Butler Hospital in Providence plans to lay off about 45 people and will make deep cuts in its outpatient services – a move that will leave hundreds of patients scrambling to find new therapists.
The psychiatric and substance-abuse treatment facility will slash the number of annual outpatient visits from 40,000 to 15,000, according to Butler officials. Its aim is to cut in half a projected $5 million budget shortfall for this fiscal year, which began Oct. 1.
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Butler lost $5 million for the year ended Sept. 30, according to hospital spokesman Jim Hallan. Hospital officials say the cutbacks are necessary because the hospital is not getting enough reimbursement money from private insurers.
“Tragically, what it costs us to pay for goods and services exceeds what we get from the insurance companies to pay for our services,” said Butler Hospital President and CEO Patricia Ryan Recupero in a written statement. “We are having to cut to the bone,” she said, adding that Butler continues to see brisk demand for its services and record inpatient numbers.
Just 18 months ago, Butler, located on Blackstone Boulevard on the city’s East Side, had more than 80,000 annual outpatient visits from patients seeking help with mental afflictions such as depression, substance abuse and anxiety disorders. That number was cut in half last year when the hospital closed its outpatient facilities in Lincoln and Warwick.
Now, Butler’s on-site outpatient services will be reduced too, offering only a few research programs and treatment administered by medical residents, Hallan said.
Many therapists who are being laid off will continue to see their patients in private practice, with some remaining on Butler’s campus, Hallan said. But other patients will be forced to look elsewhere.
“Our hope is many patients won’t see any change and they’ll still see the therapists that they have been seeing,” Hallan said. “But certainly there will be patients that are going to have to find somebody else.”
Hallan said “several hundred,” and possibly more than 1,000 patients will be affected by Butler’s outpatient cutbacks, although an exact number was not available.
Finding new therapists won’t be easy for patients, according to Dan McCarthy, associate director for the Division of Behavioral Health at the Rhode Island Department of Mental Health, Retardation & Hospitals.
He said patients with insurance would choose from their insurer’s list of mental-health providers. But “whether there is enough slack in the private-provider network is a question,” McCarthy said.
The state-run community health centers such as Providence Center are another option for displaced patients. But most of those facilities are at capacity, McCarthy said.
“The mental health centers have very limited excess capacity, and that’s because the amount that the private insurance companies pay out are not adequate to support the services,” he said.
Hallan said many patients might temporarily have to forgo mental-health services.
“There’s no doubt that when something like this happens, there will be a ripple effect throughout the community,” Hallan said. “Demand is exceeding the supply of available services out there.”
Butler, which serves children, adolescents and adults, also will drop an alcohol- and drug-treatment evening program and dramatically reduce its occupational-therapy services. Butler’s inpatient services and “partial-hospital” program – for patients who attend the hospital during the day but who don’t stay overnight – won’t be affected by the cutbacks.
Therapists, nurses and a number of administrative positions will be included in the layoffs. Employees who have worked at Butler for at least two years will be given the option to remain at the hospital through March.
“A number of people with over 20 year experience (at Butler) are being affected,” Recupero said. “Everyone feels just terrible about this.”
