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Brown University Health Evaluates Potential Closures of Key Health Services

A healthcare facility bustling with activity, reflecting the importance of accessible health services in the community.

News Summary

Brown University Health is considering the closure of Gateway Healthcare and the Samuels Sinclair Dental Center to cope with financial challenges. Gateway Healthcare, the largest nonprofit behavioral health provider in Rhode Island, has reported significant losses, while the dental center has been essential for vulnerable populations. The proposals, aimed at achieving a 3% operating margin, have sparked concerns about disrupted care and increased demand for services from primary care offices. Stakeholders are urged to stay engaged as future service sustainment discussions unfold.

Providence, Rhode Island – Brown University Health is evaluating the potential closure of two critical health service providers—the Gateway Healthcare and the Samuels Sinclair Dental Center—as part of its strategy to manage escalating financial pressures. The proposals are aimed at achieving a necessary 3% operating margin crucial for sustaining patient care, research, and workforce training.

Gateway Healthcare, acclaimed as the largest nonprofit behavioral healthcare provider in Rhode Island, has reported losses exceeding $5 million for the fiscal year 2024. This organization has been pivotal in offering behavioral health services to over 25,000 Rhode Islanders each year, while employing more than 600 staff, including mental health professionals and clinicians.

The Samuels Sinclair Dental Center, which has been operational since 1931, serves as the primary provider of dental care for children and individuals with special needs in the state. The center conducts about 19,000 patient visits annually, employing approximately 30 staff members. Its services are particularly crucial for providing pre-surgical dental clearances for patients requiring major surgical procedures.

Both closures, if enacted, would have profound ramifications on access to care for vulnerable populations. Advocates have raised alarms about the potential for primary care offices to become overwhelmed as the demand for services would drastically increase without the support of these facilities. Concerns over disrupted care for those with special needs have also been expressed by dental service providers, who highlight that the closure would negatively impact community health services.

According to internal communications from CEO John Fernandez, the review of service closures has been in consideration since at least May of this year. Alongside the proposed shutdown of Gateway Healthcare and the Samuels Sinclair Dental Center, other potential budget cuts include halting projects at Rhode Island Hospital, reducing adult inpatient psychiatric services, and discontinuing labor and delivery facilities at Newport Hospital.

The ongoing financial strain is aggravated by rising operational costs, competitive wages, and the need for investment in necessary technology. The financial evaluation for the fiscal budget of 2026 has yet to yield definitive decisions on these matters.

In efforts to stabilize funding, the Rhode Island General Assembly was solicited to approve a $90 million increase in Medicaid, which would qualify for federal matching funds, creating a total of $270 million. The legislature ultimately approved a $15 million increase in Medicaid rates, which will turn into approximately $40 million with federal matches.

Since 2012, Brown University Health has struggled to maintain a healthy operating margin, averaging $6 million annually, which falls short of its targeted margin. The state healthcare system continues to grapple with systemic challenges in funding behavioral health and substance abuse services, as noted by industry leaders.

While the organization aims to enhance its financial stability through these measures, the potential impacts on patient care, particularly for disadvantaged populations, highlight the precarious balance between financial viability and the provision of essential health services. Stakeholders are encouraged to remain engaged as discussions about future service sustainment and closures evolve.