Heads of two psychiatric units prepare for closing

JEFFERSON CITY, Mo. -- Superintendents of two mental health facilities targeted for partial closing under Gov. Bob Holden's budget plan are moving quickly to prepare for the July 1 shutdowns.

Legislators could spare the units -- a 12-bed children's psychiatric center in St. Joseph and a 16-bed skilled-nursing center in Marshall -- by rejecting Holden's proposed cuts in the Department of Mental Health.

But the hospitals' administrators began planning for the closings within hours of Wednesday's release of Holden's budget for the fiscal year that starts July 1.

Some details of the budget's likely effects on the Department of Mental Health remained uncertain as of Friday.

Holden's budget director had said the department will lose 109 full-time positions. But a department spokeswoman put the number at 127, mostly midlevel administrative positions in the psychiatric services division.

At the Northwest Missouri Psychiatric Rehabilitation Center in St. Joseph and the Marshall Habilitation Center, however, the chief concern is finding care for patients once the closings occur.

"We're looking at every avenue conceivable to make this work," said Laurent Javois, superintendent of the St. Joseph center, whose Woodson unit serves children age 6 through 17. "The department is committed to ensuring that arrangements are in place before Woodson goes away."

Average stay 11 days

Children are admitted to Woodson mostly for depression or for behavioral or conduct disorders and remain for an average of 11 days, Javois said. Of Woodson's 12 beds, 10 were occupied Friday.

Cuts in psychiatric hospitals are not out of the ordinary, Javois said; Woodson was once about three times its current size.

"It's been downsized before, so this is not a new process," he said. "It's not that unusual."

For the 370-bed Marshall Habilitation Center, the future was made somewhat unclear after a department spokeswoman said Friday that Holden's budget would close a vocational rehabilitation program.

But Holden's budget director had said Wednesday that the Marshall center would lose its 16-bed skilled nursing home on July 1. And that's what superintendent Mary Fangmann is planning for.

Fangmann said the nursing facility serves people who are mentally retarded or developmentally disabled and have special medical needs, such as feeding tubes, ventilators or help with seizures.

"They need services from licensed personnel like our (nurses) and doctors," Fangmann said. "They have a medical need on top of the disability."

Fangmann said she thought finding new care for the patients would not be a traumatizing change. A state-run habilitation center in Nevada, Mo., went through a similar downsizing several years ago, she noted.

"It's just going to be a bit of a challenge," Fangmann said. "We have done this periodically in the past. The key is just matching the right place with the right needs."

Holden's proposed mental health cuts in the budget year that begins July 1 will come in addition to $6.3 million worth of cuts the department sustained earlier this month, to reduce costs in the current fiscal year.

Department spokeswoman Jeanne Henry said the agency absorbed those cuts by laying off 18 midlevel administrators and staff; wiping 50 unfilled jobs off the books; and trimming spending for travel, equipment and motor vehicle maintenance.

In the current budget year the department expects to receive $697 million -- a 9 percent increase from 2002.

Holden's proposal for the next budget year appropriates $698 million for the department.