New Jersey opened its only state owned and operated sanatorium – Glen Gardner – in 1907. The facility was described at the time as “largely educational in character, which would give a practical demonstration of up-to-date methods of treating. . . . tuberculosis” among other things. With an original expectation of 500 patients annually, the facility treated more than 10,000 between 1907 and 1929.
By the 1920s, the sanatorium expanded its mission to include the full spectrum of tuberculosis cases, and continued in that regard until the middle of the twentieth century when medication became the prevailing treatment. In 1950 the facility expanded its scope of services to include all chest diseases, and the name was changed to the New Jersey Hospital for Chest Diseases. Indeed, throughout the 1960s, many former tuberculosis hospitals transitioned to a broader range of treatment.
In 1977, the hospital changed its name again to the Senator Garret W. Hagedorn Gero-Psychiatric Hospital as it focused on its new calling as a state nursing home and eventually a 288-bed psychiatric hospital. The hospital’s premier location high up on a mountaintop with 600 acres of provided inpatient, comprehensive psychiatric treatment for adult patients. The hospital stated as its mission “to provide quality interdisciplinary psychiatric services that maximize potential and community reintegration within a safe and caring environment.”
In 2011, New Jersey decided to close the smallest of New Jersey’s four public mental hospitals. In the words of psychiatrist David Nathan: “Finally, a good state hospital, and they want to close it. It is rare to see even a private mental hospital that gives good care to the severely mentally ill. Hagedorn is a public hospital. . . . . and it comes across as top notch.”
Even with a one-year reprieve by New Jersey’s legislature, Governor Chris Christie has targeted Hagedorn as the one to close. According to Robert Davison, chair of the Governor’s Task Force on Mental Health, the decision is “fundamentally flawed.” Davison continued: “It is irresponsible to close a state hospital in a year or less.”
Governor Christie explained that by closing Hagedorn New Jersey would save $9 million annually. It would also result in the closure of Freedom House (a center for treating addiction on the Hagedorn campus). Local residents expressed concern about the future of the 600-acre property.
Critics of the decision expressed disappointment that Hagedorn was selected over Trenton Psychiatric Hospital. One critic, Hunterdon County Freeholder Ron Sworen, stated: “Where are these people going to go? Just putting them out into the public and halfway houses isn’t the answer, the way some of these people are. It’s an important facility in our area, it’s the only one that really deals with geriatric care, that goes away and where do all these people go?”
With the closing also comes the relocation of 623 employees in the summer 2012.
To make the situation even more complicated, in July 2011 the Joint Commission found numerous deficiencies at Trenton Psychiatric Hospital and may recommend its closure. When both hospitals were considered for closure, the task force identified physical deficiencies with Trenton. According to one task force member said task force member Gilbert Honigfeld: “We made a big point that Trenton Psychiatric is basically dealing with an infrastructure and a superstructure that is upwards of 150 years old. These are old, decaying buildings with all the environmental hazards associated with that and it looks like a warehouse, which everyone is trying to avoid.”
Contrary to media headlines closely monitoring the lower- and mid-level federal courts as they opine on the individual insurance mandate, the United States Judiciary Branch may have little impact on the future of President Barack Obama’s 2010 Patient Protection and Affordable Care Act. As fascinating as the legal ramifications may be, the ways in which the Commerce Clause or the Necessary and Proper Clause impact the constitutionality of healthcare reform’s most notorious provision of late could have little meaning if the government fails to pay a few utility bills and the congressional lights go dark.
