Strategic Behavioral Health

Strategic Behavioral Health LLC says 97 psychiatric beds are needed in the five-county area that includes Scott, Clinton, Jackson, Muscatine and Cedar counties.

ANKENY, Iowa — After nearly 16 hours of testimony over a two-week period, a state panel once again deadlocked Thursday on the proposal of a Tennessee-based company to build a 72-bed psychiatric hospital in Bettendorf.

Iowa’s State Health Facilities Council voted 2-2 on the application by Strategic Behavioral Health LLC, of Memphis, to build the hospital at Golden Valley Drive and Tanglefoot Lane.

The decision was the second time that the panel came to a tie vote. It did the same in February. A majority vote is required to advance the project.

Strategic and the Quad-Cities’ two major hospitals, Genesis Health System and UnityPoint Trinity, have clashed for more than a year now over the proposal. And Thursday’s decision came after about 5½ hours of testimony that, at turns, delved into the technical but also turned visceral, as Genesis pointed to Strategic’s safety record, claiming that violations at some of its facilities portrayed a company with broad problems.

Strategic pushed back when it came time to respond, saying there had been incidents at Genesis as well and that health care facilities often deal with difficult populations.

Once again, there were only four voting members on the council at Thursday’s session. A fifth member could not be at the first part of the hearing, held Oct. 11, because of the death of a family member, and so did not take part in Thursday’s proceedings.

The Oct. 11 hearing, which went late into the night, was adjourned until Thursday.

It's not clear yet how Strategic will respond to this latest deadlock. Michael Garone, the director of development for the firm, said after the hearing that it was a “good possibility” the company would try again but it would need to regroup and consider its options before making a decision.

The next time the case could be heard again is most likely in February.

A Genesis vice president, Ken Croken, said the company was gratified by the result.

Council members Roberta Chambers of Corydon and Roger Thomas of Elkader voted in favor of Strategic. Bob Lundin of LeClaire, chairman of the panel, and Brenda Perrin of Cherokee voted against it.

Perrin paused for a lengthy period before casting her vote and later declined comment on her rationale. She was appointed to the panel this summer, succeeding a previous member who also had voted against Strategic.

Lundin said afterward that as time has passed, Genesis has expanded its behavioral health program, negating the need for more beds.

“Is there truly a need any more? I don’t think there is a need,” he said after the hearing.

Chambers, however, said during deliberations that as an attorney, she constantly hears of the scarcity of beds across the state.

“I think it would make a world of difference,” she said of Strategic.

Much of the hearing centered not only on whether the current need for in-patient beds is being met, but how to assess that. Strategic has based part of its case on a study by the Treatment Advocacy Center, a Virginia-based nonprofit whose data showed significant shortages in Iowa and the Quad-Cities.

Genesis said the center’s figures pertained only to state-run or residential facilities, not the kind of operation that Strategic is proposing. But the Tennessee company responded that a 2014 report in the Quad-Cities assessing the need for psychiatric services, in which Genesis and UnityPoint participated, used the center’s data, too.

Genesis and Trinity have argued that allowing Strategic into the market would undermine their own operations, which they say are, between them, meeting the need for behavioral services.

Genesis, in particular, argued that, since expanding its behavioral health operation with a child and adolescent unit last December and new adult beds this summer, it was meeting the need.

It said that, since July, nobody had been turned away from its in-patient unit.

“It’s a different world since July 1,” Genesis CEO Doug Cropper said.

They also argued that Strategic would not serve Medicaid patients because the state had not yet adopted a federal rule that changed long-standing restrictions on freestanding psychiatric clinics from receiving Medicaid patients.

Strategic sought to counter both arguments. Garone said the state has not yet made changes in the Medicaid rule because there was no need. And they vigorously disputed the idea that nobody had been rejected at Genesis' behavioral health unit.

Garone said Genesis had turned patients away in September, October and even as late as Thursday.

The dispute over the various safety records of Strategic and Genesis lent a harshness to Thursday’s proceedings. Both sides said they did not like bringing up the flaws of the other but did so anyway.

Genesis officials said that problems at three Strategic facilities included inadequate staffing, improper use of restraints and people walking away from a facility and that they signified broad problems in the company.

“These reports reflect systemic failures,” said Jackie Anhalt, Genesis’ vice president of patient services.

Strategic defended its record and pointed the finger at Genesis, citing reports that the hospital had four flawed procedures within a period of just 40 days last year.

Garone said he didn't like the “mudslinging" and called it a distraction from the core issues.

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