Opposition to addiction clinic closure continues

March 1, 2013
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Broad opposition to the closure of a 15-bed detox unit at Brigham and Women’s Faulkner Hospital continues to be voiced following a public hearing Feb. 15. Those who spoke at the hearing in opposition to the closure included a representative of Mayor Thomas Menino, state lawmakers, city councilors, medical professionals and “graduates” of the program.

Brigham and Women’s Faulkner Hospital, located at 1153 Centre St., plans to close an in-patient drug addiction clinic in favor of a new specialized addiction team and outpatient clinic. The change, expected to happen around the end of April, is being pitched by the hospital as a service improvement. But critics, including local state Rep. Liz Malia, say it is based on funding.

“This restructuring of addiction services has never been a financial issue, but a patient safety issue,” Faulkner Professional Clinical Services Vice President Ed Liston-Kraft told the Gazette through a spokesperson.

“The new addiction team model that we’re building represents a significant financial investment in making the care we will deliver to be safe and of high quality to our patients,” he said.

Malia told the Gazette that “very few people spoke in favor of the Partners plan.” Partners HealthCare is the owner of Faulkner Hospital.

The opposition voiced at the state Department of Public Health hearing “sent a very powerful message to the Partners folks that this is not acceptable,” she said. “They’ve got to show us where these folks are going to go if they’re not going to care for them anymore.”

“We have to look at the big picture here and look at what it costs to not treat these people,” she added. Malia is the chair of the Joint Committee on Mental Health and Substance Abuse in the state legislature.

State public health officials can require changes in the Faulkner plan or delay the shutdown, now slated for the end of April, if they believe the needs of patients will not be met by the proposed plan.

Menino stated in a letter read at the hearing, a copy of which was provided to the Gazette, that while he supports the establishment of a supplementary outpatient clinic, he “cannot support…the elimination of the in-patient substance abuse unit.”

“Given that these are currently the only level-4 [high-level care] beds in the Boston area–and the scarcity of such beds elsewhere throughout the state—it is too risky to dismantle the unit without guaranteeing patient access to in-hospital services while testing out a new model of care,” Menino wrote.

Another letter presented at the hearing, read by City Councilor Matt O’Malley and signed by 11 of the 12 other city councilors, states that the move “would not only have negative impacts on the patients…[it] will result in increased pressure on our emergency rooms, and overcrowding of other, lower-level units where the patients will not receive the same level of care.”

“The effects could be disastrous,” the letter said. “We urge you to protect this program.”

District 5 Councilor Robert Consalvo was the only councilor to not sign the letter.

According to the Department of Public Health, the 15 detox beds at Faulkner are a small percentage of the 881 beds statewide, but a large part of the high-level beds for the sickest patients, who can experience life-threatening side-effects. There are 140 such high-level beds in Massachusetts, only 26 of which are in Boston. Aside from Faulkner’s 15 beds, there are 11 such beds at St. Elizabeth’s Medical Center in Brighton.

Dr. Jacquelyn Starer, a physician in the Faulkner detox unit, criticized Faulkner administration at the hearing for saying that the 15-bed unit is often not filled to capacity. She said that administrators have intentionally under-funded the unit, only allowing 10 patients at a time, and have falsely suggested that the lower patient numbers indicate a lower need.

Social workers present at the hearing agreed, saying that it’s very difficult to get a patient into the unit.

“Most of the patient calls that our team receives are not Level 4 patients. It doesn’t mean they don’t need help,” just a lower level of care, Liston-Kraft told the Gazette. “The demand for addiction services is high but it has not been our experience that the demand is at the Level 4 level of care.”

“The closure of addiction services at Brigham and Women’s Faulkner Seven South sends a chilling message to the community and seems to be a textbook example of a hospital corporation putting the bottom line ahead of patient care and community needs,” said Jeff Hall, a spokesperson for 1199 SEIU United Healthcare Workers East, the state’s largest healthcare workers union. “Hopefully, Partners will rethink what appears to be a serious misstep on their part, one that is troubling to their own employees and the broader community.”

Suffolk County Sheriff Steven Tompkins told the Gazette in an interview that he opposes the loss of beds at Faulkner because many people who don’t get in-patient detox treatment end up arrested on criminal charges.

“In the absence of those beds, and they really need those beds there, [people with drug problems] come to us,” meaning county jail, he said.

John Ruch contributed to this article.

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