Gov. Maura Healey plans to close a mental health center in Cape Cod and a state-run pediatric rehabilitation hospital in Canton as part of her new state budget proposed Wednesday.
Healey also intends to significantly slash the state's mental health case manager workforce, and the closings and staff cuts are drawing a strong backlash from critics who predict "severe consequences" in health care.
As Healey filed her fiscal 2026 budget, a string of health care unions lamented the governor's plan to shut down Pocasset Mental Health Center -- also known as the Cape Cod & Islands Community Mental Health Center -- that is run by the state's Department of Mental Health.
Asked to confirm the closure, a spokesperson for the Executive Office of Health and Human Services told the State House News Service, "We have taken these steps to improve the care and services we are able to offer."
"We recognize these changes have significant impacts on patients and families, and we are committed to supporting them through the transition of their care," spokesperson Olivia James said. "We will also work with employees and our partners in labor to support impacted employees and ensure they are able to transition to new roles."
There are 56 employees at Pocasset. Beyond the center, Healey's budget calls for reducing the volume of mental health department case managers from 340 to 170, the health and human services office said.
Department of Mental Health staff were notified about the Pocasset action Wednesday afternoon in a "commissioner message," which noted the budget "includes closing our acute inpatient unit in Pocasset and reducing our case management staff."
"I understand that this is very difficult information to receive, but I also want to be honest about the budget realities we are facing as an agency," states the message, which was obtained by the State House News Service and circulated by Ann Looney, director of labor relations at the Executive Office of Health and Human Services.
"As the process unfolds in the weeks ahead, we will update you and your union representatives as the budget is debated, and potentially amended, before it is finalized," the message continued. "Any changes would take place after the start of the fiscal year beginning July 1, 2025, and we will meet and bargain with the unions before any changes take place."
Administration and Finance officials did not explicitly mention the Pocasset closure during a briefing with reporters Wednesday. But they said the closure of Pappas Rehabilitation Hospital in Canton -- which also involves shifting services to a state public health hospital in Westfield -- would save the state $31 million.
The Healey administration said it intends to move Pappas programs to another public health hospital, the 87-bed Western Massachusetts Hospital (WMH) in Westfield. Officials say they plan to create a specialty unit for children at WMH, including a 25-bed dedicated pediatric care program.
Pappas serves children and young adults, ages 7 to 22+, and helps patients "achieve their optimal level of independence in all aspects of life," according to a state webpage. The hospital offers 24/7 nursing care, therapeutic services including speech and language therapies, transitional programming to help patients integrate into their communities, and an on-site Special Education in Institutional Settings program that's operated by the Department of Elementary and Secondary Education for individuals under age 22.
The Department of Public Health said Pappas currently has 36 patients, including more than half of whom are over age 18 and awaiting discharge to "more appropriate settings." Some of the patients will end up at WMH, while others could be transferred to other facilities across the state to "accommodate their specific level of need."
Health officials said the relocation process will occur throughout the year, with the bulk of transitions scheduled for the fall. The plan will affect more than 225 Pappas employees, plus staff from other organizations and state agencies, according to the public health department.
The planned closure follows a campus feasibility study last year, which found "the current facilities in Canton are unable to accommodate the kind of technology and high-acuity care that many children with significant disabilities need," the Department of Public Health said. Transitioning away from Canton will also help the state improve care for children with complex medical needs, officials argue.
Department Commissioner Robbie Goldstein called the decision "necessary."
"We understand that this is a difficult step for many of the patients and families who have built strong connections with Pappas and staff," Goldstein said in a statement. "We are committed to supporting them through this transition. Ultimately, this is about improving services and providing every child with the care they need. We will also work closely with our partners in labor to connect Pappas employees with new employment opportunities."
The Massachusetts Nurses Association warned that Western Massachusetts Hospital serves a predominantly adult population and offers "few of the specialized amenities and services provided by Pappas." The union noted the Pappas campus, which sits on more than 160 acres in Canton, has a junior-sized Olympic swimming pool, a pond for water-based sports and a barn and equestrian track for rehabilitation services.
The Massachusetts Nurses Association said it represents 75 nurses and health professionals at Pappas.
"The biggest advantage of Pappas is in the full range of therapy, medical care and other services they receive across all settings," Michelle Sweeney, who directs Pappas's physical therapy program, said in a statement shared by the union. "At Western Mass Hospital, we expect they will receive, at most, one-on-one tutoring for education, while at Pappas, we are able to offer customized education in a classroom setting, and by integrating their therapy needs throughout the day."
The Massachusetts Nurses Association said it is also "vehemently opposed to the plan to close Pocasset Mental Health Center," which the union described as a 16-bed inpatient acute mental health stabilization unit serving patients ages 19 and older. The center offers short-term treatment for patients, union said.
"PMHC is vital to addressing the greatest crisis facing our mental health system which is the lack of beds to meet the needs for patients with acute mental illness, which is resulting in thousands of patients boarding several hours to several days in our hospitals emergency departments like those at Cape Cod, Falmouth and BI Plymouth Hospitals, where they go without care and too often decompensate, and many times can become violent," the Nurses Association said in a statement to the State House News Service. "PCMHC is vital to help alleviate the problem for hospitals on the Cape, where such programs are limited. The program is often full and has a waiting list for clients."
Healey appeared to allude to the Pocasset facility during a press conference Wednesday afternoon when asked why she's closing the Pappas hospital despite her administration's focus on primary care and mental health.
"I think of it as a redirecting of services, of care," Healey said. "In one place, we have a low utilization rate, only 16 beds. In another place, we have about 39 individuals housed, and a number of them -- the majority of them -- are over the age of 21, so looking at some other options, other facilities, places, where maybe it makes more sense in terms of consolidation of care or the right kind of care for those individuals."
The facility closures don't require legislative approval, state health officials said.