NH Replaces ‘Doorway’ Partners in Manchester, Nashua Amid Criticism

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Health and Human Services Commissioner Lori Shibinette speaks at a news conference with Gov. Chris Sununu and other officials behind her in this file photo.


– Republican Gov. Chris Sununu said after extensive review, New Hampshire is moving its Doorway contracts in Manchester and Nashua from Granite Pathways to Catholic Medical Center and Southern New Hampshire Health.

“As with any new system of care, we must be nimble and ready to make improvements where necessary,” Sununu said.

The nine federally funded Doorway sites in New Hampshire provide substance abuse screening, treatment referrals and case management for recovery services. Seven were already at hospitals around the state.

“Our new system has proven to work best when the HUB is affiliated with a hospital, and I look forward to a collaborative partnership with Catholic Medical Center and Southern New Hampshire Health for many years to come. The hub-and-spoke system in New Hampshire works, it has a proven track record, and the best is yet to come.”

The announcement comes after criticism from Democratic Mayor Joyce Craig and Democratic senators that the state has not done a good job dealing with the opioid crisis one year into the $64 million effort, particularly with its contract with Granite Pathways.

After Sununu’s announcement at a new conference in the Executive Council Chambers, state Sen. Dan Feltes, D-Concord, said in a news release: “Governor Sununu’s Doorway modification does not address the program’s fundamental flaw, which is the complete lack of treatment and bed capacity. His mismanagement has wasted an incredible opportunity to make substantial progress on the opioid crisis and has exacerbated the homelessness crisis in Manchester.”

Feltes, who is running for governor, said if Sununu had listened to people in recovery, or to those working in treatment centers, or to community leaders, he would understand that the real need is to increase treatment capacity and beds, Feltes said.

State Sen. Cindy Rosenwald, D-Nashua, also criticized the way things have been going with Doorway.

“Our state has spent tens of millions of dollars on the governor’s failed hub-and-spoke model, yet last year the opioid fatality rate actually increased in Nashua,” Rosenwald said.

“In 2019, during the same period that the Doorway program provided just 183 referrals in Nashua, it experienced 265 opioid overdoses and Safe Stations saw 779 walk-ins—without state funding to support the program,” she said.

While Rosenwald said she was encouraged by the participation of Southern NH Medical Center in the Doorway program moving forward, “it is concerning that it has been so difficult for the city of Nashua to get the attention of the governor’s office about the failures of the program in our area.”

The change came after the state terminated Granite Pathways’ separate contract for inpatient services for youths in need of substance abuse treatment after several drug overdoses at its youth treatment center in Manchester.

Slow Speed
Health and Human Services Commissioner Lori Shibinette said Granite Pathways worked through a lot of barriers through the start-up process, but the difference between them and the seven other Doorway programs was in forging community relationships.

“We just weren’t pleased with the speed” of the progress in Nashua and Manchester,” Shibinette said.

The Doorway system is only a year old, yet Shibinette said it has been foundational in connecting residents with opioid and substance use disorder to treatment and recovery services in their communities.

“As the system evolves in its second year, it is clear that we have several opportunities to improve access in our Nashua and Manchester communities. Catholic Medical Center and Southern New Hampshire Medical Center have strong relationships with local providers, which will allow them to grow the Doorway system in their cities. I am pleased both organizations are joining the Doorway,” Shibinette said.

Appearing with the governor and commissioner to announce the change were CMC Chief Operating Officer Alex Walker and Mike Rose, chief executive officer of Southern New Hampshire Health.

Both welcomed the opportunity to be community partners in dealing with the issues of addiction, which have gripped the state.

“CMC’s mission is to offer health, healing, and hope,” said Walker. “Collaborating on the Doorway initiative is a natural fit for who we are and what we do.”

Rose said SNHH has a long-standing commitment to providing high-quality mental health and addiction services to its region.

There will be a period of transition for those in the system and it will take several weeks for the contracts with the two hospitals to make their way to the Executive Council for a vote.

Sununu was asked at the press conference what happens next year when federal funding for the Doorway program expires. He said there have been efforts to work with Congress to make the program more flexible.

A report was released Tuesday entitled “Granite Pathways Non-Doorway Contracts Review: Findings and Recommendations.”
A copy of it can be found here.https://www.governor.nh.gov/news-media/press-2020/documents/pathways-non-doorway-review.pdf.
A copy of the review of Granite Pathways Doorway Contracts can be found here. https://www.governor.nh.gov/news-media/press-2020/documents/pathways-doorway-review.pdf

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