Questions linger about Hampstead Hospital contractor
Josie Albertson-Grove, The New Hampshire Union Leader, Manchester
5 min read
May 4—Mental health and disability-rights advocates are raising red flags about the company selected by the state to run Hampstead Hospital, which is set to become a state-owned psychiatric hospital for children and young adults.
Last year, the Executive Council approved a plan from the state Department of Health and Human Services to use federal funds to buy the hospital from the private operator that has been providing mental health treatment beds for New Hampshire youth.
The state is planning to use a contractor to provide health care services and run the hospital day-to-day. But when that $52.5 million, two-year contract came before the Executive Council on April 20, councilors tabled it, asking for more time for review and to learn more about the company, Wellpath Recovery Solutions.
Wellpath was selected for a sole-source contract, unlike similar agreements to provide services at New Hampshire Hospital, the state-run psychiatric hospital for adults.
In a statement, a company spokeswoman said Wellpath Recovery Solutions has operated psychiatric facilities for more than 20 years, and has experience in inpatient psychiatric services and substance use disorder treatment.
Amid a growing number of children, teenagers and young adults facing mental health issues, and with people sometimes waiting for days or even weeks in hospital emergency rooms for a treatment bed to become available, the pressure has been on to open Hampstead Hospital as quickly as possible.
Mental health advocates including Susan Stearns, executive director of the National Alliance on Mental Illness of New Hampshire, wonder whether the quick process has produced the best result.
"What we read out there about them is concerning," she said.
Stearns, along with the leaders of the Disability Rights Center-NH, New Futures, New Hampshire Legal Assistance, and Waypoint wrote Tuesday to the five executive councilors, outlining their worries about Wellpath and asking that either the state consider other contractors, or set up stronger oversight of Wellpath's operation of Hampstead Hospital than what's called for in the proposed contract.
"The decision to enter into a contract in excess of $52 million for the provision of inpatient psychiatric services for some of New Hampshire's most vulnerable children over the next two years should not be entered into lightly," the letter to executive councilors reads, going on to urge councilors to consider other vendors or a short-term agreement with the employees who already work at Hampstead Hospital.
While Wellpath provides mental health treatment for adults, and for youth in juvenile detention centers, Stearns noted it does not appear to operate any facilities for youth who are not involved in the criminal justice system.
A spokeswoman for Wellpath, Judith Lilley, said that while Wellpath does not currently provide services for youth, it has in the past provided services to youth in non-correctional settings, including in contracts with other states.
"While our current programs are focused on adult populations, we do accept adolescent referrals as appropriate and provide individualized, evidence-based, and age-appropriate treatment in each instance," Lilley wrote in an emailed statement. "Previously, our work at Alaska Psychiatric Institute (API) included a Child & Adolescent Unit."
The letter also notes two investigations into Wellpath-run correctional facilities.
The U.S. Justice Department criticized Wellpath's operation of a California jail, and Wellpath was named in a report from the Massachusetts Disability Law Center on the Bridgewater State Hospital, a prison for men who have been civilly committed and those who are being evaluated for competency before criminal trials.
The Massachusetts report, published in January, criticized Wellpath for unlawful use of antipsychotic medication to render a patient more docile, a practice sometimes labeled medication restraint or chemical restraint. The Massachusetts Department of Corrections defended Wellpath, saying the contractor acted within the law.
"Boarding New Hampshire's most vulnerable children already struggling with a mental health crisis in emergency departments is not the answer," the letter states, "but neither is rushing to contract their care to a for-profit corporation that is the subject of multiple complaints of abuse and neglect of the individuals entrusted to them for their care."
Time of the essence
Health and Human Services Commissioner Lori Shibinette was directed to get the hospital up and running as quickly as possible, she said during last month's meeting. She told the Executive Council that the best way to move quickly was to award a sole-source contract, rather than putting it out for bid.
The sole-source contract took seven months to draw up, she told councilors. Going through a competitive bidding process would have added another five to eight months to the timeline.
The contract requires Wellpath to open 55 beds in Hampstead by October and another 10 beds by June 2023, with the total 65 beds including 12 beds for youth who no longer needed intensive inpatient treatment.
Although she agreed that it is critical to make more beds available, Stearns said she wanted to make sure the program would be, as Shibinette has said, a "center for excellence" in youth behavioral health care.
"We need the very best," Stearns said. "I think it's OK to have that as a goal, and not to settle."
Stearns said she wants to see strong oversight continuing after the contract is awarded. The letter suggested oversight from the Office of the Child Advocate, including a dedicated staff member in that office, and regular reports to the public.
"We need rigorous oversight no matter who has this contract on day one, because these are vulnerable children," she said.
She hoped all Granite Staters could appreciate the importance of doing this right.
"We've seen such an increase in terms of children and youth having struggles with mental health over the last two years," Stearns said. "It's something that impacts all of us. We all have something at stake, and we all have something at stake in our children's futures."
