Fourth Congressional District candidate, Dr. John Paschen, stopped in Carroll at MC’s Country Café Friday to answer questions about his recently released mental health initiative. The four-part plan involves expanding access to health care, providing federal funds to cover costs, reducing utilization of emergency rooms and implementing telemedicine to reduce expenses. He says mental health is a serious concern in Iowa, and the district’s 36 critical access hospitals are currently unable to handle the issue.
Only 50 to 60 beds are available statewide for in-patient mental health treatment. Paschen’s plan would encourage critical care facilities to open small wards to house patients for a short time. He says this would require hospitals to hire additional staff, and those costs could be offset by the federal government.
Iowa law allows for psychologists with advanced specialized training to administer medication, and using telemedicine would not require a licensed psychiatrist to be on hand for treatment. Paschen, a 57-year-old pediatrician from Ames, is making his political debut with his campaign against Republican representative, Steve King. He faces a crowded field of Democratic candidates: Paul Dahl, of Webster City; J.D. Scholten, of Sioux City; and Leann Jacobsen, of Spencer. Pachen’s plan can be found included with this story on our website.
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PASCHEN’S 4-POINT MENTAL HEALTH CARE PLAN:
Use Existing Critical Access Hospitals. Iowa has 82 Critical Access Hospitals, with nearly half of them located in the 4th Congressional District. Many Critical Access Hospitals are laying off employees and are at risk of closing with additional cuts to Medicaid and the threat of repealing the Affordable Care Act. Since many mental health patients do not require long term care, but rather a place to settle down, get drugs out of their system and receive medication and/or therapy, most patients can use the existing beds in Critical Access Hospitals to satisfy their needs. Paschen believes we should identify regions with mental health care deficits throughout the state and remodel a nearby Critical Access Hospital to accommodate mental health patients. Each remodeled hospital would require 5-6 additional staff.
Feds Help Cover Costs. As a member of Congress, Paschen will work with the federal government to help cover the investment in Critical Access Hospitals. The cost of remodeling the hospitals could be covered by any upcoming national investment in infrastructure funding, including President Trump’s proposed $1 trillion infrastructure plan. The additional hospital staff would require an initial state investment. Ongoing staff costs would be either partially, or fully covered by a guarantee from the federal government to reimburse the new psychiatric patients similar to Medicare patients seen in Critical Access Hospitals – amounting to 100% of costs.
Save Money by Moving Adolescents Out of the ER. Our ER rooms have become expensive child-care for Iowa kids in need of mental health treatment. Paschen believes the Critical Access Hospitals should be open to adolescent as well as adult mental health patients. Opening the hospitals to adolescents can save money by moving kids in hospitals waiting for psychiatric beds out of emergency rooms and into a facility where they care receive quality, short-term treatment.
Use Telemedicine. With advances in our laws and existing technology, each Critical Access Hospital would not need a licensed psychiatrist to administer medication. Medication could be administered by a psychologist with advanced specialized training (signed into law by Gov. Terry Branstad in 2016), or with the guidance of a licensed psychiatrist through telemedicine.
