PROVIDENCE, R.I. (WPRI) – During a recent call between more than a dozen union workers and administrators at Eleanor Slater Hospital, the conversation became so combative that Dr. Andrew Stone felt compelled to send an email to his bosses afterward expressing concern for his safety.
“I also wish to have this email preserved should anything untoward happen to me,” wrote Stone, chief of medical services, in an April 1 email obtained by Target 12 and authenticated by multiple people.
Stone accused Laborers Local 271 business manager Michael Sabitoni, one of Rhode Island’s most prominent union leaders, of threatening him and one of his colleagues amid a dispute about whether to relocate some Slater patients because of an issue with the facility’s oxygen system.
On Tuesday, Sabitoni rejected Stone’s claim, although he acknowledged that the conversation had become emotional. Sabitoni also said he planned to advocate for administrators to be fired if “they continued down this path of being disingenuous.”
“I wasn’t threatening them, I was telling them exactly what I was going to do,” Sabitoni told Target 12. “I have no confidence in the people I was on the call with last Thursday.”
Target 12 has interviewed several people who participated on the call, along with others with direct knowledge about what was discussed. When asked if Sabitoni threatened anybody, some agreed, while others suggested the discussion had become heated but not threatening.
Stone has not filed any legal complaints or reported the issue to police. But his concern regarding the union and its influence over medical decisions at the hospital came through clearly in his email.
“I understand that labor donates a lot of money to political figures,” Stone wrote. “I fear that money and political power may be more important than keeping patients out of danger.”
The call underscores how toxic the relationship between union groups and hospital administrators has become at the state-run medical facility, which operates the Zambarano unit in Burrillville and three more units in Cranston.
“It is a low point,” Sabitoni said. “I’ve never had a scenario like this, and I’ve been doing this for a long time.”
In addition to the internal strife, the hospital has also become the focus of intense public scrutiny in recent months. Rhode Island has been moving forward with a plan to downsize and restructure the facilities, including some that have fallen into disrepair.
In addition to problems with the oxygen system at Zambarano, the Burrillville unit recently had to shut down part of its kitchens after the state Fire Marshall’s Office observed “unsafe conditions and practices.”
As for the restructuring plan, leadership has laid off several Slater employees and discharged dozens of patients – mostly in Cranston – who they have determined could be receiving the same level of care outside of a hospital setting, in accordance with federal policy dating back to the 1960s.
Union employees, some of whom have worked in the facilities for decades, publicly argue that the state should slow down, as the current workers are best suited to provide care to these unique patients. Behind the scenes, however, many are also concerned about their own livelihoods, since downsizing would likely mean more layoffs and ultimately fewer jobs in the future.
Rhode Island budgeted about $80 million for hospital labor costs during fiscal year 2019-20, according to a report last fall. At the time, there were about 210 patients across the entire hospital system.
For some family members of patients, especially those who have lived sometimes for decades at Zambarano, there is concern that too much disruption could negatively affect their relatives’ care – which has been stable for years at the state-run hospital.
“His quality of life is good there,” said Pam Costello, whose son has lived at Zambarano for several years. Costello testified during a R.I. House Oversight Committee hearing the same day Stone’s email went out.
Adding to the turmoil, R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals director Kathryn Power – who’s been leading the state’s restructuring effort – announced this week she is resigning due to a family illness. Former Gov. Gina Raimondo tapped Power to take over the department in January 2020, directing her to shore up the hospital’s operations and finances.
A recent report commissioned by the Raimondo administration estimated hospital operations cost roughly $550,000 per patient each year, about five times the average cost of services provided in nursing facilities and community-based placements.
Meanwhile, the state in fall 2019 stopped receiving millions of dollars from the federal government after an employee discovered the state was likely improperly billing the U.S. Centers for Medicare and Medicaid Services.
And while the federal government last month approved a request from the state to restart billing, the hospital hasn’t yet determined which services will qualify both retroactively and into the future. The general consensus is that it will be far less than what came in before 2019, meaning the state will either have to cut overhead or continue to cover a greater share of the total cost of the hospital.
“I believe that I helped move the organization in the right direction to embrace a more aligned set of programs and services that are highly reflective of the least restrictive environment, the most appropriate level of clinical care, and the strong themes of personal choice, a safe, stable living situation, and whole life self-management,” Power wrote in her resignation letter to Gov. Dan McKee.
Shortly after her resignation was announced, United Nurses and Allied Professionals Local 5019 president Cynthia Lussier painted a less rosy picture, describing the department as being “in utter disarray.”
Power’s departure means McKee will likely have to become more closely involved in the Slater situation, as he’s now responsible for choosing Power’s replacement – a decision that could go a long way toward signaling how the hospital system will move forward.
“BHDDH has a critical mission and it will be a priority for the McKee administration to find a candidate to live up to its values providing high-quality care and services for some of Rhode Island’s most vulnerable residents,” McKee spokesperson Matt Sheaff said in a statement.
So far, the new governor has shown little interest in diverting from the plans set in motion by his predecessor, and Power confirmed she never received any directive from McKee to change up operations under his leadership.
As part of his fiscal 2021-22 budget, McKee also proposed $65 million to build a new long-term care facility on the Zambarano campus in Burrillville – which would replace the existing facility. The proposal is integrated into the broader downsizing plan, which includes the elimination of 100 full-time positions.
But whatever the governor ultimately decides to do moving forward, his most immediate challenge could be trying to solve the current tension between his administrators and union workers.
“I’ve never seen such blatant mistrust,” Sabitoni said.