Ulster exec hopes to rally support to keep inpatient mental-health treatment in Kingston

Ulster County Executive Pat Ryan said a planned move by the parent company of HealthAlliance could extend what was to be a temporary reduction in local mental-health treatment capacity brought on by a need for greater hospital capacity for Covid-19 to a permanent one, though the company denies that any of the necessary paperwork has been filed.

In April, when the state designated the HealthAlliance’s Mary’s Avenue campus a surge hospital for Covid-19 patients, the hospital removed its 40 in-patient behavioral mental health and 20 detox and rehabilitation beds. To offset the loss, more beds were added to MidHudson Regional Hospital in Poughkeepsie, and later, detox and rehabilitation beds were set up in Kingston at HealthAlliance’s Broadway campus. But the result was fewer total mental-health beds, and travelling to Poughkeepsie creates a hardship for patients and their families, say critics.

Since then, many local, county, and state representatives have called on Westchester Medical Center (WMC), parent company of HealthAlliance, to restore services to their original level, or at least commit to doing so after the pandemic subsides. But last week, Ryan told Hudson Valley One that WMC plans not to restore the services in the future. According to Ryan, WMC is seeking to amend the “certificate of need” that lays out how many beds are required in Kingston, and the result would lock in the current situation.

We asked WMC specifically whether it had requested such an amendment to its certificate of need. A spokesperson replied: “HealthAlliance Hospital on Mary’s Avenue remains vacated under a New York State plan and no requests for adjustments to the HealthAlliance Hospital’s certificate of need have been filed at this time.”

Ryan said that while the requests have not been filed, WMC representatives have stated their intention to do so. He said the first step in the process is to “have discussions with the county health department as well as the regional office of the state department of health. Those discussions happened several weeks ago which is what prompted me to write the op-ed that I did. In addition to that, in one on one conversations with me, multiple senior leaders from their office explicitly represented that they were moving forward with this process to request the change.”

Regarding the criticism that locating inpatient mental-health treatment Poughkeepsie could be a hardship for some, the WMC spokesperson replied by pointing out that most mental-health treatment is covered with by a visit to the Broadway campus with follow-up visits at various outpatient locations throughout the county. “All of HealthAlliance’s existing outpatient behavioral health services remain available in their current locations in Ulster County. These services handled more than 58,000 visits as recently as last year.”

In the op-ed he penned for Hudson Valley One last week, Ryan argued that WMC should restore the services because of unprecedented need brought on by pandemic-related stresses and the large amount of money it received from state taxpayers.

“In late 2019, we ceremoniously broke ground on a $92.9-million retrofit of HealthAlliance’s Mary’s Avenue campus,” wrote Ryan, “primarily funded by New York State, and celebrated a future vision of a new world-class health center that will serve Ulster County and the wider region. A key part of that vision was HealthAlliance’s explicit commitment to offering behavioral health services in the new facility.”

He subsequently pointed out that the state-required certificate of need, which he described as a “charter” for a hospital outlining the health needs of the population it serves, includes the inpatient behavioral mental health beds.

Ryan said saving the mental-health beds is his mission, but he feels it will only be successful with full community involvement. Others—union members, at least initially—have already started that effort, with “save inpatient mental health” lawn signs to build awareness. “There’s so much going on” that it’s easy to lose sight of this important issue, but “if the community is aware of it and that translates to the state health department,” it’s possible the request to make this change permanent will be denied. “We need to make clear to Westchester system leadership that they have to honor the promise they made to us. We decided to invest in a buildout of the Mary’s Avenue facility based on the agreement in the certificate of need that outlines services to be delivered there, and behavioral health is explicit. . . . we taxpayers are funding this buildout.” A request to state health officials to say that there is a reduced need for those beds “flies in the face of data.”

The story was updated October 1 to include additional statements from WMC and the county executive regarding whether the certificate of need amendment had been requested.