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Hospital network will cut back

Closing of units, job cuts to affect services in 3 cities

By Liz Kowalczyk
Globe Staff / January 29, 2009
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Cambridge Health Alliance said yesterday that it will reduce its workforce by more than 300 employees, end inpatient services at Somerville Hospital, and shut down its pediatric and addiction units.

The three-hospital system, which serves many poor patients, also will scale back psychiatric care in Everett and close six primary care clinics. It has been struggling with its finances for at least a year, but state budget cuts last fall and the recession made the situation more dire, executives said.

The network will move most of Somerville Hospital's 90 beds to Cambridge Hospital by June 15, but Somerville will maintain a 24-hour emergency room and various outpatient services, including day surgery. The network's two other hospitals in Cambridge and Everett will remain open, but the eight-bed pediatric unit at Cambridge Hospital will close, as will the addiction unit at Somerville Hospital.

Hospital officials said they will eliminate the jobs of about 8 percent of the 3,900 employees, some through layoffs, and that nurses and other staff who work in units that are closing probably will be affected.

The alliance's chief executive, Dennis Keefe, said officials "went through great lengths to minimize, the best we could, the impact on patients and communities." The six outpatient clinics being closed, for example, in most cases will merge with other clinics less than a mile away, and the newly merged clinics will expand their hours. But, he said, "there may be some inconvenience for patients."

Cutting inpatient mental health services, the network will close about 60 of 127 psychiatric beds at Whidden Hospital in Everett, which will make it harder for psychiatric patients from outside the area to get a bed.

"We've evolved into a regional or even a statewide provider for mental health services," Keefe said, adding, "We're really going to focus on patients from communities we serve."

Cathy Levin, an activist with M-POWER, a consumer-run advocacy organization for the mentally ill, said the changes at Whidden in Everett could create more backups in emergency rooms. "There will be an impact because people will have to wait longer for a bed." But, she said, consumers want the state to provide better funding for crisis counseling and day programs to keep people out of psychiatric units, and that would reduce the need for beds.

Hospital officials said the reorganization plan is more dramatic than initially planned because the already-struggling hospital system saw its government payments fall when the recession hit. In the fall, the state announced it would cut $40 million from what it gives Cambridge Health Alliance, the second-largest safety net provider for the poor after Boston Medical Center, for treating patients enrolled in the Medicaid program.

"The original plan was for a more gentle rollout of the changes," said spokesman Doug Bailey. "But the economy that has affected everyone derailed us a little bit."

The network expects a $22 million operating deficit this year and had faced an unknown number of losses in the new fiscal year that begins July 1. But the reorganization and other measures are expected to save about $150 million over the next two years, Bailey said, and allow the network to operate in the black.

Some groups, including a union representing workers at the hospitals, are upset about the cuts to services at Cambridge Health Alliance and previous cuts announced at Boston Medical Center. They plan to protest at the State House today at 4 p.m.

Liz Kowalczyk can be reached at kowalczyk@globe.com

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