New York Psychiatric Hospital Officials Decide To Stop Practice of Sending Mentally Ill to Nuring Homes

Officials at New York psychiatric hospitals last week distributed memos that ordered social workers to end a six-year practice under which they discharged mentally ill patients to locked units in private nursing homes, the New York Times reports. Several state psychiatric hospitals, such as the Bronx and Manhattan psychiatric centers, issued the memos. The administration of Gov. George Pataki (R) has allowed about 12 nursing homes statewide to house discharged psychiatric patients in locked units to help "scale back the state's costly psychiatric system," the Times reports. The practice, established in 1996, has allowed the state to save "tens of millions of dollars." The state must pay about $120,000 per year to treat a patient in a psychiatric hospital, but Medicaid -- funded in part by the federal government -- covers the cost of care for a psychiatric patient discharged to a nursing home. As a result, the state must pay only about $20,000 per year to treat a psychiatric patient in a nursing home. Roger Klingman, a spokesperson for the state Office of Mental Health, did not comment on the memos. He also denied that "any policies had changed" and said that the office considers the locked units "appropriate," the Times reports. However, the locked units have raised civil rights concerns from patient advocacy groups and some state Democrats (Levy, New York Times, 10/19). According to a Times investigation published earlier this month, psychiatric patients in the locked nursing home units have little ability to oppose their confinement and cannot leave the facilities. State Assembly Democrats have said that they plan to investigate the practice. Lawyers from the civil rights division of the Justice Department also have begun to interview mental health experts, officials and others to determine whether the conditions in the locked units violate the Civil Rights of Institutionalized Persons Act, which allows the attorney general to investigate and file lawsuits related to "conditions of confinement" (Kaiser Daily Health Policy Report, 10/15).