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SALT LAKE CITY — Six months after consultants told lawmakers that privatizing the forensic unit of the Utah State Hospital could reduce the quality of patient care, a state senator is pushing legislation that would require the agency that oversees the facility to find a private operator.
However, the sponsor of SB253, Sen. Stuart Adams, R-Layton, says the bill does not mandate privatization. It seeks an array of approaches for construction of facilities or operation of services by private entities under the control of the state Division of Substance Abuse and Mental Health.
Adams, chairman of the Utah Transportation Commission, said public-private partnerships for major state road projects have been highly successful.
"All of that's been done by motivating the private sector," Adams said during a recent meeting of the Senate Health and Human Services Committee, which approved the bill.
"In my mind, why couldn't that be done within the state mental health facility?"
These people are in state custody or committed to their local mental health authorities. It's a big risk to hand the care and safety of these individuals to a private entity.
–Dallas Earnshaw, superintendent of the Utah State Hospital
Dallas Earnshaw, superintendent of the Utah State Hospital, said Tuesday that lawmakers must carefully consider the ramifications of such a change. For one, a number of reports and audits, the latest in 2008, have recommended against privatizing the operation of the state hospital. Comparing the operation of a facility that cares for people in state custody to road projects is disconcerting, he said.
"These people are in state custody or committed to their local mental health authorities. It's a big risk to hand the care and safety of these individuals to a private entity," Earnshaw said.
If a private entity assumed operations of the hospital, the state would need to hire staff to oversee the operations. That would mitigate any potential savings.
"There's a safety issue for the community, patients and the staff themselves on campus. We have the Disability Law Center monitoring at any time what we do. That would change with a private provider," Earnshaw said.
While supporters of Adams' bill say other states have privatized some or all of their state mental health facilities and programs, Earnshaw said Utah is vastly different than Florida, which privatized a hospital in South Florida.
Unlike the Utah State Hospital, which recently passed a rigorous review by the Joint Commission on Accreditation of Healthcare Organizations, the Florida hospital was unaccredited, there were multiple complaints of poor quality care, including those resulting in patient deaths.
"Advocates and NAMI (National Alliance on Mentally Illness) were up in arms wanting something done at that hospital," Earnshaw said.
While the hospital reports good outcomes, Earnshaw said Florida has other state hospitals "as a safety net the more difficult patients can be sent to. This hospital has good outcomes because they're very picky about what patients they take."
The hospital had a high degree of staff turnover the first few years of private operation, which some proponents say demonstrates the possible cost savings.
The Public Consulting Group report, presented to the Legislature's Executive Appropriations Committee in August, said cost savings realized through privatization "may result in a reduction in the quality and continuity of care to the patients within the units studied." (PCG consultants also studied units of the Utah State Developmental Center for the report.)
SB253 has been sent the to the full Senate for further consideration.
Meanwhile, lawmakers are also considering $25 million in construction funding for a pair of buildings to replace three outdated and unsafe buildings that serve pediatric and adult patients. The facilities, which also house ancillary services, are at the top of the state building list.
"Putting this building off while the privatization debate goes on and on is really jeopardizing the care of all of our patients," Earnshaw said. If the construction funds are not appropriated, the state hospital must conduct expensive repairs at each of three buildings to maintain its federal health care facility accreditation, he said.
E-mail: marjorie@desnews.com
