By PAULA TRACY, InDepthNH.org

CONCORD – A contract with Mary Hitchcock Memorial Hospital (Dartmouth Health) to operate the state’s new psychiatric hospital for youths at Hampstead Hospital was tabled for two weeks by the state’s Executive Council, with questions about state control, oversight and the future of state employees there.

Outgoing Republican Gov. Chris Sununu told reporters the seven-year deal with the state’s largest and most prestigious hospital group to run the hospital is good for kids who will be treated there and told reporters it is his final and top priority for completion of his eight years in office.

He said the contract is about long-term stability for care for some of the state’s most vulnerable citizens.

“Are we going to get a better result for the kids?….Unquestionable,” said Sununu. “At the end of the day, that is the most important thing.”

But a petition to the council signed by 110 of the current 112 employees at Hampstead, which InDepthNH.org obtained this week, said they want to remain state employees. 

The contract creates uncertainty with no guarantees regarding wages, paid time off, a likely shift in health care coverage and no guarantees to an employer match to retirement plans and a loss of access to the state pension plan.

“A loss of any amount of staff from present levels will necessitate further census reduction and or closure of units. (Hampstead Hospital) is a safety net for NH; there is no alternative facility to send you in crisis anywhere else in this state,” the petition reads. “Continuing in our present roles would be the optimal outcome for the hospital employees, DHHS, and the patients we are here to serve,” it concludes. It is signed by nurses, counselors, admission and discharge staff, safety, and social workers.

After the meeting, Sununu said these are not long-term state employees and there was never a plan in place that would have assured them of that pension.

Morissa Henn, deputy commissioner of the state Department of Health and Human Services, said she recognized that it has been a very turbulent time for staff at the hospital. In 2022 the state purchased the hospital which once served adults and children and the state contracted operation for two years by Wellpath until the end of June when its contract ended. 

Henn said after considering multiple operational models with Dartmouth Health, the contract is now for them to take over and lease the facility from the state for about $1.2 million a year with an advisory oversight board including state input.

But some councilors said they worried that there was not enough state control and wanted to see the details, particularly as it relates to employees.

Henn said Dartmouth Health has made a commitment to hiring them. Some in leadership there will remain state employees and the state is committed to finding a job in state government for others so that everyone there will have a good job.

Three of the five executive councilors peppered Henn with questions about the 138-page contract which they received just before Thanksgiving. They agreed to hold off any vote until more of their many questions can be answered.

Executive Councilor Joe Kenney, R-Wakefield, said there are many aspects and questions and wanted to know if the contract could be amended or whether it has to vote “either up or down.”

Lori Weaver, commissioner of the state Health and Human Services Department, said this is a contract the department worked on for a great deal of time and feels it is in the best interest of the state.

Attorney General John Formella told Kenney that like all contracts placed before the council, it does not have authority to modify, as it has been previously negotiated, and it is an up or down vote for the council.

Outgoing Executive Councilor Cinde Warmington, D-Concord, criticized the department for not allowing the council in on the negotiations prior to receiving the contract just days ago and said that many questions might have been able to be answered prior to the meeting.

By law, the council needs to approve the contract at its next and final meeting of its two-year term or the deal falls through, Sununu noted and though Dartmouth would continue to operate it, he said he was sure that they would not be around in two years and the state would be left to run it.

She said when the council chose to purchase the hospital (with more than $13 million in federal American Rescue Act funds) it chose the company Wellpath to run it for the early portion and then the state put it out to bid with both Wellpath and Dartmouth applying.

She said initially she believed the plan was similar to the current model at the NH Hospital, the Sununu Youth Services Center and the Glencliff Home for the Elderly where Dartmouth would provide clinical staff and the state would continue to provide management and operations.

This is a new model for the state which involves outright lease and operations.

“This model here is a model where Dartmouth is completely taking over the hospital. They will no longer be state employees and the only way the state can exercise control is an advisory committee,” Warmington said.

Weaver said the vision for the hospital workings is one of long-term stability not impacted by state budgetary constraints every two years.

Sununu said the state will save $20 million a year on this operations model and it would not be subject to the state budget ups and downs. An estimate had the state spending $34 million a year to operate it and with this contract, it will end up receiving $1.2 million in rent.

He noted the state does not need to be licensed for such a hospital but Dartmouth Health will need to get that and that oversight provides another level of safety for the patients.

Warmington said she agreed with Councilor Kenney that the council needed more time but noted if this was Dartmouth that owned this facility and wanted to transfer it to another entity, the state would put them through a very lengthy and rigorous process to ensure care and antitrust matters were considered. This is similar to hospital mergers that are now being scrutinized including one at Exeter Hospital where the terms of the agreement are being argued.

“This is a big deal,” she said. “I am so delighted it is Dartmouth…I think they are a wonderful provider….but we have not gone through the process we should go through….including that we are treating our state employees fairly.”

Sununu asked the DHHS for a summary on oversight and control to be provided to the councilors.

“We have not done the level of review that we would put another entity through, ” Warmington said.

Executive Councilor Janet Stevens, R-Rye, said staff morale at the hospital right now is very low and there are worries about what this deal will mean to staffing levels.

Meanwhile, she noted there about 12 kids waiting for placement right now at the hospital in emergency rooms.

While there is more bed capacity at Hampstead, the staffing levels are not up to the capacity yet.

She asked if Dartmouth, which took over for Wellpath six months ago, is performing to the contract?

Henn said yes, and she said she is even receiving positive calls from the local community about Dartmouth’s care. 

Not only is there hope to expand available beds but Dartmouth is looking at offering non-inpatient services, Henn said.

Stevens said she is concerned that the contract only allows the state advisory authority. 

“They make all the decisions and there is not a lot of state recourse,” she said.

Henn said there is a federal oversight requirement to be such an appropriately designated facility.

She said the state’s experience with Dartmouth is that any time there has been a request for the public good the answer has been “yes.”

“There is concern,” among staff, Stevens stressed.

Sununu said staffing is a big issue and there is no other provider that has the reputation to staff like Dartmouth. 

“We would have a much harder time as the state to recruit staff,” he argued.

In a statement on the issue earlier this week Sununu said:

“In 2022, the State of New Hampshire purchased Hampstead Hospital to ensure that critical mental health care services for children were not lost.

“This partnership with Dartmouth Health will ensure one of the country’s most prestigious health systems is taking care of New Hampshire’s kids. This is an amazing win-win opportunity that ensures world-class care while saving an estimated $20 million annually in overhead costs to the state. 

The sole source contract, which would be effective upon passage, provides for the agreement to be for seven years with the option to renew three times in five-year increments with a base rate of $1,157,494 a year with a 2.5 percent increase annually. It also calls for the state to remain for one year and to collect administrative fees of up to $5 million. 

“Without this contract, the long-term stability of the state’s only mental health hospital for children is at significant risk,” the governor stressed.

“Dartmouth Health will ensure these services are available to children and young adults in alignment with NH Children’s Behavioral Health System of Care. Dartmouth Health currently provides behavioral health services at New Hampshire Hospital and the Youth Detention Center.

The council will take up the contract again when it meets Dec. 18.

A link the the 138-page contract is here https://media.sos.nh.gov/govcouncil/2024/1204/12A%20GC%20Agenda%20120424.pdf

Separately but on the same 100-acre campus at Hampstead, the state plans to relocate its Sununu Youth Services Center in Manchester, which is closing.