A medical-management group newly affiliated with the Johns Hopkins Health System wants to build a new hospital in Harford County, but close one of the county's two existing hospitals and sharply cut services at the other.
The proposal, outlined in an application earlier this month with state health-care regulators, would roughly halve the county's licensed hospital beds, from 494 to 250.
Fallston General Hospital, labeled "obsolete" in the proposal, would be closed, and Harford Memorial in Havre de Grace would lose all but 100 of its 275 licensed beds, including its pediatric and obstetrics units.
A new $44.8 million hospital, with 150 beds, would be opened near Bel Air, on the Route 24 corridor between Interstate 95 and Bel Air, central to the heavily populated southern part of Harford County.
But the proposal by Upper Chesapeake Health System, the parent company of the two hospitals and a group of family-care centers, has touched off controversy among the county's residents and its medical community, particularly over the fate of Harford Memorial, an 83-year-old Havre de Grace institution.
Exemplifying the growing partisanship, pickets gathered outside a physicians' conference Wednesday in Edgewood with signs reading "Save Our Hospital," "Say No to Less Service" and "Hands Off Harford."
Dr. Louis Silverstein, a family practitioner in Havre de Grace and president-elect of the Harford County Medical Society, said the proposal would "cripple" Harford Memorial and the surrounding community.
"If you take 200 jobs out of Havre de Grace, you're going to do substantial harm to the community, and if you cut the [medical] beds to 75, you make it inefficient to do business here," he said.
He fears that ultimately the hospital will be closed because providing services to a limited number of people would not be cost-effective.
The Johns Hopkins Health System and the Hopkins School of Medicine announced an alliance with Upper Chesapeake in June in the first of a planned series of affiliations with community hospitals outside Baltimore.
The application filed with the Maryland Health Resources Planning Commission on July 13 specifically requests an exemption from the state's requirement for a Certificate of Need for the consolidation project.
Allan Acton, vice president for planning at Upper Chesapeake, said the Certificate of Need is a "long and cumbersome bureaucratic process that can allow projects to be tied up for years."
Opponents of the move say the exemption would free the owners from participating in an evidentiary hearing at which Upper Chesapeake would have to justify the reorganization and document the needs of current and projected populations.
Cathy Green of Edgewood, who was among the pickets outside the physicians' event at the Richlin Ballroom on Wednesday, said she objected to the plan to move pediatrics and obstetrics out of Havre de Grace.
"We don't need a [psychiatric] ward; we need room for these little guys to be born," she said, as she held her 2 1/2 -year-old grandson.
Upper Chesapeake already has state permission to transfer Fallston's psychiatric unit to Harford Memorial. In the latest proposal, 25 of Harford Memorial's 100 beds would be held for psychiatric patients.
Mr. Acton said the new 150-bed facility would provide acute inpatient care, a medical office complex for doctors, an outpatient and ancillary service area and emergency room.
He said the proposal calls for a 64 percent reduction in bed capacity at Harford Memorial because "we don't use what we have." He said Harford Memorial had an average daily occupancy of 93 in 1993.
He said a recent Gallup Poll of 500 households in Harford County indicated that four of five consumers would use a hospital if one were developed on Route 24 between Interstate 95 and Bel Air.
Critics, such as Dr. Silverstein, disagree with Mr. Acton's numbers. "Our bed census in the summer is 90 to 100," he said, but in the winter it increases to 130 to 140."
Eli Silverstein, a department store owner, said the cuts would have "dire financial impact" on Havre de Grace because "many doctors will follow the hospital to Bel Air."
"If Fallston is bad and they want to build a new hospital, fine, but don't de-license beds at Harford Memorial," he said. "It's like having two children and taking services away from one to serve the other."
Mr. Acton said Upper Chesapeake does not intend to close Harford Memorial.