Behavioral health association says state’s efforts falling short

LACONIA — A year ago, when the state budget included included $28 million for mental health and a settlement was reached in a lawsuit brought by patients denied proper care, headlines spoke of "a year of change, momentum" for the crippled system, but this week, the New Hampshire Community Behavioral Health Association firmly reminded state officials of promises unfulfilled and problems unsolved.

In a six-page letter, to Gov. Maggie Hassan the association claimed, "While some progress has been made, it is critical that these efforts are continued and expanded — because promised additions to the system have not been carried out, because the provider system is still very vulnerable, because demand is still growing, and because there are significant obstacles that that keep the community health centers from delivering services to those who need them most."

"This is a 'Don't forget about us letter,'" said Maggie Pritchard, executive director of Genesis Behavioral Health in Laconia, which serves some 3,000 mental health patients in the Lakes Region. She said that the letter raised four major issues, all of which weigh on her agency.

Although $28 million was appropriated for behavioral health, $12 million, the association wrote, "was put aside, abandoned or otherwise not made." Some $3.3 million was intended to fund ten "assertive community treatment teams" (ACTS). Pritchard said that Genesis applied to operate a team, investing in a consultant and architect to complete the lengthy application, but "never heard a word." She said that Genesis lacks a secure facility where patients who represent a danger to themselves or others can be held for 24 hours. "The money has disappeared."

Likewise, Pritchard explained that the so-called "spend down," which requires patients earning more than about $600 a month to make payments equal to what they earn over the limit to qualify for Medicaid, costs Genesis approximately $360,000 in uncompensated care. "No one with so little income has the money to pay for care," she said, "so whatever services we give provide them, we don't get paid for."

Nor, Pritchard said, has the state invested in developing and retaining the workforce the community mental health centers require. She said that apart from minor adjustments in compensation to keep pace with other community mental health centers Genesis has not increased salaries for seven years. About one-fifth of the staff of the 160 turns over each year. Prichard said that she currently has 10 vacancies, including eight positions that provide services to patients, but only one resume.

Finally, Pritchard said that with the introduction of managed care companies into the Medicaid system administrative procedures and payment structures have added to overhead. She said that Genesis must manage three different payment and auditing systems, which have tripled the administrative costs of the agency.

Pritchard likened the changes introduced by the state to "putting a third floor on a house without a foundation."



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Lawmakers agree to pay all 2014 county legal bills

LACONIA — The Belknap County Convention's Executive Committee last evening unanimously endorsed the transfer of nearly $60,000 in funds to pay the county's unpaid 2014 legal bills, bringing to an end a long-standing battle over between the convention and commission.
The county rang up nearly $100,000 in legal bills last year, largely due to a dispute over budget authority between the Belknap County Convention and the former members of the commission, and has expended nearly all of the $40,000 which was appropriated last year for legal expenses.
The committee made the decision after hearing from newly-appointed Commissioner Hunter Taylor of Alton, who said ''the best thing to do is to put this behind us. We will just incur more legal fees if this goes on.''
Commissioners voted last week to request the transfers from the Executive Committee, which had earlier this year declined to take up the transfer requests from the previous commissioners, which at year's end had amounted to $31,852.54. That grew by nearly $30,000 in January with the receipt of three new bills.
Taylor, who had been designated by the commission due to his legal expertise to look at the bills to see if it was possible to reduce them, said that the lawyers who had submitted the bills had no way of knowing that the county had exceeded its appropriation for legal expenses.
"The culprit was the old commissioners,'' said Taylor, noting that the only remedy for exceeding appropriations was removal from office, which was impossible because none of the previous commissioners are now in office. "The last thing we need is more legal drama.''
The unpaid bills all related to disputes between the former Belknap County Commissioners and the Belknap County Convention and its Personnel Committee. There are two bills for $6,856.98 and $1,080 from the Donahue, Tucker and Ciandella law firm, which represented the commission in it's challenge to the convention's successful attempt to win a temporary injunction prohibiting transfers between budget line items of greater than $300 without approval of the convention's Executive Committee.
There are also two bills from the Upton and Hatfield law firm, which represented the Personnel Committee in its handling of Mathew Logue 's appeal of his firing as Superintendent of the Belknap County Home by commissioners in late August. Those bills are for $4,973.58 and $1,325,30.
There are three bills from the Drummond Woodsum law firm which represented the commission at a hearing on Logue's dismissal and on an appeal of the Executive Committee's reinstatement of Logue. Those bills are for $12,223,28 and $4,220.90 and $5,56.67.
One of the bills for $12,525 was from the David Horan law firm which represented the county convention in its lawsuit against the commission over budget authority.
There was also an unpaid bill from the Wescott Law firm for $1,172.50 relating to a personnel issue.
There was also a bill from the Anne Rice law firm for $10,429.75. Taylor said that she had represented a nursing home employee who had successfully appealed a firing and that case was unrelated to the battle between commissioners and the convention.
Rep. Brian Gallagher (R-Sanbornton) spoke in favor of the transfers, saying that it would allow the county to ''put this behind us.''
Executive Committee Chairman Herb Vadney (R-Meredith) also supported the transfers, saying ''I don't mind being known as a cheapskate, but I don't want to be known as a thief.''

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Alton School Board backs off decision to hire retiring superintendent back as independent contractor

ALTON — After an hour of accusations, insinuations, and recriminations, the Alton School Board last night voted unanimously to rescind its vote to hire a private company to provide superintendent and curriculum services to the Central School beginning next fiscal year.

The decision in question took place in a non-public meeting held about 15 minutes before the January 31 SB-2 deliberative session. It authorized the district to hire YET — an eduction consulting firm — for one year at a cost of $125,000. The vote was three for, zero against, and one abstention from Krista Argiropolis, who said last night she abstained because she had questions. Terri Noyes was ill.

In exchange, said member Steve Miller, the company would provide a minimum of 150 days for a superintendent and 150 days for a curriculum director.
Right now, said Miller the cost of both of those positions is $202,569 including benefits.

The company, YET, LLC is an education consulting company formed by current Superintendent William Lander and former Curriculum Director Sydney Leggett, who is now the principal of the Gilford Middle School.

The company paperwork was signed by Lander and Leggett on December 12 and entered into the Secretary of State's Corporation filings on December 18 — the day he resigned at a 1 p.m. meeting of the School Board.

Leggett submitted her resignation to the Gilford School District on February 12.

Lander has submitted his resignation as superintendent to the board effective June 30, telling them he wanted to devote more time to teaching and to YET, as well as consulting for the N.H. School Board Association.

What the nearly 75 people at last night's meeting found so wrong was the process by which the School Board made the decision.

Speaking against the proposed contract — as of last night no official contract between the district and YET had been signed — was Noyes, who claims she was told there was no need for her to attend the board meeting preceding the SB-2 session.

"When did the board give you permission to negotiate that," she asked Miller, who was the person approached by Lander about hiring YET for a transition year between permanent superintendents.

"It's unethical," she said, telling Miller that not only did the board violate the N.H. Right-To-Know law by holding a private meeting to discuss a public contract but broke the board's own code of ethics by engaging in a negotiation before consulting the rest of the board.

"All outside contracts are the same, " Noyes said "They have to be done in public."

Miller said he didn't engage in any negotiations but was approached by Lander one day while he was in the SAU office. He said he felt it was appropriate to go into non-public under Right-To-Know because it was a discussion about employment.

He also invoked the U.S. Supreme Court's Citizens v. United ruling by saying that corporations are people and can have the same non-public privileges as employees.

"This has not been done honestly and transparently," Noyes rebutted.

Most of the people who spoke against hiring YET concentrated on the Right-To-Know issue. Some questioned Lander's personal ethics because he approached a board member about hiring his private company while he was still a paid employee of the School District.

Jeffrey Clay asked the three members of the board who voted for hiring YET to step down and demanded an independent inquiry into the entire process.

Cooler heads prevailed later in the meeting when Carole Locke, an educator in Gilmanton, said she thought that Miller had acted in good faith and tried to save the school some money.

She said the board should rescind the vote of January 31 and investigate the best way to make the transition for July 1 when the district will need a new superintendent.

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