State looks at closing psychiatric hospital

Crownsville among three large, underused facilities

February 02, 2003|By Ryan Davis | Ryan Davis,SUN STAFF

State officials are again looking at closing one of the state's three major Baltimore-area psychiatric hospitals, and 90-year-old Crownsville Hospital Center has emerged as an early target.

Gov. Robert L. Ehrlich Jr. released a capital improvement budget last month that would delay funding for the construction of a new Crownsville hospital until 2007. State health officials as high-ranking as the interim director for the Mental Hygiene Administration had expected the project to be funded in the fiscal year that begins July 1.

Also, a state budget analysis given to local legislators recommends closing the north Anne Arundel County hospital and moving its patients to other facilities across the state.

Faced with a $1.2 billion budget gap next year, Ehrlich and legislators are looking at consolidation of mental health services to save money.

Dick Bandelin, deputy director of the Mental Hygiene Administration, said the deficit has created an urgency that might allow oft-considered consolidation to take place this year.

"We're really trying to figure out a way we can get away with two major hospitals, instead of three major hospitals," Bandelin said.

Twice in the past 15 years, state task forces have recommended shutting one of the state's three largest hospitals -- Crownsville, Spring Grove Hospital Center in Catonsville and Springfield Hospital Center in Sykesville. Each time, a lack of support from unions, residents near the hospitals and local leaders doomed the plans.

But across the country, states facing fiscal woes are turning to their already shrinking mental health systems for more savings.

"We've reduced down and we've reduced down," said Dr. Brian Hepburn, interim director of the Mental Hygiene Administration. "Now it's time to take the next step and see if we maintain good clinical services on fewer campuses ... and save money."

"I would be surprised if we didn't come out of this session with a concrete recommendation regarding the consolidation of some facilities."

The state psychiatric system is composed of eight adult psychiatric facilities (including the "big three" hospitals) and three adolescent treatment facilities. To be admitted, a patient must be funneled through the criminal justice system or be uninsured and committed by two psychiatrists. The system is full.

During the past 20 years, the system's capacity has dwindled to 1,350 beds from 4,000, as treatment drugs and community mental health sites have emerged.

Although the system shrank, state officials shut down only one hospital, Highland Health Psychiatric Unit in Baltimore. Hospitals -- especially the big three, which were built as large asylums -- vacated most of the buildings on their sprawling campuses. Spring Grove once held 3,400 patients; now it has 270. Springfield has 275 patients and Crownsville has 210. The hospitals have relinquished some of their land and buildings to other governmental operations and nonprofit organizations, but they remain relatively small facilities surrounded by hundreds of acres.

Spring Grove has 54 buildings on 189 acres; six buildings are vacant and 12 are leased to other groups. Springfield has 54 buildings on 392 acres; 22 buildings are vacant and nine are leased. Crownsville has 43 buildings on 633 acres; six buildings are vacant and seven are leased.

"There are these huge campuses where you have not a lot of people, and it really doesn't make a lot of sense to keep these huge facilities running, when you can consolidate," said Del. Peter A. Hammen, a Baltimore Democrat and vice chairman of the Health and Government Operations Committee.

It's unclear how much could be saved by closing one of the three largest hospitals, officials said. Each is in need of serious repairs. Lawmakers have been reluctant to fund improvements at all three.

This time around, Crownsville is being studied the closest, Hammen said. It is the smallest of the three and, even though it is the youngest at age 90, is probably in the most disrepair. Bandelin said jokingly last week that it's probably visible from a plane because of the leaky steam-heating system.

Ehrlich spokeswoman Shareese N. DeLeaver said the governor is not targeting Crownsville, but noted of the delay of funding for a new hospital: "We have more pressing fiscal needs at this point."

The only plan that has emerged so far is the budget analysis obtained by The Sun after a Jan. 24 meeting of the Anne Arundel County legislative delegation. It recommends closing Crownsville, a facility for juveniles in Southern Maryland and one of two smaller facilities -- Walter P. Carter Community Mental Health Center in Baltimore or Upper Shore Community Mental Health Center in Chestertown. All patients would be transferred to existing sites.

State budget analyst Simon G. Powell wrote the report in response to an inquiry about potential ways to save money from Del. Robert L. Flanagan, a Howard County Republican.

Even though closing Crownsville would be the easiest option, the report states, Spring Grove would be the most desirable property to sell. It borders University of Maryland, Baltimore County and Interstate 695.

Del. David G. Boschert, a Republican who represents the district that includes Crownsville, said he will fight, but he doesn't expect the hospital to close.

Mental health advocate Frank Sullivan -- executive director of the nonprofit, state-funded Anne Arundel County Mental Health Agency Inc. -- said closing Crownsville would have a negative effect on local patients.

"It's wonderful to be able to put our people in the hospital near their families," he said. "Do you know how hard it is for families when somebody is hospitalized miles and miles away from home?"

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