Lebanon — Dartmouth-Hitchcock denied that it is in violation of a contract to provide psychiatric care at the state-owned New Hampshire Hospital in Concord in a strongly worded letter emailed Friday to New Hampshire Department of Health and Human Services Commissioner Jeffrey Meyers.
The letter, obtained by the Valley News and written by attorney Michael Connolly of Hinckley, Allen & Snyder on behalf of Mary Hitchcock Memorial Hospital, Dartmouth-Hitchcock’s flagship hospital, challenges two violations Meyers cited in a letter to D-H last Tuesday. Meyers said D-H had failed to provide 11 full-time equivalent general psychiatrists and a dedicated geropsychiatrist, and asked D-H to provide a plan of corrective action.
“Since the outset of the Agreement, MHMH has been fully transparent regarding the exact level of psychiatric staffing provided to NHH,” Connolly wrote. D-H met weekly with New Hampshire Hospital’s Chief Executive Officer Robert MacLeod to discuss staffing levels, the letter asserts, and also provided detailed written reports. MacLeod, in turn, provided weekly reports to state officials, according to the letter.
“Any allegations that staffing reports prepared by MHMH were inaccurate, or that MHMH did not fully disclose the level of staffing at NHH, are categorically false and defamatory,” Connolly wrote. The staffing issue also caused Gov. Chris Sununu to ask MacLeod, a state employee, to resign. The governor said he would appoint Donald Shumway, former CEO and president of the Crotched Mountain Foundation, in MacLeod’s place.
In addition, D-H’s letter says it had been thwarted in attempts to fill vacancies at New Hampshire Hospital by the behavior of state officials who had made statements that questioned D-H’s transparency and trustworthiness.
Connolly cited a Union Leader article last week that quoted Sununu as saying, “We can’t go forward trusting the word of an organization that at this point isn’t trustworthy.”
“With these serial accusations and threats, the State has knowingly and willfully created a climate that made it impossible for MHMH to fulfill the staffing levels set forth in the Agreement,” Connolly wrote. Those actions “excuse MHMH from strict compliance with the Agreement,” the letter says.
The $36.6 million contract took effect on Nov. 1, 2016.
Connolly’s letter said that D-H “often provided at least 11.0 psychiatric FTEs since the Agreement commenced.”
In a written report provided by DHHS to the Executive Council there were 8.8 full-time equivalent general psychiatrists at New Hampshire Hospital during the week of April 24 and 10 during the week of May 1. There was one full-time geriatric psychiatrist during the week of April 24, but not during the week of May 1, according to the report.
But the letter says D-H was transparent with the state about staffing levels at the hospital. It also seems to suggest that state officials, having received regular reports about the staffing levels at the state hospital without questioning them, could not suddenly charge D-H with being out of compliance.
In accusing D-H of violating its contract, Meyers also said D-H had failed to provide a “dedicated geropsychiatrist” when it promoted NHH’s gerospsychiatrist to interim associate medical director.
But, Connolly’s letter says, “objective evidence demonstrates that MHMH provides a geropsychiatrist to NHH.”
Connolly ended his letter by requesting a meeting “to discuss these issues, and how best to proceed.”
Attempts to reach Sununu through his press office on Saturday were unsuccessful. Similarly, emails to Meyers and his press officer were not returned by deadline.
D-H was awarded the contract to provide psychiatric services at the state hospital last year to replace Dartmouth College’s Geisel School of Medicine, which had restructured itself in response to a budget crisis.
Complaints from members of the medical staff about the new terms of their employment, when they faced the prospect of working for D-H rather than for the medical school, and layoffs announced by D-H not long after it was awarded the contract to run NHH, created controversy from the start.
Sununu, then an executive councilor and candidate for governor, was particularly critical of D-H.
In a phone interview on Friday before D-H had issued its response, Executive Councilor Chris Pappas, a Manchester Democrat, said the layoffs and D-H’s decision to not rehire some psychiatrists who had worked for the college but balked at switching to the medical center had made him wary.
“The history of the last year has brought it to the point where we really have to draw a line in the sand,” he said.
In a conversation before D-H issued its response, at least one observer said she wondered why the dispute couldn’t be resolved through improved communication between D-H and the state.
“I think there’s certainly a lack of communication,” New Hampshire Rep. Sharon Nordgren, D-Hanover, said in an interview on Thursday. “There could have been phone calls made.”
Nordgren, who oversees health care funding on the House Finance Committee and is the spouse of a retired pediatric neurologist at Dartmouth-Hitchcock Medical Center, said she thought Sununu’s request for MacLeod to resign seemed “a bit rash.”
It seems fair for there to be questions about the contract, but “obviously people need to talk and calm everything down,” she said.
Staff writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.