SLO County needs more psychiatric beds — not another NICU

As a general rule, competition is good for consumers: It helps keep prices down and quality up.

But when it comes to hospital care, that principle doesn’t always apply.

The last thing we need is an unnecessary duplication of services, and that’s what we’ll get if Dignity Health opens another neonatal intensive care unit, or NICU, at French Hospital Medical Center.

Sierra Vista Regional Medical Center already has a NICU that can serve 22 patients.

But as Tribune writer Sara Kassabian reported, generally only 10 beds are filled and of late, there have been only one to two babies in the NICU at a time.

And now French will be adding more NICU beds?

“I just gotta be truthful and tell you I think it’s not necessarily in the community’s best interest to do this,” said Dr. Rene Bravo, a well-respected San Luis Obispo pediatrician.

We have to agree.

A second NICU may be needed someday, but given our current demographics, right now it’s premature.

Gentleman’s agreement?

According to Bravo, in the last 1990s, the administrators of the two hospitals struck a “gentleman’s agreement” to focus on different specialties.

But instead of sticking to that informal agreement, the two hospitals have been engaged in a rivalry that reflects poorly on both of them.

In 2013, for example, Sierra Vista proposed adding a new cardiac unit that would have competed with French — generating the same type of criticism that’s now being directed at French’s plan for a NICU. It ended up shelving the idea.

This is all so counterproductive.

In a market our size, hospitals should be cooperating to ensure patients of San Luis Obispo County get the care they need, instead of trying to poach each other’s patients.

The duplication of services is even more frustrating when you consider the services we lack in SLO County — especially when it comes to psychiatric care.

There has been an increase in acute care services; SLO County added a Crisis Stabilization Unit that can treat patients for up to 24 hours, and Dignity Health is adding a similar facility at Marian Medical Center in Santa Maria that’s expected to open later this summer.

But for patients requiring hospital admission, local options are severely limited; for years, only 16 inpatient beds have been available in SLO County.

According to a 2018 statewide report by the California Hospital Association, San Luis Obispo County needs 141 additional inpatient psychiatric beds.

Templeton project

At one point, it looked as though that shortage would be cured.

In 2016, the Board of Supervisors approved a controversial proposal for a 90-bed, private psychiatric hospital in Templeton. But six years later, not a single shovelful of dirt has been turned.

It’s time to stop waiting for a project that is looking less and less viable with each passing year.

Too many patients and their families are forced to travel hundreds of miles to get adequate care or, worse yet, aren’t going without the treatment they need.

Why is no one stepping up to care for them?

We need answers

David Bernhardt, a retired physician who serves on the Transitions Mental Health Association Board of Directors, has been an outspoken critic of the situation.

When French first announced a major expansion in 2019, he called on Dignity Health to revise its plan and add a psychiatric unit.

“Leaders at French Hospital have emphasized publicly that as the only not-for-profit hospital in the city of San Luis Obispo, they can provide services to the community without regard to stockholder and corporate needs. This is an opportunity to leverage their advantage for the benefit of that community,” he wrote then.

Three years later, he hasn’t given up; he’s calling for a study that will analyze current needs and recommend solutions.

“I don’t know what we should be doing precisely, and I want to hire somebody to tell us,” he said.

He also wants to get all the players involved, including the county and the hospitals.

“We’re going to have to figure out a way to quit looking at the other guy to solve our problems,” he said.

That makes sense.

There is no question that San Luis Obispo County is underserved; 16 inpatient beds are way too few when you consider that a minimum of 50 inpatient psychiatric beds per 100,000 people is recommended. (The county’s population is approximately 282,000.)

With that in mind, is it the best use of limited resources to build another NICU when the one we have now has empty beds?

If Dignity Health is truly committed to meeting the needs of the entire community, it will put its plan on hold until we have some answers.

One more thing: In the future, both French and Sierra Vista should work cooperatively, rather than engaging in a competition that hurts us all.