The state's plan to close Crownsville Hospital Center met its first criticism yesterday, as employee union leaders and the mother of a patient at the 90-year-old mental health facility told legislators that a shutdown would put patients at risk and save much less than officials expect.
"It creates holes in an already shredded safety net," said Paul J. Gentile, president of the American Federation of Teachers Healthcare-Maryland, which represents nurses and other employees at the hospital.
Yesterday's hearing before two House of Delegates appropriations subcommittees marked the first public discussion of the state plan to save money and provide more efficient care by closing one of its "Big Three" mental health hospitals.
Nearly half the hospital system's patients are from the criminal justice system; the other half are uninsured individuals who were committed by psychiatrists. The state system's capacity has dwindled during the past 21 years to 1,204 beds from 4,390.
As a result, the state has for more than a decade considered closing Crownsville, Spring Grove Hospital Center in Catonsville or Springfield Hospital Center in Sykesville. Last month, the state Department of Health and Mental Hygiene responded to a request from the State House and selected Crownsville for closure, recommending the transfer of its patients to other facilities.
The plan would save the state more than $11 million next year, state officials said yesterday. Of that, $5 million would go toward community health service and nearly $1 million would pay for renovations to increase capacity at Spring Grove.
Spring Grove and Crownsville are about a century old and officials at each are seeking about $100 million for renovations. Yesterday, Simon Powell, of the state Department of Legislative Services, called the indecision about what facility to close "the bugaboo that's prevented the state from moving forward with the modernization of the hospitals."
After Powell's presentation, officials lined up to caution the delegates about how to follow through. The legislature will take up the plan in January.
State health officials, noting the possibility of 150 layoffs, warned that the closure would not be painless for employees or patients.
"Do we think we should close a facility? We think it can be done," said Arlene Stephenson, the state's deputy secretary of public health services.
Anne Arundel County government officials said they accept the plan as long as they get money to help laid-off employees and to handle issues related to the development of the hospital land.
Representatives of community health providers said that if their programs don't receive adequate money, patients will be unable to leave the state hospitals because they won't have anywhere to go.
Officials from other mental health groups advocated that all of the savings should be spent on mental health.
"We're very afraid if the money doesn't follow the consumers to the community, they'll get sick again," said Janice Brathwaite, the president of On Our Own Maryland.
They also said the state should add capacity to its hospital system so that patients don't have to wait in jails or emergency rooms for an open bed.
Gentile, the union official, said the projections of more than $11 million in savings don't take into account costs such as early retirement programs for affected employees and extra treatment for adversely affected patients.
Sandra Solomon, a retired school psychologist whose son is staying at Crownsville after suffering a head injury in a car accident, said she tries to visit him every day. She said she is crucial to his treatment. Solomon scolded state officials for discussing the number of beds at the facility.
"Those beds," she said, "have names, faces and families."