PROVIDENCE — The director of the department that runs Rhode Island’s “hospital of last resort” is resigning effective this week amid uncertainty and turmoil over the future of the state-run institution.
A. Kathryn Power, the director of the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, said in a letter dated March 28 to Governor Dan McKee that she was resigning effective Friday due to a family member’s recently diagnosed health issues.
The department operates Eleanor Slater Hospital, which has campuses in Burrillville, called the Zambarano unit, and in Cranston. The patients across the system have complex medical and psychiatric needs. Many have lived there for decades.
The hospital has been under intense scrutiny from unions, local elected officials, and medical professionals in the past few months. The state is planning to build a new skilled nursing facility in Burrillville. It is also planning to close two buildings on the Cranston campus.
In an interview with the Globe, Power said her decision to resign was “totally rooted in my family health issues.”
“I couldn’t do both,” Power said. “I’ve tried to do both for awhile and it just wasn’t working.”
Power also described herself as a “change agent” who would not have done anything differently in the past 18 months.
“This department and the hospital, they needed some change,” Power said. “I’m sorry I won’t be here to continue to do the work that we laid out.”
Over all, Power said the department’s actions and plans were always in the best interests of patients. Some critics of the changes afoot at Eleanor Slater, where critics say officials are aggressively seeking to discharge patients, have said the state doesn’t have better options for patients with certain complex medical conditions. Power agrees that there’s a gap in Rhode Island, and said that’s exactly why everyone in the state needs to step up.
“It’s so important to rally people and galvanize action so we can make sure we have appropriate community placements for people so they don’t have to live and die in an institution,” she said.
And what “no one ever seems to pay attention to,” Power said, is this: Most of the patients at the hospital are not receiving a hospital level of care because they don’t need it, she said. What they are receiving is more akin to a nursing home level of care or what’s called a custodial level of care.
“They cannot live in a hospital for the rest of their life,” Power said.
The moves, though, have led to a storm of criticism. One former top doctor at the Zambarano unit has said the state’s discharge policy is designed to deal with its financial problems. And advocates for people with mental health issues say the health care system in the state doesn’t have better options.
Power has defended the state’s actions, saying that it must, under the law and in the best interests of the patients there, find the least-restrictive treatment settings for them. The hospital is stuck in the past, Power has said, using paper medical records and operating from outdated buildings.
The hospital system also lost out on millions of dollars in Medicaid funding because it violated a federal rule on the mix of psychiatric to medical patients. In late March, the federal government signed off on its billing practices again.
Power had returned to state service in January 2020 after a previous stint at the department. She was appointed by former governor Gina Raimondo.
“Just as in my previous stewardship of this department, my priority has been, first and foremost, the well-being and sensitive care of individuals with behavioral health conditions, intellectual/developmental disabilities, and hospital patients,” Power wrote to McKee.
“[The department] has a critical mission and it will be a priority for the McKee Administration to find a candidate to live up to its values providing high quality care and services for some of Rhode Island’s most vulnerable residents,” McKee spokesman Matt Sheaff said in an e-mail. “We thank Director Power for her service on the state and federal level and wish her all the best.”