The meeting came on the heels of an announcement that,
due to cuts in state funding, CHA will eliminate 300 jobs across the
network and will consolidate and eliminate some services. Major changes
in Somerville include the elimination of the Addictions and Detox Unit
and inpatient services at Somerville Hospital.

Other changes
include the closure of six primary care centers, including two in
Somerville. The dental practice in Somerville will close and merge with
their Cambridge site, the number of beds in psychiatric units across
the system will be halved, and adolescent inpatient services will be
eliminated at Cambridge Hospital.

The mood at the community
meeting was somber as the panelists laid out the budgetary context that
lead to the proposed cutbacks.

"We're facing dramatic cuts
related to the loss of revenue from the Commonwealth," said the
alliance's chief executive officer Dennis Keefe, explaining that 15% of
its budget being cut halfway into 2009, and 25% beginning in July 2009.
CHA is especially sensitive to fluctuations in state funding, since
these funds account for 67% of its budget, he said.

These levels
of reductions, however, are a significant improvement over the state's
initial proposal, Keefe said. Had Somerville's Congressional delegation
had not stepped in to negotiate with the administration, CHA would be
facing bankruptcy. The higher level of state funding, however, is
contingent on CHA consolidating.

Mayor Curtatone urged the
attendees to keep the proposal in perspective, saying that "the changes
to services at Somerville are intended to make sure it survives in the
long run." When attendees suggested that they hadn't tried hard enough
to fight the budget cuts, the Mayor countered strongly, saying that if
the Somerville delegation hadn't worked together to counter the initial
budget, Somerville Hospital would be closing.

"Even a victory is
a loss for the community," State Senator Anthony Galluccio said of the
delegation's success in securing higher levels of funding than
originally proposed.

Many of the community members who
contributed to the discussion were skeptical that CHA would remain able
to serve all its members if the proposed changes pass. Some argued for
the necessity of eliminated programs, and many expressed disappointment
over the losses sustained by CHA.

Several community members
responded strongly to the closing of the Addictions and Detox Unit. One
of the unit's staff members said that many of their patients are
homeless, and that if they lose this safe space they will have nowhere
to go, and will start using again. Panelists admitted that they did not
have any definitive solutions, but said that they will be working
closely with community providers and the Department of Public Health
(DPH) to figure out how to meet the needs of those who are losing the
service.

A staff member from the dental services unit addressed
the panel, asking how they would be able to serve the same number of
patients with the proposed system-wide reduction from 12 to 5 dentist
chairs. Chief Operating Officer Allison Bayer responded by saying "we
can do more with less," and that implementing administrative lessons
learned will help them increase their operational efficiency.

Another
CHA staff member asked the panel how the issue of how parking would be
handled at merged sites that will absorb new patients, saying that the
parking situation is already bad enough at some locations to cause
patients to switch providers. Panelists responded that they are looking
into shuttle services to alleviate this issue.

A staff member
from the pediatric inpatient unit, which would close under the current
proposal, asked the panel about their basis for this decision. CEO
Dennis Keefe responded by saying that it was a utilization issue, and
that in the past year, 43% of the time the unit had one or zero
patients.

One attendee explicitly called for single-payer healthcare, and this comment garnered the loudest applause of the night.

Panelists
concluded by acknowledging limitations presented by both budget and
current state policies, but maintained that this proposal would provide
the best possible outcome. "If this fails, we have no backup" cautioned
State Representative Denise Provost.

CHA board members will vote on the proposal on February 10.

In
an effort to correct a few items in last week's story that were
misreported, Doug Bailey was interviewed to set the record straight.

The
reported cut of 300 employees will be spread throughout the entire CHA
network and not all at Somerville Hospital. These cuts are combinations
of layoffs, resignations, hourly changes, retirement and regular
attrition, according to Doug Bailey, CHA Chief Communications Officer.

Clinics
will not be cut at Somerville Hospital. Bailey said,"Clinic and
administrative services will be expanded under the proposed plan,
preserving the hospital as a vital and thriving institution."

The
reduction in psychiatric beds is almost entirely at Cambridge Hospital,
not Whidden as previously reported, and the SH Adolescent Psych unit
will be transferred to Cambridge Hospital.

After the changes, CHA will still have 95 mental health beds, one of the largest facilities of its kind in the state.

Bailey
continued, "We believe we can continue to meet the needs of core
communities with this level of attention and focus on mental health
services."

There is no existing pediatric unit at SH and thus there will be no cuts in this type of service there.

Bailey
praised the work of Mayor Curtatone and his office, referring to the
many hours of hard work put in between CHA and the mayor's office in
helping make these tough decisions.

"It's really difficult to
convey how much painstaking research goes into these decisions. We're
keeping the Somerville ER open and the Cambridge Hospital is less than
a mile away."