NH Union Leader – December 19, 2024
By KEVIN LANDRIGAN, Union Leader Staff
The seven-year lease for Dartmouth Health to run the only state-owned psychiatric hospital for juveniles cleared the Executive Council Wednesday. Gov. Chris Sununu called the pact one of the crowning achievements of his eight years in office that will end early next month. “We have Dartmouth Health taking care of our kids right now; it’s just awesome,” Sununu told reporters. “They agree New Hampshire kids should come first.” The support of town officials in Hampstead and Senate Majority Leader Regina Birdsell, R-Hampstead, were critical to finalizing the agreement, Sununu said.
The 4-1 approval of the contract came over the opposition of Councilor Cinde Warmington of Concord, the council’s lone Democrat. Warmington argued the 138-page contract had too many holes, including a lack of reporting and a guarantee that in-state residents would get priority for inpatient services, and the need for more communication earlier with the existing employees.
“It’s a big, big change for the state and the concern we have to address fundamentally is we cannot have kids sitting in hospital emergency rooms for days and weeks on end and not getting the treatment that they need,” said Warmington, who at one point called the plan “half-baked.”
She tried to table the contract for a second straight meeting, but the other four councilors opposed that move. Since Wednesday was the council’s last meeting of the year, the proposed contract would have died due to inaction and the process would have to start all over before a new council in 2025. “They are the only game in town, they are the best game in town, and they are mission driven,” said Councilor Joe Kenney, R-Wakefield. The Dartmouth Health-owned Mary Hitchcock Memorial Hospital will actually run the facility. Negotiations produced a hybrid public/private partnership that gives Dartmouth Health the lease for which it will pay the state more than $1 million a year. The deal allows for three extensions at five years apiece that could take the relationship out to 2046.
The contract calls for the state to remain involved in management of services for one year after the contract is approved and to collect an administrative fee of up to $5 million. Sununu said turning management over to Dartmouth Health will save the state $20 million compared to what the taxpayers would pay under state administration. The state bought the privately-owned Hampstead Hospital in 2022. The state ended its agreement with the first provider, Wellpath Recovery Solutions, after a year and a half in the wake of many complaints about the response to acts of violence by juvenile patients.
Dartmouth Health officials said final negotiations will proceed with the goal of a final closing in February. “Young people in our state deserve outstanding clinical care to support their health and well-being,” said Dr. William C. Torrey, Dartmouth Health chair of psychiatry. “At Dartmouth Health, we are deeply committed to developing, implementing, and offering evidence-based mental health best practices and in training the next generation of mental health professionals.”
The state’s lead negotiator predicted other states will look to this effort as groundbreaking.
“This model sets us on a path toward success, stability, and growth,” said Health and Human Services Commissioner Lori Weaver. Deputy Commissioner Morissa Henn said it would have been presumptuous for administrators to have conversations with current Hampstead employees until the contract won approval. “We are teed up now to have town hall meetings and office hours with employees starting tomorrow,” Henn said, adding that Dartmouth Health has committed to at least a 2% pay raise plus up-front bonuses for workers who agree to stay on the job.
She resisted the “worst-case scenario” offered by Councilor Ted Gatsas, R-Manchester, who said the contract will lead to a large exodus among the more than 110 workers who have worked under three different management teams over the past three years. “It is always normal when you have change, there is a natural attrition that occurs,” Henn said. “We will not see anything close to what you are talking about.” There are currently about 35 residents in a complex designed to have nearly 80 patients. The state deliberately chose not to set a minimum bed requirement for the new provider, Henn said.
“We believe and have learned in our experience that is important for the providers themselves to have flexibility,” Henn said. “It’s not fair to patients to be enforcing a certain number (of patients) to be side by side in a given unit given their needs may require special arrangements.” Setting a bed quota goes against the ultimate goal, which is for most juveniles to be treated at home or at a less restrictive setting closer to where they live, she added. “It is important not to imply that more beds are good,” Henn said. Dartmouth Health already provides medical administration at New Hampshire Hospital and services at the Sununu Youth Services Center in Manchester.
The council has approved spending nearly $40 million to build a smaller replacement to the Sununu center on the grounds of Hampstead Hospital, which will focus more on treatment and less on incarceration of troubled juveniles. “They have never reneged on their commitment to the community,” Henn added.