DMH could lose 160 in-unit beds
Worcester spared in new plan
By Lee Hammel TELEGRAM & GAZETTE STAFF
Under the administration’s budget proposal for next fiscal year, 160 beds in state Department of Mental Health hospitals would disappear without allotting new dollars for services in communities to which patients would be discharged, DMH Commissioner Barbara Leadholm acknowledged.
While 626 beds in DMH continuing care facilities would decline to 466 after the proposed cut, Ms. Leadholm said plans for the new Worcester State Hospital will not change. State officials have said the $302 million, 430,000 square-foot hospital now under construction, with private rooms for 260 adults and 60 adolescents, will be substantially complete by March 2012.
Other DMH inpatient beds are in Taunton, Tewksbury and Boston.
Ms. Leadholm said planning is under way for how the bed reduction would be accomplished and from which facilities.
The governor’s proposed budget is the first step in a process that includes budgets proposed by the House, the Senate and a conference committee. In past years, the Legislature has not felt bound by the governor’s proposal. But next fiscal year’s $1.2 billion budget gap, brought on by the end of federal stimulus funds, has created a new tone.
State Rep. Vincent A. Pedone, D-Worcester, said he is concerned about reducing hospital beds without adding community resources, and about a “gap in the safety net” because of reduced funding. But “as we start up the budget deliberation, the revenue numbers and available funds may not allow us to do the things we want to do,” he said. “The reality is that we have a serious budget deficit on our hands.”
Advocates for people with mental illness and agencies that serve them are appalled by the state administration’s proposal to cut $21.4 million from the DMH budget in fiscal 2012, which begins July 1.
“The cut to the Department of Mental Health is an unsustainable cut that I would say all of us in the mental health community call upon the Legislature to overturn,” said former DMH commissioner Marylou Sudders.
Ms. Sudders, president and chief executive officer of the Massachusetts Society for Prevention of Cruelty to Children, was chosen by the DMH to co-chair a commission two years ago to recommend ways to reduce the number of inpatient beds to deal with difficult financial reality.
She said Tuesday that DMH’s plan “totally violates the spirit of the commission that Jim Brett and I co-chaired. That commission said that in order to appropriately close beds for individuals ready to be discharged, you have to have community services available to them in the community.” The state’s budget-cutting, falling disproportionately on DMH, “will leave people with mental illness at risk in the community.”
Indeed, some community services would be cut. DMH plans to cut $3 million from its $19 million psychiatric rehabilitation clubhouse account. Clubhouses, which supply access to mental health and other health care, jobs and other forms of support, are one of the last day treatment programs to survive DMH cuts two years ago.
Also, $2 million would be cut from services to emotionally disturbed children and adolescents and their families.
Kevin L. Bradley, executive director of the 700-member Genesis Club in Worcester, said DMH provides 70 percent of the clubhouse budget. A cut could mean putting people on a waiting list to get in, instead of the current open enrollment.
The National Alliance on Mental Illness of Massachusetts is concerned about the impact of 24 percent of the DMH’s inpatients entering the community.
“They are presumably the ones who need the most care” if they are discharged to the community, said Ross W. “Guy” Beales Jr. of Fitchburg, president of NAMI statewide and its North-Central Massachusetts chapter.
“Even if all 160 people are ready for discharge to a less intensive level of care, they will displace other consumers who are in supportive housing” in the community, he said.
Ms. Leadholm said she cannot say what the effect will be before plans for the budget cuts are complete. It’s difficult to say because the intensity of services needed by each individual varies, and each person discharged from a hospital will get an individualized service plan, she said.
There are 100 to 150 people in the hospitals identified as ready for discharge, according to the commissioner. Also, there will be less need for hospital beds, she said, because “with the recovery model, many people are able to live in the community and may not ever come into the hospital,” although they would have needed to under department practices two years ago.
“You have to talk about recovery, the community system that exists, and other alternatives,” Ms. Leadholm said.
Alternatives Unlimited, a $35 million Whitinsville-based nonprofit, provides a great deal of the community-based flexible programs funded by DMH in Central Massachusetts. Executive Director Dennis Rice said that model of program can provide some day activities for people with mental illness in group residences or their own apartment, “but not nearly the structure that a clubhouse could provide.”
Rep. James J. O’Day, D-West Boylston, a member of the Mental Health and Substance Abuse Committee, said the DMH is taking a disproportionate hit in the budget.
“People who were hoping to be in a community bed will be out on the street,” he said, “putting thousands of people at risk.”