Hospital feeling budget squeeze

Psychiatric facilities seek to maintain level of services

State hiring freeze

November 30, 2001|By Jackie Powder | Jackie Powder,SUN STAFF

Confronting $1.6 million in budget cuts, Crownsville Hospital Center officials said yesterday that the hospital might have to reduce mental health services to comply with state-required cost reductions.

The cuts - nearly 5 percent of its $33 million operating budget - are on top of other cost-cutting measures that went into effect this year at the 90-year-old state psychiatric hospital.

"With these cuts we have nothing else to pull from," Ronald R.J. Hendler, superintendent of Crownsville, said yesterday at a meeting of the hospital's Citizen Advisory Board. "We really need to have the system bail us out or we need to reduce services."

He did not provide details on what services would be reduced.

Hendler said Crownsville's cuts are among the largest for Maryland's 11 psychiatric hospitals, but it is not alone. More than $9 million has been cut from the operating budgets of the hospitals, said Oscar L. Morgan, director of the state's Mental Hygiene Administration.

"Right now, we basically have a hiring freeze," Morgan said. "We'll selectively hire, mainly staff who work with patients, but not hire administrative personnel."

Spring Grove Hospital Center in Catonsville took a $1.8 million cut, 3.6 percent of the hospital's $50 million budget, said Superintendent William B. Landis. He said the cuts might lead to a reduction in the number of patients.

"We may have to reduce patient census in the long haul and go to limited admissions," Landis said. But he added that "we think we can make it through if there are no more cuts."

The cuts in the psychiatric hospitals' budgets are part of the $87 million in state spending reductions approved this month by the state Board of Public Works in the first round of cost-cutting in a slowing economy. The hospital cuts were based in part on the number of staff vacancies at each facility, Morgan said.

Crownsville had looked for ways to save money this year - including a hiring freeze - to address a $600,000 deficit caused mainly by high fuel costs last winter and maintenance of the facility's antiquated infrastructure.

Hendler told the advisory board that little room remains for further cuts in the operating budget, which includes drugs, clothing and food, "things patients need on a daily basis," he said.

Although Hendler said services might be affected, Morgan, the Mental Hygiene Administration director, said a reduction in clinical services for patients is "not on the table."

"We're looking at nonpersonnel cuts, looking if we can delay purchasing equipment and if there are any cost savings because of the decrease in fuel costs," Morgan said.

Crownsville continues to have a rising demand for services, despite the state's effort over the past decade to place more patients in community treatment settings. With many chronic patients in community-based centers, the proportion of seriously ill or violent patients at the hospital is higher than ever.

Crownsville's budget pays for 185 beds, including 18 juvenile placements - but Hendler said that recently the average patient census has been about 222. He said Crownsville generally has a waiting list of 14 to 24 patients for adult placement and court-ordered psychiatric evaluations.

At the same time, staffing shortages are significant, particularly among nurses.

Of the 215 positions in the nursing department, 45 are unfilled, including registered nurses, licensed practical nurses and direct-care assistants.

"We're meeting minimum staffing in the nursing area," Hendler said. "We were hoping we would be able to pick up our nursing staff."

Also, 77 of the hospital's 534 employees are eligible for retirement this year.

Despite the budget cuts, Hendler said the hospital must not lower standards of care.

"We will continue to admit patients and continue to maintain the safest and most therapeutic environment for patients," he said.

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