ADAM: THE DARTMOUTH-HITCHCOCK
CONTRACT WITH THE STATE HOSPITAL
WAS SINGED BY CONTROVERSY.
NOW A ANOTHER -- NOW, ANOTHER
POLITICAL FIRE AFTER IT CAME TO
LIGHT THAT THE HOSPITAL HAS NOT
HIRED THE NUMBER OF PSYCHIATRIST
SUPPOSED TO BE SUPPLIED.
WHAT BROUGHT TO YOUR LINE OF
QUESTIONING WITH THE STAFFING?
>> THERE WAS A LOT OF CONCERN
BECAUSE THERE WAS A LABOR
DISPUTE GOING ON WHEN THE
POSITIONS WERE TRANSFERRED FROM
THE COLLEGE TO THE HOSPITAL.
THERE WERE A NUMBER OF QUALIFIED
MEDICAL PROFESSIONALS,
PSYCHIATRISTS, DID NOT NEGOTIATE
THEIR TERMS OF EMPLOYMENT AND
ENDED UP LEAVING.
THE STATE WAS CONCERNED WE WOULD
NOT HAVE A NEW HAMPSHIRE
HOSPITAL FULLY STAFFED.
SO THEY WERE SORT OF ON
PROBATION.
WHEN THE FULL CONTRACT WAS
APPROVED LAST FALL, WE WANTED TO
MAKE SURE WE RECEIVED WEEKLY
UPDATES IN TERMS OF THE STAFFING
LEVELS AT NEW HAMPSHIRE
HOSPITAL.
I NOTICED THAT SOME OF THE
NUMBERS BEGAN TO DIP.
WHEN I FLAGGED THAT FOR THE
DEPARTMENT, THEY ALSO REALIZED
THAT THE NUMBER OF LAYERS --
NUMBERS THE COUNCIL AND THE
COMMISSIONER HAD BEEN RECEIVING
WERE FAULTY.
THAT THERE WAS A GAP BETWEEN
WHERE THE HOSPITAL WAS SAYING WE
SHOULD BE IN TERMS OF BENCHMARK
NUMBERS AND MARY WERE IN TERMS
OF THE NUMBERS.
WE WERE A COUPLE OF POSITIONS
BELOW.
WE WERE MISSING A GERIATRIC
PSYCHIATRIST.
THERE WERE A COUPLE OF POSITIONS
THAT DHMC HOW TO BRING ON BOARD
BY JULY 1.
THEY ARE OUT OF POSITION.
THEY HAVE A LOT OF WORK TO GET
IN COMPLIANCE.
WE WILL GET A RESPONSE ON MAY 9
FROM DH MC TO THE DEPARTMENT.
THE DEPARTMENT HAS FIVE DAYS TO
ASSESS WHETHER OR NOT THE PLAN
IS VIABLE.
ADAM: THAT IS THE CONTEXT WHERE
IF PEOPLE WERE LOOKING INTO THIS
WITHOUT THAT CONTEXT, THEY MAY
SEE ONE OR TWO DOCTORS.
BUT GIVEN THE PROBLEMS THAT HAVE
HAPPENED BEFORE, THIS IS WHY IT
IS A CONTROVERSY.
COUNCILOR PAPPAS: IT IS A
CRITICAL POPULATION.
THE CARE THAT IS PROVIDED IS
PRIORITY NUMBER ONE.
WE FEEL THAT HAVING THE
OPERATION FULLY STAFFED IS
IMPORTANT TO HAVE A QUALITY OF
CARE.
THE COMMISSIONER BELIEVES THAT
HE DOES NOT BELIEVE QUALITY OF
CARE IS COMPROMISED.
THE COUNSELOR AND THE GOVERNOR
-- THE COUNCIL AND THE GOVERNOR
BELIEVES THERE SHOULD BE A FULL
REVIEW.
WHEN YOU LOOK AT AN INCIDENT
THAT JUST HAPPENED LAST YEAR,
WHICH TRIGGERED A SENTINEL
REVIEW, WHERE A WOMAN WAS
DISCHARGED AND TRAGICALLY
COMMITTED SUICIDE SHORTLY AFTER,
THERE IS NO ROOM FOR ERROR IN
THE CARE PROVIDED THERE AND
HAVING THE NEW HAMPSHIRE
POSSIBLE -- HOSPITAL FULLY
STAFFED IS KEY.
ADAM:
ADAM: THEY ARE SAYING THAT STATE
OFFICIALS, AT LEAST AT SOME
LEVEL, NEW ABOUT THIS ALL ALONG.
COUNCILOR PAPPAS: SURE.
THEY WERE UNDER THE MICROSCOPE
YOU THEY DID NOT PERFORM TO THE
LEVEL WE THOUGHT THEY WOULD
PERFORM TO THEY NEEDED 11
PSYCHIATRIST.
THEY HAD BETWEEN EIGHT AND 10
THE LAST FEW MONTHS.
THAT IS NOT IN ACCORDANCE WITH
THE CONTRACT WE APPROVED.
THEY HAVE TO COME INTO APPLIANCE
-- COMPLIANCE.
THERE SHOULD NOT BE THIS KIND OF
FINGER-POINTING.
WE NEED TO GET EVERYONE INTO A
ROOM, MAKE SURE EVERYONE IS
WORKING INTO THE SAME DIRECTION.
LOOKING OUT THE OVERALL HEALTH
CRISIS, THIS IS A SMALL PIECE OF
THE PUZZLE.
THERE IS SO MUCH MORE WE NEED TO
INCREASE THE NUMBER OF BEDS
AVAILABLE AND DEAL WITH THE
OVERCROWDED SITUATION IN ELLIOT
HOSPITAL AND CONCORD HOSPITAL,
WHERE THESE ACUTE MENTAL HEALTH
CASES ARE BACKING UP AND
CLOGGING THE SYSTEM.
THERE NEED TO BE MORE SUPPORT IN
THE COMMUNITY AS WELL.
I KNOW THE LEGISLATURE AND
GOVERNOR HAPPEN WORKING IN A
BIPARTISAN FASHION IN FINDING
MORE FUNDING TO CONSTRUCT NEW
BED SPACE.
THAT IS AN IMPORTANT PIECE OF
THE PUZZLE.
WE HAVE TO GET THIS RIGHT.
THIS IS SOMETHING THAT CAN BE
SOLVED.
WHEN YOU THINK ABOUT
DARTMOUTH-HITCHCOCK, THEY ARE A
WORLD-CLASS MEDICAL FACILITY,
ONE OF THE STATE'S LARGEST
EMPLOYERS -- I BELIEVE THEY HAVE
ABOUT 10,000 EMPLOYEES.
I HAVE FAITH THAT THEY CAN FIX
THIS ISSUE.
THEY HAVE A GREAT RELATIONSHIP
WITH THE STATE, DIVIDING THOSE
DOCS FOR NEW HAMPSHIRE HOSPITAL
FOR A LONG TIME.
THEY ARE AN IMPORTANT PARTNER.
IT REALLY, WE HAVE TO DRAW A
LINE IN THE SAND.
WE CANNOT SETTLE FOR LESS THAN
THE NUMBER OF PROFESSIONALS THAT
THE CONTRACT CALLS FOR.
ADAM: YOU MENTIONED THE BIG
PICTURE.
YOU HAVE THESE ISSUES AT THE
STATE HOSPITAL, DCYF STILL NEEDS
TO REFORM, EVEN THOUGH THE ALARM
WAS RAISED IN 2015, MENTAL
HEALTH SERVICES, THE OPIOID
CRISIS.
THERE ARE A LOT OF FIRES BURNING
IN A LOT OF FRIENDS.
YOU FEEL DHHS IS ON TOP OF THIS?
COUNCILOR PAPPAS: THEY ARE
PUTTING OUT A OF FIRES.
I DO NOT THINK THEY HAVE A STASH
-- STAFF RESOURCES TO COPE.
WE ISSUED A STATEWIDE AUDIT OF
DCYF.
THEY LOOK AT SOME OF THE CASES
THAT HAVE MADE THE NEWS, REALLY
HEARTBREAKING CASES.
ONE OF THE COMMISSIONER DEDUCED
FROM THAT PROCESS IS HE NEEDS
MORE STAFF.
THERE IS A MORALE ISSUE.
I THINK THAT IS LINKED TO THE
NUMBER OF STAFF OUT THERE.
THAT IS WHAT I WOULD LIKE TO SEE
COME OUT OF LOAD LEGISLATURE --
COME OUT OF THE LEGISLATURE THIS
TERM.
THAT DEPARTMENT DEALS WITH
PEOPLE WHO ARE GOING THROUGH
TOUGH TIMES.
PEOPLE WHO NEED ASSISTANCE.
KIDS WHO NEED PROTECTION.
WE CANNOT SHORTCHANGE THAT.
ADAM: THERE IS A FLIP SIDE IN
THAT I DO NOT THINK WE CAN
EXPECT HHS TO SOLVE ALL OF THE
PROBLEMS IN THE WORLD.
IS THAT A KEY PART OF THIS?
DO YOU THINK WHAT WE HAVE IN
TERMS OF OPIOIDS, MENTAL HEALTH,
IS THAT A SOLVABLE PROBLEM THAT
HHS CAN GET ON TOP OF?
OR IS THIS BIGGER THAN THE
GOVERNMENT?
COUNCILOR PAPPAS: IN PARTICULAR
WITH DCYF, THAT IS SIGNIFICANT
IN TERMS OF STAFF WOULD BE ABLE
TO HELP ADDRESS.
THOSE ARE THINGS THAT REQUIRE
MORE COOPERATION.
CERTAINLY, WE HAVE BEEN GETTING
A LOT MORE ATTENTION AND
RESOURCES THEN THE FEDERAL
DELEGATION HAS BEEN FIGHTING
FOR.
THAT WILL NOT SOLVE IT.
THE STATE GETTING MORE RESOURCES
OUT TO TREAT PREVENTION AND
RECOVERY IS AN IMPORTANT PIECE.
THAT WILL NOT SOLVE IT.
IT REALLY STARTS AT THE
COMMUNITY AND FAMILY LEVEL.
WE HAVE A NUMBER OF GREAT
GRASSROOTS ORGANIZATIONS THAT
ARE DOING INCREDIBLE WORK ON
THIS.
THEY ARE HELPING LEAD THE
CHARGE.
THEY ARE ON THE FRONT LINE.
OUR FRONT -- FIRST RESPONDERS.
IT IS GREAT THAT THE PLAYSTATION
PROGRAM HAS SPREAD ACROSS THE
STATE.
WE HAVE INTERESTING THINGS GOING
ON IN NEW HAMPSHIRE.
IT IS NOT A TOP-DOWN SOLUTION,
BUT IT IS ALL OF US WORKING
TOGETHER, THINKING OUTSIDE OF
THE BOX, THAT WILL HELP THE
STATE.
YOUR NAME IS THE --
ADAM: YOUR NAME IS THE ONE THAT
COMES UP WHEN I TALK TO
DEMOCRATS ABOUT WHO THEY WOULD
LIKE TO SEE RUN FOR HIGHER
OFFICE.
BUT YOU SEEM COMFORTABLE WHERE
YOU ARE AND YOU ALWAYS KIND OF
DEMUR ON THESE QUESTIONS.
WHAT YOU STAY ON THE COUNCIL OR
RETIRE?
COUNCILOR PAPPAS: THE COUNCIL IS
AN INTERESTING VANTAGE POINT.
IT IS SUCH AN IMPORTANT PIECE OF
STATE GOVERNMENT.
WE ARE THE NEXUS OF SO MANY
IMPORTANT DECISIONS.
WITH THE ISSUE AROUND DHMC, YOU
CAN ASK QUESTIONS AND YOU CAN
REALLY GET A RESPONSE AND MAKE
SURE THAT THERE IS
ACCOUNTABILITY AND OVERSIGHT.
I LIKE THE POSITION I SERVE IN
THE COUNCIL.
I CERTAINLY HOPE TO KEEP DOING
IT.
I ALSO RUN A SMALL BUSINESS IN
NASH -- IN MANCHESTER, WHICH
OCCUPIES SOME OF MY TIME.
BUT I HAVE A COMMITMENT TO THE
STATE.
AS SUPPORT, I MIGHT THINK ABOUT
PUTTING MY TALENT SOMEWHERE
ELSE.
BUT FOR RIGHT NOW, I AM HAPPY
WITH WHAT I AM DOING.
ADAM: YOU MENTIONED SMALL
BUSINESS.
IS THERE ANYTHING TILL LIKE --
SEEMINGLY NO ONE HAS READ IT,
BUT THE HEALTH CARE ACT THAT HAS
JUST PASSED IN CONGRESS,
ANYTHING TO LIKE?
COUNCILOR PAPPAS: I DISLIKE MOST
OF IT.
ONE OF THE THINGS I THINK THAT
IS MOST ALARMING TO ME IS THE
EMPLOYER MANDATE THAT WAS PULLED
BACK IN THE ACT THAT PASSED
CONGRESS.
AS AN EMPLOYER, I FEEL A
RESPONSIBILITY TO PROVIDE FOR
THE WELL-BEING OF MY WORK FORCE.
EVEN BEFORE THE AFFORDABLE CARE
ACT WAS PASSED, WE PROVIDED
COVERAGE.
I THINK THAT IS THE RIGHT THING
TO DO FOR EMPLOYERS ACROSS THE
STATE.
WHEN YOU ARE LOOKING AT A TIGHT
LABOR MARKET, YOU HAVE TO
PROVIDE A GOOD WAGE AND A GOOD
BENEFIT PACKAGE TO ATTRACT
EMPLOYEES.
THAT IS WHAT EMPLOYERS ARE
LOOKING TO DO IN THE STATE.
SUPPORTING THE WORKFORCE IS
IMPORTANT.
I AM DISAPPOINTED THIS HAS
PASSED.
NO ONE REALLY READ THE BILL.
THEY RUSHED OFF TO THE WHITE
HOUSE TO CELEBRATE ITS PACKAGE
BUT DID NOT UNDERSTAND
IMPLICATIONS IN TERMS OF WHO
WOULD LOSE COVERAGE, WHAT IT
WOULD MEAN FOR PEOPLE WITH
PRE-EXISTING CONDITIONS.
THAT IS A DANGEROUS WAY TO
LEGISLATE.
I HOPE THE SENATE BRINGS SOME
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