able to send my Medi-Cal patients is to UC Irvine Medical Center.”