Health leaders signal cautious optimism about Baystate’s plan

  • Baystate Franklin Medical Center in Greenfield. Recorder Staff/PAUL FRANZ

Staff Writer
Published: 3/4/2019 9:28:31 PM

GREENFIELD — Leading health care providers in the area are reacting with cautious optimism to the proposed closure of Baystate Franklin Medical Center’s in-patient mental health unit in lieu of a new regional, for-profit behavioral health hospital in Holyoke.

While the Massachusetts Nurses Association and some local and state legislators have sharply criticized the centralization that would close Baystate Franklin’s East Spoke psych unit, senior health officials, along with local Baystate Health trustees Bob Pura and Tim Farrell saw benefits to the change planned by the organization that controls a majority of the region’s health care.

“The fact that they have come up with a regional approach to try to ensure that there is access to beds all over their region is a blessing, actually, as opposed to just closing the units that are going to be affected,” Behavioral Health Network President and CEO Katherine Wilson said.

The proposed cuts, announced earlier this month without public input and without advance warning to nurses in the units, would close the inpatient services at the psychiatric units at Greenfield’sBaystate Franklin Medical Center, Palmer’s Baystate Wing Hospital and Westfield’sBaystate Noble Hospital.

In place, a hospital run by Baystate Health and for-profit US HealthVest would likely open at the site of the Geriatric Authority in Holyoke,​​​​​​ near the Holyoke Mall, with 30 percent more beds, totalling 120 for western Massachusetts. The changes are likely two years away, although the City of Holyoke is slated to approve the purchase of the building as early as this coming week.

Baystate Health has not formally said the individual psychiatric units are poised to close.

In a set of statements released by hospital spokespersons Thursday, they pointed to the lack of being able to fill the beds in places like Greenfield’s psych unit, known as “East Spoke.”

In the 2018 budget year, Baystate said on average 13 patients a day were in the 22-bed facility. This was a by-product of a combination of health care factors, including a lack of appropriate staffing to handle the needs of patients. Every other person in Baystate Franklin’s emergency department who needed to be transferred to a mental health unit were sent to other hospitals, Baystate officials said.

Dr. Barry Sarvet, chairman of psychiatry at Baystate Health and chairman of the department of psychiatry at the University of Massachusetts Medical School at Baystate, said intake is an issue not only in the region, but across the country.

That point was echoed by several health providers who spoke this week about these proposed changes. They often acknowledged the tension of closing local behavioral health units for a regional one, but noted that the centralized approach has the potential for improved services and for keeping some fashion of inpatient mental health services in the Valley.

Center for Human Development Chief Operating Officer Lois Nesci said it seems Baystate has had some “forward thinking” on offering these centralized services.

“I believe and I hope it can only bring additional support to those in most need of behavioral health services,” Nesci said.

Clinical & Support Options Vice President of Community Based Services Nick Fleisher said there are pros and cons to the centralization of the behavioral health hospital.

“I want to emphasize that we feel this is a complicated issue that Baystate is embarking on,” Fleisher said. “It’s good that they’re trying to come up with a creative solution. There’s still so much we don’t know about it. We’re waiting to hear more. We’re partnered with Baystate and we will continue to partner with them as closely as we can.”

Of the organizations that provide the continuum of care of human services in the region, a majority have facilities in Greenfield. BHN runs Northern Hope, the detox center at the Lunt Silversmiths buildings; CSO provides crisis services and often is the one directly on the ground assisting folks in need; ServiceNet provides services to those in need of shelter; CHD has a wide array of medical services and helped the Community Health Center of Franklin County open up its new joint health care center on Main Street in the old Sears and Roebuck building.

A lot of these organizations also evolved from the era of deinstitutionalization and the closing of the state psychiatric hospital in Northampton as service agencies were tasked with assisting people in need of services, while not restricting their freedom of movement.

Ed Sayer, CEO of CHCFC, the community health center, said he was mixed about the decision.

“So many general hospitals that have psych units across the country are closing because they just can’t make it work financially,” Sayer said. “I’m grateful. They’ve made a commitment to keep their psychiatric service. All of that is good. The problem is that it’ll have significant impact.”

Sayer discussed at length some of the chief problems advocates have voiced over the proposal: questions of transportation, continuity of care and staffing.

Sayer, who used to run an inpatient unit at Cooley Dickinson, said it can be very difficult to run one when adequate staffing is not available.

This is an issue others noted, where the profession first off does not produce enough certified employees to meet the needs of this region. In addition, when people do choose to go into the field, they have lower salaries than hospital nurses on average, plus high levels of stress, so burnout tends to be high.

Sayer pointed to increasing work with teaching hospitals, and potentially bringing up conversations of partnerships that can facilitate a pipeline of adequate staffing to the region.

Transportation issues

On transportation, Baystate in its statement said the site in Holyoke was selected because of its central location to Interstate 91 and the Massachusetts Turnpike, along with access to public transportation.

There are little means of getting to Holyoke from Greenfield by public transportation and even less of an ability from around Franklin County; there is no means of getting there on the weekends by public transit from the hilltowns. It is possible that people in need of going to the proposed hospital in Holyoke could be transported by ambulance, which could be reimbursed by insurance — although there are separate issues to be raised about widespread concerns across the county over having sufficient ambulance services.

The broader question is how people would get back to their respective communities after being discharged from inpatient services, which typically lasts less than a week.

“If it turned out they did nothing and the patients just went to Holyoke, it’d be a catastrophe, but I don’t think that will happen,” Sayer said.

Opioid Task Force of Franklin County and the North Quabbin Region Co-Chair and Franklin County Register Probate John Merrigan said he has been in discussions with Ron Bryant, the president of Baystate Franklin and Noble, about transportation among other issues.

Merrigan said Bryant is committed to making sure the transportation question is answered.

“Right now they have a lot more to do to solve the community concerns and I want to give them that chance before I say ‘yay’ or ‘nay,’” Merrigan said. “Right now they’re being responsive to our concerns, so we’re going to wait it out.”

ServiceNet Vice President of Strategy and Business Development Jim Frutkin said he is also waiting to find out more information on the plans. He acknowledged the potentional loss of a local resource but said the systems around it — like all of the service agencies in an area like Greenfield — would remain ready to provide those services as they have been.

He said it could also be beneficial because of a proposed increase in specialized care in the area, along with additional services for children and adolescents.

A spokesperson for the Massachusetts Department of Mental Health said in a statement this weekend the governor’sadminstration is investing $1.9 billion through the 2022 budget year for behavioral health services. There are 2,945 acute psychiatric beds in the state, according to DMH, through 67 psychiatric hospitals and acute units in general hospitals.

“Increasing timely access and availability of a full range of quality treatment options is one step to fulfilling the unrealized promise of treating behavioral health in parity with physical health care,” the DMH spokesperson said.

You can reach Joshua Solomon at:

jsolomon@recorder.com

413-772-0261, ext. 264




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