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What Ails Them

Town Meetings across Franklin County express worries about hospital services.

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Tuesday, May 21, 2013
The rally in support of Baystate Medical Center nurses, hosted Occupy Franklin County, begins on the Town Common with a song lead by Tom Neilson on guitar ,and Ann Lewin, a nurse at BFMC, holding loud speaker. story DR 12/3/17 Geoff Bluh

Over the past several weeks, Town Meetings in nine Franklin County communities have passed non-binding resolutions expressing concern about changes at Baystate Franklin Medical Center—the county’s sole hospital—that supporters say have reduced residents’ access to necessary healthcare.

According to the resolution, “some important services” once available at BFMC are now only available at Baystate Medical Center in Springfield, about 40 miles south. (The formerly independent Franklin Medical Center affiliated with Baystate Health in 1987.)

Having to go to Springfield for services, the resolution says, “presents a challenge for many residents,” particularly given the region’s limited public transit.

The resolution calls on Baystate to “commit all necessary resources to ensure the provision of all needed services and to commit to the long-term viability of a full-service community hospital” at BFMC.

So far, voters have approved the resolution in Deerfield, Montague, Hawley, Shelburne, Colrain, Erving, Buckland, Whately and Heath. Town Meetings in Leyden and Wendell are due to vote on the resolution in the next few weeks.

Backers of the resolution say it indicates widespread uneasiness about the future of medical services in Franklin County.

The hospital’s administration, however, disputes claims that BFMC has lost services to Springfield and maintains that the resolution is a ploy by the nurses’ union, which has been engaged in contentious contract negotiations with Baystate for 19 months.

 

Certainly, that contract dispute is firmly in the background of the resolution campaign.

Last October, the nurses union, which represents 209 members at BFMC, staged a 24-hour strike, which drew considerable support from residents and community groups, many of whom joined the nurses on a picket line. While wages are part of the contract dispute — a major sticking point is a proposal by management to change eligibility for overtime pay — there are larger issues at stake about the quality of healthcare in the county, said Donna Stern, a psychiatric nurse at BFMC and co-chair of the nurses’ bargaining unit.

“Conversation blossomed around the strike,” Stern said. “That conversation went well beyond our contract to (residents’) concerns about their local hospital.”

In March, the Mass. Nurses Association organized a public forum at Greenfield High School on services at BFMC, where residents expressed concerns about reductions in pediatric care, mental health and other services, including ones they said were being transferred to Springfield. Some at the meeting questioned whether healthcare decisions were being made for financial reasons. After the meeting, a working group was formed to address those concerns.

Several elected officials also attended the meeting, including Franklin County Sheriff Christopher Donelan, who later told the Greenfield Recorder that hospital officials ignored his efforts to talk about the concerns. “I think it’s very disturbing that elected officials and community leaders cannot get their phone calls returned,” he said.

 

In a press release about the Town Meeting resolutions, the MNA outlined cuts it says have taken place at BFMC, including “the elimination of pediatric services, reduced urology services, reduced services for the treatment of cardiovascular disease, elimination of home care services and reduced lab services, along with cuts in the staff who deliver direct patient care.”

In an interview with the Advocate, BFMC President Chuck Gijanto called some of those claims “mystifying” and maintained that Franklin County hasn’t lost services to Springfield.

For instance, he said, the hospital continues to have a pediatric practice, and while there has been a reduction over the years in inpatient pediatric care at BFMC, that’s a reflection of medical advances that have resulted in fewer children being admitted as inpatients anywhere. Kids who do need specialized care are sent to Springfield, Gijanto added, although that’s always been the case.

In other cases, he said, changes at the hospital reflect financial and other constraints that are common across healthcare these days, not a decision to shift services to Springfield.

For example, he said, BFMC lost its urologist last year and has struggled to find a replacement, as has been the case in many rural areas, where recruitment of physicians, especially specialists, is challenging.

BFMC added a cardiac office last year, he said, and has also added vascular-surgery services, which will be built up as demand grows. And the homecare program was eliminated almost a decade ago, “because there wasn’t enough volume to support the services,” Gijanto said, adding that there are private homecare companies in the area.

Earlier this month, BFMC sent a letter signed by Gijanto to all Franklin County households, in which he sought to counter “some of the recent negative publicity created by the (MNA) about community healthcare services shrinking and/or moving elsewhere.”

The letter listed areas where services have expanded, including sports medicine and rehab, and described BFMC’s relationship with the Springfield hospital as way to offer fuller services to patients. “We view it all as local care—our community hospital; our top notch academic medical center just down the road,” Gijanto wrote.

 

Hospital administrators, Gijanto told the Advocate, share the community’s interest in seeing strong services at BFMC. “We agree with them. We want a viable hospital in our community, and a viable hospital in our community really means something different than it did 10 years ago.” That includes, he said, a shift toward more outpatient care and away from inpatient hospital beds — “and that’s where nurses jobs are,” he said. “They’re concerned about those jobs.”

The Town Meeting resolution campaign, Gijanto said, is “a tactic that the MNA is using all across Massachusetts right now: if you can’t get the contract you want, you start trying to shake the confidence in the hospital throughout the community. … This is purely a tactic to get us to agree to the contract demands that we’ve indicated are not financially viable to us.”

But Stern denies that the resolutions are a union ploy. By organizing the March meeting, she said, the nurses union simply created an opportunity for residents with concerns to share their experiences and discuss how to address them. To say that the effort is driven by the union is an insult to engaged residents, Stern said.

“The people that are coming out for this working group, these are really intelligent people, well-informed people who have been doing their own research.” She also criticized Gijanto’s letter, saying it glossed over problems and showed a reluctance to engage in a back-and-forth with those expressing concerns.

The nurses’ union and Baystate management were due to return to the negotiating table on May 22.•

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