Cambridge Health Alliance’s will host more psychiatric services for children and adolescents under a plan approved by trustees Tuesday. (Photo: Marc Levy)

Cambridge Health Alliance will expand and reconfigure its in-hospital psychiatric services over the next two years, especially for children and adolescents. The changes, approved by trustees Tuesday, will add services, more than double the number of beds for children and adolescents and move them from CHA Cambridge Hospital to the former Somerville Hospital.

For adults, CHA will open two units at Cambridge Hospital for a total of 22 new beds, the Alliance said in a press release. Eight of those beds will be for patients who are difficult to place in an inpatient unit because of their severe illness. Children and adolescents will get 42 new beds; the total expansion is 64 beds.

The Alliance is a safety-net system that serves many low-income and uninsured patients and is also a major regional provider of behavioral health services. The press release said emergency room wait times for mentally ill patients continue to rise because of the pandemic and continuing needs. The state’s secretary of health and human services, Mary Lou Sudders, praised the Alliance, saying: “Once again, Cambridge Health Alliance has stepped up to meet the health needs of the community, and in particular children with complex behavioral health needs.” And CHA spokesman David Cecere called it “an important initiative to meet the needs of our patients and communities.”

At the same time, there were hints that some neighbors of the former Somerville Hospital site, which now houses an urgent care center, specialty clinics and doctors offices, are not happy about the plan. At the Alliance trustees’ meeting Tuesday conducted via Zoom, chairman Joshua Posner gingerly welcomed some observers who had heard about the plan at a neighborhood meeting the previous night. He told them that the trustees didn’t have a time set aside for public comment at that meeting but they could send messages, and that the board would discuss the plan in private after a brief public session. Cecere said there will be monthly neighborhood meetings about the proposal at which residents could provide “their input on changes to the campus.”

The press office for Somerville mayor Joe Curtatone didn’t answer an email seeking comment.

The details

Cecere provided these details about the plan:

The adolescent psychiatric unit at Cambridge Hospital, which serves patients from 13 to 20 years old, will be the first to move to Somerville, with a target of April. It will expand to 21 beds from 14.

The number of beds for children aged 3 to 12 will increase to 24 from 13. The new child service in Somerville will have two 12-bed units and is targeted to open by the end of next year.

The Alliance will offer a new service for children and adolescents with autism spectrum and other neuropsychiatric disorders. Twelve-bed units for each age group will open in Somerville, targeted for the end of next year.

After the youth services move, the Alliance will use that space for 24 new adult psychiatric beds, including eight for hard-to-place patients with severe illness. The target for opening those units is March to April 2022. The Alliance now has 40 adult psychiatric beds at Cambridge Hospital.

Past proposed cuts

Proposals to expand hospital services could require state approval determining that more beds are needed. Cecere said Alliance officials believe the system is exempt from filing a Determination of Need application because its plan is “in response to the statewide mental health crisis that has been further exacerbated by the Covid-19 pandemic.” The Alliance will still have to go through “multiple approval processes” with both the state departments of public health and mental health before it can open units, he said, and will submit a formal notice to the public health department “in the near future, and DPH will determine the approval track that CHA needs to follow.”

The plan to expand psychiatric services contrasts with controversial efforts to cut youth behavioral services in 2013 and to end the Cambridge Hospital psychiatric emergency room in 2014. Both drew widespread opposition. The Alliance avoided the 2013 reduction when state legislators approved increased aid to the Alliance; the separate psychiatric emergency room no longer exists.

The Alliance’s budget for this fiscal year forecasts an increase in the number of psychiatric patients admitted to its two hospitals in Cambridge and Everett, citing “ongoing elevated” need resulting from the pandemic.

But volume dropped sharply from expected numbers for both psychiatric and general medical patients during the spring. In the first quarter of this fiscal year, from July 1 to Sept. 30, inpatient volume remained below the level for the same period the previous year.