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The Minnesota Department of Health is backing the construction of a mental health hospital in St. Paul, but has also raised concerns about the project.

A partnership between Fairview Health Services and Acadia Healthcare will finance and operate a new facility licensed for 144 inpatient beds at the former Bethesda Hospital site in St. Paul, near the Capitol. According to the proposal, the new hospital would replace services that were formerly provided by Fairview Health Services at St. Joseph's Hospital.

The total cost for construction of the new facility is estimated around $62 million.

On Monday, MDH said that moving forward with establishing the hospital is "in the public interest" due to a lack of inpatient mental health beds during a wider "bed capacity crisis."

However, MDH said there remained some concerns to address. 

Chief among those is despite the claims by Fairview and Acadia that the new standalone hospital would replace the services offered at St. Joseph's – which Fairview closed in June, MDH said this isn't the case.

The department expects "significant" inpatient care gaps that other providers will have to fill. MDH says the clinic lacks an emergency department for receiving patients who are undergoing a mental health crisis. Due to the facility not offering a full medical care, it will only serve a subset of mental health patients.

Additionally, the facility is expected to operate with less staff from the standard set nationally and elsewhere in the state.

“The public review of this proposal shows how much need there is for additional mental health beds in Minnesota,” said Commissioner Jan Malcolm in a statement. “As we seek to address the acute shortage we are facing, we hope this review highlights the need for policy makers, health care organizations, mental health care providers, employers and insurers, and patients to work on solutions to fully meet the state’s mental health needs.”

MDH surveyed mental health care stakeholders and the general public through presentations, letters and a public meeting held this summer. Among the main concerns on the proposal are:

  • The hospital will serve only a subset of the patient population based on diagnosis and potentially lower care needs, and the staffing plan at the proposed hospital is much leaner than other inpatient mental health units in Minnesota
  • Most of the increased patient load from the closure of the emergency department and beds at St. Joseph's Hospital had already been absorbed by surrounding hospitals. It will place a strain on emergency rooms and inpatient mental health units.

The state currently has six Community Behavioral Health Hospitals that provide short-term inpatient psychiatric care, according to MDH. 

The Bethesda Hospital was shut down in October 2020 as part of a series of cuts, which followed a period in which it was temporarily used as a COVID-19 facility following the onset of the pandemic in March 2020.

It came after Fairview announced losses of $163 million for the first six months of 2020.

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