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Boston Globe
30-01-2025
- Health
- Boston Globe
Pappas Hospital is old and costly. But before closing it, the state needs to prove care won't suffer.
By late January, he could dress himself, brush his teeth, sit up, and touch his toes, Rivera said. And he's happy. He attends school at the hospital, made friends, and took a trip to Target. The young man's goal is horseback riding and every day, using his wheelchair, he visits the horses on the hospital campus. He's living there indefinitely, as his parents can't bring him home until they find a handicapped accessible apartment with space for their family. Get The Gavel [Coming soon] A weekly SCOTUS explainer newsletter by columnist Kimberly Atkins Stohr. Enter Email Sign Up Rivera, who lives in Worcester, worries his son will emotionally shut down again if Pappas closes and patients are sent to Western Massachusetts Hospital in Westfield, as Healey has proposed. 'He's not going to be able to move out of bed,' Rivera said. The student population that Pappas serves would be expensive to treat and educate anywhere. The state subsidizes the hospital with $31 million a year. But Health and Human Services Secretary Kate Walsh says the proposed closure isn't about budget, but quality of care. After decades of disinvestment, its buildings are outdated, and a 358-page facilities study from 2023 found structural issues, problems with ventilation and electrical systems, inadequate room sizes, poor Wi-Fi, and other issues. Public Health Commissioner Robbie Goldstein said one major problem is the hospital can't serve children on ventilators because of a lack of electrical capacity or medical gases and small rooms. Advertisement 'The clinical needs of kids who need to be at a place like Pappas have changed, and the physical plant, the capabilities of those buildings, weren't up to modern medicine,' Walsh told the editorial board. Keeping the hospital open would undoubtedly require major facilities investments. But staff members, parents, and former patients are raising important concerns about whether Healey's proposal would accommodate children's medical needs at the cost of eliminating the enormous range of educational, recreational, and therapeutic services now offered there. Related : Based on accounts from staff, parents, and a 2019 A former employee's Advertisement The state plan would renovate a Western Massachusetts Hospital wing to create a 25-bed pediatric unit with assistive equipment and activity and play areas. State officials would work with families to find appropriate settings for other Pappas patients, including some who are turning 22 and aging out. The biggest question is how comparable the services would be. Officials from several unions representing workers, who oppose the closure, and families worry that children wouldn't be allowed to leave on weekends, wouldn't have access to full-time school, and would lose field trips, recreational opportunities, and freedom of outdoor movement. 'They're not going to have a prom at Western Mass Hospital,' said Nancy Silva, who retired from Pappas after 37 years and is a union leader at AFSCME. 'Instead of being alongside their peers, they're going to be within a geriatric population.' Goldstein acknowledged some services will be lost, but said the state is working on giving patients access to farmland on the Western Massachusetts campus so they can grow vegetables, is discussing schooling options with education officials, and will let them leave on weekends. If the state could commit to those programs now, it might assuage the concerns of some parents. Before proceeding with a closure that will move patients further from their families — who today are predominantly in eastern Massachusetts — and eliminate the recreational and social activities on the Pappas campus, state officials should also fully consider other solutions. There's no question renovating Pappas would take money — hundreds of millions of dollars, according to Goldstein. But, according to the facilities report, if the state can upgrade patient bedroom areas, it could house 74 students, increasing the insurance reimbursements that come in. There might be other ways to serve new populations and increase revenue — reviving a former summer camp for children with disabilities, expanding a new respite program that takes children for short-term stays, or opening the facility to patients with different types of diseases or care needs than are currently served there. While many students remain there for years, school officials at one point considered accepting students short-term to help them learn specific skills. Targeted, gradual investments could presumably keep core buildings usable or open new spaces. Advertisement There may also be options for raising money. The facilities report says the hospital has 110 acres of undeveloped land. It suggests potential uses like administrative housing, outpatient services for adults who have aged out of Pappas, or a solar panel farm. The latter two options could generate revenue. The state could also sell unused land to private developers and use that money to renovate the hospital, or develop a public-private partnership involving development and renovations. Silva said for about 20 years, the school would fund-raise to take each year's graduating class to Disney World. Perhaps philanthropy could cover recreational 'extras.' Ideally, the state would have invested in Pappas for decades and not let the facilities deteriorate. Today, state officials are right in seeking to provide care in facilities that meet modern medical standards. At the same time, Pappas has provided a unique environment for severely disabled children that has cultivated joy and independence. If ultimately there is no way to keep Pappas open, state officials must ensure that what it does right isn't lost in the transition. Advertisement Editorials represent the views of the Boston Globe Editorial Board. Follow us
Boston Globe
28-01-2025
- Health
- Boston Globe
Healey's cuts would be a blow to the state's most vulnerable
Get The Gavel [Coming soon] A weekly SCOTUS explainer newsletter by columnist Kimberly Atkins Stohr. Enter Email Sign Up Pappas provides students with vocational experiences that would guide them toward next steps in the community. The facility to which these students would be moved — Western Massachusetts Hospital in Westfield — is geared to adult patients and does not begin to meet the sensitive needs of these children. Advertisement Betty Chelmow Canton State should be investing in Pappas, not abandoning it After more than a century, the Pappas Rehabilitation Hospital for Children is slated for closure ('Healey plan cuts health spending'). According to Robbie Goldstein, state public health commissioner, 'Ultimately, this is about improving services and providing every child with the care they need.' No it isn't. What they need and deserve is the skilled, dedicated, and compassionate care they are getting at this underappreciated and underutilized gem of a state facility. The staff, many with decades of experience there, know how to do their very demanding jobs. This level of expertise cannot be duplicated. Children with complex physical, medical, and communication challenges can get all of those needs addressed at Pappas if only the state would commit to the facility and not treat this population, among the most vulnerable in the Commonwealth, as if they were expendable and ship them off to an inappropriate facility nearly two hours away. Advertisement My daughter spent 13 years at Pappas. She learned academic and self-help skills. She had a vibrant social and recreational life. She got excellent medical care. And she made friends with other children who never had one. Massachusetts should be upgrading, expanding, and showcasing this facility, not abandoning it. Naomi Angoff Chedd Brookline Facility's services can't be replicated at Western Mass. site As a retired special education teacher who worked for the Department of Elementary and Secondary Education at the Pappas Rehabilitation Hospital for Children for 23 years, I was saddened to learn of the proposal to close this facility. Pappas is a true collaboration between the Department of Public Health and DESE. Students not only get room and board but also many therapies, including occupational, physical, speech, and recreational, as well as medical, nursing, psychology, and social work services. This hospital has one-of-a-kind amenities that the Western Massachusetts Hospital does not, including an auditorium that has fully accessible seating on terraced levels as well as stage access. The facility also provides art, music, and computer access and adaptations. On top of all of that, it is also close to Boston and its excellent pediatric medical institutions. Governor Healey should reconsider her decision. Bruce Connelly Winchester When cuts must be wielded, we often see mental health on the block True to form, when budget cuts need to happen, the Department of Mental Health is often front and center. Eliminating 50 percent of case manager services to the most vulnerable of our residents is unconscionable. Advertisement As a social worker who started my career in community mental health and at DMH during the Reagan years, I am disappointed to see our Democratic governor make this move. Case workers do some of the most difficult work in the Commonwealth. This is a shameful proposal. Janet England Brighton The writer is a licensed independent clinical social worker.
