Tuesday, December 28, 2010

Arbour Hospital - A Primer

Arbour Hospital:
A Primer

Arbour Hospital
Arbour Hospital is a 118-bed psychiatric facility, located at 49 Robinwood Road in the Jamaica Plain area of Boston. It is part of the Arbour Health System chain.

Arbour’s inpatient services:
- An adult unit;
- An adolescent unit;
- A Latino adult program;
- An “Intensive Inpatient Observation Service” for crises; and
- Inpatient Electroconvulsive Therapy (ECT) services.

Outpatient services are provided for:
- Dual Diagnosis (adolescents and adults);
- Electroconvulsive Therapy (ECT) services;
- Partial hospitalization programs for adults, adolescents, and Latinos

Additionally, Arbour runs a 24-hour evaluation center and a “sober living” house for men.[1]

The Neighborhood - JP
Jamaica Plain, or “J.P.” is a popular neighborhood for young people, and has a strong social justice community. We hope that J.P. residents will take interest in this issue. State legislators representing the hospital’s district are Rep. Jeffrey S├ínchez (D-Boston), and Sen. Sonia Chang-Diaz (D-Boston). It is represented in the U.S. House of Reps. by Rep. Michael Capuano (D-Somerville).[2] Arbour Hospital’s CEO is Joe Murphy.

Arbour Hospital is a complex of buildings hidden from street view. It’s modern but shabby in appearance. In years of advocacy regarding psych hospitals, myself and others have seen a clear and constant pattern of disrespect there towards patients. Arbour has a very poor reputation in the consumer/survivor community, making it an ideal focus for rights activism.

What's the Problem?
From the info I have gathered, telephones are in public places, sometimes at nurses’ stations, and are often shut off. Visits are limited and denied completely in places. Patients are not aware of the rights they have, and there are reports of denial of interpreters and even food. Arbour provides ‘fresh air’ space, but it’s woefully inadequate (A triangle about nine feet on all sides). Smokers and nonsmokers are herded into this tiny space. This is a demeaning and disrespectful practice.

Unlike most private hospitals, Arbour is part of a ‘for-profit’ chain. Quarterly financial reports are not available for AHS facilities, but the information is ‘aggregated’ into the financial report of AHS’ parent company, Universal Health Services, which reports handsome profits (see below).[3]

On AHS’s home page, its CEO states that “Our staff views every patient as a fellow human being…who is entitled to empathy, dignity, [and] respect.”[4] Sadly, the evidence suggests otherwise.

Arbour Health System (Parent Company)
Arbour Health System (AHS) is the largest mental health/substance abuse provider in Massachusetts. There are app. 540 beds at Arbour’s six inpatient facilities, which are:

- Arbour Hospital (118 beds);
- Arbour-Fuller Hospital (South Attleboro, 101 beds);
- Arbour-HRI Hospital (Brookline, 68 beds);
- Lowell Treatment Center (Lowell, number of beds not available);
- Pembroke Hospital (Pembroke, 115 beds); and
- Westwood Lodge (Westwood, 133 beds).

AHS’ inpatient services include child, adolescent, adult, substance abuse/dual diagnosis, developmental disability and geriatric units. Short-term residential programs exist, including acute residential housing and “sober houses” for men and women. In addition, AHS runs the Choate Emergency Services Program (ESP) in Lowell.

Outpatient services provided by AHS include 15 partial hospital (PHP) programs at all hospitals plus the Boston Center clinic in Boston. Arbour Counseling Services has 11 outpatient clinics throughout Central and Eastern Mass., and Arbour SeniorCare provides mental health services to nearly 200 nursing homes.[5]

The CEO of Arbour Health System is Gary Gilberti, who is also a Senior Vice-President of Arbour’s parent company (see below). AHS was the birthplace of the private psych hospitals’ trade group - the Massachusetts Association of Behavioral Health Systems (MABHS), who has served as MABHS’ President.[6] This organization, which lobbies for most private psych hospitals in the State, is powerful and persistent. They have been the most outspoken opponents of patients’ rights reforms, and they are fighting the “Five Fundamental Rights/Fresh Air” bill very hard.

Universal Health Services (parent company of Arbour HS)
The Arbour Hospital and AHS are in turn run by a huge national corporation, Universal Health Service (UHS). Founded in 1978, UHS, headquartered in King of Prussia, Pennsylvania, is the largest provider of inpatient behavioral health beds in the US.[7] It is one of the largest hospital mega-chains in the country, running approximately 205 inpatient hospitals in 38 States plus Puerto Rico and the U.S. Virgin Islands. Of approximately 24,000 beds total, about 20,000 are for behavioral health and group homes. UHS runs about 45 medical facilities, but the rest are in behavioral health.

In addition, UHS runs group homes for ‘at-risk’ adolescents, schools for developmentally disabled and troubled youths, and juvenile detention centers.[8] In November 2010, UHS bought Psychiatric Solutions, Inc., one of the largest hospital chains in the US, for $3.1 Billion. Psychiatric Solutions, along with UHS, has been the focus of several U.S. Department of Justice investigations regarding alleged Medicare fraud, questionable business practices, and abusive treatment - especially towards children and adolescents.

UHS’ 2008 net revenue was over $5 billion, $1.2 coming from behavioral health.[9] The third quarter of 2009 shows a 41% increase in stock value and a 4% increase in net revenue compared to a year ago. Inpatient behavioral health admissions and lengths of stay also increased. According to an industry analyst, “The behavioral health business has been a very stable source of growth for Universal.”[10] Alan B. Miller, the CEO of UHS, cites “the steady performance of our behavioral segment” as a major factor in UHS’ financial success.[11] In 2009, Mr. Miller was the second-highest paid public health CEO in the nation, making over $12 million.12

In December 2006, Service Employees Industrial Union (SEIU) Local 1107, based in Las Vegas, published the report “Failure to Care: A National Report on Universal Health Service’s Behavioral Health Operations.” This report detailed serious violations across the UHS system, including serious incidents at Pembroke and Westwood Lodge Hospitals. It includes a section on “How to Protect Your Community From UHS,” stating “quality behavioral healthcare cannot be provided” with UHS’ “profit-driven business model.”13


I would like to emphasize that we are not trying to imply that those people who work at Arbour Hospital are “all bad.” I’m sure there are staff there doing their best to help. However, I believe it is of paramount importance to expose the conditions at Arbour Hospital to the public, the media, and lawmakers. We will send a clear, powerful message to ALL psych facilities that routinely violate our rights: risk management, perceived financial hardship, and understaffing can NEVER excuse illegal and inhumane actions. The rampant violations of human rights we are seeing go against the principles of good treatment and recovery. Yes, the hospitals are powerful, but WE have the moral upper hand.

Onward,

Jonathan Dosick
Coordinator, “Five Fundamental Rights/Fresh Air” effort
Southborough, Massachusetts
Jdosick@gmail.com





NOTES:
[1] Arbour Hospital homepage (http://www.arbourhealth.com/arbour.htm)
[2] Commonwealth of Massachusetts, Elections Division. My Election Information web page (http://www.wheredoivotema.com/bal/myelectioninfo.php)
[3] Jonathan Dosick, phone call to Arbour Hospital, December 28, 2009.
[4] Arbour Health Systems homepage (http://www.arbourhealth.com/)
[5] Ibid.
[6] Arbour Health Systems, “AHS CEO Elected New MABHS President,” AHS News, 9:3, (June 2006), Page 3 (http://www.arbourhealth.com/AHS%20News%20June%2006.PDF)
[7] Universal Health Services, Inc. homepage (http://www.uhsinc.com/index_uhs.php)
[8] Universal Health Systems, Inc. list of Behavioral Health Care hospitals (http://www.uhsinc.com/hospitals.php?type=behavioral)
[9] Universal Health Services, Inc. Universal Health Services, Inc. 2008 Annual Report
(http://phx.corporate-ir.net/External.File?item=UGFyZW50SUQ9MzM0NDgzfENoaWxkSUQ9MzE3NTMzfFR5cGU9MQ==&t=1)
[10] Marilyn Much, “As Recession Closed In, Hospital Chain Took Close Look At Expenses,” Investors Business Daily, Jul. 15, 2009 (http://www.investors.com/NewsAndAnalysis/Article.aspx?id=482297)
[11] Universal Health Systems, Inc. Press Release: Universal Health Services, Inc. Reports 41% Increase in 2009 Third Quarter Earnings Per Diluted Share, Raises Full Year Guidance (http://ir.uhsinc.com/phoenix.zhtml?c=105817&p=irol-NewsArticle&ID=1348684&highlight=), 10-29-09
12 Wortham, April. “CHS' Smith tops list of highest paid public health care CEOs,” Nashville Business Journal, 2010.
13 Service Employees International Union, Local 1107. Failure to Care: A National Report on Universal Health Service’s Behavioral Health Operations (http://www.qualitycarenevada.org/vertical/Sites/%7B992C33D2-E5F7-4961-AC41-C67ED717C22F%7D/uploads/%7BD315D6AE-ECC8-4A7F-85BB-F9C5C4B3951E%7D.PDF), Las Vegas, NV: SEIU Local 1107, 2006.

Saturday, December 18, 2010

Welcome to JusticeinJP!

The aim of this website is to keep a sharp focus on the human rights violations occuring at the Arbour Hospital in Jamaica Plain, Boston.

Arbour has a dismal and alarming reputation for violations of patient safety, improper use of force, rude and dismissive staff, and a lack of caring. As a longtime activist for rights at psychiatric hospitals, I have heard of many truly shocking occurences at Arbour.

The most important thing that this site hopes to provide is a forum for people to tell their firsthand stories about problems at Arbour Hospital. We are planning to bring these issues to the public, but we are in need of personal stories.

That being said, I want to reassure anyone posting to this site (which is still being created), that your confidentiality will ALWAYS be respected. I will be working on the best and most secure way to contribute to this site.

I hope this is a useful site for all, and it can be a vehicle for change. The consumer/survivor community must send a strong and united message: that this is nothing short of a civil rights issue, and we cannot and will not tolerate being treated as second-class citizens. The 'Status Quo' is no longer an option.

Onward,

Jonathan Dosick
Email: JDosick@gmail.com