Pubdate: Tue, 14 May 2002 Source: Journal News, The (NY) Copyright: 2002 The Gannett Company, Inc. Contact: http://www.nyjournalnews.com/ Details: http://www.mapinc.org/media/1205 Author: Meredith Carey Bookmark: http://www.mapinc.org/rehab.htm (Treatment) FDR HOSPITAL CLOSES DRUG ABUSE UNIT MONTROSE -- A substance-abuse program for the mentally ill at the veterans hospital will close its doors today. Hospital administrators at the FDR campus of the VA Hudson Valley Health Care System last week said the unit has repeatedly failed to meet its goals and that they were shutting it down in accordance with union guidelines. Administrators could not be reached yesterday to elaborate on the unit's shortcomings. The last two patients in the unit have completed their program but will remain in the hospital, moving to the next phase of treatment, a hospital spokeswoman said. Between January 2001 and February 2002, the unit for the mentally ill and chemically addicted served 262 patients. Several employees of the MICA unit are questioning the hospital's motivation in shutting it down. They say they are caught in the middle of an internal dispute between the unit's head nurse and the administration. All 21 unit employees are being transferred to new positions either at the Montrose hospital or the Veterans Affairs campus at Castle Point in Dutchess County. A union representative said that even though they have lost the fight to keep the MICA unit open, negotiations with the hospital over the workers' job placement and security are continuing. Administrators said their decision was not fueled by any labor issue but a desire to overhaul the entire residential substance abuse treatment program at Montrose. The residential treatment program is made up of four components. In addition to the MICA unit, there is a program designed for patients whose primary problem is chemical addiction but who also have psychiatric issues. There is also a post-traumatic stress disorder unit and a program that helps homeless veterans find employment and housing. Administrators plan to combine existing services into one program. The new program will better assess each individual and design treatment based on his or her needs. For example, under the current program, each unit offers an anger management class. Under the new program, patients will find anger management classes tailored for those just starting out and for those who are further along in their recovery, said hospital spokeswoman Nancy Winter. Winter said the hospital is making the changes because patients have asked for more individual care. In addition, doctors and administrators at Montrose decided on revamping their program after visits to a VA hospital in West Haven, Va., and other programs serving troubled vets, Winter said. She said they were using a "treatment mall" model -- one large central treatment program with many smaller, boutique-like programs inside it -- that hospital administrators wanted to bring to Montrose. The new program also is in response to the difficulty veterans have been experiencing in making the transition back into their communities once they completed residential treatment, said Montrose hospital director Michael Sabo. "Folks get attached to the institution and are not able to go out in the community," Sabo said at a meeting with administrators last week. "This change will give them the appropriate coping tools." The new program will have psychiatric, psychological, educational, vocational and spiritual components. Treatment teams will coordinate the patient's recovery plan. The program will be located in Building 12, administrators said. The MICA unit was housed in Building 13. "It will give us flexibility of treatment," said Dr. Joseph McFadden, manager of mental health care services for the Montrose hospital. He is overseeing the program's reorganization and will manage it once it is completed. "It will create an environment more conducive to reintegrating people back into society," he said. The hospital's residential program will continue to operate during the reorganization, which administrators expect to complete during the summer. A relatively new economic reality facing all VA health care agencies in the Northeast is a decrease in federal dollars, said Jerry Donnellan, a veterans advocate who is director of the Rockland County Veterans Service Agency. "We in the Northeast lost about 15 percent of our budget about five years ago," Donnellan said. "We receive less money, and the cost of living is higher here." Donnellan said that alcoholism is 2.5 times more prevalent among the country's 26 million veterans than in the general population. He estimated that 20,000 veterans are in Rockland, 70,000 in Westchester and 7,600 in Putnam. "They are having to do more with less. They have health care needs that they have to treat," Donnellan said. "Programs that seem less of an emergency are probably going to get a smaller share of what's there." Winter, the hospital spokeswoman, said the changes at Montrose are in no way tied to budget constraints but acknowledged that the hospital receives less money than it did several years ago. - --- MAP posted-by: Jay Bergstrom