Secure Psychiatric Unit

The governor and House budget writers are at odds over how to replace the Secure Psychiatric Unit at the State Prison in Concord.

CONCORD — House budget writers have zeroed out one of Gov. Chris Sununu’s most widely applauded initiatives — his plan for a new secure psychiatric unit to house some of the state’s most challenging mental health patients.

The House Finance Committee will vote Wednesday on its version of the two-year revenue and spending plan, which is at odds with the governor’s plan on several fronts, including family medical leave, capital gains taxes, business taxes, education funding and mental health services.

The recommended House budget, scheduled for a floor vote on April 11, strikes out $26 million for a new 60-bed forensic psychiatric hospital, which would have to be planned by November 2019 and operational by June 2021, according to the budget proposal Sununu submitted in February.

The House is taking a more cautious approach, recommending funding for a study committee to oversee planning for such a facility, but with no groundbreaking anticipated until 2022, if at all.

“We think it’s too soon to construct a new 60-bed forensic unit. We thought there has to be a lot more planning for that,” said Rep. Sharon Nordgren, who chairs the Finance Committee division dealing with Health and Human Services.

“If you were at a school district meeting, you wouldn’t just give the district money to build a school. You’d want to know how it’s going to be staffed, who’s going to go there, how many teachers are you going to need? This budget will start that process, but not put all the money up front.”

Sununu cited the new forensic hospital as one of the top priorities in his budget address. New Hampshire is one of only a handful of states that houses certain patients who pose a danger to themselves or others in a secure mental health unit at the state prison, even though they’ve committed no crime.

“I put a team together to design a plan to ensure all populations were considered and no stone was left unturned,” Sununu said in his inaugural.

He called the new secure psychiatric unit the linchpin in a $40 million package of mental health initiatives that also included funding for new community-based housing units for adults and children transitioning out of New Hampshire Hospital.

Budgets at odds

The House budget includes funding for the transitional housing to accommodate those leaving New Hampshire Hospital, both adults and children, but no money for a new building or wing.

“We aren’t sure there needs to be a separate facility,” said Nordgren. “There may be space opening up at New Hampshire Hospital when the children move out, or we may need another building. That’s a discussion that needs to be had.”

Sununu reacted angrily to the news that the budget coming from the legislature may be lacking one of his signature initiatives.

“I am shocked that Democratic leadership went from applauding this initiative in my budget address to failing to fulfill New Hampshire’s obligations in the state’s 10 Year Mental Health Plan,” he said.

“New Hampshire families have waited over 20 years for a solution and it is unconscionable that House Democratic leadership is now telling them that it is ‘too soon’ to move forward with this solution.”

Sununu urged the Senate to reverse the House action before the budget lands on his desk at the end of the session in June.

“The Senate Finance Committee must immediately restore this critical funding so that New Hampshire is no longer the only state in the nation that keeps involuntarily committed mental health patients inside a prison,” he said.

Lori Shibinette, CEO of New Hampshire Hospital, favors the governor’s approach, but not all stakeholders agree.

Alternative options

Michael Skibbie, policy director for the Disability Rights Center, worries that the state will invest millions in brick and mortar when it should instead be boosting its Medicaid payment rates so that providers could rebuild the community-based services for which New Hampshire was once famous.

Moving children and adults who no longer need to be at New Hampshire Hospital into community settings will open up all the space needed at the psychiatric facility to create a secure forensic unit, while also easing the backlog of mental health patients in hospital emergency rooms, according to Skibbie — without a $26 million construction project.

Shibinette has testified that it is not feasible to operate a psychiatric hospital that includes a conventional patient population as well as a forensic population. That’s one dispute House budget writers believe needs to be resolved before ground is broken on a new wing or building.

The House budget also includes a capital gains tax the governor doesn’t want, a family and medical leave plan that he opposes and a reversal of business tax cuts that he wants to see take effect.

House budget writers removed most of Sununu’s one-time earmarks for municipal projects, opting instead to revive a revenue-sharing formula that hasn’t been used for more than a decade.

Finance Committee Chairman Mary Ann Wallner of Concord says some compromise will be necessary between the House and Senate, and between the legislature and the governor, to get a budget signed into law by June 30.

“Those are big areas in the budget, but there are lots of smaller areas that we might be able to negotiate with the governor on,” she said. “We want to leave those negotiations open and not preconceive what the final decision will be.”

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