Budget Writers Agree on Secure Psychiatric Unit, Kid’s Mental Health Services

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GARRY RAYNO photo

House members of the budget conference committee including chair Reps. Mary Jane Wallner, D-Concord, Sharon Nordgren, D-Hanover, and Dick Ames, D-Jaffrey, discuss what to do during their meeting with Senate negotiators.

By GARRY RAYNO, InDepthNH.org

CONCORD — The House agreed Tuesday to Senate budget items boosting funding and new facilities for health and human services programs particularly in mental health and substance abuse areas.

House and Senate negotiators are working to reconcile their different $13 billion versions of the next biennium’s budget before Thursday’s deadline.

Chief among the differences between the two budget plans was a new Secure Psychiatric Unit to house those who are a danger to themselves or others currently housed at the State Prison.

The House did not include a new unit in its budget although Gov. Chris Sununu recommended a 60-bed facility on State Hospital grounds, because budget writers said they had little to no information from the governor’s office. The Senate approved a 25-bed, $17.5 million facility in its budget.

On Tuesday the House agreed to the Senate plan, while last week Sununu proposed a compromise 35-bed facility.

Senate Majority Leader Dan Feltes, D-Concord, said the 25-bed facility is in line with lawmakers’ and the governor’s wishes for a new Secure Psychiatric Unit.

“This is a reasonable proposal,” he said.

The Senate plan also would move children out of the State Hospital into a facility in Hampstead that is still under negotiations, and then renovate the space vacated by the children at the state hospital to create between 32 and 48 new beds to help alleviate boarding mentally ill patients in hospital emergency rooms until a bed opens at the state hospital or other treatment facility, and referrals from community mental health centers.

While the House agreed to the plan, it could not vote on the new children’s facility until negotiations are complete.

“We looked at the totality,” said Senate Finance Committee Chair Sen. Lou D’Allesandro, D-Manchester. “We looked to try to solve it all. In the past we’ve done little piecemeal things and waited until we were sued.”
House Finance Committee Chair Rep. Mary Jane Wallner, D-Concord, said the House did not have the information needed to make an informed decision on a new SPU when it had to act on its budget.

“It is a big decision, building a new SPU on the grounds of New Hampshire Hospital,” she said. “Building a SPU on the grounds of New Hampshire Hospital is a large investment and we really needed to do the work to understand how we .  . . spend public money on this facility.”


The House also agreed to the Senate plan for expanding children’s mental health programs including a mobile crisis unit to serve just children, and other recommendations under the state’s new mental health plan and the agreement reached several years ago in a lawsuit  taking the state’s mental health system to task.

The two sides agreed to add $3.45 million to the budget for increased rates for substance abuse treatment and mental health providers to the $5 million already in the budget.

The extra money was earmarked in Senate Bill 5 as part of an agreement last year that moved Medicaid expansion recipients from private insurers to the state’s traditional managed-care Medicaid program.

The switch to the traditional program reduced reimbursement rates for providers, mostly in the substance abuse area working with people caught in the state’s opioid epidemic.

The $3.45 million includes $450,000 for emergency shelter for people addicted to opioids.

The House also agreed to adding $1.7 million in federal and state money to increase the rates for hospitals that are designated receiving facilities for the mentally ill seeking emergency services.

The provision would add 10 new designated receiving facility beds that would serve a statewide need to go along with the 44 beds currently in existence, all in southern New Hampshire.

Also, the House agreed to a Senate plan to create a $2 million program to help low-income seniors with the “donut hole” when Medicaid Part D drug benefits no longer cover prescription costs.

Feltes said New Hampshire is one of only about dozen states that don’t help their low-income seniors with drug costs.

Also, the House agreed to the Senate plan to begin an adult dental benefit under the Medicaid program. The Senate agree to begin the program in the first year of the biennium instead of the second year.

The two sides have not reached agreement on a Senate plan to increase Medicaid provider reimbursement rates across-the-board by 3 percent a year costing about $60 million over the biennium. Sununu wants to provide $30 million and let HHS officials decide how the money would be spent. 

Scholarships

The House agreed to the Senate’s overhaul of various student scholarships including a new loan forgiveness program aimed at attracting young talent to the regenerative tissue work being spearheaded by Dean Kamen in Manchester’s Millyard.

The new scholarship program is funded by a one-time borrowing of $5 million from the UNIQUE program.

The changes also move the governor’s scholarship program from the Department of Education to the Treasurer’s Office.

Education Funding

The two sides did not agree on an education funding plan, which is one of the last key issues to be resolved Wednesday.

The House used a capital gains tax to fund much of its $160 million increase in state aid to school districts by restoring stabilization grants to their original level before 4 percent annual reductions began three years ago and reestablishing a disparity aid program to help property poor communities.

The Senate plan restores the stabilization grants but distributes about $71 million less than the House plan for disparity aid.

The two sides clashed over the capital gains tax, which House Ways and Means Committee vice chair Rep. Dick Ames, R-Jaffrey, said would raise $150 million annually with 80 percent of the money coming from those who earn $200,000 or more.

But D’Allesandro said the Senate rejected the capital gains tax, and instead funded its budget with existing taxes and tax reform.

The two sides have agreed on a commission to determine the cost of an adequate education and how best to distribute state aid. The commission would receive $500,000 from the Education Trust Fund.

Revenue Sharing

The House and Senate have not agreed on a revenue sharing plan with cities and towns. The House included $12.5 million in revenue sharing in the second year of its budget.

The Senate proposes $20 million in revenue sharing in each year of the biennial budget. D’Allesandro said there are no strings attached and communities can spend the money any way they want.

The day before the House and Senate agreed to increase general fund estimates by $15 million for the biennium mostly for higher business tax returns.

Both bodies agree to freezing business tax rates at calendar 2018 levels instead of a rate reduction called for in law for 2019, which provides $90 million in revenue, and a mandatory paid and family leave program, both of which Sununu opposes and has said would ensure his veto.

Wallner, who chairs the conference committees on House Bill 1 ad House Bill 2 — the budget package — said she wants to compete work by Wednesday so the finished product can be reviewed and signed off on Thursday.

The committee meets again Wednesday morning at 10 a.m.

Garry Rayno may be reached at garry.rayno@yahoo.com

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