WORCESTER, Mass -- In response to a proposal by UMass Memorial Medical Center (UMMMC) to close 13 of its 28 inpatient psychiatric beds at its University Campus, Worcester District 4 City Councilor Sarai Rivera is proposing an order that would appear on the March 7 city council agenda.
The order calls on the city manager to provide the City Council with a report “concerning what impact UMass Memorial Medical Center's closing of thirteen psychiatric beds may have on health care throughout the city, including information concerning its impact on accessing timely healthcare for those with behavioral health conditions who are boarding in our hospital emergency rooms… and what effect this will have on the City's economically disadvantaged and homeless communities.”
In January, the management of UMass Memorial Medical Center announced plans to close 13 of the 28 psychiatric beds on 8 East, its busy inpatient psychiatric unit, and to convert these beds to medical surgical beds. The Department of Public Health will hold a public hearing on March 30 in Worcester concerning the plan to determine if this is an essential service that should be maintained. The public hearing is part of the legal process UMass Memorial is required to go through prior to closing the beds. Councilor Rivera is seeking the impact analysis prior to the hearing so that the council can determine if they need to weigh in on the issue to protect the interests of Worcester residents impacted by the plan.
The Massachusetts Nurses Association, which represents the nurses at UMMMC, and mental health advocates, including the National Alliance for the Mentally Ill, oppose the closure as it will have a devastating impact on the care of acutely mentally ill patients, not only in the city of Worcester, but throughout the entire region. Nurses and advocates applaud the Council’s efforts to study the plan and will be holding a rally at 6:30 p.m. prior to the council meeting, and will then testify at the meeting in support of the order
“We believe this is a shortsighted and dangerous proposal that is in direct violation of the UMass mission to provide comprehensive care to all members of the Greater Worcester community,” said Lisa Goss, RN, a psychiatric nurse who has worked on 8 East for more than 12 years. “These are patients in crisis with multiple diagnoses who need immediate inpatient services who will now be forced to travel long distances for care, receive inadequate care, or go without treatment altogether.”
Background on the Issue
On 8 East staff care for patients from the age of 16 up to geriatrics. They suffer from a range of mental health issues such as depression, bipolar disorder, anxiety, schizophrenia, addiction, and also may be suicidal, self-injurious, and have homicidal thoughts and behavior. These patients often also need treatment for other medical issues which they are able to receive on 8 East because it is a medical psychiatric unit within an acute care hospital.
This unit is nearly always full, while at the same time, the UMass University and UMass Memorial emergency departments are overburdened with psychiatric patients waiting for a bed on this or any other unit in the state that can take them. These patients often wait several hours or several days for a bed.
UMass management is proposing this dangerous plan at a time when there is a critical and growing shortage of mental health beds in the Commonwealth. A recent report by the state’s Mental Health Advisory Committee found that more than 40,000 patients a year are boarding in our state's hospital emergency departments, many for days or even weeks waiting for treatment.
Another recent report by the Health Policy Commission highlighted the issue of ED overcrowding and increased visits to hospitals by patients with behavior health issues. The report found that Central Mass hospitals saw a 35 percent increase in visits to hospital emergency departments by patients with mental health conditions over a four year period, the same period when UMass closed a psychiatric unit at Burbank Hospital.
Yet another DPH report on mental health bed and service capacity showed that central Mass ranks near the bottom among regions of the state for beds per population. For copies of the reports cited above, contact David Schildmeier at firstname.lastname@example.org
In proposing this plan, UMass cites the fact to DPH that they have contracted with TaraVista Behavioral Health Center, a Devens facility to provide beds for impacted patients, and it noted that Signature Healthcare Services LLC, a California-based operator of private psychiatric hospitals, is due to open a hospital in Westboro.
As stated above, many of the patients on this unit suffer from comorbidities, which means they have medical as well as psychological issues that need to be treated. “Neither of the facilities proposed to take our patients can provide that level of care so they will be of no use,” Goss explained. Also in the case of the private facility, it, like many private facilities, are reluctant to take MassHealth patients, which means this is another cohort of patients, the most poor and underserved, who will go without care.”
The MNA believes this proposal is a cynical ploy by UMMMC to boost profits by converting psychiatric beds, which are subject to lower reimbursement rates, to more profitable medical surgical beds.
Since the announcement, the nurses have been mobilizing the community to be aware of this plan and to urge concerned residents to attend the public hearing on March 30. A petition is also being widely circulated opposing the closing, which will be presented at the hearing. The nurses have also had a meeting with upper management of the hospital where they urged them to rescind this plan, at which time UMMMC management refused to change their course.
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.