Gov. Martin O'Malley's proposed 2013 budget aims to close the assisted living unit at Springfield Hospital Center in Sykesville, where 40 patients currently live and 40 employees currently work.
But the plan doesn't leave either group out in the cold, health officials said.
The patients will be transferred to private facilities and other living arrangements in the community, with the cost of their housing and care services still provided by the state, if needed, said Brian Hepburn, executive director of the Mental Hygiene Administration, which oversees the state's public mental health system.
Under the proposal, the assisted living facility would be the only operation closing at Springfield Hospital.
Other operations at the campus in Sykesville, which had more than 300 psychiatric beds budgeted by the state in 2009, according to a 2010 report by the Maryland Health Care Commission, will continue.
Employees of the assisted living center will be shifted into other, currently vacant positions in the state's mental health system, mostly at Springfield but possibly at Spring Grove Hospital Center in Catonsville, or Clifton T. Perkins Hospital Center in Jessup as well, Hepburn said.
"There will be no layoffs. They will all be absorbed into vacancies," Hepburn said.
"The overall impact on patients and employees, you can say it's neutral," Hepburn said.
"There're some people who would say there's a big benefit," he said.
The assisted living unit at Spring Grove, which currently has 48 patients and 21 employees, will also be closed under the governor's proposal.
Together, the closures will save the state $3.8 million, according to the governor's office.
About $1.1 million of that savings will be diverted directly into the budget for community care funding, which will be tapped for a variety of services in the care of those patients who will be displaced from Springfield and Spring Grove, including renter subsidies for patients who find independent living situations, Hepburn said.
That funding will remain in the state's mental health budget moving forward, for future patients, Hepburn said.
Placement in the community
Aside from diminished state overhead and employee costs at the hospitals, the federal government will also provide matching funding for some community placements, which would further offset the cost of patient care to the state, Hepburn said.
Community-based state support for mental health patients is what advocates recommend, and is in line with a trend toward deinstitutionalization of patients in favor of community placements, home-based services and treatment at community hospitals, state health officials said.
"It's a sound approach," said Dr. Joshua Sharfstein, the state's health secretary. "…Not only for Marylanders as patients, but for Marylanders as tax payers."
What the transition will look like – and how rapidly it would occur – is to be determined, officials said, but will involve the health department working directly with the hospitals, Carroll County's Core Service Agency, which is the local authority responsible for mental health services, and private care facilities, Hepburn said.
"It's really going to be a very individualized decision for all the patients," said Sarah Hawkins, head of the county's Core Service Agency.
Hawkins said she expects many of the patients will do well in the community, though they will lack the immediate access to more intensive hospital care, should they need it, that they enjoyed at the assisted living unit at Springfield.
Hawkins, whose agency already works to place patients coming out of Springfield in the community, said there are not many available resources in the county, especially 24-hour care options, so placements will need to occur in other local jurisdictions.
Any decision on how to utilize the space vacated by the assisted living unit would be made following the transition of patients, Hepburn said.
Hearings on the Department of Health and Mental Hygiene's budget are scheduled in the Maryland Senate on Feb. 10 and the House on Feb. 13, in Annapolis.