With longer distances to travel the cost of relocating inpatient mental health services from the St. Lawrence Psychiatric Center to facilities downstate could fall on families and the county, advocates fear.
The state Office of Mental Health has proposed closing inpatient beds in Ogdensburg, instead diverting patients to Centers of Excellence downstate and focusing on community-based care.
SLPC Task Force Chairman Charles Chuck W. Kelly said there has not been much discussion concerning who will end up footing the bill for the longer commute.
Thats one of the questions we have not had answered, he said, adding that he fears it will be an unfunded mandate passed to the county.
The task force had a face-to-face with Gov. Andrew M. Cuomo on Tuesday where they argued on behalf of keeping inpatient beds in Ogdensburg.
One of their grievances is the distance between the north country and facilities downstate that will see families struggling to visit loved-ones and increase the cost of transportation generally.
Mr. Cuomo is expected to announce his recommendations related to the reorganization of mental health services in the state this week.
Currently ambulette services are used to drive psychiatric patients who do not require medical supervision from Claxton-Hepburn Medical Center, the only hospital in the county capable of referring patients to SLPC, to the inpatient center for just over $50, including a $36 Medicaid base charge and a $3 per mile fee.
Patients who do require the supervision of an emergency medical technician, a decision made by a physician, are transported in ambulances where the fees are much higher.
Christopher Frary, with Frary Medical Transport, said his ambulette service makes roughly three trips between Claxton-Hepburn and psychiatric center each week.
If they were transporting patients downstate on a regular basis Mr. Frary said, We would probably have to hire some more people and buy more vehicles.
Patients who are not on Medicaid will have their private insurance companies billed more for the longer commute and those who are uninsured will be handed a more expensive bill.
Mr. Kelly said he has seen a transportation bill for more than $2,100 for a teenager who required ambulance transport to an inpatient facility in Syracuse.
Medicaid fees, which are covered by a combination of county, state and federal money, will likely increase if patients are being transporter further, adding, especially, to the financial squeeze being felt at the county level, Mr. Kelly said.
If they cant pay what are they going to do? he said.
From January to October of 2013 Claxton-Hepburn transported 306 mental health patients to inpatient facilities, primarily at SLPC, Vice President of Clinical Services and Chief Operating Officer at Claxton-Hepburn Medical Center Vicki E. Perrine said. Each of those transports relied upon an ambulette or ambulance service.