Country Haven to close after today

CORNING — The only facility that offers residential care, including mental health care, in Corning will be closed after today.

Country Haven, a residential care facility that provides care for individuals with intellectual disabilities, mental health issues or physical care needs, will close its doors. The residents currently at the facility are being transferred to new facilities or living situations based on their care needs, while staff members have been offered new employment opportunities.

“The goal whenever individuals come here is to get them to a stable means of maintaining their conditions so they can move back out into society as more capable individuals,” said Rene Lauer, administrative assistant at Country Haven.

Some individuals may have been in a traumatic accident and only require physical help until they are recuperated, while others have been at the facility for decades because of a physical or intellectual disability.

All of the residents have found new residency, whether in a community-based residential care facility outside of Adams County or home-style apartment situation in Corning.

Mental health

A main source of the closure comes from the new mental health care regulations across the state of Iowa.

“Due to a lot of the regulation that’s come about regarding mental health care in the state of Iowa, we’ve been struggling recently with expenses due to the different pay scenarios through Medicaid and it’s recent privatization,” Lauer said. “We’ve been trying to change around different avenues of how we provide services, but that has been quite a challenge to do within the constraints of how the Department of Inspections and Appeals, which is our governing agency, requires RCFs to provide care. So, we’ve just come to a point where we can no longer financially sustain this nature of a business.”

The privatization of Medicaid, which occurred in April 2016, made it so services were funded by managed care organizations instead of the previous state-managed Medicaid office. Lauer said this caused problems with correct assessments of individuals’ level of care

“We’re having some difficulty with, I think, the individuals who are trying to oversee the financial aspect of providing Medicaid, and there’s a conflict with the individuals who are trying to determine the best needs-based scenario for each individual,” Lauer said. “The cost for providing for some of the needs of the individuals is not matching up with what they believe the cost should be. So, what that’s doing is limiting the services that are available to the folks who either formerly had services or are really struggling to get on services.”

Additional challenges included lagging times for payment of services causing a substantial amount of providers of mental health to no longer be in business, as well as new case managers who don’t know their clients.

When the Clarinda and Mount Pleasant mental health institutes closed in 2015, Lauer said, Country Haven was affected because the facility lost two avenues to turn to when individuals had an advancement of their mental condition, making them aggressive or destructive.

“While, a lot of the times in the news media, they’re reflecting that’s a big savings for the mental health industry, overall our society isn’t saving because now you’re driving those individuals to go to emergency rooms who are not definitively trained for mental health crises,” Lauer said.

Lauer also said individuals could end up in a jail setting until proper placement is found, which could be detrimental to the individual.

Emergency room

Megan Shatava, LPN and social worker at CHI Health Mercy in Corning, said the hospital is not equipped to treat mental health patients.

“We don’t have an on-site psychologist or psychiatrist, so, a lot of the times, what we see is it’s getting a lot harder and harder to get placement for people, especially for people who come in with a behavioral issue,” Shatava said.

For these patients, who would otherwise put strain on an emergency room, CHI developed a volunteer committee to stay with mental-health patients until such placement is organized. These volunteers have had continuing education hours to prepare them in the case of a self-harming patient or one who might harm others.

“Unfortunately for a lot of people, they don’t have room, and those people are here so we try to care for them as far as medically,” Shatava said. “Then there are times that they are discharged to a family member or whoever their caseworker is.”

Shatava also said she believes that organizing patients from a residential care facility to the open community could be detrimental if those patients have not had the experience of the outside world.

“I believe that a lot of the people that they’re trying to get placed in homes within the community where they’re not as supervised, a lot of those people who live out there have been institutionalized and they don’t know how to live in the world,” Shatava said. “They are more used to being around people and being told what to do, how to act. It’s very structured, and we anticipate people who are just put out in the community.”

In the end, any influx of patients is all dependent on the different individuals’ needs of care, which Country Haven employees believe can be implemented by CHOICE Inc. staff.

What happens next

After it was decided to close Country Haven, a 60-day notice was sent out to employees, clients, families and affiliated providers. Since then, current staff members have been working to relocate individuals based on their current levels of care, whether that is to the community-based care housing in Corning or another facility in a different community.

CHOICE Inc. is a community-based health-care housing situation for those who need supervision throughout the day. Staff members can monitor clients for several hours or a full 24 hours, depending on their care needs.

The homes allow the individuals to rent a room and be more independent, with less structure. The individuals must maintain hygiene of the space, purchase their own groceries and cook for themselves. If an individual needs assistance in any aspect of daily living, however, it is available.

“It gives them much more of a home environment so it doesn’t feel as facility based, as many rooms down a hallway, so they have their own individual rooms,” Lauer said. “There’s a lot more consumer involvement in the communities.”

While this works for some people, others will need a higher level of care.

“Even though our state has this drive that everybody should be integrated into the community, that setting doesn’t fit everyone. So, it’s kind of like knocking a square peg into a round hole,” Lauer said. “There are always going to be individuals who are going to need a higher level of care and there are fewer and fewer opportunities for that.”

Also, staff members received the opportunity to transition to CHOICE Inc. as well, some taking advantage of the employment to maintain care with the individuals. Others, however, chose to pursue other paths of employment.

Meanwhile, the building and property Country Haven stands on is owned by the county, and Lauer said she is unsure what will happen to it once the facility is vacant.