MNA: DPH Deems Steward Morton Hospital's 32-Bed Substance Abuse Treat Unit An Essential Service "Necessary for Preserving Access and Health Status Within the Hospital's Service Area."

Advocates voice skepticism of the impact of the DPH decision, as it is the latest of dozens of such closings deemed essential, which hospitals closed anyway, as DPH has no authority to require providers to maintain any service, no matter how essential to public health

The decision comes as the Joint Committee on Healthcare Financing has scheduled a hearing on June 20^th to consider pending legislation designed to give the state and communities more power to preserve essential services

BOSTON, June 7, 2023 /PRNewswire/ -- The Department of Public Health has issued its findings regarding Steward Healthcare's plan to close the 32-bed MORCAP (Morton Comprehensive Addiction Program), located at Steward Morton Hospital in Taunton, deeming the program an essential service "necessary for preserving access and health status within the hospital's service area. The full DPH letter can be found here.

The DPH finding follows strong opposition and extensive testimony from local public officials, nurses, addiction treatment and community advocates who attended the required public hearing, held by DPH on May 18, where they claimed the closure will only add to a growing crisis in the region, as local hospital emergency departments are already overburdened with patients waiting for addiction treatment beds and services. 

In its letter detailing its findings, the DPH notified Steward that they have 15 days to submit a letter detailing it's plan on how the corporation intends to mitigate the negative impact of the closure on the community, including how it intends to provide alternative sources of transportation, ensure access to this same level of care at alternative sites, how they will ensure those services admit patients regardless of their insurance status, and how these alternative services will be safely staffed, among other requirements. 

"While we are pleased to see that DPH agrees with us that this is an essential service for the community, we see their call for a plan from Steward as an empty exercise, as the plan fails to do the only thing that will ensure access to the same level of care for the community, which is to maintain this essential service!" said Katie Murphy, president of the Massachusetts Nurses Association, which represents the nurses who staff the program. "For 15 years we have watched Steward and all other hospital systems close these programs, issue these pointless plans required by DPH, which, first of all, are no substitute for the service being lost, and second, the hospitals rarely if ever follow through on what is promised in those plans."

The MNA is not alone in its skepticism about the current process for addressing the loss of essential services. State Senator Marc Pacheco, who represents Taunton and other communities served by MORCAP, submitted scathing written testimony critical of the process, stating in part:

"The public hearing process conducted by the Division of Health Care Facility Licensure following the proposed closure of an essential service is completely devoid of any value to the community members who participate. Considering the consistency with which the Division officially deems a local community's healthcare services "essential" just they are nevertheless relocated and/or gutted, this painful process borders on unusual cruelty to the community members whose health and well-being rely on said care. If the Department or Division officially finds services to be "essential," and then does nothing to prevent those services from being eliminated, then I respectfully submit that our current classification system has no actual value or purpose."

The MORCAP facility provides desperately needed alcohol/substance abuse detox and recovery services to the people of Southeastern Massachusetts. The service was previously called the NORCAP Lodge and located in Foxboro, where it was affiliated with Steward Good Samaritan Medical Center. In 2021, Steward initiated its closing, but made a pledge to the DPH and the community that it would be replaced by the new permanent MORCAP facility at Morton Hospital in Taunton. In response to the NORCAP closure proposal, the DPH had deemed it an essential service to the region to preserve the public health in the community. In pursuing the new closing of MORCAP, Steward initially wrote to the DPH that it would transfer the facility to a new location, to Steward's Carney Hospital in Dorchester– a facility in another County, where there is already an overwhelming demand for addiction treatment. Steward subsequently rescinded that application, and changed it to an application simply to close the Morton facility. The owners say they might in the future apply to build a new facility at Carney, but to date they have not submitted such an application. 

This closing is the latest in a line of service closures by hospital systems in recent years, including the loss of behavior health beds, maternity, pediatric, oncology and other services, services in most every case the DPH has deemed to be essential to those communities. Yet DPH lacks the authority to stop such closures and in nearly every case, the providers closed those services.

The MORCAP decision follows just two weeks after UMass Memorial Health filed its request with DPH to close the Birthing Center at the UMass Memorial Health Alliance Leominster Hospital, a service that policy makers, caregivers and community advocates contend will jeopardize the health of mothers and newborns in Greater Leominster and Fitchburg, leaving mothers to deliver in overcrowded emergency departments or on the side of highways as they travel to birthing centers in faraway communities.

In response to this dangerous trend, the MNA has filed two pieces of legislation that would provide communities and officials with more data and more power to protect needed services. The first of these bills listed below will be the focus of a hearing by the Joint Committee on Healthcare Financing, scheduled for June 20 at the State House at 10 a.m. 

An Act Relative to the Closing of Hospital Essential Services will:

• Extend the official notice period to the DPH in advance of a closure or discontinuation of health services.
    
• Require any hospital proposing closure or discontinuation of health services to provide evidence of having notified and provided the opportunity for comment from affected municipalities before the notification period begins.
    
• Instruct the Attorney General to seek an injunction to maintain the essential services for the duration of the notice period.
    
• Prohibit the hospital from eligibility for an application for licensure or expansion for a period of three years from the date the service is discontinued, or until the essential health service is restored, or until such time as the DPH is satisfied with a modified plan.
    
• Prohibit the closure of beds, units, or facilities during any declared state of emergency pertaining to health care.

An Act Assessing Health Care Access will:

• Require the Department of Public Health in consultation with the Health Policy Commission to commission a study analyzing and delineating the existing cadre of services provided by the state's acute care medical and psychiatric hospitals based on the need for those services in all regions of the Commonwealth, with recommendations as how to ensure access to those services.

"By allowing these closures, our public health system demonstrates to already vulnerable and marginalized groups that their interests do not matter," Murphy said. "The Commonwealth must put patient and community needs at the forefront of this decision-making process."

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 25,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on healthcare issues affecting nurses and the public.

SOURCE Massachusetts Nurses Association