A man named Tripp faces an unexpected deadline in his struggle to pull himself out of a life of drink and drugs.
Tripp, 46, is being treated at Fayette House in Baltimore, one of 17 halfway houses and scores of other residential addiction treatment centers across Maryland that have lost funding in the state's emergency budget-balancing act.
Barring an infusion of money from another source, Fayette House will close Dec. 1. And Tripp and many other recovering addicts may find themselves back where they were before being referred to a state center for treatment.
"The only thing I have to do to keep from dying on the street is to revert to being a criminal," said Tripp, who declined to give the rest of his name. He pondered his future from the Fayette House living room, which looks out on the corner of Baltimore and Monroe streets.
It could have been worse. The state originally had planned to chop $88 million from the Maryland Department of Health and Mental Hygiene, including $12 million from the drug and alcohol program. That would have eliminated state financing of all residential treatment centers.
But in a deal reached earlier this month to cut the health budget by $61 million, drug and alcohol treatment centers recovered about $4 million, said Michael Golden, a spokesman for the health department.
Local government health agencies learned last week that the money recovered will go toward partially restoring the budgets of nine out of 10 intermediate-care treatment centers in the state.
The intermediate care programs provide 28 days of residential treatment and counseling to prepare an addict to re-enter society. They were retained in the state's spending plan because "that's the biggest need," Golden said.
The state still intends to stop all funding of its halfway houses, detoxification programs and long-term residential care centers, except for one long-term program in Montgomery County.
Detoxification is the process of ridding the addict's system of drugs and alcohol. A halfway house is for an addict who has already undergone some treatment and who is ready for possibly a year or more of job training, work and education while living in supervised quarters. Long-term care is for clients with continuing mental or physical ailments, perhaps caused by their addictions, who might require further residential care.
As detoxification centers close, an addict might go to a hospital for such treatment, Golden said, and from there, to intermediate care.
Many halfway houses and long-term treatment centers that were previously funded by the state are expected to close. The Baltimore Recovery Center's detoxification unit,
which served 1,000 people last year, has already closed because of the loss of $424,635 from the state, according to William Hathaway, executive director.
Such closures, coupled with cuts in medical assistance for drug detoxification, mean that addicts seeking detoxification will go to hospital emergency rooms in severe withdrawal "so that the hospital cannot turn them away," Hathaway said. The expense to hospitals and their rate-payers will be huge. Baltimore Recovery Center costs $105 per day, he said, compared with an average of $450 per day in a hospital.
Outpatient clinics, which were never up for elimination, will continue to get state money, but less of it.
The loss of more than $63,000 at EPOCH House, an outpatient treatment center with four branches in Baltimore County, will mean shrinking the program by about one-third, said John Ramsay, its director. EPOCH, which treats about 525 people, will lose six counselors, he said, and addicts seeking treatment will have to wait twice as long to get in, possibly a month or more.
Many local governments are still deciding whether to make up for the loss of state funding.
In Harford County, where a halfway house is losing state money, county officials are trying to figure out how much of the total loss HTC of state aid to all areas of government can be covered by the county's $9.8 million surplus from fiscal 1991.
In Anne Arundel, County Executive Robert Neall announced a plan last week to cut employee salaries and reorganize management to make up for current and future cuts in state aid. Of those savings, about $150,000 will go toward covering the loss of state money for county addiction treatment centers.
Anne Arundel's three halfway houses and one long-term care center will be asked to share that $150,000 to "buy them some additional time," said County Health Officer Tom Andrews. "Some could limp along for another few weeks, or consider conversion of staff to volunteerism."
If the centers have to close, the idea is to provide "a more rational approach to making a discharge plan for each client, rather than putting them out on the street on Nov. 30," he said.
In Carroll, Deputy Health Officer Larry Leitch expects that the total loss of state funds for a detoxification unit and a long-term care center will close them because the county is unable to help.