Labor and Health Care Issues
Committee Advances Nurse-Backed Bill to Help Behavioral Health and Substance Abuse Patients Languishing in Emergency Departments
BOSTON, Mass. – State lawmakers have voted to advance a bill backed by the Massachusetts Nurses Association that will move patients suffering from behavioral health and substance abuse problems out of overcrowded emergency departments and into a program at Taunton State Hospital where they can receive the specialized care they need.
On Thursday, March 15, members of the Joint Committee on Mental Health, Substance Use and Recovery gave a favorable report on “An Act relative to creating a pilot program to transfer high acuity behavioral health and dual diagnosis patients away from overcrowded emergency departments (S. 1112).” The measure was filed by Sen. Marc Pacheco, D-Taunton, and Rep. Patricia Haddad, D-Somerset.
Senate President Pro Tempore Marc R. Pacheco (D-Taunton):
“Emergency rooms are not appropriate places for the treatment of behavioral health and substance abuse problems, it’s as simple as that,” Pacheco said. “Mental health support must be smart and robust with humane, suitable care. Specialized treatment at Taunton State Hospital will help provide patients with the care they deserve.”
House Speaker Pro Tempore, Rep. Patricia A. Haddad (D-Somerset), who served as Co-Chair of the State Legislature’s Mental Health Advisory Commission:
“This bill will provide much-needed, professional care in a safe setting for those in need,” Haddad said. “It will offer medically-stable, behavioral health patients with the focused treatments and transitional services that they greatly need away from overcrowded emergency clinics and hospital emergency rooms.”
MNA Vice President Karen Coughlin, a registered nurse at Taunton State Hospital who served on the Mental Health Advisory Commission:
“The state and our private-sector facilities need to open more beds for those suffering with mental health conditions and addiction,” Coughlin said. Positive movement on this legislation is a step toward ensuring our patients receive the care they deserve. No one should have to wait in a crowded emergency department without access to critical behavioral health care and dual diagnosis treatment.
“We also need The Patient Safety Act, a 2018 ballot measure that will dramatically improve care in every Massachusetts hospital by setting safe limits on the number of patients each nurse cares for at one time. Our emergency departments are understaffed, causing severe crowding and unacceptable wait times for patients and their families.”
An Act Relative to Creating a Pilot Program to Transfer High Acuity Behavioral Health and Dual Diagnosis Patients Away from Crowded Emergency Departments (S. 1112/H. 1064)
This bill creates a pilot program at Taunton State Hospital to transfer medically stable, high acuity behavioral health and dual diagnosis patients away from overcrowded emergency departments until such time that an appropriate placement is found to meet the patient's needs.
An influx of behavioral health patients into Massachusetts emergency departments has been clashing against an ED system in which patients are already waiting too long for care.
“We need more high-acuity beds like those proposed in the Taunton State Hospital pilot program, and also more long-term and transitional services,” said Linda Condon, an RN in the ED at Morton Hospital in Taunton. “Patients are being released from short-term acute psychiatric facilities without transitional services or long-term treatment and are going right back to the emergency department to start the process all over again. We’re also understaffed. Until we safely limit how many patients a nurse can care for at one time and increase the number of beds available, patient care is going to suffer.”
Data from the Health Policy Commission shows that Massachusetts EDs saw a 13 percent increase in mental health and substance abuse patients from 2011 to 2015. “Moreover, the proportion of (behavioral health) patients who “boarded” in the ED (i.e., spend 12 or more hours in the ED from the time of their arrival to their time of departure) also increased during this time period, contributing to significant cost and care delivery inefficiencies,” the HPC said.
An earlier study conducted by the Mass legislature’s Mental Health Advisory Commission found that as many as 40,000 patients a year are boarding in our state’s hospital emergency departments, waiting for hours or even several days for appropriate beds and services. Research by registered nurse and Boston College associate professor Judith Shindul-Rothschild also demonstrates the existing ED wait-time problem in Massachusetts hospitals. For example, her research showed that patients at UMass Marlborough Hospital on average waited more than two hours to be evaluated in the ED.