- Associated Press - Wednesday, May 3, 2017

CONCORD, N.H. (AP) - Republican Gov. Chris Sununu has forced out the chief executive of New Hampshire’s state-run psychiatric facility and criticized the private hospital tasked with staffing it after learning the hospital has been understaffed for months.

“We’ve been paying for psychiatrists that have not necessarily been there,” Sununu said on Wednesday during a news conference. “It’s troubling, it’s disappointing.”

The state signed a $36 million contract with Dartmouth-Hitchcock, a private hospital, last year to provide services at New Hampshire Hospital, the state-run hospital for mental health services. But state health officials recently learned that Dartmouth-Hitchcock has been regularly providing between eight and 10 general psychiatrists, rather than the 11 required in the contract. It also lacks a dedicated geriatric psychiatrist, another requirement.

A spokesman for Dartmouth-Hitchcock said Wednesday the hospital has always been fully transparent with the state on staffing.

Health and Human Services Commissioner Jeff Meyers sent Dartmouth-Hitchcock a letter Tuesday outlining the problems and giving officials five business days to provide a corrective action plan. Sununu asked New Hampshire Hospital chief executive Bob MacLeod to step down. Don Shumway, the former head of Crotched Mountain rehabilitation facility, is heading New Hampshire Hospital on an interim basis. MacLeod could not immediately be reached.

Dartmouth-Hitchcock spokesman Rick Adams said the hospital was “surprised and deeply troubled” by Sununu’s comments because the hospital has been “completely transparent” with the state regarding staffing levels including through weekly reports. Dartmouth-Hitchcock officials have requested a meeting with Sununu and Meyers, Adams said.

“Throughout the course of this contract the state agreed that the staffing levels have been appropriate and the patient care is high quality,” Adams said.

Sununu and state health officials say it doesn’t appear quality of care has been hurt. But the issue is the latest twist in a long-running fight over whether the state provides enough mental health services. Waiting lists for treatment beds have recently skyrocketed, causing patients in need of help to wait in emergency rooms for days at a time.

“That’s what you don’t want to happen, a discontinuation in services or a loss in quality of care,” Sununu said.

While the contract has been in place for months, Meyers only began looking into staffing in recent days following questions from Democratic Executive Councilor Chris Pappas. The council receives periodic staffing reports from New Hampshire Hospital, and it appears a clerical error made it appear that only 10 psychiatrists were required. It’s unclear who is at fault for the error.

When Meyers started looking into the staffing, he realized Dartmouth-Hitchcock wasn’t complying with the contract.

“Whether nobody noticed or nobody cared to say anything I don’t know, to be honest,” Sununu said. “Either way, it’s a problem.”

The state has no plans to terminate the contract with Dartmouth-Hitchcock, but Sununu said it could ask for some of the money back given the contract called for more staffing by psychiatrists than were actually working. Adams said the contract was for a “fixed price.”

Sununu said he will ask the attorney general to review the contract and ask Meyers to put more quality controls in place. New Hampshire hospital will now be required to provide weekly staffing updates to Meyers.

The contract with Dartmouth-Hitchcock has been the subject of scrutiny from the start. Last year, when it transferred from Dartmouth College’s medical school to the private hospital, a group of psychiatrists quit amid a labor dispute. And last fall, days after the contract was approved, Dartmouth-Hitchcock announced mass layoffs. Sununu, then an executive councilor and gubernatorial candidate, called for the contract to be re-bid. It remained it effect.

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