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Garry Rayno's State House Dome: Mental health help fixes are coming slowly

January 09. 2016 7:55PM

ABOUT 18 MONTHS AGO the state reached agreement on a plan to improve its mental health system, which had fallen from its one-time perch as a model for the nation.

The state said it would boost community-based services so those with mental illness would be less likely to go to hospital emergency rooms, or stay for an extended period in institutional care at New Hampshire Hospital or Glencliff Home.

The estimated cost to upgrade the mental health system to reach the benchmarks was about $30 million spread over a couple of state budget cycles.

Last week the expert reviewer overseeing progress on the settlement issued his third report, showing mixed results with some positive areas but also some areas where the state was slow or failed to meet benchmarks.

“We continue to be pleased to see continued development of what we know to be effective services for people with mental illness,” said Amy Messer, executive director of the Disability Rights Center for New Hampshire, which filed the suit that led to the agreement, “but we have a long way to go and a lot more work to be done before (people have access to the services they need.)”

One area Messer praised was the development of what are called Assertive Community Treatment teams in 11 regions of the state. The teams include psychiatric specialists, nurses, social workers, job counselors and others who are available 24 hours a day, seven days a week to respond to people in crisis.

If someone has a crisis at night they can call their ACT team and meet with them in his or her community and be helped through the crisis.

Messer said there are teams in every region, and while some are robust, others need more personnel to meet the model.

If an ACT team is not in place or available, there are mobile crisis units that can be called in to help.

The state hired Riverbend Community Mental Health to provide mobile crisis services, including housing in the Concord area, and is about to issue a request for proposals for the same services in the Manchester area with the understanding the services will be available by summer.

“This is a proven method to help stabilize people and begin to engage their recovery efforts,” Messer said. “If you can keep people out of New Hampshire Hospital, and also emergency rooms, they are far less likely to end up in an institution.”

Another high point is support housing, a continuing problem for those with mental illness. In the expert's report, the state is ahead of schedule in securing housing units.

“That's a really positive development,” Messer said. “This is a very important program that makes a difference for a lot of people. Having a roof over their head allows them to participate in recovery services.”

That's the good news for the state.

One of the keys to the settlement is transitioning people from the Glencliff Home and New Hampshire Hospital to their communities.

The expert reviewer notes that the state has done little to move the four residents out of Glencliff Home as was called for in the agreement.

“The DHHS (Department of Health and Human Services) needs to take aggressive executive action to increase the speed and effectiveness of transitions from the New Hampshire Hospital and Glencliff,” the expert wrote.

He said he would focus on that area for the next report in six months.

The expert, whose name was not attached to the report, was also critical of the state's speed in forming ACT teams in some areas of the state.

“We look forward to continue to work with the state,” Messer said. “We recognize there is still a long way to go. We view this not as an agreement to do a little bit more of the same, but for system transformation and change.”

Citizens United

People opposed to the Supreme Court's decision in the Citizens United case allowing unlimited corporate, union or private money into political campaigns believed they had a victory Thursday only to have it snatched away after key House technology failed.

The failure was the voting system, so instead of a two- or three-minute process, a roll call vote had to be done the old-fashioned way, calling out the names down the rooster so each representative could cast his or her vote.

Senate Bill 136 passed the Senate late last year after much discussion and revisions, but the House retained the bill to work on it this summer and fall.

The Legislative Administration Committee recommended more study for a bill that establishes a committee to monitor proposed constitutional amendments in Congress dealing with the issue.

Opponents of the ruling know interim study in the second year of the two-year term is nothing more than a polite way to kill a bill and they worked to overturn the committee's recommendation, which they did successfully by two votes.

Those seeking to kill the bill tried to table it, but that lost by four votes, and then House Minority Leader Stephen Shurtleff, D-Concord, moved to pass the bill, which lawmakers did by four votes.

When he asked the House to reconsider the vote and vote it down so approval would stand and the bill would go to Hassan without any shenanigans, the electronic voting machine broke.

The 45 minutes it takes to do a roll call vote was a little too much for some House members that late in the day and they left.

When the roll call on reconsideration was tabulated, it passed instead of failed, and opponents moved to kill the bill and that passed.

Some members said afterwards there was some strong-arming by leadership to kill the bill, but that happens all the time.

If the electronic system had worked when Shurtleff called for reconsideration, the bill would be on its way to the governor's desk and not a victim of technology. The voting system was replaced three years ago because the old system was unreliable.

Right to Know

Any reporter will tell you obtaining public documents under the Right-to-Know law can be either easy or difficult depending on the community or agency or person being dealt with.

It is no secret it has become more difficult to obtain large amounts of information and expensive if charged by the page and for research.

This week may bring some good news for those seeking electronic records.

Under House Bill 606 no fee can be charged for electronic record transfers if printed copies are not involved.

The Senate will vote on the bill Thursday, but it will have to go back to the House because the Senate version is different from the House's.

The Senate Executive Departments and Administration Committee voted 4-0 to recommend the bill pass.

Drug epidemic

The three bills the drug task force voted to fast track to the governor's desk this month have a public hearing Tuesday before House and Senate committees.

The public hearings begin at 9 a.m. and the committees are expected to make their recommendations on the bill by the end of the week with a vote before the end of the month.

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