By GARRY RAYNO, InDepthNH.org

CONCORD — The state will have to increase what it is willing to pay transitional housing providers in order to add more beds to the system, a legislative committee was told Friday.

More transitional housing beds are needed to reduce the number of children and adults in mental health crises in hospital emergency rooms waiting for treatment.

The current biennium’s budget includes $5 million for 40 additional transition beds for patients at New Hampshire Hospital who no longer need that level of care so the wait for beds at that facility would be reduced.

Katja Fox, director of behavioral health at the Department of Health and Human Services, told the Joint Legislative Fiscal Committee Friday that in ongoing discussions with providers, they clearly said the mental health system’s rates are not high enough to make it a viable option for them to open up beds.

She said the department is preparing to address the issue with the Senate Finance Committee when they meet later this month.

“The (provider) community is telling us in very strong terms,” Fox said, “the rates just don’t cut it to stand up beds and we have to address it.”

She said the department has added 16 transitional beds at the Philbrook Center and two others, but no other beds are likely to be added by the end of the biennium.

Earlier in the meeting, state Sen. Lou D’Allesandro, D-Manchester, asked what the department is doing to address the backlog of children and adults in hospital emergency rooms waiting for a bed at the New Hampshire Hospital, the state’s psychiatric hospital.

“The numbers continue to grow,” he said. “This problem is pervasive and will get worse once we get kids back to school.”

D’Allesandro understood some contracts were about to go to the Governor and Executive Council for approval and wondered where that stood.

Fox said the department has been working around the clock to address the issue. 

“This is very, very concerning as we saw it grow as a crisis situation for children,” Fox said, “and we took a number of steps to start to lower the number. Anyone waiting is one too many.”

She said they have temporarily reinstated 10 beds at New Hampshire Hospital for children, and a contract for additional beds will go before the Executive Council soon.

Fox noted schools will be back to full-time instruction Monday and the division believes that will impact the situations as teachers will be with students and have a “360-degree view.”

“We are going to do everything we can to intervene before we reach an acute stage,” she said.

D’Allesandro said he expects the situation to be exacerbated when kids return to classrooms, noting the Manchester schools are going to need social workers in every school when students return to deal with the problems that have gone unaddressed during the pandemic.

“I appreciate that everybody recognizes this is a critical situation,” he said. “Mental health is something that has been adversely affected by the pandemic and it is not going away.”

D’Allesandro said no one wants to return to the days when New Hampshire Hospital held 3,000 patients.

He said while the 10 beds for children at the facility is a stop-gap measure, they really should not be in an adult facility.

State Sen. Cindy Rosenwald, D-Nashua, asked when the contract to treat children at Hampstead Hospital would go into effect and how many beds would be available.

New Hampshire Hospital Chief Executive Officer Heather Moquin said seven additional beds would be available the first week of May.

In February more than 50 children were waiting in emergency rooms around the state for beds to open so they could be treated. That number has dropped, but those waiting for treatment have been in double digits for some time.

Medicaid Growth

Health and Human Services officials were questioned about projected growth in the Medicaid program as a result of the pandemic.

The department cites a consultant’s report that predicts the state’s Medicaid patients will grow from 43,000 to 105,000 due to the pandemic.

To date the department has seen all Medicaid cases grow by a little less than 41,000 said state Medicaid Director Henry Lipman, but suggested it would likely grow more as the pandemic continues.

The increase is about 40 percent for the Medicaid expansion program for low-income adults, he said, with about 20,000 not normally eligible for the program who are due to programs related to the pandemic.

The department uses the consultant projections to increase federal Medicaid reimbursement, both for the number of cases and at an enhanced 6.2 percent rate under federal COVID relief and recovery programs.

Information items provided the committee by the department indicate $71.5 million in additional federal Medicaid money for the state.

The Fiscal Committee does not act on the information items, which need only Gov. Chris Sununu’s approval in a state of emergency under a law lawmakers passed in 2002 after terrorist attacks on New York City and Washington, DC.

Lawmakers sued the governor over the issue last year, but lost, and several bills before the legislature this session would curtail a governor’s authority under a state of emergency.

The information items, most for Health and Human Services, show the state using $42.65 million in CARES Act money for a variety of programs including day care facilities, community services block grants and department costs due to COVID-19 including overtime and technology equipment.

The state received $1.25 billion in CARES Act money that had to be used by the end of the calendar year, but its use has been extended through this year.

Other federal money will be used for personal protection equipment as well for vaccination expenses.

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