Published: April 23, 2008 11:36 pm      

MEMORIAL: Letter shows ‘draft’ proposal to close child’s unit drew health officials ire

Although they have since come to terms on satisfactory arrangements, New York state health officials were not pleased with the timing and quality of Niagara Falls Memorial Medical Center’s original proposal to close its child and adolescent psychiatric care unit.

In a letter dated Feb. 15 and addressed to NFMMC President and CEO Joseph Ruffolo, officials from the state Department of Health and state Office of Mental Health, suggested that the hospital’s preliminary plan to close the Bridges Child and Adolescent Behavioral unit by March 1 failed to meet state regulations and did not satisfactorily explain how patient needs and other issues would be handled once the unit ceased to exist.

A copy of the letter, signed by Thomas Wallace, field office director for the Office of Mental Health, and Sheila Kee, associate commissioner for the state Department of Health, was obtained by the Gazette through a Freedom of Information request.

“Our offices take strong exception to the fact that the Jan. 16, 2008, date at which the closure plan was submitted to the Department of Health and Jan. 28, 2008, date which the plan was submitted to the Office of Mental Health fail to meet the advance notification requirements specified by New York state regulations,” the letter reads. “Regulations governing the New York State Department of Health stipulate that a licensed facility must provide a 90-day advance notification for a service or program closure. Similarly, the Office of Mental Health’s process for a Full Review Prior Approval Review closure application is approximately 120 days. Niagara Falls Memorial Medical Center’s failure to meet these requirements could result in enforcement actions.”

The hospital’s Board of Directors agreed in January to move forward with the unit’s closure, citing serious and long-standing challenges in the county’s Medicaid approval process and inadequate payment rates for behavioral health services. Initially, the board set a March 1 shutdown date for child psychiatric services. In February, the hospital provided union workers in the unit with layoff notices. The closure was later extended to May 2.

The letter in question was sent to Ruffolo “very early” in the closure process and speaks to many issues that have since been addressed and are no longer relevant, according to hospital spokesperson Patrick Bradley.

Bradley likened the original closure plan to more of a draft proposal and said it was prepared by staff from the hospital and the Bridges unit who were not entirely familiar with the ins and outs of state requirements for eliminating such programs.

Back in February, state health officials called on Memorial to amend its initial closure plan to address several areas that were not “sufficiently” explained, including patient transfer procedures, transportation arrangements for linking patients to needed services and educational programs intended to inform parents, families and the community about the availability of alternative services.

The letter asked for the closure plan to be amended to address 10 specific issues, including the development of formal agreements with other medical facilities and transportation service providers, procedures for transferring patients to other facilities and provisions for educational outreach programs.

The hospital submitted its final closure plan for the unit on April 4. Three days later, James Clyne, director of the Department’s Office of Health Systems Management, sent another letter to Ruffolo, indicating that the hospital’s final plan “satisfactorily meets the criteria set forth by the department” and Memorial staff was authorized to begin shutting down the unit.

“The hospital’s closure plan has been approved by the health department and we are still moving forward with a closing date of May 2,” said Jeffrey Hammond, a spokesperson for the state Health Department. The plan also been accepted by Niagara County’s Community Services Board. Bradley said the hospital expects to receive a formal authorization from the Office of Mental Health sometime this week.

The unit will stop accepting new patients on Friday. The closure plan calls for children under 12 who visit Memorial and are in need of mental health assistance to be transferred to BryLin Hospital in Erie County. Adolescents older than 12 will be directed to Erie County Medical Center. As part of the plan, informational letters and fliers will soon be distributed to community members and organizations, explaining the details of how to access care in the wake of Bridge’s closure.