Nelson

Governor Carcieri has removed Ellen R. Nelson as director of the state Department of Mental Health, Retardation and Hospitals, and appointed her his special adviser on hospital acquisitions and mergers, a newly created position that the governor described as temporary.

Carcieri does not intend to replace Nelson at MHRH, one of the state government’s largest and most complex departments. Instead, two division heads will report to the deputy secretary of health and human services, Adelita Orefice.

Nelson is leaving her post, but keeping her same $127,000 salary, to advise Carcieri on an issue over which the governor has no statutory authority.

The director of health and the attorney general decide whether to allow hospital mergers, and have staff devoted to handling the expected proposal to merge the Lifespan and Care New England hospital groups.

Asked why the governor needed an adviser on hospital mergers, his spokesman, Jeff Neal, said: “He is the head of government. He is going to have an important voice in the debate about these potential hospital mergers.” Neal said Carcieri wanted someone outside the formal regulatory process to examine the big policy issues.

Both Neal and Nelson said the change did not result from any disagreement between Carcieri and Nelson, who took the helm at MHRH in 2006. Nelson said that the idea for the change came from the governor.

“I welcome the opportunity,” Nelson said. “The health department has a specific regulatory role. I bring to the table the expertise of running hospitals in terms of the impact on the community.” Nelson was once president of Bradley Hospital, and from 2004 to 2006 she was responsible for the public hospital system in Massachusetts.

With 1,600 employees and a budget of almost $500 million, MHRH oversees the state-run hospital and mental-health, substance-abuse, and developmental disabilities programs.

When Nelson leaves, which she said would happen probably by Monday, Craig Stenning will take charge of developmental disabilities and behavioral health at MHRH. John Young, currently the Medicaid director, will oversee the Eleanor Slater Hospital. Orefice said that the state would probably recruit a new Medicaid director.

Orefice said that Nelson’s departure provided the opportunity to reexamine the programs at MHRH, along with those at the four other state agencies involved with human services. Orefice is looking at consolidating administrative functions and reorganizing services for better efficiencies at those agencies, she said.

Additionally, the General Assembly is considering a plan, proposed by House Finance Committee Chairman Steven M. Costantino, to merge the state’s five human-service agencies into one.

Roberta Hawkins, the state’s long-term care ombudsman, said the plan not to replace Nelson “makes me very, very, very nervous.” Hawkins said she fears the governor intends to privatize the entire Eleanor Slater Hospital, which cares for chronically ill people who are too sick or difficult for nursing homes, including elderly and mentally ill people. (Neal said, “There are no current plans to privatize Eleanor Slater Hospital.”)

H. Reed Cosper, the state’s mental health advocate, was also distressed by the decision not to appoint a new MHRH director. “The department needs unified leadership,” Cosper said. “I see this as yet another downgrade in the visibility of the constituency. And it’s a shame.”

ffreyer@projo.com