Updated: Apr 6, 2021
Our blog has thousands of recipients weekly and is widely read outside of the State of Rhode Island. Many comments we have received through our website and Facebook pages indicate a level of disbelief that a state would turn its collective backs on the most vulnerable population that it has an obligation to take care of - but this story continues and the more that is exposed, the more it looks like an attempt to whitewash the truth.
We can trace this current crisis back to 2009 when the Obama Administration issued a mandate that all those who received reimbursement from the Center for Medicare and Medicaid Services (CMS) develop an electronic health records system to continue receiving reimbursement from the federal government. For over ten years, the State dragged its feet on developing this program for the Eleanor Slater Hospital system even though they had the opportunity to receive a program for "the cost of the CD" from the Veteran's Administration.
As a result, the administration ended up losing its ability to collect reimbursement from CMS in 2019, which appears to have become the pretext for closing the hospital, citing this lack of federal money and the fact that the cost of operating the Eleanor Slater system fell directly on the backs of Rhode Island’s taxpayers, even though it was their own mismanagement (or plan) that resulted in this situation.
And that leaves this question, “If it were any other agency or department, would that paperwork have been completed in a timely manner so as to avoid the reimbursement cut off, or was it a plan to close the hospital system using this as a convenient excuse?”
As someone who worked with federal grant monies in the past, I can almost assure you that the State of Rhode Island has scores if not hundreds of such federal paperwork requirements to complete annually in order to receive federal monies for projects, so why did they ignore this one for nearly a decade?
So let’s look at this story in retrospect and where we are at this point.
Our previous blogs discussed Zambarano, its rich history, and the stories of miracles that have occurred there. In our last blog about this controversy, we discussed the first hearing that occurred on this issue that seemed like such a disconnect between reality and the administration's spun truths that on so many levels it was both embarrassing and infuriating.
So much so that State Senator Jessica De La Cruz issued a press release the following morning highlighting her and Representative David Place's concerns:
“Last night, the Senate held its first oversight hearing regarding Eleanor Slater Hospital (EHS), in which we heard from members of the hospital administration. Unfortunately, some of the administration's testimony was inconsistent with reports and testimony received by doctors, mental health, and patient advocates. Clearly, future oversight hearings will need to address these discrepancies. Fortunately, tonight the Senate passed a new rule that allows the Committee Chair to require that testimonies offered are sworn in. Rhode Islanders expect and deserve open, honest, and forthright testimony, especially from their state government.
Representative David Place and I are renewing our calls that all hospital discharges cease and admittance begins immediately until oversight hearings conclude and Disability Rights Rhode Island investigation is complete.”
A Swipe at Zambarano Staff
The day following the hearing, I received an email from an "undisclosed source", who identified themselves as a "state employee" claiming that “the staff was concerned about their own jobs and did not truly care about the patients at Zambarano”. This, as I read and re-read it, was a not-so-subtle swipe at those who provide care to those at the hospital.
As someone who worked in social services and the counseling field both as a provider and an administrator for over three decades, I was completely angered by this and the veiled attempt to discredit the staff to somehow justify the administration's actions. Although I did not answer the emailer, my response is this, “why shouldn’t they be worried about their jobs?”
Those staff who provide services for patients at the Eleanor Slater Hospital system have families, too. They have children, cars, mortgages, and need to be concerned about their jobs. I have witnessed the work of dedicated health professionals. I have stood next to staff at Shattuck Hospital (where I worked) as they cleaned up diarrhea from an AIDS patient with Clostridioides difficile (C. diff, a contagious and severe form of diarrhea) while holding her hand and assuring her that everything would be alright. I watched a young social worker meet with a family after their son overdosed on fentanyl, providing support and understanding to a mother and father who had struggled with their child's addiction for 25 years.
Those who choose this work certainly don't do so for the money. There is something special inside them that gives them the compassion to care for those with developmental disabilities, people with mental illness or suffering from an addiction, teens, and adults with traumatic or acquired brain injuries, elderly with dementia, and those without a voice or anyone to advocate for them. Many are alone in the world. The work they do is difficult, demanding, and something that others depend on.
Many who do this work have undergraduate or advanced degrees yet make less than the barista who serves you the morning coffee. And, imagine the student loans that must be paid for. Many who do this work don’t pay off these loans until their own children are preparing for college.
These people make a significant difference in our society and the lives of others in a work environment that others would not dare venture into. They are required to have strong professional and personal boundaries, something most in other jobs cannot begin to fathom. These workers, to be successful, must keep their thoughts to themselves, to never impose their needs or values onto those they provide services to or their families.
So to address the 'state employee' who somehow thought that taking down the staff who are concerned for their own well-being and that of their own family, you certainly won't find a sympathetic ear here. And, you should be ashamed of yourself.
A Long Planned Closure?
Then came another email from a different state employee who chose to shed some light on this issue and who claimed to have knowledge that the plan to close Zambarano has been in the works for years. The first email stated:
"I read your (sic) [blog] on Saving Zambarano, you should be looking at DCAMM "Division of Capital Asset Management and Maintenance" they are the ones who are suppose to maintain the Hospitals, they have been holding off spending on the hospitals for the past two years trying to close a 2 million deficit in their own budget & using the excuse that they are going to close the hospitals anyways, that's why nothing gets fixed at Zam, all these problems have been known about for years."
So, who or what is the Division of Capital Asset Management and Maintenance? According to the website:
The Division of Capital Asset Management and Maintenance was established by the RI Legislature in 2016. Under the leadership of the Department of Administration’s Director Michael DiBiase, DCAMM’s Division Director Carole Cornelison leads a team of over 100 staff across five state campuses and numerous satellite locations. DCAMM has the responsibility for managing and maintaining an asset portfolio of 1800 buildings statewide while meeting the highest standards for health, safety, security, accessibility, energy efficiency, and comfort for the state employees who occupy these buildings and the public they serve.
This was followed up with another email from the same source, stating:
"The Chief Integrated Facilities Manager denied the repair of the 02 system at Zam last year, there are emails regarding this, also the Division Director of DCAMM has stated in the past that the State should not be in the hospital business, they are already getting ready to transfer patients tomorrow from Zam to Regan & are trying to keep it quiet very few at Regan know that its happening."
A Lack of Candor?
If we are to believe these emails sent to us, the problem with the oxygen system was known about last year, yet, according to Kathryn Power, the director of the state's Department of Behavioral Healthcare, Developmental Disabilities and Hospitals last week, this was a recently discovered issue.
"Over the past 24 hours there was a fairly difficult problem as a result of the fire marshal's visit to Zambarano," said Power, regarding the oxygen tank leak. "Looking at what happened, if some of the patients need to be moved to the Regan campus [in Cranston] — [we] need to make some decisions as to what to do as next steps," she said.
What or who is to be believed? The emailer told us that there exists an email chain within the Division of Capital Asset Management and Maintenance that can prove prior knowledge of these problems that the administration willfully failed to address and are now using these as a step-by-step process to close Zambarano.
These emails I received were sent to those who can do the proper investigative work on this and hopefully expose this ruse if they are indeed true.
Thumbing Their Nose at the Vulnerable
So as the untruths continue to mount, those who claim to care about the disabled and their families in the state showed the most disgusting level of disrespect possible -- they signed off at the latest hearing on Zambarano without notice.
On Thursday, April 1st, another hearing was held on the closure of Zambarano. Kathryn Power and her top deputies signed off without telling those at the hearing they were leaving, astonishing lawmakers and families who still had questions for them about the future of the hospital.
Before this rude and callous act, State Representative, Patricia Serpa, a Democrat who is the chair of the committee, addressed Power about the Zambarano controversy. "When these things are shrouded in secrecy, cloaked in secrecy and information is not revealed, I think we can agree that you can see why the families of some of these patients, and frankly the staff, you can see why they become suspicious of the motives of your department, they become suspicious of the direction your department is taking because they feel left out of a significant portion."
When Power and her team signed off, Serpa stated, "I think it's important but apparently we have some directors who don't share our sense of importance. Families are reasonably upset for the plans or the lack of plans for their loved ones."
Others also weighed in on the fate of Zambarano with NBC 10 news.
"We're a family up there," said Shirley Pacheco. "My son Adam has been up there for 26 years. To be honest with you, I don't think Adam would have survived anywhere else for 26 years had it not been for Zambarano and the care he gets up there."
"Our patients are scared," said Kwame Larbi, President of Local 1350. "They keep asking questions, 'What's going on?' 'What's up?' We are all scared."
"The story is always changing, there's no clear direction and it just makes no sense at all," said Nicole Barnard, a lawyer for RI Council 94.
"You're hearing that doctors are being pressured to discharge patients by people who don't have medical degrees and don't even know the patients," she said. "You have people who require very intensive, around-the-clock care, and people are talking about discharging them with no plan out there."
Following last week's fiasco at the hearing, Kathryn Power resigned, stating this was something she had planned to do. Her letter reads as follows:
It has been my pleasure to return to state government in January 2020 as the Director of the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals.
I believe that returning to the department helped all of us embrace a more aligned set of programs and services that are highly reflective of the least restricted environment, the most appropriate level of clinical care, and the strong themes of personal choice, a safe, stable living situation, and whole life self-management.
Just as in my previous stewardship of this department, my priority has been, first and foremost, the well-being and sensitive care of individuals with behavioral health conditions, intellectual/developmental disabilities, and hospital patients.
Serving more than 50,000 Rhode Islanders with complex conditions is a daily challenge and the 1100 staff who work in this department are strong public servants with remarkable compassion and dedication to our mission.
Due to a family member's recently diagnosed health issues, I submitted my resignation to the Governor; my last day as Director will be April 9, 2021.
It has been an honor to serve the citizens of the state of Rhode Island once again, and I thank you for all the ways you have helped me move the department forward.
Wishing you the best,
Providence Journal Report
Today (April 5, 2021) The Providence Journal reported that the state-run Zambarano Hospital in Burrillville currently has just two full-time doctors for 74 patients.
One is on borrowed time, having been laid off and then given a temporary reprieve.
When she leaves, the state's "last-resort" hospital for patients with traumatic brain and spinal cord injuries, which as recently as a year ago had six full-time doctors, could have one.
Two doctors retired over the last six months, earlier than they said they had planned. Two were laid off. The House Oversight Committee learned Thursday of the resignation of a third Zambarano doctor, Bette Jean Gillerin. Gillerin has not spoken publicly.
But Dr. Normand Decelles Jr., the recently retired physician administrator/medical director at Zambarano, told the lawmakers that Gillerin's resignation, after 24 years at the hospital, followed a "contentious conversation" she had the night before with Dr. Andrew Stone, the chief of medical services at Eleanor Slater Hospital.
"How shall I say [it]? Dr. Stone attempted to persuade Dr. Gillerin to transfer Zambarano patients to Cranston, 'for their safety,'" Decelles said. "She resigned on the spot effective April 14, 2021."
"I continue to learn every day about administration gas-lighting the staff and the public ... while in reality gutting Zambarano. ... and forging forward with irresponsible actions that put the safety of current patients at unnecessary and preventable risk,'' Decelles said.
So let's remember, these are elected officials, who are supposed to look out for the most vulnerable of our society. When we elect them, we also assign to them a responsibility to appoint those with similar stewardship of protecting those who may be unable to care for themselves. These are the unelected officials who are in cabinet positions, heads of agencies, and other government positions. And from top to bottom, they need to be held accountable. We will continue to follow this story.