Plan to downsize hospitals gets support

8 psychiatric facilities would remain open, cut patient size, panel told

August 04, 1999|By Greg Garland | Greg Garland,SUN STAFF

The Glendening administration's plan to keep all eight of Maryland's psychiatric hospitals open -- but with fewer patients and staff -- got a favorable reception from a legislative committee yesterday.

Mental health advocates who have pushed to close some of the hospitals endorsed the proposal, which would shift resources to community-based programs as the hospitals are downsized.

The General Assembly directed the state Mental Hygiene Administration last year to review its facilities and develop a plan for downsizing, consolidating or closing some of the state-run psychiatric hospitals.

Oscar L. Morgan, director of the agency, told the House Environmental Matters Committee yesterday that the plan represents a "systemwide approach" aimed at improving mental health services while keeping costs down.

The proposal calls for reducing the average daily population at the hospitals by 310 people over the next five years, from the current level of 1,380. About 450 staff positions would be eliminated through attrition.

The plan calls for pumping $57 million into community-based mental health programs during that period. Part of the money would come from $17 million in savings from scaling back hospital operations.

The plan also recommends that much of the land and some buildings on hospital campuses be sold to private vendors or transferred to other state agencies. The campuses have 279 buildings on 2,515 acres, although only 172 buildings and 1,567 acres are used for inpatient services.

Terry S. Bohrer of the Mental Health Association of Maryland, a nonprofit citizens group, told legislators that keeping all of the hospitals open, while downsizing them and putting more resources into community programs, is a sensible approach.

Although Bohrer's group had backed a 1995 task force recommendation to close one of the three largest hospitals -- Crownsville, Springfield or Spring Grove -- she said the "landscape has changed considerably" since then.

She noted that admissions to state-run hospitals have risen 14 percent over the past year, while managed-care practices have dramatically decreased the length of stay for mental health patients in private hospitals.

Group's support

The downsizing plan also won the endorsement of the Maryland Association of Psychiatric Support Services, which represents a network of community-based service providers. The group previously pushed for closing one of the hospitals, but said it is pleased because the plan has a similar goal of shifting more resources from hospitals to community-based programs.

"We strongly support the Mental Hygiene Administration's downsizing plan as the least we should do to make our state's public mental health system more responsive, accessible and cost-effective," said Herbert S. Cromwell, the group's executive director.

In preparing the plan, a committee of the state agency had recommended changing one of the smaller state hospitals in Chestertown from an acute-care psychiatric facility to one serving people with a combination of substance-abuse problems and mental illness.

But the agency rejected that after protests from legislators representing the area, hospital workers and others. Morgan said psychiatric hospital beds need to remain in Chestertown to serve the Upper Shore region.

For the most part, legislators had no criticism yesterday of the agency's decision to not recommend closing the hospitals. Some said they worry the downsizing would go too far in releasing people with serious psychiatric problems into the community.

`In the right direction'

Del. Ron Guns, an Upper Shore Democrat who chairs the House Environmental Affairs Committee, said he wants to make sure that money is allocated to strengthen community programs.

Overall, he said he likes the plan.

"I think it's a step in the right direction," Guns said.

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