By Bill Forry

Facing long odds, key political leaders huddled twice over the last week in hopes of cobbling together an eleventh-hour reprieve for the Little House Health Center. The Dorchester Avenue health center will be closed permanently in April under a current plan announced last week by Beth Israel Deaconess Medical Center, the hospital which runs the health center.

Last Thursday (Jan. 16), Beth Israel-Deaconess's president, Paul Levy, met with Congressman Stephen Lynch, State Senator Jack Hart and State Rep. Martin Walsh, who requested a meeting to discuss alternatives to closing the 30 year-old center. On Tuesday, a second closed-door meeting was held in Walsh's office and included City Councillor Maureen Feeney and personnel from the city's Public Health Commission.

Also on hand for both meetings were Bill Walczak, executive director of the Codman Square Health Center and Joel Abrams, executive director of the Dorchester House Multi-Service Center. The two health centers, which are affiliated, have devised a plan to take control of the Little House Health Center and keep it open. However, the deal is contingent on Beth Israel-Deaconess contributing an estimated $500,000 in transition costs, mostly to cover the anticipated operational losses in the first year. Beth Israel-Deaconess rejected the proposal in December, but has come under pressure from neighborhood politicians to reconsider.

This week, Mayor Thomas M. Menino also joined the lobbying effort, blasting Beth Israel-Deaconess's decision and calling for negotiations to keep the center open.

"We've been working with them for a while and it's unfortunate that they've decided to just walk away," Menino told the Reporter. "There should be a way to transition this and we should fight to maintain Little House as a provider of health care."

"This is a mentality of just walking away from people and for (Beth Israel-Deaconess) to walk away at this particular time sends a very bad message," said Menino.

According to State Senator Jack Hart, he and his legislative colleagues have launched a "full court press, times ten" to prevent the health center's closure. Hart says that saving the Little House Health Center has become a priority because "otherwise, a lot of people would go without preventive health care and, in the end, it would cause more severe and emergency cases down the line."

Paul Levy, president of Beth Israel Deaconess, notified the state's Public Health Department last week that the hospital would close the Little House Health Center in April. Levy cited increasingly low patient loads, financial difficulties and the availability of other high quality health centers in the neighborhood as factors in the decision.

However, Hart and others say that, in fact, Beth Israel Deaconess is "abandoning" the neighborhood. They want the hospital to do more to guarantee that the health center will continue to operate under the management of another health system.

"We are very, very disappointed with Beth Israel- Deaconess," Hart said on Tuesday. "They may have their own reasons. I know they've taken a loss over the last few years. But, in my opinion, based on the discussions we've had, they're not holding up their end of the bargain."

Beth Israel-Deaconess took control of the Little House Health Center in 1998, in the aftermath of a dispute between the community board that founded the center and longtime patron Caritas Carney Hospital. The community board, which includes some of the original parents who conceived the health center in the early 1970s, voted to leave its partnership with Carney and begin an affiliation with Beth Israel Deaconess. Hopes ran high among the staff and board members that the new affiliation would bring more investment to the aging Dorchester Ave. storefront, including the construction of a new facility.

"We believe that they had promised to pump significant capitol into the health center- and now we're asking them to pony up," Hart says. "We hope (Beth Israel-Deaconess) will be a partner and give us what I call a severance package to provide for this opportunity."

Not everyone is so optimistic, however. A letter signed by the community board of the Little House Health Center and sent to patients last week struck a note of resignation.

"The dedication of the staff, the legacy of our founders and the commitment of the board isn't enough to allow us to continue our mission. Although we still continue to work with elected officials, the future seems clear. The staff, and the committee will do everything we can to ensure a safe transition for all our patients and consumers," read the letter.

On Tuesday, Beth Israel-Deaconess spokesperson Judy Glasser said that the hospital's decision "has not changed."

"We'd be very happy to turn it over to another health center that would make it viable," Glasser said. "But, we're not in a position to subsidize somebody else's health center. If someone else has a different plan with a different set of resources behind them..."

Voices, however, are emerging from other quarters in the city that seem to bolster the chances for a different outcome. John Auerbach, executive director of the Boston Public Health Commission, echoed Senator Hart's sentiments in an interview with the Reporter this week.

"We are very concerned about the prospect of the Little House closing. We think that there needs to be additional planning to ensure that there are adequate options for patients... before (Beth Israel-Deaconess) proceeds with closing the center," Auerbach says.

Foremost among those options, Auerbach agrees, is the proposal by Walczak and Abrams, which would allow the storefront to remain open under the management of Health Service Partnership, a collaborative effort of Codman Square Health Center and Dorchester House.

"Beth Israel-Deaconess hasn't refused to engage in those discussions," according to Auerbach, but, "they have not been willing to reconsider what steps they can take to ensure that another option will work."

Sources familiar with the negotiations tell the Reporter Beth Israel-Deaconess has balked at the idea of contributing any funding to a proposed transition at Little House. The Codman Square-Dorchester House team believe that they can absorb many of the new costs associated with taking over the health center, but are unwilling to take the full burden, which they believe Beth Israel-Deaconess should rightfully share. The Dorchester House-Codman Square team has already scaled back its estimated costs by $250,000 in an attempt to bring Beth Israel-Deaconess closer to an agreement, but so far the Brookline hospital has refused any such arrangement.

Joel Abrams of Dorchester House said Tuesday that he is encouraged by the commitment of the legislators who have taken up the cause and hopes that Beth Israel-Deaconess will re-consider their position.

"We really believe the Little House should be preserved," Abrams says. "Our mission is to contribute to the well-being of the community. Our boards and Bill (Walczak) and I felt this was something we should propose and the (Little House community) board accepted.

"We felt Beth Israel-Deaconess was the appropriate party to provide the transitional funding we would need. Unfortunately, they begged to differ."

Sen. Hart says: "Bill (Walczak) and Joel (Abrams) have been extraordinary in their interest in picking up the health center under their umbrella. The difficulty is that Dorchester House and Codman Square can't incur the kind of first year loss that they anticipate. They can't take that kind of risk on their own" Hart says.

"We are willing to take a substantial risk in taking this on," Abrams added, "and we're asking for some guarantee that we could at least cover some of the operational losses for the first year."

"We're hoping that (Beth Israel) Deaconess will change its position and provide the funding that we're seeking," Abrams said. "We still we feel that it can be done. As far as we're concerned, we will try any option."

John Auerbach agrees with Hart and Abrams that Beth Israel-Deaconess has an obligation to find another solution other than closure.

"It's definitely true that hospitals a few years ago were very interested in establishing relationships with community health centers and they promised a lot when they established them in order to lock them up for referrals," says Auerbach. "And now that they are focused on their bottom lines, a number of hospitals are questioning those relationships. That is unfortunate because the centers were led to believe that they were establishing long term relationships."

Abrams says that time is running out, however. A hearing has been scheduled for February 11 by the state's Public Health Department to review the hospital's plan to close the center. The date now looms as a deadline for reaching a compromise to avoid shutting the center's doors forever.