Bartlett Regional Hospital’s financial health is ailing and leaders are asking Juneau residents for a second opinion about a proposed remedy that could trim or eliminate six “non-core” programs.
The hospital has not been profitable since 2019 and has been losing about $1 million a month since the summer of 2020, Juneau Assembly members were told during a joint meeting Wednesday night with Bartlett’s board of directors.
“We have three years of cash left from today — three years of cash before we’re closing the doors, essentially,” said Max Mertz, chair of the hospital board’s finance committee. At that point “we’re not able to make payroll without significant adjustments to the way that we’re operating. So we’re left with very stark choices about how we want to move forward to have…a strong independent hospital for the next 20 or 30 years.”
The examination of the six programs targeted for cuts is to ensure the hospital can continue the core services “that you normally see a hospital do,” he said.
“The other services that are not part of that core are services that typically you see other providers in those communities doing,” Mertz said. “That’s not to say that they’re not vitally important.”
Among the programs being evaluated are Rainforest Recovery Center, which provides residential and outpatient substance abuse treatment; Applied Behavior Analysis (ABA) Therapy, which works with people ages 2-21 diagnosed with autism; crisis observation and stabilization services; outpatient psychiatric services; and hospice and home care.
The primary alternative to cutting or eliminating programs — some of which may be taken over by another entity — is the City and Borough of Juneau providing additional funding for those programs at the municipal-owned hospital, according to the presentation made to the Assembly. But Assembly members said that could result in a mill rate increase and/or other costs to residents.
“It seems to me there’s still some stuff that needs to play out, especially hearing from the public and seeing what they’re willing to support,” Mayor Beth Weldon said. “Because, to be quite honest it almost needs to go an advisory vote — does the public want their mill rates to increase to accommodate these programs? But maybe that somebody will come up with something different or manna will come from Heaven.”
Public comment is being sought by the hospital’s board of directors at two forums Tuesday, June 4, and Monday, June 10, both starting at 5:30 p.m. at the hospital’s administrative building. Virtual participation will be possible. Public comments can also be submitted by 4:30 p.m. June 19 via the hospital’s website at www.bartletthospital.org/sustainability and by mail to BRH Board of Directors, 3260 Hospital Drive, Juneau, Alaska, 99801.
The hospital board plans to review community feedback and make recommendations on non-core programs at its June 25 meeting.
The hospital’s finances were “pretty stable” before the COVID-19 pandemic, but in addition to the enormous costs and operational difficulties during the pandemic there was “a lot of turnover and a lot of drama” among leadership, Mertz said.
“We’ve had several CEOs during that period of time,” he said. “I think the Bartlett board bears a certain amount of responsibility for that. It’s also a matter of just chance and what happened, but nevertheless it’s been very disruptive.”
Several residents testified during the meeting in favor of preserving the programs under scrutiny. Abi Spofford, a Mendenhall Valley resident, said she suffered a mental health crisis about nine months ago where “non-core” services ended up providing help she couldn’t get at the hospital.
“I found myself needing immediate access to mental health treatment,” she said. “I could no longer advocate for myself. I had exhausted all options and I needed help. I walked into the cold, sterile mental health unit at Bartlett defeated. For 48 hours I searched with the help of my caseworker for any program that could help me upon discharge. My support system made endless calls to programs around the country, my insurance company and finally helped me find a program that helped me stay alive to be right here in front of you today.”
People needing such services the most now are likely unable to advocate to Assembly and other officials on their behalf, and “the cuts that you are proposing today to the outpatient programs could have catastrophic effects on our community,” Spofford added.
The six programs being evaluated and the board’s current recommendations are:
• Rainforest Recovery Center, a 16-bed residential and outpatient treatment program that has never been self-sustaining and is expected to lose nearly $800,000 next year. The board’s recommendation is to “determine whether a 3rd party can be identified to take the program over in full from Bartlett. If this is not realistic, closure of the program. This program could be retained if the CBJ Assembly chose to provide a permanent subsidy. This is a difficult financial recommendation and is in no way a reflection of the individuals who provide and receive these services.”
• ABA therapy: Taken over by Bartlett in June of 2021 from a private contractor hired by the Juneau School District because it was “deemed to be a community need.” However, two providers in the programs have submitted their resignations effective June 13 and are starting their own company to provide similar services, and the recommendation from the board is to “support departing staff in start up of new ABA program through private practice.”
• Crisis Observation Services (COS)/Crisis Residential and Stabilization Services (CSS) for Adults and Adolescents: While Wanner’s analysis states “adolescent and adult crisis services are needed in Juneau,” Bartlett has only been able to provide CSS services to adolescents “due to facility layout and staffing concerns.” The board recommendation is “program closure and space utilization plan development for Aurora building. This program could be retained if the CBJ Assembly chose to provide a permanent subsidy. This is a difficult financial recommendation and is in no way a reflection of the individuals who provide and receive these services.”
• Bartlett Outpatient Psychiatric Services (BOPS): Since the 1990s has provided individual and family psychotherapy, plus medication-assisted treatment for substance abuse. Staffing has grown rapidly in recent years, from the equivalent of 4.12 full-time positions in 2018 to a projected 13.69 positions next year. However, the program is also projected to lose $2.8 million next year. The board’s recommendation is to “manage as a core service and pursue outpatient service reductions. Changes are within management’s purview and do not require Board approval.”
• The final two programs are hospice and home health services, which were taken over by Bartlett in mid-2023 after Catholic Community Service halted both programs in the fall of 2022. For both programs the board states it recognizes “the importance of this program to the community and will work to ensure that services are retained in the community. Management will pursue transfer of operations to a 3rd party provider. If this is not successful, the Board and management will pursue permanent subsidization.”
• Contact Mark Sabbatini at mark.sabbatini@juneauempire.com or (907) 957-2306.
