President's Column: Economic climate means trouble for Cambridge Health Alliance
From the Massachusetts Nurse Newsletter
February 2009 Edition
By Beth Piknick
In the wake of the announcement last month by Cambridge Health Alliance of a comprehensive reorganization plan, the MNA nurses at the alliance’s associated facilities took the time to issue a powerful statement that addressed their concerns over how the Alliance will be able to meet the communities’ needs should the plan be implemented.
Under the plan, inpatient medicine and surgery at Somerville Hospital, will cease by June 15. Two of the eight psychiatric units will close, while one unit at Somerville Hospital will move to Whidden Hospital in Everett and another will move from Somerville to Cambridge Hospital. The pediatric unit at Cambridge Hospital will close by March 31. The plan also calls for the layoff of 8 percent of the workforce (300 FTEs) and includes a hiring freeze and a capital spending freeze, an elimination of travel, and no raises for system executives.
All of these changes would be bad in the best case scenario, but for the communities served by the Cambridge Health Alliance hospitals the effects will be nothing short of devastating.
Cambridge Health Alliance is designated as a healthcare safety net for its communities, and the hospital’s MNA nurses are critical strands in that net. They are the ones who are responsible for the patients every minute of every hour of every day.
And while it is true that some MNA jobs will be affected by this consolidation, the alliance’s nurses have a broader legal and ethical responsibility— that being the safety of their patients and the greater community.
We understand that the decisions to consolidate services have been made after careful consideration, and in a good faith effort to deal with a real and serious economic crisis. However, a good faith effort does not necessarily ensure that the public health needs of a community are being appropriately served by this consolidation of services.
Specifically, the MNA and its members at the Alliance are deeply concerned about the loss of the addictions unit at Somerville Hospital. At a time of economic recession, the incidence of substance abuse—and the need for treatment for addictions—will only increase. The loss of this service will mean that many of those in the community suffering from the disease of addiction will go untreated and, as a result, we will see an increase in crime, in family distress and suffering in our communities.
We are also concerned about the net loss in psychiatric beds called for under this proposal. This decision is unconscionable at a time when there is a desperate need in our state and our region for an increase in access to acute mental health services. Again, this decision is being made at a time of economic distress, which studies have clearly shown increases the incidence of acute mental illness and the risk of suicide. Right now we see patients throughout our state languishing for days in emergency departments waiting for a mental health bed. At a time when our state has passed a historic law calling for mental health parity, we are now decreasing access to that level of care.
Cambridge Health Alliance has always been a full service health care provider offering a continuum of care for the community from cradle to grave and the affiliated hospitals have typically seen between 7,000 and 8,000 pediatric patients in its Emergency Department each year. They see another 80,000 children in their affiliated clinics. And as many as 400 kids a year stay overnight in their pediatric unit, and many others end up staying in their unit for observation.
But under the proposed plan, the parents and children in the community will no longer be able to rely on Cambridge Health Alliance for this level of locally based care.
Now they will have to cross the river and go to the large Boston hospitals where they will compete for care, not only with the residents of Boston but with all the suburban communities from which those major medical centers so aggressively attempt to attract patients.
With this consolidation and the loss of pediatric beds, psychiatric beds, and the shifting of inpatient beds within the system, everyone should be concerned about the impact this will have on patients’ access to the care they need when they need it.
Again, we understand that there is tremendous financial pressure being applied to CHA and that changes are required. But we find it hard to understand why CHA has been penalized by the state and the marketplace, and has been forced to withstand disproportionate cuts in funding and a reimbursement rate for services that prevents them from fulfilling their role in the new system. We cannot and will not remain silent and pretend that the plan that is being proposed will meet the health care needs of this community.
The MNA and its member nurses at CHA are appealing to community leaders and policymakers to use whatever influence and power they have to protect the health and safety of the commonwealth’s citizens by ensuring the survival of a true health care safety net at CHA. We must all lobby for health reform that not only provides insurance to the underserved, but also provides safe and appropriate health care when it is needed. We must convince the legislature to better regulate health care so that our health care system is rational and fair and provides care based on what is best for our communities.