Health center ends care for 5K adults

February 1, 2013
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By Peter Shanley and John Ruch, Gazette Staff

JACKSON SQ.—The Martha Eliot Health Center (MEHC) at 75 Bickford St., which is run by Boston Children’s Hospital (BCH), will no longer care for adult patients, it was announced Jan. 29 in a letter to BCH’s staff, associated personnel and volunteers.

The change will affect about 5,000 adult patients, according to Dr. Shari Nethersole, MEHC’s acting medical director, in a Gazette interview.

MECH will keep treating children and adolescents, but will transfer the care of adult patients to other facilities in what is expected will be a months-long process that starts immediately.

The focus on young patients is part of BCH changing its clinical services on “what it does best,” Nethersole said. There are about 4,000 child and teen patients at MEHC, she said.

“After much deliberation, we have decided that we must focus Boston Children’s expertise and resources solely on providing patient care and developing community health and outreach programs for those we know best—the children and adolescents of the community,” said the letter from BCH Chief Executive Officer James Mandell and BCH Chief Operating Officer Sandra Fenwick.

Nethersole did not say why MEHC is making the change at this time. She did say there is “not any specific financial pressure.” Instead, she said, BCH is responding to trends in the health care industry, particularly the “coordinated care” or “total care” model emphasized in the new federal Affordable Care Act health insurance reform legislation. That model involves medical practices offering not just the usual doctor’s office care, but also connections to social workers, psychologists, nutritionists and similar experts in a patient’s total health. As a children’s hospital, BCH does not have those kinds of networks for adult patients, Nethersole said.

Nethersole said that BHC attempted to team up with one or more adult health care providers at MEHC and keep treating adult patients, but those talks “did not come to fruition.” BCH spokesperson Rob Graham said the hospital agreed to keep the identity of those potential partners confidential.

Capacity at community health centers has been an issue in recent years, especially with mandatory health insurance and a shortage of primary-care doctors, as the Gazette previously reported. But, Nethersole said, various other health centers have expressed a “willingness and desire” to take on MEHC’s adult patients. They include the Dimock Community Health Center in Jackson Square and a new Brigham and Women’s Hospital-affiliated practice on S. Huntington Avenue in Jamaica Plain. Health centers in Roxbury and the South End also have spaces open, Nethersole said.

MEHC aims to have all of its adult patients transferred to other facilities by July. A letter to all patients is going out in English and Spanish. Nethersole said that MEHC will provide active help in finding a new doctor to patients who need it, and will proactively identify patients who might need extra help.

While child and teen medicine will be the focus of MEHC in the future, it may change significantly, too. Nethersole said that BCH and MEHC will talk with public health officials, other health centers and similar community experts to make sure MEHC’s services are needed and not duplicating those already available.

“It’s hard to say what’s going to be there” in terms of health services and programming, she said, describing BCH officials as “wide open to what the needs are.”

MEHC is the only health center completely owned and operated by BCH. The hospital’s partnerships with several other clinics will be maintained, Nethersole said.

As for MEHC staffing, “the possibility and likelihood will be some staff will not be retained,” Nethersole said.

“As you can imagine, there was a lot of distress and [questions about] what it will mean for the future,” Nethersole said of MEHC staff learning of the change earlier today. But, she added, the staff also expressed a willingness to make the transition work.

It is unclear whether the move will require regulatory approval. Nethersole said that BCH has “had conversations” with the state Department of Public Health and so far has not been told of any required public hearings.

The health center was founded by a different operator in the 1960s inside the Bromley-Heath public housing development. In the 1990s, it moved into its current building in an expansion and improvement demanded by the community as part of the redevelopment that brought the Stop & Shop supermarket to Jackson Square. BCH took over the health center more than 20 years ago, Nethersole said.

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