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3/15/2021 Sen. de la Cruz, Rep. Place call on governor to halt Zambarano discharges

STATE HOUSE, Providence – Senate Minority Whip Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield) and Representative David Place (R-Dist. 47, Burrillville, Glocester) have asked Governor Daniel J. McKee to halt discharges and immediately and reinstate admissions to the Zambarano Unit of the Eleanor Slater Hospital until the Disability Rights RI investigation into patient abuse is concluded.

“Two separate agencies have called for investigations into the unattainable ‘criteria for admission’ BHDDH instituted last year,” de la Cruz said. “We need to ensure that no one else is harmed because of these irresponsible efforts. No more patients should be moved while the administration and the legislature work toward a long-term solution for these vulnerable people.”

The legislators have been working to keep the doors of Zambarano open. They recently learned that hospital administrators began planning the closure last year under the guise that services were not needed, and then began pressuring physicians to improperly discharge patients.

“It has become clear that administrators endeavor to make ‘qualifying for care’ at Zambarano impossible for everyone – including current residents,” the legislators said.

“This cannot stand. The nurse’s union has told the Department of Health that the Zam administrators’ efforts to discharge all the patients – with nowhere to send them – violates state statute.  Never mind that it’s a violation of basic human dignity and abandoning moral responsibility for people who cannot speak for themselves,” Place said.

The text of the letter is below:

March 15, 2021 

His Excellency Daniel J. McKee 
Governor of Rhode Island 
222 State House 
Providence, RI 02903 

Dear Governor McKee: 

Thank you for the time and attention you have invested in learning about what is happening to patients at the Eleanor Slater Hospital (ESH), specifically our constituents at the Zambarano Campus in Burrillville. We implore you to instruct the hospital administration to halt discharges immediately and reinstate admissions to Zam until the Disability Rights RI investigation into patient abuse is concluded. No more patients should be moved while your administration and the legislature work toward a long­
term solution for these vulnerable people 

We deeply appreciate the efforts you are making, but are concerned that you are not being fully informed of the true nature of the situation. It has become apparent that there is an organized effort on the part of BHDDH to discharge acute care patients when there is nowhere else capable of caring for them. Further, we have learned that there is a plan to downgrade Zambarano's license from an acute care facility to a nursing home. The United Nurses & Allied Health Professionals, which represents employees at Zam has asked the Department of Health to investigate "the effort underway to eliminate care at the facility." 

As you are aware, further clarity has been brought to the issue of admissions/discharges thanks to the information provided by the hospital's former physician administrator/medical director Dr. Normand Decelles Jr. Dr. Decelles told us that hospital administrators began planning the closure last year under the guise that services were not needed, and then began pressuring physicians to improperly discharge patients which has led to Hospital administration "mounted an increasing pressure campaign against ESH  physicians" - which included "verbal intimidation" - to get the doctors at the hospital to sign discharge forms stating that patients "did not need continued care at Zambarano ... since none of these patients had a safe discharge plan, physicians could not responsibly sign these documents," Decelles wrote.
To make matters worse, we learned that administrators unilaterally developed new admission criteria, which were contrived, non-standard, and clinically invalid. These "clinically invalid" criteria for admission have resulted in zero (0) patients being admitted to the Zambarano Hospital since February 2020. BHDDH has functionally closed the front door to every patient that requires help but can't find it anywhere else. It has become clear that administrators endeavor to make "qualifying for care" at Zambarano impossible for everyone - including current residents. 

"Administrative allegations that Zambarano patients need to leave now because they never 
should have been admitted are disingenuous and fabricated," the doctor said. So egregious are these 
efforts, Mental Health Advocate Megan N. Clingham called the administration's plans "inhumane." 

This new "qualifying criteria" must be disregarded and the old standards -the standards that 
actually permitted this essential facility to admit patients -must be reinstated. To do otherwise is 
immoral, cruel and dangerous. 

One need only look at the case of Aiyana Milton of Charlestown, RI. Ms. Milton was diagnosed with schizoaffective disorder as a child. She spent seven years as a patient at ESH and was discharged. Administrators said she was well enough to enter a group home. After the discharge, she was admitted for several short-term psychiatric stays. Her family said none of the facilities were able to meet her 

In February 202 l -one year after the new admission criteria was put into use -Ms. Milton had an episode in which she set fire to an apartment complex, making 60 people homeless. 

Dr. Decelles said "the federal law whose purpose is to optimize patient independence and 
freedom is instead being utilized by Administration as a fiat for evicting RI's most vulnerable and 

We could not agree more. We are horrified to learn what is transpiring at Zambarano. This is a matter of human dignity and moral responsibility. What exists now is a hospital-it takes care of acute care patients -and it is clear BHDDH plans is to downgrade the facility to a nursing home. These are two different facilities with two different missions. 

Downgrading the license and operating under these impossible admissions criteria is a violation of RIGL §23-l 7.l4-l8(a), which prohibits any licensed hospital from eliminating and/or significantly reducing primary care services without prior approval. Both the statute and the corresponding 
regulations require that a hospital submit a written plan describing the impact of the reduction and/or elimination on the community. See RIGL §23-l 7.14-l 8(b) and the corresponding regulations at 
§23. l 3(A)(2). The statute and the regulations also contemplate an opportunity for public comment. See RIGL §23-l 7.14-l 8(c) and the corresponding regulations at §23.13(A)(4).

We urge you to freeze all discharges and revert to the previous admissions criteria until these 
multiple investigations are concluded. Thank you for your attention to this matter, and we look forward to hearing from you. 

Jessica de la Cruz, 
Senate Minority Whip

David J. Place,
Representative, District 47

For more information, contact:
Katie Haughey Cardoza, Senate Minority Office
State House Room 20
Providence, RI 02903
(401) 222-2708