Behavioral health care funds to be released in Mass.
Money meant to address staff shortages
Last year, Massachusetts set up a behavioral health fund amounting to $192 million, the remainder of $400 million from the American Rescue Plan Act. The money was meant to support initiatives to attract and retain behavioral health workers, and provide loan repayment programs, compensation for unpaid internships, and scholarship funding. Unfortunately, those funds did not trickle down.
This fall, however, the Department of Health and Human Services has plans to allocate approximately $25 million for scholarships, another $25 million toward stipends for student field work or other internships, and about $3 million to cover behavioral health licensure fees.
More than half of the funds slated to go toward loan repayment programs will not be available until March 2025.
The funding is an attempt to address staff shortages that have led to months-long waitlists for care.
A report this past May from the Massachusetts Health & Hospital Association (MHA) spelled out that behavioral healthcare is in crisis:
“As patients are stuck in beds, hospitals must absorb the costs of unpaid care for people that can’t be transferred out. Patients are boarding in hospital emergency departments because they can’t be admitted. Hospitals are spending enormous sums of money to hire temporary workers to continue providing high-quality care. Licensed beds can’t be staffed because there are not enough workers. Bed occupancy is unrelentingly high.”
MHA recommended measures to address the problem including growing the healthcare workforce by joining the Nurse Licensure Compact (which 41 other states have already done); reducing the barriers for those who wish to join the profession; and improving insurance reimbursement as well as the ability to transition patients to post-acute care settings.
But this problem has been ongoing for some time. David Matteodo, MPH, executive director of the Massachusetts Association of Behavioral Health Systems, previously spoke with New England Psychologist about staff shortages and the problems they created.
“The two biggest holes are nurses and mental health professionals. That’s been our biggest problem,” he said. “We haven’t been able to fill the beds. We’ve got about 600 people boarding in the ERs per day. Ironically, we have about the same number of beds. But we can’t put a patient in a bed if we don’t have the staff.”
Following up with Matteodo recently, he said there is an upside. While there is still a significant staff shortage in the behavioral health field, there has been some improvement.
New hospitals are being built or opening, which means more beds. (Norwood Hospital was being built but has been abandoned because of financial issues. But according to Boston’s Channel 25 News, Brockton Hospital was set to open in August after an electrical fire last year with a renovated emergency department and 12 new psychiatric beds.)
He said ED boarding in the state is down.
“I’m not sure if that’s a summer lull or if we’re getting back to some stability,” Matteodo said. “We’ve seen improvements, but there are still some gaps. You can have more beds, but you still need the staff to manage it.”
Katie Murphy, president of the Massachusetts Nurses Association (MNA) and an ICU nurse at Mass General Brigham, countered Matteodo’s point about available beds because other hospitals are in danger of closing.
She discussed the impact of Steward Health Care’s Carney Hospital and Nashoba Valley Hospital set to close by the end of August because of bankruptcy filings. Steward Health Care closed New England Sinai Hospital in April. The company was also in charge of the plans for Norwood Hospital, hence the standstill. Both Carney and Nashoba serve low-income communities.
“If Steward Healthcare’s Carney Hospital in Boston closes, we’re losing 70 beds. That’s going to be a massive problem,” she said. “If they close and people outside Boston are already backed up, it’s going to affect the whole state.”
Matteodo said it is not only acute care hospitals settings experiencing this issue. Nursing homes have been hit hard by staff shortages with people waiting for beds in geriatric psych units. When it comes to funding, he said, “The frustration has been the speed of implementation, but the good news is it’s going to come out in the coming months.”
Murphy noted, “People feel they do not have enough staff to care for their patients. It’s as simple as that.”
But there may be a silver lining. As New England Psychologist was going to press, Governor Healey announced a plan to rescue Steward’s financial problems from closing much-needed hospital space.
The state has found new owners and has a plan to move forward. Lawrence General will take over Holy Family, Haverhill, and Methuen Hospitals.
Lifespan will take over Morton and St. Anne’s Hospital and Boston Medical Center will take over Good Samaritan and St. Elizabeth’s.
About the state’s rescue mission, Healey said, “It’s a win for Massachusetts because we got rid of a really bad operator.”
MNA responded to Healey’s hospital negotiation saying it was a “positive development and a welcome sign.” However, they are still concerned about Carney and Nashoba hospitals impacting their communities “as the loss of these hospitals would precipitate a public disaster.”