Wednesday, July 24, 2024

The CHA Somerville campus displays some health specialties on Highland Avenue. (Photo: Marc Levy)

Cambridge Health Alliance wants to switch half the beds in a new unit for children and teens with neurological and developmental disorders to space for adolescents with more common psychiatric illnesses, because most of the special beds are empty. The health care system asked state officials Tuesday for permission to make the change, chief executive Assaad Sayah said.

“We are in a learning phase,” Sayah told members of the CHA trustees finance committee. As of Jan. 24 there were only five patients in the 24-bed unit, he said. “There are units open for years that are not fully operational,” he said. “Currently one of the largest has only eight patients.”

Neurodevelopmental disorders for children and teenagers include autism, attention deficit/hyperactivity disorder and intellectual disability. The new unit was part of a substantial expansion of psychiatric services for children and adolescents at the CHA Somerville campus that more than doubled the number of beds for that age group. The Health Alliance had not treated kids with neurodevelopmental disorders before.

It wasn’t clear whether CHA is considering ending neurodevelopmental services entirely. Sayah said the Alliance wants to switch half the beds temporarily “at least while we are assessing the eventual operation of that unit.” He added that adolescent psychiatric treatment “is where the need is.” System spokesperson David Cecere said: “We are committed to providing high-quality inpatient psychiatric care to as many children as possible in the state. The neurodevelopmental program is a new, specialized unit that requires time to develop, including training and recruiting staff. Given the tremendous demand across the state, we are exploring our options in regard to expanding our inpatient psychiatry access for adolescents, which is an area of great need.”

The 24-bed neurodevelopmental unit, a 21-bed space for adolescents and 24 beds for children from 3 to 12 opened in June. State leaders had praised CHA for expanding services at a time children and teens in mental health crisis sometimes waited for days and even weeks for an available inpatient bed.

None of the new inpatient units at Somerville appear to be full, though. Psychiatric discharges at Somerville, where mental health is the only inpatient treatment, were more than 70 percent below the budgeted level as of Dec. 31, according to the most recent financial report presented to trustees.

And inpatient psychiatric volume for all age groups at CHA continues to lag far behind expectations. The report said the number of psychiatric discharges overall was more than 50 percent below projections for this fiscal year, which ends June 30.

Aside from psychiatry, CHA is contending with a statewide shortage of anesthesiologists, chief financial officer Jill Batty said. Chief medical officer Jeffrey Hoffman called it a “crisis,” although Batty said “surgical volume has been pretty stable” and Hoffman said surgeries had been “pretty close” to budget projections despite the shortage.