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DPH Issues Finding Declaring Child Psych Unit at Cambridge Health Alliance an Essential Service

Massachusetts Nurses Association/NNU, 5/24/13

States CHA Closure Plan Would Deprive Children in Eastern Mass. of Access to Needed Care
The Department of Public Health has just issued its findings regarding the proposed plan by Cambridge Health Alliance to close its nationally recognized child psychiatric unit for the care of young children with acute mental illness (see the letter attached)  The DPH finds that this unit provides an essential service that is “necessary for preserving access and health status in the Cambridge Hospital’s service area, which for the children and adolescents it serves extends throughout Eastern Massachusetts.”
The DPH based its finding on the testimony of dozens of mental health advocates, physicians, nurses and parents of former patients who spoke in passionate opposition to the closing at the hearing on May 8, where the only people speaking in favor of the unit’s closing were two officials from Cambridge Health Alliance. The DPH letters cites a number of serious issues related to the propose closure plan, including that Cambridge Health Alliance:

  • had failed to consult with members and leaders of the community that it serves to assess the impact of reducing beds on patients and families in need, and possible alternatives to reduction of necessary services;
  • would, under its plan, reduce the number of beds available for younger children and thus increase time spent waiting in area emergency departments throughout the Commonwealth;
  • would through the reduction of its beds, and the provision of child and adolescent psychiatric services on one unit rather than its two distinct child and adolescent psychiatric units, place younger patients at risk; and,
  • would, through the reduction of its beds, force families to find services outside of the hospital’s service area, thus reducing family involvement and support for children in need.
  • The DPH letter calls upon Cambridge Health Alliance to provide a detailed plan as to how they will address these concerns and maintain access to services for these children, which will then be reviewed by DPH and the Department of Mental Health.

View the DPH report

In the wake of the announcement by Cambridge Health Alliance (CHA) of their plan to close 11 child psychiatric beds, specifically beds dedicated to the care of children age 3 – 9, the Massachusetts Nurses Association/National Nurses United had announced its strong opposition to this plan as it represents an abandonment of a population of children who need the care provided by this award-winning program.
“We greatly appreciate DPH’s findings that this is an essential service, and that the loss of this services will deprive children throughout the region the care they deserve,” said Betty Kaloustian, RN, chair of the MNA local bargaining unit at Cambridge Hospital, which represents the nurses who work on the unit.  “Our hope now is the CHA changes its plans and the state officials do whatever is necessary to ensure that this service remains open for these vulnerable children.”
Currently, Cambridge Health Alliance operates two separate units for the care of children and adolescents with acute mental illness:  a 13-bed Child Assessment Unit (CAU) for children ages 3 -12; and a separate 14-bed Adolescent Assessment Unit for children 12 -19.  The CHA plan is to consolidate these units, reducing the 27 beds currently available to children to just 16 beds – a 40 percent cut to their bed capacity for children with mental illness.  The new combined unit will serve children from 9 – 18, which will mean younger children aged 3 – 8 will no longer have access to care at the facility.  In fact, 45 percent of the children seen on the CAU are between the ages of 4 – 8.

The decision comes at a time when there is a critical shortage of all types of mental health services and beds in the commonwealth, particularly beds for children and adolescents.  In fact, the legislature has formed a special Mental Health Commission this year, which was created specifically to respond to this growing crisis.  As a result of this crisis, more than 40,000 patients a year, many of them children and adolescents, are being boarded in our hospitals emergency departments waiting from several hours to several days for treatment beds, and the waits for children and adolescents are even longer.

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