DOVER — Strafford County has signed a deal with the state to provide 16 beds at Riverside Rest Home for nursing home eligible citizens needing behavioral health care.
At their regular meeting on Aug. 3, Strafford County Commissioners signed a contract with the New Hampshire Department of Health and Human Services to make 16 behavioral health long-term care beds available in a secured unit at the county nursing home.
County Commission Chair George Maglaras said having the contract with the state means the county will be paid by the state to operate the unit.
“It’s a secured unit,” said Maglaras. “We are working now on the internal structure we need and making sure key personnel are in place. We know there is a great need, and we want to make sure we can give options first to residents of Strafford County.”
Strafford County Administrator Ray Bower said he watched what was happening in the state in terms of mental health services and thought the county could help.
“I reached out to the state and said I think we can work together here,” said Bower. “The state and the county negotiated a contract ($340,000) to retool that closed unit and make it work for this need. It works for the county as well, because we get reimbursed at a higher level than for a normal Medicaid resident.”
Bower said the contract will go to the governor and Executive Council next for approval, and if they sign off, the county is ready to start, with beds opening up as soon as September.
Riverside already has a behavioral health unit (22 beds), one of only three nursing homes in the state to have this feature (Cheshire and Hillsborough being the other two). The new beds will be an extension of their current services.
Last year, the state announced it would not challenge a federal court order giving it until May 2024 to stop holding people having mental health crises in hospital emergency rooms for days, even weeks. Patients must now be given a hearing on their case within three days, Bower said.
“We took four patients from the state last year when former DHHS commissioner Lori Shibinette was trying to place patients,” said Bower. “We have the infrastructure and licensed, skilled staff to work with them. In fact, three of the patients were able to be reintegrated into the nursing home population. Just because a person starts on that unit, does not mean they must remain there.”
Bower said 16 patients is a slightly fluid number. In a traditional setting at Riverside, there are two residents per room. The designated unit is a 20-bed one.
“Sometimes behavioral health residents do not do well with a roommate, so that’s where our estimate comes from,” he said. “Perhaps some of the patients will be fine in that setting but we are assuming at first, most will not. They have their own set of issues, mostly language, (there) can be some violence. We have staff who are skilled in handling behavioral health and maybe we can work with some of them and reintegrate them to a more traditional setting.”
The patients going to Riverside will not be young people. Bower said to take them at Riverside, they need to be nursing home eligible. Bower said that relies mainly on a person’s ability to handle their activities of daily living (ADL).
“That means their ability to care for themselves, cooking, bathing, but also being able to understand and manage their own medications,” said Bower. “It can depend on whether or not they have help, whether there is anyone for them to rely on.”
Meanwhile, the state is looking to build a dedicated behavioral health hospital. The Department of Health and Human Services is working on an agreement with SolutionHealth to support the construction of a new facility in Southern New Hampshire with 120 beds: 72 for adults, 24 for older individuals with geropsychiatric issues, and 24 for children and adolescents. Care provided by the facility will prioritize the needs of involuntary patients while serving voluntary patients as well, those with co-occurring issues, and those with intellectual and developmental disabilities.