PROVIDENCE, R.I. (WPRI) — Family members, advocates and employees of Eleanor Slater Hospital called on state officials Monday to slow down an ongoing effort to downsize and restructure the state-run medical facility, arguing there aren’t enough community-based alternatives for patients with unique health care needs.
The R.I. Senate Committee on Rules, Government Ethics and Oversight met for four hours to discuss various issues tied to the state-run hospital system, which has multiple units in Cranston and at its Zambarano campus in Burrillville. The system has been hemorrhaging tens of millions of dollars in state money since 2019 when it fell out of federal compliance and stopped billing for Medicaid reimbursement.
As part of their review of operations since then, officials at the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) have determined many of the patients living at the hospital for years, sometimes decades, should be receiving services through community-based settings in accordance with federal law.
Nearly two dozen people testified in opposition to the idea, however, and many argued the state doesn’t have an adequate level of community-based care facilities to serve many of the hospital’s patients with complex medical, behavioral and mental illnesses.
“There’s no place to go,” said Marcia Boyd, a mental health advocate whose cousin currently lives at the hospital. “It just doesn’t exist.”
BHDDH Director Kathryn Power, who has been heading the state’s effort to overhaul the hospital system since last year, largely agreed with the assertion, saying there is a gap in the state’s continuum of care and that there should “be far more movement across different settings in our system.”
But she’s adamant that the state must gradually move patients out of long-term, hospital-based facilities and into community care centers, which is a legal requirement known as deinstitutionalization that dates back to the 1960s.
“No one should live their life in a hospital,” Power said.
To address the lack of community-based resources, Power said the state is currently working with various groups to try and bolster resources for community-based facilities. She’s hopeful the state will spend some of the billion-plus dollars it’s poised to receive through the American Rescue Plan Act to help support the effort.
But she pushed back on the widespread narrative that the state is pressuring patients to leave the hospital system, calling it a “public misunderstanding” based partly on misinformation. Besides so-called “forensic patients,” who are ordered in and out of the hospital by the courts, Power said only 22 patients have been discharged since last July.
“Absolutely none of these patients were discharged against their will,” she said, adding that her department has “desperately tried to explain” this to people.
The explanation, however, was challenged by several people who testified throughout the night, including Dr. Normand Decelles, who worked at Zambarano for more than two decades before leaving last year.
The doctor, who has become an outspoken critic of the state’s restructuring effort, claimed he was pressured by administrators last year to discharge 100% of patients from the Burrillville facility. (There have only been four discharges from Zambarano since then, according to data the state provided to the committee.)
Decelles argues the state’s motives stem from its financial problems with Medicaid.
“Eliminating Rhode Island’s only long-term hospital is one step forward for the administration and its budget, but one giant leap backward for Rhode Island health care,” Decelles said.
When asked about the doctor’s version of events, which were first made public in an open letter he released earlier this month, Power took issue with them.
“I’m disheartened that they were given the amount of press coverage that they did,” she said. “I disagree with it.”
The Medicaid problems at Eleanor Slater happened under Gov. Gina Raimondo’s administration, but they are coming to a head just as her successor Gov. Dan McKee has ascended to the state’s top job.
As part of his recently proposed state budget for fiscal year 2021-22, the new governor called for shutting down two units in Cranston and building a new $65 million skilled-nursing facility on the Zambarano campus in Burrillville.
The plan would also result in the elimination of 100 full-time jobs, although McKee and Power have pledged to keep Zambarano open throughout the construction process. The state’s plan, which has been in the works since last fall, has been met with pushback from multiple unions, whose members make up most of the workforce across both campuses.
“The state has been failing to live up to their obligations with us and there are still many unanswered questions,” said James Cenerini, a lobbyist for RI Council 94, AFSCME and AFL-CIO. “A lot more attention needs to be dedicated to this.”
Cynthia Lussier, a registered nurse and president of UNAP Local 509 at Zambarano, called for state officials to be more transparent with her members. Both Lussier and Cenerini were critical of the state’s contractor, Alvarez & Marsall, which was hired to come up with the restructuring plan.
“We ought to just say ‘stop,'” Lussier said. “Stop for a minute and take a look at what Rhode Islanders really need. Let’s do an assessment of what’s needed in our state to care for our citizens.”
Committee Chairman Sen. Louis DiPalma said lawmakers would be reviewing the hours of testimony, which would be taken under consideration as part of the decision-making process moving forward. He underscored that the state’s restructuring proposal wasn’t a done deal yet.
“With regards to the plan, it’s just that,” DiPalma said after everyone had testified. “It’s a proposal and it’s now in the hands of the General Assembly. We will move forward from here.”