Senate Finance Committee approves psych facility compromise

Monitor staff
Published: 5/28/2019 5:16:33 PM

New Hampshire’s Senate Finance Committee is backing a plan to create a psychiatric facility in the state, breathing new life into a proposal by Gov. Chris Sununu months after the House stripped it from the budget.

But the plan, recommended 4-2, scales back Sununu’s original vision for a standalone psychiatric hospital, reducing the bed count from 60 to 24 and the price tag from $26 million to $17 million.

It’s the latest in a series of compromises being put forth to address yawning differences between the Republican governor and Democratically controlled Legislature over the budget. After weeks of rallies in which Sununu decried the House budget for tax hikes and surplus spending and threatened a veto, Senate Democrats are seeking to stake out common ground.

On Tuesday, those efforts hit full throttle, as senators on the six-member committee released and voted on a series of amendments relating to education and health care funding, intended to strike a balanced budget and head off a veto.

The senators approved plenty of spending amendments, including $6 million to build up mobile crisis units and behavioral health care for children; $11.5 million to build and staff a children’s acute psychiatric treatment center in Nashua; $5 million for transitional housing beds and $5 million to enhance provider reimbursement rates for mental health and substance use disorder.

“This particular amendment is consistent with what Rep. (Renny) Cushing and the governor have talked about: taking care of the SPU situation,” said Sen. Dan Feltes, a Concord Democrat. “That’s what this does.”

But to secure some investments, committee members opted to curb others. Most significantly: A previous Senateproposal to raise Medicaid reimbursement rates by 12% across the board – payments critical to funding for clinics and providers – was reduced to a 6.2% hike, cutting the proposed hikes in half and saving over $50 million.

Senators also moved to dramatically cut back a bill signed into law last week: Senate Bill 11, which was intended to reduce emergency department boarding by funding receiving facility beds at hospitals. That bill, signed with fanfare, would originally fund 30 designated receiving facility beds among at least three different hospitals. The budget amendment would scale that down to 10 beds total, and make it exclusive to Cheshire and Sullivan counties.

In place of a robust network of DRF beds, the Senate budget would instead fund increased mental health beds in targeted facilities.

The 25-bed psychiatric facility, which would be built on the grounds of New Hampshire Hospital in Concord, could take in involuntarily committed patients currently stuck in the secure psychiatric unit in the state men’s prison. The 18-bed Nashua facility for acute psychiatric care would allow most of the 25 children presently in New Hampshire Hospital to be moved out.

Then, the amended budget would use $3 million in general funds and $1 million in hospital trust funds to renovate the children’s beds of the state hospital to house adults, opening up 48 beds in total, according to Department of Health and Human Services officials.

Department of Health and Human Services Commissioner Jeffrey Meyers, who has been pushing for the construction of a separate facility to house secure psychiatric unit patients, praised the three-piece proposal.

“It absolutely significantly addresses the issues that we raised,” Meyers said. “It puts the kids in a better place for them, it creates significant new space at the New Hampshire Hospital to address the ER boarding crisis, and it creates a new secure psychiatric facility to at a minimum address the needs of those who are civilly committed.”

The health care spending amendments are one of many changes the Senate has made to transform the budget into something with fewer points of contention.

Last week, the Finance Committee rejected a proposal to create a capital gains tax in New Hampshire, striking down a House Democratic proposal that had drawn opposition from the governor.

In a “straw vote” Friday, the five-member committee opted to remove the proposed tax from the budget trailer bill, House Bill 2. The plan would have expanded the 5% tax that already applies to interest and dividends earnings to capital gains earnings – and it would have doubled the exemptions for all those earnings from $2,400 to $5,000 per person.

The proposed capital gains tax formed a critical piece of House Democrats’ plan to boost school funding. An estimate in February found that it could bring in about $95 million, after taking into account revenue lost from raising the exemptions. Democrats argued that it would fall largely on a small population of wealthy residents. But Republicans called it overreaching and unreliable, arguing people might leave the state or delay making asset sales until the tax were later repealed.

Sununu called it a “terrible idea,” and railed against it in a speech to the Greater Concord Chamber of Commerce as one in a list of proposals that could lead to his veto over the final budget.

Friday’s and Tuesday’s amendment votes are not yet binding; Senate Finance may continue to make amendments Wednesday before passing it off to the Legisative Budget Assistant. But it likely eliminates the capital gains option moving forward.

The committee will vote on the fully amended budget Friday.

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