May 1st, 2017

Bed reduction plan at UMass Memorial Medical Center causes outcry

UMass Memorial Medical Center’s plan to convert 13 of 28 psychiatric beds to medical surgery beds has met with widespread opposition.

Eric W. Dickson, M.D., president/CEO of UMass Memorial Health Care said that the hospital serves a critical role as a trauma center for patients with life threatening illnesses who are shipped there from “less comprehensive” hospitals.

Transitioning the beds for life-saving surgeries is the “right decision,” for the region’s patients, he said, because as a practicing emergency physician, he has personally witnessed the “daily challenge of too few beds for the large number of critically ill people waiting to be transferred or admitted for care. This (shortfall) creates potential patient safety issues not only on the university campus, but also across central Massachusetts.”

As part of the plan, the 8 East inpatient psychiatry unit will maintain 14 medical psychiatric beds and adjacent space will be renovated, beginning this July. The construction will take about a year and coincide with the reduction of beds, according to Anthony Berry, hospital spokesperson.

Hospital officials contend that the campus averages six to eight acute care psychiatric patients at any given time. In addition, they say that other available resources, nearly 300 new psychiatric beds, are opening elsewhere in central Massachusetts where patients with non-medically complex psychiatric issues can be accommodated.

Mental health advocates, legislators, the Worcester city council and others have gone on record with opposition to the proposal. More than 150 people attended a three-hour public hearing on the matter on March 30 to express their concerns.

Laurie Martinelli, JD, MPH, executive director of the National Alliance on Mental Illness of Massachusetts was among those to testify at the hearing. She told New England Psychologist in a later phone interview that she requested that UMass Memorial Medical Center hold off on closing the psychiatric beds until the addition of beds at Westborough Behavioral Healthcare Hospital and TaraVista Behavioral Health Center are complete.

She noted that she is a member of the Executive Office of Health and Human Services (EOHHS) work group on Emergency Room Boarding.

“Emergency Room boarding of people with mental illnesses is a well-documented, chronic problem,” she said. EOHHS estimates that more than 40,000 residents board longer than 12 hours in ERs because of a shortage of inpatient psychiatric beds annually.

Patients who are uninsured or on MassHealth tend to face longer boarding times than privately insured individuals, Martinelli added.

Other problems include the difficulty people will experience traveling to get care, the lack of public transportation for family members and other visitors to get to facilities in Devens and Westborough and the lack of mental health professionals to staff facilities at capacity.

TaraVista Behavioral Health Center in Devens plans to bring 107 beds online but had to stall progress at 25 beds because they can’t find enough mental health professionals to work there, Martinelli said.

She said the state-wide shortage of professionals will probably impact the Westborough facility as well, where 152 beds are expected. The Westborough Behavioral Healthcare Hospital is scheduled to begin taking patients in May.

Despite these new facilities in the works, they will not meet the unique needs of the patients at UMass, said David Schildmeier, spokesperson for the Massachusetts Nurses Association, an organization that has been very vocal in its objections to the plan.

He noted that central Massachusetts has one of the highest rates of mental illness in the state and that the UMass unit is always full and patients spend hours and even days waiting for beds to open up.

Between 70-90 percent of these patients, he said, have co-morbidity issues – both physical and mental health issues – that are cared for in one setting.

TaraVista does not accommodate people with physical issues and the Westborough facility does not accept MassHealth patients, leaving a huge number of patients with nowhere to go, he said

Of the proposed reduction in beds, Schildmeier said “On any level, this makes no sense.”

He added, “People with mental illnesses are waiting four or five times longer for beds to open up. They are the ones suffering the most.”

The Worcester City Council voted unanimously in opposition to the bed reduction, but has no authority over UMass Memorial Medical Center.

At press time, the Department of Public Health was expected to render an opinion, although its commissioner spoke in opposition at the hearing. DPH has no authority over UMMC either.

Dickson declined to answer the question as to whether or not the hospital may alter its plans in the wake of all the opposition.

By Susan Gonsalves

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