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Headrest Installs New Interim Executive Director

  • Hilde Ojibway, interim director of Headrest speaks with Eric Harbeck billing manager at Headrest on July 15, 2016 in Lebanon, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Hilde Ojibway, who has headed up Listen and the Good Neighbor Health Clinic, is now the interim director of Headrest in Lebanon, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.



Valley News Staff Writer
Saturday, July 16, 2016

Lebanon — A nonprofit on the front line of the area response to the opiate epidemic has tapped a long-time community agency executive to lead it as it struggles with new state funding requirements and staff shortages.

Hilde Ojibway, of White River Junction, was introduced at the June 23 annual meeting of Headrest Inc. as the interim executive director of the organization, which operates a regional crisis hotline and a 90-day residential program for people recovering from substance abuse.

Ojibway said an enormous increase in the demand for the agency’s services has been driven by a surge in opioid abuse that has touched many families: “If everyone who had been affected were suddenly wearing a red hat tomorrow, you’d see a lot of red hats in the Upper Valley.”

But changes in the rules and paperwork required to receive government financial support for services for people coping with drug problems strained Headrest’s administrative and financial management capacity, according to Ojibway.

Laurie Harding, the president of Headrest’s Board of Directors, said that the transition in state funding from block grants to a fee-for-service basis added hefty administrative burdens.

For decades Headrest depended on grants, including those from state and local governments, to pay for services, said John Creagh, the former chairman of the organization’s board.

“That system went away,” he said.

The transition to fee-for-service “was a large and difficult cultural change for the organization,” he added.

Ojibway said that Headrest, a tiny organization with an annual budget of about $700,000 that operates in a 70-year-old, 2,300-square-foot building just downhill from Lebanon’s downtown fire station, was left with “more work, not a lot more money and fewer people” to do that work.

The organization’s decision last fall to shut down its outpatient counseling program upset some in the community. More recently, the departure of former Executive Director Suzanne Thistle created a leadership vacuum.

Thistle was Headrest’s clinical director for five months and top manager for 13 months until her tenure ended in May, according to her LinkedIn page.

Harding declined to comment on the circumstances of Thistle’s departure because it was “a personnel matter,” but said that the former director had tired of her long commute, wanted to spend more time on clinical work and “left by choice.”

Thistle could not be reached for comment.

Ojibway said she was in Sydney, Australia, in early June — she had accompanied her husband, who had an academic fellowship — when she got a midnight call from members of the Headrest board asking her to take the reins.

The telephone discussion lasted less than five minutes before she agreed to lead Headrest, she said. Her commitment, she said, was for “six to 12 months so that I could help set up systems and stabilize (the organization), and so they could very carefully select the new director, who hopefully will be here a long time.”

Ojibway, who was born in Michigan and moved to the Upper Valley in 1986 when her husband, Bruce Duthu, became director of the Native American Studies Program at Dartmouth College, has a lengthy resume of Upper Valley nonprofit leadership.

For 10 years she was the executive director of Listen Community Services, which operates thrift stores and a food pantry and provides heating assistance and other services to low-income families.

From 2008 until 2012, Ojibway was executive director at the Good Neighbor Health Clinic and Red Logan Dental Clinic in White River Junction. Ojibway returned to the helm of those clinics in an interim capacity in 2014.

Ojibway also served as interim director of Vital Communities, an organization that promotes regional solutions to Upper Valley social issues, during 2014 and of Hannah House, which served pregnant teens until it shut down in 2012. She also was a one-term Democratic state representative in Montpelier, and still sings, plays guitar and writes songs for the folk trio Never Too Late.

On Thursday, Ojibway talked about her commitment to Headrest as a way to help address the current wave of drug abuse and about the challenges facing the organization.

The conversation began as Ojibway and members of the Headrest staff wrapped up a going-away party for a residential counselor who had been hired by Dartmouth-Hitchcock.

The counselor’s departure highlighted the hiring and staffing challenges facing Headrest and other nonprofits responding to the state’s opiate crisis. Headrest is “a very, very small organization ... like a team with no bench,” she said. “There’s nobody sitting on the bench waiting to come into the game.”

Although there is always a waiting list for Headrest’s residential transition program, only four of Headrest’s 10 beds currently are occupied, Ojibway said.

The agency has not rushed to fill the beds in part because it currently lacks the staff needed to provide that volume of high-quality support services, even though vacant beds beds reduce revenue, she added.

So staffing up Headrest is one of her priorities, Ojibway said: “We need to recruit people and beef up their training.”

Changes at Headrest are in the works even as New Hampshire is moving forward with a five-year plan that will spend up to $150 million in federal Medicaid funds to expand the state’s capacity to treat substance use disorders and mental illness and to integrate that care into the broader health care system.

In the Upper Valley and southwestern New Hampshire, Dartmouth-Hitchcock and two of its hospitals have applied to serve as administrators of a so-called integrated delivery network that would include six hospitals, six behavioral health groups, three peer recovery organizations, three county governments and three regional public health councils.

Besides Headrest, Upper Valley institutions and organizations that would be part of that network include Mary Hitchcock Memorial Hospital, Alice Peck Day Memorial Hospital, New London Hospital, Valley Regional Hospital, West Central Behavioral Health, Grafton and Sullivan counties and the Upper Valley and Greater Sullivan public health councils.

Ojibway said that she was not yet up to speed on how participating in that network would affect Headrest.

According to Headrest’s publicly disclosed tax returns, in the fiscal year that ended June 30, 2015, expenditures exceeded those from the preceding year by $101,000, leading to a deficit of that same amount. During that year, Headrest’s spending on salaries, wages, benefits and payroll taxes rose 18 percent, to $650,000 from $550,000 the previous year. Headrest finished fiscal 2015 with net assets of $175,000, mostly in cash, down from $236,000 a year earlier.

There is still enough money on hand to execute a turnaround, Ojibway said: “We’re confident that we have the resources we need for this year, but it needs to work.”

Ojibway said her priority goals are to build a strong financial and administrative foundation for the existing services and to replenish the staff.

Harding said that the Headrest board recognizes that the community needs more substance use disorder services and is committed to restoring some outpatient counseling services.

But putting in place so-called intensive outpatient services — which entail thrice-weekly three-hour group sessions and a weekly one-hour individual session — would require the hiring of two additional counselors, Harding added.

Ojibway, noting that there had not been a transition plan or process in place for her, said that she would also work on “helping with the orientation of the new director, so that person won’t experience what I’m experiencing now.”

Headrest also needs a new home, and although efforts to solve that problem could get underway during her tenure “it will be a long time coming,” Ojibway said.

Headrest’s quest for new quarters suffered a setback in 2014, when neighborhood opposition blocked the organization’s bid to relocate to a larger building in downtown Lebanon.

Meanwhile, efforts to rebuild the organization can’t wait.

Ojibway noted that the hotline operation has been a solid component of Headrest service efforts even as its counseling and residential transition programs have evolved.

And that evolution will continue, she said: “Two or three years from now it’s going to look different than it does today. I don’t know how. But it will.”

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