Sununu signs bipartisan mental health bill to address ER boarding crisis 

  • Gov. Chris Sununu signs SB 11, a bipartisan bill to address the emergency department boarding crisis, at NAMI NH headquarters in Concord, May 21, 2019 Courtesy

Monitor staff
Published: 5/21/2019 5:18:08 PM

A sweeping bill to address New Hampshire’s emergency department boarding crisis became law Tuesday, after Gov. Chris Sununu signed a measure advocates hope could turn the crisis around.

Senate Bill 11 attempts to address a decade-long problem for the state: the dozens of mental health patients trapped in emergency departments and awaiting care. As of Sunday, 34 were housed in emergency departments, part of a backlog brought on by a severe shortage of beds, according to Sen. Tom Sherman, the bill’s prime sponsor.

“The foundation for meaningful progress has been laid, and I would like to thank the House and Senate for working in a bipartisan manner to get this done,” Sununu said.

The bill allocates $10.6 million to help open up pathways to care, including over $5 million to help increase “designated receiving facility” beds. Those beds, which would need to be constructed and run by hospitals, would allow an off-ramp for those stuck in boarding rooms to receive acute mental health care.

Presently, mental health patients who are taken to emergency departments face waits of days or weeks until beds open up. Under state statute, those who are involuntarily admitted to emergency rooms due to mental health crises must be transferred “immediately” to designated receiving facilities. In practice, that rarely happens.

In the past, efforts by lawmakers to fund the beds have faced a problem: Hospitals haven’t stepped up. Money set aside in 2017 for designated receiving facility beds had to be reallocated by the Department of Health and Human Services after no hospitals bid on the contracts.

Hospital CEOs have argued the proposed contracts carried impossible financial burdens, and that building and maintaining the new beds would cost more than it would save. SB 11 sought to address that concern. In addition to $4.4 million funding for the construction of 30 new designated receiving facility beds spread among three facilities, this year’s legislation includes measures meant to help financially assist the hospitals with creating the new beds.

The legislation includes $1.1 million in increased Medicare reimbursement rates for both designated receiving facility beds and inpatient admissions – reimbursements that supporters of the bill argue will help boost staffing levels. It also requires insurers pay up to 21 days of per diem treatment for those stuck in emergency departments to balance costs.

And in measures that advocates say will help patients at both ends of the mental health crisis, the bill provides $3 million to mobile crisis response units – which allow clinicians to reach people in their homes at all hours – and $2.1 million to go to affordable housing initiatives for those discharged and recovering from mental illness.

The bill, most of which takes effect immediately, comes as New Hampshire’s boarding crisis has exploded. In 2013, the state had an average of nine people in emergency rooms; in the past six years the number has quadrupled, according to Ken Norton, executive director of NAMI N.H., which tracks daily numbers of patients.

On Tuesday, Sherman, a Rye Democrat and physician praised the governor’s signature, which he said “will address the emergency room boarding crisis as rapidly as possible.”

“SB 11 is a major step forward in New Hampshire’s efforts to rebuild our mental health system and ensure that our citizens have access to the mental health care they need, when they need it, and in facilities designed to meet their needs,” he said.

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