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Official: Commissioner Chooses D-H for State Hospital Contract



Valley News Staff Writer
Monday, August 08, 2016
Lebanon — The Executive Council will be asked to award a three-year contract to Dartmouth-Hitchcock to provide professional services at New Hampshire Hospital, the Concord facility where the state’s most severe cases of mental illness are treated, according to Executive Councilor Joe Kenney.

Kenney, a Wakefield Republican whose district includes most of the Upper Valley, said he had been told by Health and Human Services Commissioner Jeffrey Meyers that he had reached a decision on the contract, which has sparked a dispute between D-H and some psychiatrists and other professionals who worked at the hospital under a previous contract with Dartmouth College.

Meyers’ decision came despite a June 15 letter signed by all five council members and sent to Meyers saying the council “would prefer to see a new bidding process for this item.” That was the day the council signed off on a four-month, $2.9 million extension of the previous contract with Dartmouth, which then assigned the temporary deal to D-H. That arrangement was set to run through Oct. 31.

Approval of the temporary deal sent D-H on a quest to find psychiatrists to fill vacancies at NHH, where eight psychiatrists and four advanced practice nurses who had balked at D-H’s initial bid were let go on June 30.

D-H shut down nine beds at its flagship hospital in Lebanon and reassigned an unspecified number of psychiatrists and other professionals from Lebanon to Concord.

Critics of the deal worried about the potential adverse impact on patients inside and outside the hospital from turnover, inexperience or shortages of professional caregivers.

Such concerns got additional fuel last week when indepthnh.org, a website affiliated with the New Hampshire Center for Public Interest Journalism, reported that a 63-year-old female patient from NHH had died in an apparent suicide on July 27 in downtown Nashua.

Nashua police did not respond to a request for comment on Monday.

State HHS spokeswoman Kathleen Desmarais said that the department was “aware of the tragic incident that occurred in Nashua involving a New Hampshire Hospital patient.” Desmarais said privacy laws prevented disclosure or discussion about any individual or further comment, but confirmed that the department would be “reviewing this matter as a sentinel event under RSA 126-A:4, IV.”

That’s a provision of the law that, among other things, allows HHS to monitor and evaluate “the appropriateness of services provided to individuals served by the department or any of its contract service providers so that problems or trends in the delivery of services are identified and steps to correct problems can be taken.” Records of such reviews or investigations are generally “confidential and privileged,” the statute says.

The HHS website describes a sentinel event as “an unexpected occurrence involving the death or serious physical or psychological injury, or risk thereof, signaling the need for immediate investigation and response, or other serious event.”

Meyers’ decision took D-H across an important threshold in its bid to become the permanent supplier of psychiatric services at the hospital. Kenney said that Meyers told him that he was “convinced the contract is in the best interests of the patients and clients we serve.” The contract will be on the agenda of the council’s Aug. 24 meeting, Kenney said.

Meyers was on vacation and unavailable for comment on Monday. On Friday, HHS spokesman Jake Leon said, “We are unable to comment on procurement (issues) until they are before the” governor and Executive Council.

Rick Adams, a D-H spokesman, said that until the council acts, it would be premature to comment on Meyers’ decision.

Dartmouth’s Geisel School of Medicine provided professional psychiatric care at the hospital since the 1980s, most recently under a five-year, $38-million contract that began in 2011. As part of a restructuring designed to reduce deficits at Geisel, Dartmouth earlier this year announced plans to transfer hundreds of jobs and some programs, including the entire psychiatric department, from the college to D-H.

Some of the psychiatrists and nurse practitioners at the state hospital balked, citing uncertainty about changes to their pension benefits and other terms of employment that would follow their placement on the D-H payroll.

On June 30, about a dozen who hadn’t signed letters of intent for D-H saw their jobs vanish.

The controversy produced a flurry of activity on the op-ed pages of Granite State newspapers. Award the contract to D-H and “New Hampshire’s mental health system, already in crisis, will go over the cliff,” Matthew Davis and Robert Murray, a pair of former NHH psychiatrists, wrote in the July 10 Valley News.

Eight days later, Dartmouth-Hitchcock’s general counsel, John Kacavas, fired back in the same space, saying the July 10 letter’s “overheated rhetoric has caused undue fear and anxiety.”

Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229.