Ayotte stops at LRGH for discussion of opiate abuse

LACONIA — U.S. Senator Kelly Ayotte joined some two dozen medical practitioners, social service providers, law enforcement officers and emergency medical technicians at Lakes Region General Hospital yesterday to address the ongoing scourge of opiate abuse.

"I'm here to listen and I'm here to learn," said Ayotte, adding that she has sponsored and supported a number of bills dealing with different aspects of the substance abuse crisis as well as taken steps to strengthen initiatives to prevent and treat addiction and curb trafficking in narcotics.

Marge Kerns, vice-president of clinical services at LRGHealthcare, reported that so far this year the emergency rooms at Lakes Regional General Hospital and Franklin Regional Hospital have treated 71 patients for overdoes of heroin, fentanyl and other narcotics. "We will probably break 100 this year," she said, which would be double the number in 2014 and four times the number in 2013.

"We can't arrest our way out of this problem," Ayotte said. "It is a public health epidemic throughout the state."

One after another stressed that narcotic addiction is a disease that requires a regimen of treatment and program of recovery. And none challenged Dr. Fred Jones of the Emergency Department at Lakes Region Genera Hospital, who recalled responding to six overdoses on a single shift in May, when he remarked there is nowhere to send people for acute withdrawal for long-term treatment."

Dr. Paul Racicot, an emergency physician at LRGH who is experienced in treating substance abuse, said the capacity to offer medically assisted treatment, using drugs like suboxone, is especially limited. Few physicians provide it and they are restricted to the number of patients they can treat. He noted that medically assisted treatment is proving more and more successful and capacity to provide should be expanded.

Margaret Franckauser of the Central New Hampshire Visiting Nurse Association and Hospice, said that insurance carriers raise obstacles to treatment, primarily by requiring prior authorization for treatment when, in case of substance abuse, a long-term commitment by the patient is required.

Apart from treatment, several speakers emphasized the importance of prevention and early intervention. Franckhauser, together with Chris Santaniello of Lakes Region Community Services, noted that their personnel are in homes throughout the region and well placed to warn of the dangers of substance abuse as well as to detect indications of it. "We should take advantage of every possible touch point," Franckhauser said.

Henry Lipman, a senior vice-president at LRGHealthcare and Laconia city councilor, said that while law enforcement, emergency services and non-profit organizations, along with individual volunteers, are addressing the problem "it is time to leverage these efforts with more public funding."

City Councilor Bob Hamel (Ward 5) lamented that "a cloud has come over Laconia" and called for more opportunities for treatment. "A lot of this comes down to money," he said.

Belmont expects recreation trail construction to proceed with additional contributions from town & state fund

BELMONT — Town Land Technician Rick Ball said yesterday that the Selectboard has agreed to pay a 20-percent share ($17,007) of the $85,036 shortfall in funding for construction of the phase 1 of theWinnisquam Scenic Trail.

The recreation trail, which will run primarily along side the railroad tracks from the Agway store on Rte 3 to the Roberts' Town Beach was projected by engineers to cost $726,278. The lowest construction bid, however, was $825,290 and came from general contractor Nelson Communications Service, Inc. of Center Conway.

Ball said yesterday that he has requested that 80 percent of the shortfall ($68,029) come from the N.H. Department of Transportation, which manages the Transportation Enhancement Program grant fund.

Ball said the DOT representative who manages the Transportation Enhancement Grant program told him there were a few more hoops to jump through before the state provides the balance of the money needed to properly complete the project.

"It seemed to me that it was procedural but I can't say for sure," said Ball yesterday.

The cost of the project includes about $100,000 for on-site engineering and about $725,000 for actual construction costs.

The trail has been 12 years in the making and is part of the scenic corridor railway trail system. A separate not-for-profit group called the Belmont Regional Alternative Trail System raised money for years, initially starting with two phases. As construction costs rose, the town shifted its focus to Phase I and was given approval to go out to bid in August.

Ball said there is a three-month construction time allotment and Nelson Communications is ready to go. He said there is a possibility that the trail may not be paved this year because of the delay but hopes the bulk of the construction can be finished by the first snow fall.

Lawmakers approve $46k expenditure for pilot recidivism program at county jail

LACONIA — The Executive Committee of the Belknap County Convention has approved a transfer request from the Belknap County Commission for $46,564 to fund a pilot program at the Belknap County House of Corrections which is designed to reduce recidivism.
The action came Monday at a meeting held at the Belknap County complex and was unanimously supported by the four members of the seven-member committee who were present.
Acting Belknap County Corrections Superintendent Keith Gray said that currently 70 percent of those held at the facility are repeat offenders and that the goal of the program is to reduce that to 35 percent over the next few years. The program will also serve as a bridge to wider programming which would be offered at a proposed 64-unit community corrections facility which are currently being developed by a jail planning committee and will come before the County Convention later this year for a bond issue of around $7 million for construction.
County Commission Chairman Dave DeVoy (R-Sanbornton) said that currently many of those held at the county jail are ''sitting around watching TV and talking with other inmates abut what they'll do when they get out'' but are not receiving any programs designed to help them deal with alcohol and substance abuse problems.
''We want to put people to work doing good things and this program will help us get started,'' said DeVoy.
Last week commissioners voted unanimously to seek funds for the pilot program which will provide a comprehensive substance abuse/behavioral health assessment and treatment and offender case management program as a first step towards a planned "community corrections" center.
The program was developed by a committee of county agency representatives working with consultant Kevin Warwick, whose firm was hired to develop programs for a community corrections facility for the county, and calls for contracting with a private community-based treatment contractor at a proposed cost of $46,564 for six months of services provided by equivalent of 1.5 full-time workers.
The program, as outlined last week by Warwick and Jacqui Abikoff, Horizons Counseling Center executive director, would provide early intervention and screening assessments which would classify and target offenders appropriately and identify low risk offenders, who could be considered for alternative programs and moved out of the jail, as well as high risk offenders, who would be targeted for intensive treatment services at the jail.
The plan calls for a three track system to identify the treatment and transitional needs of offenders, an intensive treatment program for those serving a minimum of 90 days who have been identified as high risk, which would see 12-15 hours a week of treatment; a second track for short-term offenders identified as low risk and a third track for pre-trial inmates.
Members of the committee which came up with the pilot program included Gray, Belknap County Attorney Melissa Guldbrandsen, Public Defender Jesse Friedman, Restorative Justice Director Brian Loanes, Sheriff Craig Wiggin, Department of Corrections Program Director Tamara McGonagle and Abikoff.
Rep. Brian Gallagher (R-Sanbornton), a member of the Executive Committee, said that he was encouraged by the group that the commissioners had put together and praised them for ''putting together a plan which shows a vision for the county.''
The Executive Committee authorized the transfer of the funds from the $363,000 remaining in the jail planning account in the corrections department budget.
Rep. Herb Vadney (R-Meredith), who chairs the Executive Committee, issued a warning of sorts about the jail planning effort, saying that he was concerned over how the county will be able to handle the additional $454,000 in first year staffing costs for a community corrections center and the estimated $240,000 in program provider costs.
''I don't see how the county can come up with the new money. We're going to have to consolidate and cut people (elsewhere),'' said Vadney.
The Executive Committee also approved the transfer of $15,000 for overtime wages in the Corrections Department with the funds coming from the part-time wages account.
DeVoy said the transfer was needed because two full-time employees are out with injuries and overtime is being utilized to adequately staff the jail.
Gray said that the department has lost four full-time employees and five part-time employees this year and that newly-hired corrections staff need to attend the state corrections academy for five weeks as part of their training.
Rep. George Hurt (R-Gilford) asked if the department was aware ahead of time about the resignations and is there was an ongoing hiring process. Gray said the department is provided notice of resignations and that he has to go through a request to fill a vacancy process which takes about a month.