PROVIDENCE – A state budget plan released this week by Gov. Dan McKee would see a new hospital built on the Zambarano campus of Eleanor Slater Hospital at a cost of $65 million to replace the existing 189-bed facility.
The proposal would see a 98,000-square-foot building with 85 beds constructed over the next three and a half years in Burrillville, replacing the current hospital, built in 1901. The new structure would be erected on the sprawling, 250-acre Wallum Lake campus with the help of a $53.6 million loan.
But questions remain for local legislators who have advocated in recent months to keep the Burrillville hospital open – including the issue of what will happen to existing patients at Zambarano. The hospital provides long-term care to those with complex and demanding medical conditions, many of whom are immobile, and in need of constant and specialized medical assistance.
“Nothing in the budget plan actually addresses our primary concern,” said Rep. David Place. “There’s no place for the existing patients to go.”
The proposal, presented as part of McKee’s $11.2 billion budget for the 2021-22 fiscal year, is in keeping with the recommendation of consulting firm Alvarez & Marshal, put forth in a, “transition and redesign plan,” last year. Former Gov. Gina Raimondo hired the firm to conduct a cost-saving study on consolidation of the state-run hospital chain, which also includes units in Cranston.
The finance-focused study called for the discharge of patients under the principal that all should receive care in the, “least restrictive,” setting possible, a mantra repeated in McKee’s draft budget.
“This proposal ensures that Rhode Island meets healthcare delivery best practices by treating individuals with much shorter lengths of stay, shifting treatments to comprehensive mental health services in the community rather than restrictive settings,” the budget documents note.
It seems major financial problems at Zambarano began in September of 2019, when Rhode Island fell out of compliance with the federal government and could no longer bill for Medicaid reimbursement. According to recent reports, the issue, caused by failure to invest in a computerized records system, cost Rhode Island taxpayers at least $60 million.
The state applied to be reinstated with the federal system last May, but still remains in noncompliance.
With no formal action taken on the study’s recommendation and funding halted, it seems the hospital stopped accepting new admissions last spring, and doctors say they were pressured to release patients even if they could not find placement elsewhere.
Place, along with Sen. Jessica de la Cruz and patient advocate groups, have been ringing alarm bells over those discharges, and questioning when the public would be informed of the state’s long-term plan.
According to a recent report in the Providence Journal, Zambarano’s current patient count is 74, compared with 92 last year.
Cynthia Lussier, president of United Nurses & Allied Professionals Local 5019, which represents Zambarano’s registered nurses, confirmed to NRI NOW last month that two of the hospital’s six wings are slated for closure, affecting 22 patients. UNAP is calling for a formal investigation of the decision.
With more potential discharges looming, both patients and their families have written letters in recent months on behalf of the hospital, pointing to the role Zambarano has played in their quality of life.
Place points out that in recent weeks, several doctors have also spoken up, stating the discharges are, “wholly inappropriate.”
“Governor McKee’s plan doesn’t do anything to address that concern,” Place said. He notes that the McKee proposal is, “not only a new building. It’s a new facility.”
“They want to close the hospital and build a nursing home,” Place said. “Those are two totally different levels of care.”
de la Cruz cited similar concerns.
“We see there’s a large amount allocated to Zambarano, but it looks as though it would serve a different population,” she said of the budget.
The senator noted that due to risks associated with the current building, discussion has focused on the cost of repairs.
“The question everyone’s asking is if it makes more sense to tear down the hospital and build a new one,” she said, noting that she’s scheduled to tour Zambarano next week.
McKee’s plan for the Burrillville facility is part of a larger consolidation effort that includes eliminating 100 full-time positions, and shutting down the Cranston-based Aldolf Meyer and Regan units of Eleanor Slater to create a standalone Institute for Mental Disease.
Officials from the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, which oversees Eleanor Slater, have said that staff reductions would come by leaving some unfilled positions vacant, as well as through attrition and early retirement.
The governor also recommends financing $1.4 million over the next four years, “to facilitate asset protection for buildings, equipment, road, parking, open space, and utilities at the Zambarano Campus.”
“This multi-year project will make the repairs necessary to ensure the reliability of the campus infrastructure, to include the domestic water
supply, the wastewater disposal system, the steam heat, and the electricity provided to the buildings that house institutional patients on the campus,” note budget documents.
State officials have said that patients would be allowed to continue to live in the existing hospital during construction.
Rhode Island lawmakers will review the Eleanor Slater proposal in the upcoming weeks as part of the state budget process, which heads first to the House of Representatives.
de la Cruz said that she believes that regardless of the outcome, McKee will be forthcoming about plans for the hospital’s future. She noted that before Raimondo left the state to accept a position as secretary of commerce for President Joe Biden, legislators were left searching for answers, even as it became clear changes were taking place at the hospital.
“He’s been very responsive, so I’m confident he’s going to be transparent about the process,” said de la Cruz of McKee. “I’m very hopeful.”