Plans are under way to open a long-term health care unit at the Francis Scott Key Medical Center for AIDS patients, who often have no where else to go and get misplaced in costly acute care hospitals.
The Seton Hill Manor Nursing Home in West Baltimore now is the only place in the state that provides care for chronically ill acquired immune deficiency syndrome patients, who continue to grow in number.
Officials of the Johns Hopkins Health System -- which runs Johns Hopkins Hospital and the Francis Scott Key Medical Center -- confirmed reports yesterday that they are working to establish a 16-bed unit for AIDS patients at Key, which is licensed for both acute and long-term care beds. But, no one could say when the unit would begin accepting patients.
The proposed unit is expected to provide care for a population that is "too sick" to care for itself at home because of debilitating episodes of the incurable disease but is not sick enough to require around-the-clock medical attention.
"The cost of hospital care is half the problem," one Hopkins AIDS specialist said. "The rest is that these are people who don't belong in a hospital, but are stuck there because they have no place to go. It drives them crazy to be in a hospital where everyone is sick."
For the past three or four years, Hopkins AIDS experts urgently have been calling for the development of programs that are alternatives to acute care and its escalating price tag. And, they have been wondering publicly why a state with a perceived excess of several thousand beds can't find chronic-care beds for AIDS patients.
According to a statement released this week by Marian Glick, a Hopkins spokeswomen, discussions are continuing between the JHHS, the Maryland Health Services Cost Review Commission -- the state agency that sets hospital rates -- and the state health department's division of licensing and certification. The talks "pertain to licensure and reimbursement issues of running the proposed unit," the statement said.
The staff of the Johns Hopkins Hospital AIDS Service will provide the medical management for the proposed unit, the statement said.
Lorraine Raffel, owner and operator of the Seton Hill Manor Nursing Home, who opened her doors to four AIDS patients in 1985 and now cares for 57 patients, said that within a period of 15 months during 1988 and 1989, she was able "to save the state over $1 million."
She said she was able to do that because she provided care for AIDS patients at a much lower rate than hospitals. "During that 1988-99 period, the hospitals were charging $900 a day for AIDS-patient care," she said. "I was providing it for under $150 a day."
The state reimburses Seton Hill from its Medicaid funds that are matched by the federal government on a 50-50 basis, said Raffel, who also runs two other nursing homes.
When Raffel responded to the state's call to help care for AIDS patients, Seton Hill became the first private nursing home in the state to announce its willingness to care for AIDS patients.
In 1985, only 246 cases of AIDS had been reported to the state health department. "Now, the need for AIDS patient care is growing," Raffel said. "If you look at the statistics you will see that so far in Maryland about 3,200 people have been diagnosed with AIDS. This is a fast-growing population."