By PAULA TRACY, InDepthNH.org
JAFFREY – Medicaid reimbursement rate increases for birthing units around the state were approved Wednesday as Executive Councilor Cinde Warmington spoke of the long-term damage being done to maternal health-care since the state’s new abortion ban went into effect.
The Concord Democrat said it is becoming harder for the state to attract and retain physicians, and the ban leads to operating room decisions that put women’s lives and doctors’ liberties in jeopardy.
Also, increases in malpractice insurance are making it possible for the state to see new “maternity deserts” forming as birthing units close and rural hospitals give up on providing deliveries, she said.
Already, Frisbie Memorial Hospital in Rochester has announced it is closing its birthing unit and sending patients to its sister hospital in Portsmouth.
Warmington vigorously challenged Gov. Chris Sununu’s comparison of New Hampshire’s abortion ban as being the same as New York’s and Massachusetts’, saying doctors here have to decide between whether to save the life of the mother or be found guilty of the crime of performing an abortion after 24 weeks.
The Executive Council also approved spending about $250,000 in federal American Rescue Plan dollars to help pay for home birth and midwife services as Warmington noted malpractice insurance for maternal health is now skyrocketing.
Meanwhile, Attorney General John Formella said he is still investigating whether a merger agreement between Frisbie Memorial Hospital and HCA violated the terms as Frisbie is in the process of closing its birthing unit.
The Governor and Executive Council also approved a number of contracts worth millions of federal dollars to help people survive the winter, including more rental, fuel, electric, and water assistance, which is separate from a legislative vote last week to allocate more than $40 million in state surplus revenue for added heating and electric assistance which will increase the number of those eligible by about 50,000 across the state.
In New Hampshire, abortions are no longer allowed after 24 weeks of pregnancy. This law went into effect on Jan. 1 as part of a Republican-backed budget bill. It is controversial and central to the Democrats’ efforts to win elections this November.
Warmington, the lone Democrat on the five-member council running for re-election and so is Republican Gov. Chris Sununu.
Sununu has stated that he signed the budget bill but was not pleased with all the provisions in it related to abortion restrictions, but maintained that most people support a ban on abortions after 24 weeks of pregnancy.
Warmington lit into the governor when the discussion at the table turned to the issue of abortion early into the meeting.
Executive Councilor Joe Kenney, a Wakefield Republican, asked about saving birthing centers that are closing in rural areas.
He said his area in the North Country lost more population than the rest of the state and said he was concerned about future challenges to keeping birthing centers open.
Henry Lipman of the Department of Health and Human Services, said passing measures such as the increases in rates “is a beginning of what needs to be done to maintain obstetric services in the state.”
“We are trying to work on a number of different fronts,” Lipman said noting there is a need for more recruiting and training and retention of staff and to not “treat each hospital as an island.”
The state is leading the region in population growth. Lipman said Dartmouth-Hitchcock Medical Center in Lebanon is looking into the issue of emerging “maternity desserts” to ensure New Hampshire does not create one.
Lori Shibinette, outgoing commissioner of the Department of Health and Human Services, confirmed there are costs that women and the medical community are suffering from the new restrictions.
The Republican-backed council has also voted to oppose funding for family planning services at a handful of centers that provide abortions, including Planned Parenthood. Shibinette has said in the past that that is adding to the problem of accessing reproductive health for many women of modest means.
Warmington said she is being told by officials at DHMC that it is very tough to recruit people into the field here in New Hampshire now when the state has such abortion restrictions, particularly aspects of criminal charges for physicians doing the care they have done here for years.
Executive Councilor Janet Stevens, a Rye Republican, asked if Shibinette could define the ban that is in effect.
Shibinette said she would defer to her lawyer “but generally speaking anything in the second or third term of pregnancy there is a limit on that…”
“So 27, 28 weeks?” Stevens asked.
“24,” Shibinette said.
“So 24 weeks, the same as Massachusetts and the same as New York,” Sununu said.
Warmington rejected that assertion.
“So, governor I just have to beg to differ. There is no exception for the health of the mother. There is an exception for the life of the mother.
“But when a mother comes in and she is hemorrhaging, a doctor has to sit there and make a decision about whether we are talking ‘is this mother going to die? Is it 100 percent chance she is going to die or is it 90 percent chance?’ And that doctor has to make that decision with the awareness that he or she might go to jail if she makes the wrong call. So it is not the same as Massachusetts. You need to stop saying that because you are misleading the public. You have a ban that is endangering the lives of women in our state. You need to stop saying that it is the same in Massachusetts” Warmington said.
“Further discussion?” said Sununu.
After the meeting, Warmington said that when HCA took over Frisbie Hospital, it was done under the direction of the Charitable Trust Division of the Attorney General’s Office and there were certain provisions or conditions. The question is whether or not, by discontinuing the provisions of birthing services, they have violated the conditions of that merger.
While an investigation into that is not complete, as Formella said, Warmington said she looks forward to the findings this fall.
She said the DHMC system is really providing maternal backup for rural care right now and it is fragile.
“If these rural practices don’t have some place to send their complicated pregnancies, then they don’t feel comfortable providing obstetrical services in their community. And Dartmouth is saying that this abortion ban is actually inhibiting their ability to retain (or attract) physician providers to come to our state because they don’t want to take the risk that their provision of service may be criminalized from the abortion ban,” Warmington said.
She said the whole new abortion ban should be thrown out in the state but particularly onerous is the provision about physicians having to decide or face criminal liability.
“You’ve got physicians put in a very, very bad spot and it is really a danger to the health of women and the lives of women in New Hampshire,” Warmington said.
Unlike Massachusetts and New York, as she said she understands it “there is no exception in New Hampshire for the health of the mother.”
ROADSHOW MOVES TO JAFFREY
The meeting was held in an airplane hangar at Jaffrey Airfield – Silver Ranch. The Executive Council has been on the road all summer visiting each of the five council districts offering councilors a chance to showcase a part of their district.
The meetings have been held in Plaistow at the YMCA, at the Hooksett Library, at New England College in Henniker, and atop Mount Washington.
Wednesday’s meeting was hosted by Executive Councilor David Wheeler, R-Milford, who chose the airport.
Constructed in 1946 as a private airstrip, it is a public-use facility that recently underwent a major improvement. The council honored, among others, Harvey Sawyer for his lifelong service to the community through the airfield operations.
The meeting also began with the singing of the National Anthem by first graders from the Dublin Christian Academy. Breakfast for the council and governor was made by the Francestown firefighters at their station nearby.
NEW PARKS DIRECTOR NOMINATED
Sununu has nominated Brian J. Wilson of Simsbury, Conn., as director of parks.
Wilson previously worked for the department in the Seacoast area and is currently the deputy state parks director in Connecticut.
He is a graduate of UNH and has 24 years of experience in the field. If confirmed he will return to New Hampshire and begin Nov. 1, succeeding Phil Bryce of Deering.
Bryce was confirmed as a public member of the Mount Washington Commission, which is currently working on a new master plan. He had been previously involved in the commission as parks director. On Oct. 7 at Franconia Notch State Park, the commission will meet to vote on a draft of the master plan.
$6 MILLION FOR VACCINES
As COVID-19 is expected to possibly spike this fall, the council voted to enter into a contract with On-Site Medical Services, LLC, Claremont for $6 million for COVID-19 testing, COVID-19 vaccines, and other vaccines.
The contract is through Feb. 28, 2023, with the option to renew for up to three additional years. It also voted to approve a four-year contract with the same provider for a licensed medical director to develop and implement medical direction and training programs for Regional Public Health Networks.
Warmington recused herself from voting on both items citing a conflict.
Wheeler asked why the contract for the director stated it would be keeping a list of those who don’t want the vaccine.
DHHS’ Trish Tilley said the contract states that New Hampshire offers an opt-out process to account for the doses but the information on the individual does not go to the federal government.
Wheeler suggested tabling the matter before Tilley came back with the information but Councilor Kenney said it was too important to hold up the contract for two weeks.
TWO-YEAR CLOSURE FOR BRIDGE IN LYME
The council approved the Bureau of Construction to enter into a contract with New England Infrastructure, Inc., Hudson, Mass., on the basis of a low bid of $8,940,000 for bridge rehabilitation of state Red List Bridge No. 053/112 that carries East Thetford Road over the Connecticut River between Lyme and Thetford, Vt., using federal funds.
The bridge will be closed for two years but local officials are supportive of the closure, councilors were told.