By GARRY RAYNO, InDepthNH.org
CONCORD — A proposed 60-bed secure psychiatric unit on New Hampshire Hospital grounds would allow “start-to-finish” treatment for the civilly committed, state officials said Monday.
But several Concord lawmakers and residents said the facility should be elsewhere as it would be viewed as a prison in a residential neighborhood.
Gov. Chris Sununu included the proposed 60-bed facility in his proposed budget plan, but House budget writers removed it saying they did not have enough information to include it in the $13.67 billion package approved last week and sent to the Senate.
On Monday House Finance Committee’s Division III hosted a meeting with representatives from other House committees and the City of Concord, Department of Health and Human Services and Department of Corrections officials, social service advocates and local residents.
Currently the state’s secure psychiatric unit is at the State Prison for Men in Concord. Discussions about a new facility have gone on for years to separate the civilly and criminally committed, which the new facility would allow.
A 25-bed facility on the grounds of New Hampshire Hospital was approved two years ago in the budget package, with an appropriation of $8.75 million, but was never built. Sununu included a 60-bed facility in his budget and $17.5 million this year, which the House removed.
Health and Human Services officials believe a 25-bed facility built to accommodate a later addition of 35 more beds would cost about $40 million.
State officials said the governor believes the revenue shortfall may be breached by American Recovery Act recently approved by Congress. But the federal guidance on how the public works money may be spent has not been issued.
Of more concern at the meeting was the location of the facility.
Area resident and a State House lobbyist Karen Soucy said she lives in a wonderful neighborhood across the street from the proposed facility. “I could throw a baseball and hit the location,” she said.
The one site state officials have considered is near the corner of Fruit and Clinton streets and Concord District Court.
She said she knows dealing with the state, that does not have to comply with city zoning regulations, is like David and Goliath.
Rep. Katherine Rogers, D-Concord, suggested including a provision in a budget amendment for the Senate that would require the department to work with the city and the public as the project moves forward.
She and others asked if other sites were being considered, and Heather Moquin, NH Hospital Chief Executive Office, said it is the only option they have looked at, but alternatives could include any other-state owned land.
House Finance Committee Chair Rep. Ken Weyler, R-Kingston, suggested the agency look at the Sununu Youth Services Center in Manchester which House budget writers want closed after the next fiscal year and removed further funding from their budget.
The Sununu Youth Services Center was built to house over 140 adolescents but only about a dozen reside at what was formerly the Youth Development Center.
Weyler said it is already a secure facility and has a larger buffer around it. “Maybe this would be a way to repurpose the center without spending millions of dollars more,” he said. “The Sununu Center should be closely looked at for this purpose.”
Carlos Baia, Concord assistant city manager for development, listed the number of state facilities already in Concord, like the men’s and women’s prisons, NH Hospital, a number of halfway and transitional houses that he said all present a challenge to first responders.
“This proposal would add another institution to the South End of Concord,” Baia said. “Based on the sketches shown, people will say this is a prison building in a residential area of the South End.”
He noted the site’s close proximity to a daycare and pre-school, Memorial Field, Rundlett Middle School and Concord High School.
“Alternative locations warrant a conversation to have a more measured approach,” Baia said, “and a better distribution throughout New Hampshire, because this facility would serve the entire state, not just Concord.”
Moquin said the proposal expanded to 60 beds to address several other problems.
She said there are 24 beds at NH Hospital that are used for forensic patients, who are long-term patients, and if they were moved into the new facility those beds could be repurposed for shorter term emergency services, helping reduce the number of mentally ill waiting in hospital emergency rooms for beds to open.
But Michael Skibbie, Disabilities Rights Center-NH’s policy director, said the problem is not the 24 forensic patient beds but people who no longer need that level of care waiting at the hospital for transitional housing.
The two groups that make up the forensic patients at the NH Hospital, he said, are those not guilty due to insanity and those incompetent to stand trial.
They are there as a step down in restrictions from the secure psychiatric unit on the path to potential release back into the community, he said, and putting them into the new forensic facility would be a more restrictive environment, not less.
And he said a recent study of the state’s mental health system said no new beds are needed. “Going beyond current needs is not appropriate,” Skibbie said.
But Moquin said the plan is to provide multi levels of care from “start to finish” hopefully ending with reentry into the community.
That would be very different from the situation now, she said, with two care teams – one at the prison and one at NH Hospital.
Several lawmakers sought information on the number of civilly committed patients at the secure psychiatric unit and those criminally committed.
Paula Mattis, director of medical and forensic services at the prison, said the current center usually holds about 45 people but accommodates up to 66.
Currently there are 12 patients who would be eligible for the new unit if it were built today, she said.
Mattis said with a new facility, the prison would still need its own unit in order to manage the people with severe mental illness in prison.
The state has been lucky because some state prison systems are more like state hospitals with the number of inmates with severe mental illness they hold.
She said along with those from the state prison system, mentally ill prisoners from county facilities not equipped to handle them, also are housed in the unit at times.
Several lawmakers said they would rather see a phased approach to the project, first building a 25-bed facility before adding additional beds.
The ranking Democrat on the House Finance Committee, Rep. Mary Jane Wallner, D-Concord, said from what she learned from the presentations, “I am more and more convinced a 60-bed hospital is not warranted at this point, that 25 beds will meet the needs we have.”
She suggested continuing to meet with Health and Human Services officials and others to learn more as the project details develop.
But Finance Division III chair Jess Edwards, R-Auburn, asked the representatives from other House committees to provide suggested amendment language they could give to the Senate along with the notes from that day’s meeting. He said along with Weyler, they would decide if more meetings would be held.
Garry Rayno may be reached at email@example.com.