White Coat Notes

Cambridge Health Alliance puts off decision to shrink child psychiatry services

Cambridge Health Alliance officials said Wednesday they will not shrink services to children and teens with acute mental illness this year, as they had planned.

The hospital system backed off a proposal to consolidate psychiatry units serving children and teens and to cut the total number of beds from 27 to 16, a week after the state Department of Public Health issued a letter saying those services were critical to eastern Massachusetts.

In their version of the state budget, passed last week, state senators made a change that would allow Cambridge Health Alliance to receive an additional $2 million in federal health care funding — a temporary fix to help keep the units open.

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“We are going to have to have a more long-term resolution to this,” said Chief Executive Officer Patrick Wardell. “This will give us a year to either work out what that long-term solution is to keep [the units] separate or to come up with another strategy.”

Wardell said it was gratifying to see how strongly people felt about the proposed changes.

Cambridge Health Alliance had announced in April that it would combine two inpatient psychiatry units on the Cambridge Hospital campus, one that serves adolescents ages 12 to 19 and one serving children as young as three, citing budget constraints and a focus on community-based care.

At a state hearing earlier this month, people overwhelmingly spoke against consolidating the units, praising the high quality of care provided and expressing concern about ever-shrinking resources for families affected by severe mental illness.

In a May 22 letter, the Department of Public Health said it had determined the beds were “necessary for preserving access and health status” in the region, but that decision was not binding. The state can only make recommendations to hospitals about such changes in services.

In March, after taking criticism during a public review, Partners HealthCare said it would reduce cuts to inpatient mental health services at Brigham and Women’s Faulkner Hospital. The changing tack by Cambridge Health Alliance this week further shows the power of public pressure, said Laurie Martinelli, executive director of the National Alliance for Mental Illness of Massachusetts.

“I think it’s a victory — a huge victory,” she said.

It’s also a short-term one. Martinelli said she thinks there should be a broader state-led effort to look for ways to increase payments to mental health care providers.

“Hospitals like Cambridge Health Alliance shouldn’t lose money by providing care to people with mental illness,” Martinelli said.

The Massachusetts Nurses Association, which represents nurses on the units, applauded the decision, saying it protects the hospital’s role in the health care safety net for the poor.

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