Missouri closing several mental health facilities

Friday, April 9, 2010 | 5:08 p.m. CDT

JEFFERSON CITY — Several state-run mental health centers will be closed and about 300 jobs cut as Missouri implements "a major shift" in inpatient psychiatric care that will eventually save the state more than $7 million each year, according to Department of Mental Health Director Keith Schafer.

The reorganization will end Missouri's role in running acute-care mental health units, where people typically are housed for a few days or weeks but not long term.

Schafer said he's hopeful that private and nonprofit hospitals would fill the void, even if it requires they add more beds for mental health patients.

"I am concerned about closing acute care. I wish I didn't have to," Schafer said. "But the realities of the economic times don't support it."

The state bears the full cost of treating patients at its psychiatric facilities, whereas the costs to treat them at traditional medical hospitals are partly covered by Medicaid, Schafer said.

Missouri's tax revenues have been falling for two years, forcing cuts both in the current budget and next year's proposed budget. The state expects even greater financial troubles in 2012, when federal stimulus payments end.

The changes are expected to save $1.5 million in the proposed $23 billion state budget that begins July 1, a small piece of the $506 million in general revenue expenses sliced Thursday by the Senate Appropriations Committee.

About a dozen mental health employees who could lose their jobs protested outside the Capitol with their families Friday, saying they were worried about the well-being of patients who would be transferred or released. Some patients could be affected as soon as July.

"People who may have been doing well for the last couple of years or even months, it may be a big setback for them as far as their rehabilitation or recovery," said Brandy Branson, 23, a nurse at one of the Fulton State Hospital units targeted for closure.

"I'm definitely concerned with the jobs, (but) I'm more concerned with the clients because these people are lost in society," she said.

The Department of Mental Health plans to close short-term care psychiatric units at St. Louis Metropolitan Psychiatric Center and Southeast Missouri Mental Health Center in Farmington.

Those vacated rooms will be filled with long-term psychiatric patients transferred from the Fulton State Hospital. Some mental health patients from around the state also will be released to group homes or other community-based psychiatric services.

The domino effect of closures and layoffs will fall primarily on the Fulton State Hospital, which opened in 1851 and is the oldest public mental health facility west of the Mississippi River.

The changes are projected to save Missouri $7.4 million annually and eliminate about 300 employee positions once fully implemented. The final round of employee layoffs and patient transfers is scheduled for June 2011.

Members of the American Federation of State, County and Municipal Employees, which represents the mental health workers, delivered about 2,500 petition cards Thursday to Gov. Jay Nixon's office asking his administration to find other ways to save money.


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