Taunton Hospital Closure Plans Stirring Fierce Battle on Beacon Hill 03/23/2012

STATE HOUSE, BOSTON -  A member of Senate President Therese Murray’s leadership team predicted Thursday that the Senate would support blocking a Patrick administration move to shutter Taunton State Hospital, a mental health facility that serves the state’s southeast region.

Sen. Harriette Chandler (D-Worcester), assistant majority leader, told a capitol auditorium packed with union members opposed to the closure that she believes “the Senate as a whole” would demand a comprehensive study before any changes are made the mental health system.

Chandler spoke at a rally organized by Sen. Marc Pacheco and House Speaker Pro Tempore Patricia Haddad to oppose the closure. The state Department of Mental Health announced the closure in January, indicating that it would move the bulk of the hospital’s 169 beds about 55 miles to a new, state-of-the-art facility in Worcester slated to open this year. The closure is due to be completed before Dec. 31, 2012.

Under the administration’s plan, a portion of the beds would also be transferred to Tewksbury, about 60 miles from Taunton. The Patrick administration has described the move as a sound decision to shift the state’s focus toward community-based services, to move patients out of an antiquated facility to a more modern hospital, and the help DMH live within a budget that has been whittled down in recent years.

Advocates for keeping the hospital open have rejected those arguments as misleading and short-sighted. The proposal to halt the closure in favor of a study fueled an often ear-splitting rallying cry delivered by attendees of the rally: “Stop and Study.”

A growing chorus of legislative leaders, southeastern and central Massachusetts lawmakers and municipal officials have warned that closing Taunton State Hospital would leave the region without easy access to long-term mental health beds, forcing patients and their families to travel long distances to the Worcester facilities or worse, cramming them into already-stuffed emergency rooms and acute care facilities.

In addition, advocates for maintaining the hospital say the facility’s 415 employees would be redistributed throughout the mental health system, potentially creating havoc for less senior employees, who could be bumped to new facilities.

Although many of the arguments presented at Thursday’s rally have been voiced by critics of the closure in recent weeks, the tone was markedly more militant.

Tony Caso, executive director of AFSCME 93, a union that represents 250 Taunton State Hospital workers, called the administration’s plan a “threat that needs to be stopped.” Rep. James O’Day (D-Worcester) said a “fight” to prevent the closure “begins today.” Karen Coughlin, vice president of the Massachusetts Nurses Association, called the closure plan “a cold-hearted and dangerous decision that will have devastating consequences.”

Rep. Shaunna O’Connell (R-Taunton) called attendees of Thursday’s rally “soldiers” who would not permit the closure of the facility.

“This is a fight. This isn’t something that we’re going to give it a shot and see what happens. We mean business,” she said.

The push to keep the hospital open drew a bipartisan cadre of lawmakers – from Republican Reps. Keiko Orrall of Lakeville, Angelo D’Emilia of Bridgewater and Jay Barrows of Mansfield, to Democratic Reps. David Sullivan of Fall River, Sarah Peake of Provincetown and Tim Madden of Nantucket. Bristol County District Attorney Sam Sutter, a Democrat, was also on hand. The mayors of Taunton and Worcester joined the rally as well.

Asked about the issue on Thursday afternoon, Senate President Therese Murray said southeastern Massachusetts hospitals lack the number of beds to handle the demand for mental health services in the region should Taunton close. “I think that’s something the members feel very strongly about,” she said.

Asked about the Patrick administration’s contention that even without Taunton, the southeastern region would be left with 32 beds in Fall River and Pocasset, Murray said, “The hospitals are already suffering and you have people in the ERs waiting to get into the few beds they have so we need a bigger presence than that.”

Administration officials say the opening of the Worcester facility will maintain the number of inpatient mental health beds across the state at 626 and that the southeastern region will be left with a broad array of community-based services.

Administration officials have distributed packets of information to lawmakers making their case for closing the facility. They noted that all employees from Taunton would be offered jobs at the new facility. They also noted that many of the residents at Taunton State Hospital hail from other regions of the state, including 61 who come from outside the southeastern region. They also point out that patients are admitted and discharged from the hospital every day, meaning that only 10 to 20 current patients will likely be at the facility when the beds are transferred to Worcester and Tewksbury.

Administration officials also distributed a chart detailing the hometowns of patients at other mental health facilities across the state, including Worcester State Hospital, Tewksbury, Shattuck, Solomon Carter Fuller, Corrigan and Pocasset. In each case, patients hail from across the state. Some patients at Worcester State Hospital, for example, come from New Bedford, Boston, Acton, and Brookline, while some patients in Tewksbury came from Westborough, Worcester, Marlborough and Quincy.

In addition, the administration counted as supporters the heads of the Association for Behavioral Health Care, the Massachusetts Association for Mental Health, the Massachusetts Society for the Prevention of Cruelty to Children, the Disability Law Center, the Center for Public Representation and the Massachusetts Association of Behavioral Health Systems.

Marcia Fowler, commissioner of mental health, declined to respond to the more fiery rhetoric lobbed by protesters and sidestepped when asked whether she believed election-year politics has played a role in the tenor of the conversation. She said her goal is to “continue sharing what the facts are.”

Fowler said that currently, there are more residents seeking to leave long-term care facilities than there are patients waiting to be admitted. She said that arguments that the closure of Taunton would pack emergency rooms, strain law enforcement or increase homelessness were ill-informed since only private mental health hospitals accept patients from emergency rooms. Fowler also noted that a 2004 mental health study – one that opponents of closing Taunton say bolsters their case – actually concluded that only about 613 inpatient beds were required in the system.

“We still have people in our facilities that are waiting for community placement,” she said. “I think what we need to do is continue sharing what the facts are and to keep reiterating that there is not reduction in service and there is expansion in service. We are expanding community placements which is where our significant need is.”

David Matteodo, executive director of the Association of Behavioral Health Systems, said his group has opposed previous hospital closures but views the closure of Taunton differently because the state will maintain its total number of mental health beds at 626. Although he said that each day, about 50 to 70 patients in acute care facilities often wait for “weeks” to get into long-term care beds, the Department of Mental Health “insists they have enough beds” and are attempting to reduce the average stay in long-term facilities to help see more patients.

Matteodo, who lobbies on behalf of mental health and substance abuse facilities, agreed with protesters’ call for an independent analysis of the state’s mental health needs, but he said a moratorium on closing facilities should not be a prerequisite.

“What we’re saying is, as long as the total [of beds] stays the same, that’s our key right now,” he said. “Whether they need more, you can argue for that. DMH thinks – I think their message over the last few years they want to emphasize community so much, they could get by with less. What we’re saying is, we’re not sure.”

The Massachusetts Association of Mental Health argued in budget testimony earlier this month that if the Legislature blocks the closure of Taunton State Hospital, it is obligated to find another $20 million to $25 million to ensure that both the Taunton facility and the new Worcester hospital are able to operate at full capacity. But even if those funds are available, said the organization’s executive director Bernie Carey, it would be better spent on an expansion of community-based services.

Pacheco, a Taunton Democrat, rejected administration arguments, contending that they intentionally omitted facts from their argument, including the fact that the state’s 626 mental health beds are already short of the 740 beds recommended by the agency in 2004. The new Worcester facility, he argued, was intended to be a hub for central and western Massachusetts’s mental health needs.

“But on Day 1, as it opens, under the plan that is proposed, the overwhelming majority for those slots will be full because we’ll be transferring patients from the Taunton facility taking up the slots that were promised for Central Mass,” he said. “That’s what they don’t say. If I had that record, from a mental health perspective on this issue, I wouldn’t want to be talking about it either.”