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Hassan proposes $28 million more funding for mental health care community services

For weeks as she prepared her vision for how the state will operate over the next two years, Gov. Maggie Hassan has been receiving daily updates on the growing number of people waiting in local emergency rooms for psychiatric treatment.

The number has grown over that time, to a record high last week of 44 people, 18 of them children.

In her state budget, released yesterday, Hassan proposed adding $28 million over the coming two years to address the problem, which she called “one of our most pressing public health challenges.”

Her proposal does not approach the request community mental health care providers made last month, seeking a $38 million increase over the next two years, funding they said would have brought the state up to date on the 10-year mental health plan adopted – but never funded – in 2008.

Hassan said in her address she is committed to moving forward with the 10-year plan, calling it “critical for the safety of the public and the health and well-being of individual citizens.”

The money is allocated for several priority items:

∎ A new, 10-bed inpatient facility, in an existing hospital, for patients in a mental health crisis. Only Elliot Hospital in Manchester has this type of facility, with eight beds available.

∎ 16 beds for patients in need of short-term inpatient care for acute psychiatric treatment, doubling that resource.

∎ 74 new community treatment beds. As of January 2012, there were 159 of these placements available.

∎ Funding to give housing subsidies and residential support services to 100 additional people with mental illness.

∎ 10 new Assertive Community Treatment teams, a support for people in crisis that can lead to decreased needs for hospitalization. Nine of these types of teams are already in place, serving people in four regions of the state. However, none of the existing teams serves children; six of the new ones will.

∎ Funding to bring assistance and treatment to 350 more older adults who are at high risk for hospitalization.

∎ An additional 10 percent in funding for peer support programs.

Taken together, the elements of the plan are “a very significant move forward to try to treat people within the community,” said Kathy Sgambati, a former state senator and former deputy commissioner of the state Department of Health and Human Services. Sgambati worked with Hassan as a budget adviser on the mental health system.

She pointed specifically to the services for elders with mental illness, estimated to cost $100,000 each year, and the peer support programs, receiving $150,000 each year, as “cost-effective community-level services that can really help people avoid hospitalization.”

That New Hampshire’s lack of community-based services for the mentally ill create or increase unnecessary hospitalizations is the allegation made in a lawsuit filed last year by several patients and their families. Sgambati said the proposed increases weren’t directed at that complaint specifically.

“The lawsuit is out there, and I think we have clearly met with a number of advocates . . . but our approach was to take the most critical needs and find the capacity to fund them.”

Amy Messer, legal director for the Disabilities Rights Center, is the lead attorney on the case. While she was pleased with the governor’s proposals, particularly the expanded assertive community treatment teams, she would not say whether it could affect the suit.

“The question remains whether we’ll have the right mix and sufficient capacity of services to end the needless institutionalization that currently exists,” she said. “We hope to work with the governor and the state to really craft a positive, meaningful and lasting reform.
. . . There’s still a lot more work to be done.”

‘Some things . . . all of us can support’

While some parts of Hassan’s budget won little enthusiasm from state Republicans, funding for increased mental health care seemed to earn bipartisan support.

“I thought her suggestions were very innovative, and I’m looking forward to working with her,” said Sen. Nancy Stiles, a Hampton Republican and chairwoman of the Senate Health, Education and Human Services Committee.

“There’s some things that I think all of us can support: more funding for the (developmental disabilities) wait list, mental health programs, CHINS, the community health center. These are some priorities that Republicans have had for a long time,” said Sen. Jeb Bradley, a Wolfeboro Republican.

But, Bradley added, “we can’t be paying for things with uncertain revenue sources. . . . These are the things that I think Republicans, but certainly Democrats also, will be asking, to make sure that the numbers add up and this is a balanced budget.”

Hassan described the funding increase as “restoring” the budgets for those programs.

In 2011, the Legislature passed a budget that cut funding for the Department of Health and Human Services by $238 million, including a $2.5 million cut that brought the state’s psychiatric care facility down to its current capacity of 152 beds.

Health and Human Services Commissioner Nicholas Toumpas announced in December a plan to reopen 12 beds in July.

As they did after Toumpas’s announcement that there will eventually be more space at the state hospital, mental health care providers said they valued Hassan’s apparent support for the 10-year plan, but noted they are still far from feeling the benefit of any increased funding.

“This is a big step forward,” said Roland Lamy, executive director of the New Hampshire Community Behavioral Health Association. “The fact that the governor seems to support the priorities of the 10-year plan is critically important . . . (But) we’ve been very vocal over the fact that we’re in an immediate crisis. This is a great step, and a strong recognition that there is a problem for the people of New Hampshire.”

(Sarah Palermo can be reached at 369-3322 or
spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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