State finds Holyoke Medical Center’s birthing services ‘necessary’ for area

  • Holyoke Medical Center, Wednesday, June 3, 2020. —GAZETTE FILE PHOTO

Staff Writer
Published: 8/19/2020 12:50:15 PM

HOLYOKE — As Holyoke Medical Center seeks to close its Birthing Center, the state’s Department of Public Health has deemed those services “necessary for preserving access and health status within the Hospital’s service area.”

The DPH’s determination comes as part of the state’s “essential service closure process.” The department held a public hearing on July 28, during which the hospital made its case for closing its 13-bed obstetrics service and 10-bassinet infant nursery. CEO Spiros Hatiras said the hospital had to do so largely because of a low birthing volume and the challenges that result.

Many community members and former employees, however, voiced outrage over the closure, which they said would disproportionately harm people of color and low-income patients in the city. Some former employees also accused Hatiras of undermining the Birthing Center by creating a work environment that forced out a popular midwifery practice and other longtime employees — allegations detailed in a Gazette investigation published in early June.

After gathering evidence, the DPH has now deemed the service necessary. As a result of that determination, the hospital must submit a plan to the department outlining how it intends to maintain access to inpatient maternity beds and bassinets for residents of its service area.

In an Aug. 12 letter to the hospital’s lawyer, the DPH laid out several elements that must be part of that plan. The department asked the hospital to provide information on the location and service capacity of alternative delivery sites, including whether those facilities have the ability to handle increased patient load, what type of services are available at those facilities and what medical diagnoses are accepted there.

Transportation was also a large concern that DPH wants the hospital to address. The department asked for details on travel times to alternative service delivery sites, an assessment of transportation needs and a plan to address them, and information about the effects of traveling on expectant mothers. The plan must also include a list of transportation options that exist for patients and how they will be made aware of those options.

Based on testimony from the July 28 public hearing, the DPH also requested details on how the hospital’s plans will meet the cultural and linguistic needs of patients in Holyoke, where more than half of residents identify as Hispanic and many speak Spanish as their preferred language.

The DPH also noted the concerns of those who spoke at the public hearing about access to family planning services, particularly given the fact that Holyoke Medical Center patients are being sent to Mercy Medical Center, a Catholic facility.

On the section of its website that lists its family planning services, Mercy lists only one option: the “Creighton Model FertilityCare System,” which is a fertility awareness method of family planning that involves tracking the menstrual cycle and avoiding sex on fertile days. The hospital’s website says it is 99.5% effective in avoiding pregnancy, but groups like Planned Parenthood put the effectiveness of fertility awareness methods at as low as 76% because they can be difficult to use correctly.

In its letter to Holyoke Medical Center, the DPH asked that the hospital’s updated plan include information on what steps it will take to ensure patients continue to have access to birth control and other sexual and reproductive health services after the hospital discontinues obstetrics services.

Finally, the DPH noted that some who spoke during public testimony said that Holyoke Medical Center had failed to appropriately communicate with the local community about the impact of eliminating the Birthing Center.

“The plan which you are required to submit must address how Holyoke Medical Center intends to initiate ongoing engagement with the local community to ensure they are aware of the impact of the discontinuance of these services and their input on the development and implementation of a plan to ensure access in the future,” the DPH letter reads.

Holyoke Medical Center has until the end of the month to provide its plan to the DPH. The department will review that plan, and if it finds that more information is needed it can ask the hospital to submit another response.

That is the end of the DPH’s authority when it comes to the unit closure, however. The state has no power to stop the closure or penalize the hospital for closing services, even if they are deemed essential.

Holyoke Medical Center had already closed its Birthing Center in early April in order to take in residents of the Holyoke Soldiers’ Home, where a coronavirus outbreak was spreading and would eventually kill at least 76 veterans. That closure happened more than a month before the hospital formally announced on May 29 that it planned to permanently shutter its obstetrics unit and infant nursery.

But local residents and health care advocates are still demanding that their voices be heard, with some calling for Holyoke Medical Center to reverse course and keep the Birthing Center open.

A local group known as the Coalition for Birthing Care Access is holding a demonstration Thursday at 3 p.m. on the corner of Beech and Northampton streets in Holyoke to call on the hospital to stop the closure of the Birthing Center. The coalition includes a partnership between Planned Parenthood Advocacy Fund of Massachusetts, the Massachusetts Nurses Association and Massachusetts Jobs With Justice.

One of the coalition’s members is Nykole Roche, the associate director of the Massachusetts Nurses Association’s division of labor action. She said the DPH should be able to have greater say over whether hospitals continue to provide services that are deemed necessary, but that current law doesn’t give the department that authority.

“We need to empower the Department of Public Health to make decisions about community-based health care,” she said. The nurses union has backed a bill that would, among other provisions, allow the attorney general to seek an injunction to maintain essential services during an expanded notice period. The bill would also make hospitals ineligible to apply for licensure or expansion for three years after discontinuing a service unless they restored that service or DPH approved a modified plan.

For now, residents who disagree with the closure will protest. One of those who will be at Thursday’s demonstration is Holyoke resident Sasha Jimenez, who said that the community can’t continue to let things like the Birthing Center closure happen.

“It has provided such great equitable care to Black and brown women in this community,” Jimenez said. “Removing it would do such a disservice.”

Dusty Christensen can be reached at dchristensen@gazettenet.com.


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