Addabbo Center Closing Causing Stress
Although many say there is now a greater need for mental health services following the traumatic events of Hurricane Sandy, the Joseph P. Addabbo Family Health Center’s mental health clinic and Children’s Day Treatment center (CDT) will close by June 30th.
The closings will leave many clients and children seeking new locations and employees searching for new jobs.
At the end of April, the Addabbo Board of Directors voted to close the programs at the nonprofit, federally qualified health center, which was initially founded to provide health services to the medically underserved Rockaway community.
The mental health clinic provides mental health services to the community through social workers and psychiatrists. The CDT schooling program provides 16 slots for children who some say “would have been institutionalized without it,” as they suffer from serious behavior and mood disorders.
Although people will lose their jobs because of these closings, some find the loss of these vital programs to be more devastating.
“These are services that the community very much needs,” Ron Lamb, Director of Mental Health said. “It’s an impoverished community with many social problems and a community that has experienced many traumatic events, with the most recent being Hurricane Sandy. It’s quite a loss to the community that they had to shut this down.”
Michael Crosby, a social worker for CDT calls the closing “a matter of life or death for those children.” Crosby is worried about two children in particular. “I’m very afraid they will not make it. Either they’ll wind up in jail or we’ll find them dead in the street. That’s how important this is,” he said.
Doreen Thompson, a social worker for CDT over the past five years, said that the kids have grown to trust the staff and having to relocate them to other locations will be detrimental to their progress. “I think it’s a terrible idea. It’s unfair to these kids,” Thompson said. “It’s really messing with their trust issues.” She says that larger schools won’t be able to provide the family-like atmosphere that the CDT offers in the small program.
About 70 percent of the center’s patients are covered by Medicaid. According to a source with knowledge of events, it was learned that the Addabbo Center had been inadvertently overbilling Medicaid for these services. In November, 2012, the center received a letter from the Office of Mental Health saying the center had a new base Medicaid rate, retroactive to October 1st, 2010.
On April 22, 2013 the New York State Department of Health sent a letter saying the center owed nearly $550,000 due to the retroactive rate adjustment. In addition to the amount owed, CEO Robert Fliegel says the mental health program suffered a loss of more than $300,000 from 2011-2012 and patient visits dropped by 2,000 over two years.
According to Fliegel, the decision to drop the mental health clinic and CDT was made so the rest of the medical center can carry out its “core mission,” which Fliegel says is “to deliver four core services including internal medicine, family practice, OB/GYN and dental services.”
The CEO says “mental health is not part of our core mission” and it was taking away from other services. “It’s unfortunate, but it’s the state and Department of Health that doesn’t want to pay for these services.”
According to Fliegel, he explained the situation to the Board of Directors and they voted to terminate the mental health programs. A letter was then sent to the Office of Mental Health (OMH) explaining the plan. Fliegel says OMH replied in full support of ending the programs.
However, not everyone is in support of the decision and many feel that not enough was done to prevent it. Several employees, clients and parents of children in the CDT program claim they weren’t consulted about the plan until the decision was already finalized, about a week after the center received the letter about the retroactive payment. Some believe there were other motives to close the programs.
Board member and former treasurer, Sanford Bernstein, who could not be present at the board vote, said, “Mr. Fliegel’s assertions that these programs have to go because they threaten core services are simply chicken little hyperbole, a smokescreen to hide the real reasons behind the move. Mental health is an easy target of opportunity because it occupies space the Addabbo Center wants to support a takeover of St. John’s Hospital outpatient clinics.” Bernstein says the Addabbo Center and St. John’s are negotiating terms of an agreement that could add thousands of Medicaid visits for Addabbo and result in adding $ millions to the Addabbo bottom line.
Bernstein claims that “the center turned profits of $3.7 million in 2011 and $1.6 million in 2012 while funding these critical services and absorbing any losses. There is no compelling financial reason to close down these services now.”
Some staff members claim that Dr. Peter Nelson, the former CEO of the center who was fired in January, “would have never let this happen.” Fliegel, who was the Chief Financial Officer at the time, replaced him.
Dr. Nelson believes there were ways to save the programs. “They acted too quickly. I know they’re concerned about money. The reimbursement of the mental health program has been reduced by the state but you can always work out a deal with the state and pay that back in 10 years,” Nelson said.
He admitted that the “workers saw less patients than needed to break even,” but he said that the “union worked with us to increase productivity. I don’t think the board gave us enough time to save it.”
Bernstein believes that the Board only acted on Fliegel’s recommendation. “No input was taken or solicited from the patients,” he said. “The Board is supposed to be acting to protect the interest of patients and it failed them.”
Clients who use the mental health services and CDT are devastated by the news and many aren’t sure what to do. Some mental health patients were referred to places like the New Horizon Counseling Center, St. John’s Episcopal Hospital’s Community Mental Health program, Catholic Charities, Ohel Children’s Home and Family Services and Safe Space, but there is no other program like CDT on the peninsula. Even if they can find another location, the transition will not be easy.
A mental health client named Sophia has concerns about having to start over again with a new therapist at another location. “I’ve seen a therapist for a couple of years and now they’re not going to be there and having to start over again is going to be very difficult,” she said. She’s not even quite sure where to go as the “waiting list is tremendous” for other mental health facilities on the peninsula and leaving the beach gives her anxiety.
Ramona Hopkins, a parent of a child that has attended CDT for two years said, “I don’t see how they can close a program that helps kids with school and mental issues. They need the people to support them and for them to cut the program and make the students go somewhere else, I don’t think that it’s going to be a smooth transition for those kids.”
Some parents have already seen this occur. Juana Ruiz, the parent of a child in CDT and another child that receives mental health treatment said, “when they told the kids, they were all crying.” She said that her son, who has been going to the same psychiatrist since he was three years old, is having difficulty starting over at New Horizons. “He has to start again and has to get to know the new therapists there and he’s not talking,” she said.
Vanessa Scott, a parent of a child that is about to graduate from CDT spoke about how much the program meant to her son. “When he went to that school, he learned how to support his anger with the support of the staff. I really think that school is needed..”
Nelson and some current employees said that the Children’s Day Treatment program had no financial issues. “We actually had some income from CDT that we could roll over into the other mental health program,” Nelson said. Fliegel says the program only had income because they were paying low rent while it was located at Peninsula Hospital. The program, which was temporarily moved to Brooklyn after Hurricane Sandy, was set to go to a new location in Far Rockaway, which Fliegel says would have set them back around $100,000 in rent and construction.
To that, Bernstein said, “The Board had an opportunity to solve its space problem before the hurricane by purchasing the former Peninsula Hospital clinic building where the CTD school was located when the hospital closed last year but declined to take action.
“The Board needs to meet immediately and reverse its decision. A mutually beneficial partnership with St. John’s can be worked out without destroying the mental health services now being offered by the Addabbo Center.”