By GARRY RAYNO, InDepthNH.org
CONCORD — State budget writers accepted more than $12 million in federal pandemic relief money for two projects public health officials believe will help relieve a long-running mental health crisis in the state.
For the last 10 years Health and Human Service officials have tried to reduce the number of adults and adolescents waiting in hospital emergency rooms for a bed to open at a psychiatric care facility.
Portsmouth Regional Hospital and its parent company HCA plan to build a 96-bed behavioral services hospital and the state will contribute $15 million in capital defrayment in return for a seven-year contract for as yet to be determined minimum number of beds. The project is estimated to cost $45 million to build.
The for-profit company, which also owns Parkland Medical Center in Derry, and Frisbie Memorial Hospital in Rochester, would consolidate its behavioral health programs into the new facility, which is expected to be Epping with a preferred site off Route 101 on the west side of the junction with Route 125. The company has yet to seek local approval for the project.
Several members of the Joint Legislative Fiscal Committee wondered if the contribution would set a precedent for the state supporting a private project, developed by a for-profit company.
Health and Human Service division of behavioral health director Katja Fox said not on this scale, but the state has provided incentive and rehabilitation grants to private and non-profit long-term care facilities.
Health and Human Services Commissioner Lori Shibinette told the committee the state is prepared to provide another $15 million capital defrayment to a similar hospital project being developed by a non-profit organization.
The two organizations were the only ones that stepped forward willing to build additional mental health beds, she said.
“The boarding crisis has been going on for 10 years,” she said, adding the department has added more beds and mobile rapid response crisis teams.
“The (mental health) system has been running at 100 percent capacity for 10 years,” Shibinette said, “and it is not meant to do that.”
The project will bring on a total of 38 new beds and services will be consolidated into one facility, and she said the beds in the new hospital will be both for voluntary and involuntary patients.
Shibinette said the emergency room boarding figures are only for involuntary patients. On Thursday 20 adults were waiting for a bed to open, and five children.
The project would include 68 adult inpatient beds, 16 geriatric inpatient beds, and 12 adolescent(12 and older) inpatient beds.
The facility would also have an additional 15 beds for an outpatient partial hospitalization program, and two specialty programs for adolescents: eating disorders and dual mental health and substance use diagnosis.
The eating disorder program may remain where it is currently in Salem, but could be moved to the new facility in information provided to committee members.
And the Attorney General’s Office would need to approve moving the behavioral health beds from Frisbie to the new facility.
Susan Stearns, Executive Director of National Alliance on Mental Health New Hampshire, said additional beds are welcome as well as the partial hospitalization program.
The current system is not robust enough to provide other levels of care, she said.
Stearns said the boarding crisis is the most visible focus of the system’s shortcomings, but the community mental health system needs to be robust enough for people to receive services early on so they do not have to be placed at inpatient facilities.
“There’s a lot of work to do system-wise, but this will help,” Stearns said. “I would like to see something in the North Country where the closest hospital bed is in Franklin.”
There needs to be more statewide access, Stearns said.
Last fall Gov. Chris Sununu announced the state would buy Hampstead Hospital, which has contracted with the state to provide in-patient psychiatric care for children during the pandemic.
The fiscal committee and executive council approved $15.1 million in federal recovery money to purchase the 111-bed facility, although staffing shortages have reduced the number of patients to about 40.
The state has grappled with adolescents stuck in hospital emergency rooms since before the pandemic began. However, the pandemic greatly increased the number of children needing inpatient psychiatric care.
On Friday the committee accepted $2.2 million in federal pandemic money for a behavioral health strike team to assist Hampstead Hospital in responding to adolescents in mental health crises.
According to information Shibinette sent to the committee, a daily average of 16 youths waited for psychiatric care during the first two weeks of December.
In the state’s biennial budget, the legislature also approved $30 million for a new forensic psychiatric hospital adjacent to New Hampshire Hospital.
The facility would replace the secure psychiatric unit at the state prison in Concord.
The fiscal committee also approved accepting $12 million in American Relief Program Act funds to bid on at-home COVID-19 test kits.
If the state is successful in securing the test kits, they would be sold through the Liquor Commission and the money would be returned to the state pandemic relief fund.
Sununu announced the state would buy the test kits at his press conference Wednesday on the state’s response to the pandemic.
Garry Rayno may be reached at email@example.com.