Alan Sager and Deborah Socolar, who have documented trends in and dangers of hospital closings in Massachusetts and nationally, call on Governor Deval Patrick to declare a public health emergency to protect North Adams Regional Hospital. These are some of the reasons:
1. Declaring the emergency is justified. Former state public health commissioner Howard Koh (now U.S. Asst. Secretary for Health) recognized over a decade ago that, in Massachusetts, “we cannot afford to lose another hospital.” One high state official said as far back as 2001 that “lives are really at risk” if another emergency room closes.
2. Declaring a public health emergency will authorize state government to take control of North Adams Hospital. This action will cut through the assertions that the state lacks the ability to act.
3. There is a precedent for this form of state action to protect health. In 1976, Gov.
Dukakis declared a public health emergency to protect residents of a Merrimack
Valley nursing home.
4. Declaring a public health emergency will allow the commissioner of public health to appoint a skilled hospital turn-around expert to manage North Adams Hospital. That person will take steps to raise patient volume and revenue, and to cut costs.
5. If this hospital closes, people in North Adams and northern Berkshire County would be endangered by the long distances and travel times required to reach other hospitals. For example, from the town of Florida, it would require 23 miles driving and at least 37 minutes (non-rush hour travel time from MapQuest, calculated at 10 A.M.) to the nearest hospitals, which is in Bennington, VT.
It would also be 25 miles and at least 45-50 minutes from Florida to Pittsfield (where Berkshire Medical Center is located). It would be over 31 miles and at least 42 minutes to Greenfield (where Baystate Franklin Hospital is located).
The following provides more information on travel times.
6. Residents of Berkshire County are older and poorer than the state average. Almost one-fifth (19.7 percent) are over age 65, versus one-seventh (14.4 percent) statewide.
Berkshire County residents also are poorer. The county’s median household income is 28.7 percent below the state average.
In North Adams itself, median household income in 2012 was fully 45.2 percent below the state average.
Together, this means that area residents are undoubtedly more in need of hospital care and less able to afford travel to distant alternatives.
For decades, poorer communities in Massachusetts have disproportionately suffered hospital closings. It is time to stop that pattern.
7. How to finance North Adams Hospital’s stabilization and conservation?
• In the short run, North Adams Hospital should be given immediate claim on financial aid from the state’s Distressed Hospitals Trust Fund, established by law in 2012, which now holds about $128 million (see http://www.mcchweb.org/legislativeissues.html)
• Additional funds can be gathered by reducing the state’s increases in across-the-board aid to all hospitals and instead channeling more of that money to hospitals that are needed and in danger of closing.
We found that across-the-board Medicaid increases go to the 20 most prosperous hospitals in the state. Many large hospitals are very financially secure. They do not need extra state help. Hospitals at risk of closing over the next five years do need extra state help. Scarce state dollars must be better targeted.
8. With half of the state’s acute care hospitals closed since Pres. Kennedy’s election in 1960, each surviving hospital and emergency room should be considered needed unless proven otherwise.
9. The legislature should pass and the governor should sign a hospital receivership statute to regularize the process of state protection for each needed hospital. Such legislation has been pending since 1993. In 2000, the state’s just-enacted HMO receivership law proved very helpful in conserving Harvard-Pilgrim.
10. Nationally, hospitals that close have actually been slightly more efficient, on average, than those that survived, suggesting that no effective free market “survival of the fittest” acts to protect lower-cost hospitals.
11.The majority report to the state’s Health Care Task Force in 2001 called for
stabilizing community hospitals to reverse the drift of patients to high-cost teaching hospitals. Since then, health care policy discussions in Massachusetts
have increasingly highlighted that need.
12. It is almost impossible to re-open a hospital that has closed. Staff and patients disperse and cannot be readily reassembled. Facilities that have been acceptable under grandfathering provisions would have to be brought up to current code.
So now is the time for action, not words.
Sager and Socolar call on Gov. Patrick to declare a public health emergency to avert the dangerous and possibly irreversible closing of North Adams Hospital.
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