PROVIDENCE — On Wednesday, the House Finance Committee delved into the shrinking budget for the agency that runs the state’s “last resort” hospital, the likely loss of any federal Medicaid dollars and a proposal to borrow and spend up to $22 million renovating buildings slated for closure on the Cranston hospital campus.
It’s a mess. The House Finance Committee is not the first legislative committee that has tried to untangle it this year.
And the hearing is taking place on a day when one of the lawmakers who have been bird-dogging the controversy made public the resignation letters of two nurses who wrote they’d had enough.
“Unfortunately, this resignation is due to the hostile and stressful working environment I have been experiencing increasingly over the last year,” Michelle Garabian wrote Debra Martinelli, the manager of nursing services on the Zambarano campus of the hospital in Burrillville.
“It has felt like watching the slow painful death of a legacy,” Garabian wrote. “Belittling and berating are now the new normal.”
“This is disappointing,” said state Rep. David Place, R-Burrillville, “but very predictable … when the governor leaves an administration in place that, based on public testimony, has done nothing but intimidate and harass the employees of Zambarano for the past year and a half.”
In written testimony to the House committee, certified nursing assistant Cynthia Bolduc said she has witnessed doctors “taking patients off of necessary medicines that stabilize their behaviors in order to be able to ship them out to private nursing facilities in the community … [that] will not accept patients who are on certain kinds of medication.”
Removing patients “from these stabilizing drugs … [causes] very negative reactions such as refusing to eat, punching people and extreme self-mutilation,” she said.
“Unfortunately, we have recently lost a patient who died after being removed from the medication who then ceased all eating,” Bolduc wrote. (BHDDH has not yet responded to questions about her allegations.)
Issues lawmakers will confront
The bid for the $22 million to renovate several buildings on the Cranston campus is included in the budget that Gov. Dan McKee proposed to state lawmakers a week after his predecessor, Gina Raimondo, left on March 2 to become U.S. commerce secretary.
It’s a situation the agency – which has a newly appointed director, former Landmark Medical Center president and CEO Richard Charest – has not yet explained. (His Senate confirmation hearing is Thursday.)
The budget seeks approval to issue $22 million in “certificates of participation,” a form of borrowing that does not require voter approval for the “renovation and new construction of various facilities of the Eleanor Slater Hospital system, including Regan, Benton, Mathias and Adolph Meyer Buildings on the Pastore campus, the Beazley Building on the Zambarano campus, and newly constructed facilities as may be determined to best address present and future public health-care service needs.”
Several of those buildings are slated for closure or replacement under the Raimondo downsizing plan that McKee placed on hold amid allegations by doctors that they were being pressured into taking inappropriate and unethical actions to discharge patients who had nowhere to go.
RI Council 94 AFSCME is also battling the plan, which could cost union members’ jobs if the “Benton unit” is the only building left open on the Cranston campus and licensed for psychiatric patients only.
“Eleanor Slater Hospital acts as the provider of last resort for medically fragile patients, who require acute psychiatric care … not guilty by ‘reason of insanity’ patients, and critical medical long-term care for elders requiring specialized services, such as ventilator beds,” Council 94 lobbyist James Cenerini wrote the lawmakers.
“Council 94 believes that this ill-advised plan should be scrapped,” Cenerini wrote.
Cenerini also posed a number of questions. Among them: “Why has BHDDH stated that over 50% of patients at Zambarano are psychiatric? Is this an intentional stratagem to prevent the resumption of billing?”
“Why should an agency that has wasted millions of dollars on consultants and can’t keep their numbers straight be granted another $60 million,” he said of the separate amount McKee is seeking to build a new building on the Zambarano campus to provide nursing-home instead of hospital-level care.
And “why is the administration pursuing the closure of the Regan building when it is the most modern Eleanor Slater Hospital Building?” asked Cenerini, whose union represents about 412 hospital employees in Cranston.
McKee told reporters at a wide-ranging news conference on Tuesday that he shares lawmaker and union concerns about the sudden surge in the number of patients that BHDDH’s top administrators have classified as psychiatric and thus, under federal rules, ineligible for federal Medicaid dollars.
On the Zambarano campus alone, the latest report says, the percentage of psychiatric patients jumped from 2% to 58% since May 2020.
The report was signed by Jennifer White, the chief financial officer, and Dr. Brian Daly, the chief medical officer, whom the House Finance Committee is expecting at Wednesday’s hearing to answer questions.
“The information is not in alignment … from day to day,” McKee said. “That’s why we brought in the hospital association to do a really deep dive on what’s happening.”
