Calls for mental health reform

New report paints a bleak picture of a ‘failing’ system

Published Sept. 23, 2008 in the Keene Sentinel
By Casey Farrar
Sentinel Staff
A task force made up of community mental health care providers and state health officials says that the state needs to invest in mental health care at local levels to prevent costs from shifting to other areas of government.

“We are on the mend,” Jue said. “But it’s meant making some tough decisions and restructuring some programs to help us break even. And we couldn’t have done it without community support.”

Jue said that for the last two months, with the help of an increase in private donations and grant money, the agency has managed not to spend more than it makes.

The agency has received more than $60,000 in private donations since it went public with its financial woes in May, Jue said.

Starting Oct. 1, the agency has promised to bump its employees’ salaries back up nearly to the levels they were before the cutbacks, Jue said.

But when an audit of the agency’s finances from the 2008 fiscal year, which ended June 30, is finished later this month, Jue expects it to come in at least $550,000 over budget.

To deal with the budget shortfalls, the agency has begun restructuring programs.

It has been beefing up children’s programs, which are supported by federal and state money, and shrinking the agency’s adult outpatient counseling services by eliminating six counseling positions and shortening the length of care for people who can’t pay and aren’t considered a danger to themselves or others, Jue said.

“We’re still able to see as many people as before, but we will have to prioritize and be more measured in the care we can provide,” Jue said.

The agency has been seeking partnerships with other nonprofit organizations in the region that could provide long-term treatment options, but money is tight everywhere, Jue said.

And Jue said while he understands that the state government is tackling its own budget shortfalls, it is important to bring the problems in the mental health system to lawmakers’ attention.

“When it comes down to it, the state has to come forward and help out with this,” Jue said. “We’re still under-funded for 24-hour crisis care, we’re still under-funded for psychiatric services and there still aren’t enough residential beds to meet the need in the state.”

Several of the recommendations in the task force report, which will be presented to executive branch, legislative, judicial and local public officials, draw on proposals outlined in a 23-year-old plan to restructure the state’s mental health system that state health officials say were never implemented.

The 1985 report focused on scaling back a reliance on inpatient mental health care at state facilities like New Hampshire Hospital, and building treatment programs in communities.

But while programs were cut at the state hospital, community programs didn’t grow enough to meet the need, over-burdening the New Hampshire Hospital with nearly twice the number of admissions over the past 15 years, according to the report.

By increasing programs to help mentally ill people get and maintain affordable housing, adding 132 new inpatient beds in community residential facilities and developing teams of community-based outreach workers, fewer of the state’s mentally ill population will need to seek help at the state hospital, according to the report.

“Ultimately, the success of this new investment strategy will be measured in the improved quality of care for N.H. citizens,” said Roland P. Lamy Jr., executive director of the New Hampshire Community Behavioral Health Association, a group formed by the state’s 10 local centers.

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.

Findings from an 18-month study, unveiled in a report Monday, showed that local law enforcement, hospital emergency rooms, the court system and county jails shoulder the burden of under-treated mental health conditions, according to Nicholas Toumpas, commissioner of the N.H. Department of Health and Human Services.

“(The state’s) mental health care system is failing and the consequence of these failures is being realized across the state and its communities,” Toumpas said.

The report prepared by the task force, a collaboration among the state health department, the New Hampshire Hospital Bureau of Behavioral Health and the Community Behavioral Health Association, recommended a multi-year plan to overhaul the system that includes more community-based housing for treatment and more money for maintaining qualified staff.

Kenneth Jue, CEO of Monadnock Family Services, a community mental health center serving the Monadnock Region, echoed the findings in a recent interview with The Sentinel.

The agency is beginning to come out of a financial crisis this year that has resulted in the loss of at least 12 employees and caused staff pay and benefits to be slashed by nearly 7 percent in May, Jue said.

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It could be worse

Region’s banks ride out storm

Published Sept. 18, 2008 in the Keene Sentinel
By Casey Farrar
Sentinel Staff
Local people may have an easier time dodging the fallout from this week’s unsettling Wall Street shake-up than in some other parts of the country, banking officials say.

As news broke of investment bank Lehman Brothers’ bankruptcy, Bank of America’s purchase of brokerage firm Merrill Lynch and the federal government’s bailout of insurer AIG, several local bank officials say they’ve received surprisingly few calls from concerned customers and investors.

“We’ve had a few calls, but the biggest impact is on psyche of the customers of the bank,” said Danny H. O’Brien, president and CEO of Portsmouth-based Ocean National Bank.

“They’re trying to discern what they’re reading in the paper and trying to figure out if these problems apply locally.”

And while the current picture of the nation’s financial system is grim, leaders of several community banks in the region say they saved themselves and their customers trouble by not taking part in the subprime mortgage lending craze — where scores of financial institutions offered home loans to high-risk borrowers who didn’t meet accepted standards, including credit status, income and job history, and income-to-mortgage-payment ratio — that led to this year’s mortgage meltdown.

N.H. Banking Commissioner Peter Hildreth, who oversees state-chartered financial institutions, said he is confident the state’s banks have enough capital to function as usual in the face of nationwide troubles.

“They’ve got good reserves,” Hildreth said. “They’re doing okay.”

When customers raise concerns about the security of their money, bank officials have ramped up efforts to give customers information about the Federal Deposit Insurance Corp. deposit insurance.

Under FDIC regulations, deposits of up to $100,000 per person are insured, with $250,000 additional coverage for retirement accounts. People with a higher balance can purchase certificates of deposit through a bank network for coverage up to $50 million.

O’Brien said he’s had a trickle of questions for about six weeks, since California-based IndyMac Bank was seized by the federal government, but questions have picked up in recent days.

“We’re suggesting cool heads,” O’Brien said. “From people that have investment portfolios with us and people who have accounts, we’re working one on one with the customer so they understand where things stand.”

Connecticut River Bank, based in Charlestown, prepared a flier several weeks ago to give customers with answers to questions about whether their money is safe.

It explains FDIC regulations and gives a snapshot of the bank’s financial health, including the fact that the company held more than $20 million in capital by the end of 2007.

Gary W. Gray, president and CEO of Connecticut River Bank, said the company has seen an increase in deposits over the last five months, which he attributes to people choosing to pull money from the volatile stock market and put it in more conservative places.

The bank’s investment portfolio also does not include stocks of Fannie Mae or Freddie Mac, two banks bailed out by the government last month, or Lehman Brothers bonds, which Gray says has saved investors from losing vast sums of money in the recent financial crisis, although the hit taken by the market is having a lesser effect on other stocks.

Gregg R. Tewksbury, president and CEO of Savings Bank of Walpole, said that while he remains concerned about what depositors’ reaction will be to the financial crisis, he hasn’t seen any significant changes in behavior.

“We run our bank conservatively, with a mind-set that we will always be able to give people their money when they need it,” Tewksbury said. “But we’re letting people know if they have insured deposits, they’re fine. We’re just talking to them about how we’re operating the bank to give them comfort.”

James M. Dunphy, president and CEO of Hampshire First Bank, said only a few customers have called with concerns. They are being advised to go on with business as usual, Dunphy said.

“Unlike the last time, in 2001 where it was a New England problem, it’s not as prevalent here and things are still strong,” Dunphy said.

But, bankers say, the psychological and financial impact of the generally weak economy has resulted in an increase in delinquent loan payments and a drop in demand for loans.

“This is not 2005 or 2006 and the demand for credit is not what it was over the last couple years,” O’Brien said. “People are being very cautious and postponing some of their decisions to borrow until there is more certainty in the future personally or business-wise.”

And although delinquencies have risen less than 1 percent over the last year at Connecticut River Bank, Gray says the bank is being proactive in combating delinquencies before they become a problem.

“Our delinquency rate has held pretty well but we’re working a lot harder than we did two years ago,” Gray said. “If someone starts slowness in payment we’re talking to them much earlier and trying to get it corrected.”

Statewide, foreclosures increased 90 percent in June over the same month in 2007, according to the N.H Housing Finance Authority, a nonprofit organization that helps low- and moderate-income families find affordable housing.

But compared to states like Florida and California, the state hasn’t been heavily affected by economic downturns, according to O’Brien.

O’Brien said New Hampshire may have been spared because of lessons learned in the past, including the technology bust of 2000, which hit the state hard.

“There wasn’t as much overbuilding as you’re seeing in other states,” O’Brien said. “Builders adjusted to marketplace demands and kept things at a steady level.”

A smaller industrial market and more small, local businesses than in other states have also helped pad New Hampshire’s economy from much of the major turmoil felt in other parts of the country, he said.

“This is a small-business area and state, and that works to our advantage,” O’Brien said. “We are not talking what people are reading in the paper. The scale is entirely different.”

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.

Tests to see how to make homes more energy efficient gain in popularity

Published Sept. 17, 2008 in the Keene Sentinel
By Casey Farrar
Sentinel Staff

SPOFFORD — John Kondos’ phone has been ringing off the hook lately.

 

A government-funded weatherization program includes energy audits for low-income families. By weatherizing homes based on the recommendations from the audits, the government can save money in the long run because people will use less oil, according to Andrew S. Gray, New Hampshire’s weatherization program manager.
“The goal of the program is pretty simple,” Gray said. “It’s to reduce the heating and cooling costs for the home by installing those measures identified in the audit. Those homes will then cost less money to heat, which translates into an across-the-board savings.”

Kondos said his interest in helping people become more environmentally friendly without costing a lot of money has tied in with the audits.

“It’s such a basic thing to do and it can have significant impacts for people’s energy conservation,” Kondos said. “That’s why I decided to do them.”

Kondos’ assessments, which cost $225 for up to a 2,000-square-foot house and an additional fee pro-rated for larger houses, use a “blower door” test and computer program that offer homeowners a report of what can be done to increase the home’s energy efficiency.

A blower door is a flexible panel fitted into an exterior door with a powerful fan mounted inside. All the other doors and windows of the house are closed as the fan blows air out of the house, lowering the air pressure inside.

This allows outside air, which is at a higher pressure, to flow in through all unsealed cracks and openings.

Kondos said while he sometimes finds leaks along windows and doors, he also finds that many homes have insulation problems.

“Windows are rarely the problem,” Kondos said. “Everyone thinks it’s the windows, which can be extremely expensive to replace, but most houses don’t have adequate insulation.”

Attics and basements often have insulation problems that cause heat loss in the winter, Kondos said. Homeowners often replace the insulation or close off parts of the house that are improperly insulated to improve energy efficiency.

Roofs that develop ice dams, or a buildup of ice in gutters that spreads up the roof under shingles, or melt unevenly, are signals of insulation problems in an attic, according to Kondos.

He said heat loss can also often occur at spots where an addition was improperly sealed or, in pre-built homes, at the joints.

“Twelve to 15 years ago, building science was not what it is today,” Kondos said. “So I look at the house as a system and try to locate all the possible sources of energy loss.”

The reports he provides to customers includes recommentdations listed most cost effective to least, giving homeowners a range of changes they can make.

“I look for the quickest payback — things that are the least expensive with the highest return,” Kondos said. “Weather stripping a door, for example, can cost under $25 and it may pay for itself in less than one winter.”

The assessments Kondos does are a less expensive alternative to energy audits, which can cost up to $1,000.

Audits, which use blower door tests, also include more comprehensive testing and detailed analysis reports. They are required to attain Energy Star ratings or LEED certifications.

Kondos said that by learning ways they can conserve energy, many people often save money in the long run.

“People think about buying a new heating source, but more and more I think people will begin to understand how important it is to reduce the building’s need for energy by reducing the wasted energy,” Kondos said.

u Find do-it-yourself home energy audit tips and information about professional energy audits at the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy Web site: www.eere.energy.gov/consumer/your_home

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.

 

A Shortcut to Normalcy

Housing efforts aim to put homeless back on track

Published Sept. 6, 2008 in The Keene Sentinel

Casey Farrar
Sentinel Staff

David J. LeBlanc 2nd considers himself one of the lucky ones.

After arriving in Keene two years ago, he spent six months living in a homeless shelter, several months living in his car and a night in the woods.

Eventually, a volunteer coordinator at The Community Kitchen, where he was volunteering, put him in touch with someone living in subsidized housing who needed a roommate.

LeBlanc made the transition from homelessness to permanent housing without wading through piles of paperwork and waiting on a lengthy list.

Yet many homeless people in the Monadnock Region are not so lucky, sometimes spending months or years trying to get into a permanent home – and their numbers are growing, according to officials at local human services agencies.

To combat the increasing need for housing, officials are turning to new initiatives aimed at putting the homeless into permanent housing quickly, then offering support services to keep them there.

Two such initiatives are Housing First — directed at permanently housing the chronically homeless, or people who are disabled or have mental illness and have been without housing at least a year — and Rapid Rehousing, which works to find permanent housing for families who have been in shelters or on the streets between one and six weeks.

Programs based on these ideas have been under way in several cities for years, with results local officials see as hopeful for helping  Keene’s homeless population.

The U.S. Department of Housing and Urban Development has been putting one-third of its money toward permanent housing since 1999, and between 2005 and 2007 the number of chronically homeless people in the country has dropped by 30 percent, to just over 120,000, according to a recent study by the department.

According to the National Alliance to End Homelessness, there are now 354 communities with 10-year plans to reduce homelessness, including plans in Nashua, Manchester and a plan covering the state of New Hampshire.

Ronalee M. Frost, an outreach worker at Monadnock Family Services’ Projects for Assistance with Transition from Homelessness, points to the achievements of a program in Portland, Maine, called Logan Place, which opened in 2006 and provides 30 apartments to men who had been homeless repeatedly or for long periods.

The program is shaped around the Housing First model. After rapidly taking people out of the shelter system, it includes services such as crisis intervention, follow-up case management and housing support services to prevent the reoccurrence of homelessness.

In the year after the program opened, the percentage of chronically homeless in the city was down to 19 percent, from 26 percent in 2006 and 37 percent in 2004, according to the city of Portland’s 2006-07 Consolidated Annual Performance and Evaluation Report.

The residents of the apartments also make fewer emergency calls, spend less time in prison, earn higher incomes, and many have joined substance-abuse treatment programs or begun mental-health programs since moving in, according to a report on the program’s Web site.

Frost said she’s interested in finding a way to implement the concept in the Monadnock Region to speed up the process of putting homeless people into permanent housing.

Meanwhile, Laurie J. Saunders-Jewett, director of homeless services for Southwestern Community Services, which runs three homeless shelters in Keene, is writing a grant through the U.S. Department of Housing and Urban Development for money to bring a Rapid Rehousing program to Keene.

If approved, Southwestern Community Services would help homeless families who have been on the streets between seven days and six weeks in finding private housing. The families would pay 30 percent of their income for rent, with the rest subsidized, Saunders-Jewett said.

“It will put them into housing and then provide case management and medical assistance for 12 months,” Saunders-Jewett said.

The program could help free up space in Keene’s shelters, which are being pushed well beyond capacity, and help people who can’t afford high rent prices stay in housing, according to Saunders-Jewett.

LeBlanc agreed that one of the biggest challenges facing homeless people in the Monadnock Region is finding permanent housing they can afford.

For him, falling on hard times in Springfield, Mass., brought LeBlanc back up to the Monadnock Region, where he had lived before. And while he thought it would only take a couple months to get back on his feet, he had a hard time finding a job that would pay enough to get by on.

A sous chef with experience in high-end restaurants, LeBlanc has had trouble finding work related to his experience.

“They’ll hire an $8-to-$10-an-hour dishwasher, but no one is looking for a $15-an-hour chef, and here in Keene you can’t afford an apartment and utilities and food on $8 to $10 an hour,” LeBlanc said.

LeBlanc said he continues to search for a job as a chef while volunteering more than 20 hours per week at The Community Kitchen and several other community organizations.

Dawn Christianson, a disabled homeless woman who grew up in Jaffrey and has been living on the streets in Keene since last March, said many homeless people in the area want to get into permanent housing but have huge obstacles to tackle to get there.

Christianson said even with help from human-service agencies in Keene, she’s had difficulty completing all the paperwork to get on a waiting list for housing.

In order to prove she’s disabled and needs a first-floor apartment, Christianson said, she has to visit a doctor she can’t afford.

She said she also needs to get some of the documents for housing notarized, but needs identification to do so and doesn’t have a driver’s license or passport. To make things easier, Christianson said, there should be less paperwork.

“Every time I get one thing done, I find out I need something else I don’t have,” Christianson said. “It’s very frustrating. And since I’m disabled and don’t have a car, I can’t get around very easily so it’s really hard. There should just be one form for everything.”

Frost and Karen Bednarski, an outreach worker for Southwestern Community Services, go out three times a week to find members of Keene’s unsheltered population and help them access food, medical services, shelter and search for permanent housing.

Frost brings paperwork for medical assistance and housing out to homeless people on her outreach visits, but says the Housing First approach would streamline the process, allowing her to find housing for people immediately and then work with them on other issues.

“I don’t know about you, but when I have to fill out a complicated form, I like to sit in a quiet place, at my desk, and take my time,” Frost said. “Imagine trying to do all this, without a full stomach, sometimes on very little sleep out in the forest or on a picnic table. And then you need a pen, too.”

And while Frost estimates between 20 and 30 people she’s worked with have found permanent housing since November — statistics on the number housed are not kept — she says it’s not enough.

“For most of these people, their lives are like a puzzle that’s fallen apart,” Frost said.

Frost said the people she works with often face the stigma that they are out on the streets because they have done something wrong. But for many people, events out of their control have stripped them of everything, and without family or friends to fall back on, they fall to the fringes, she said.

With this in mind, a major part of transitional program’s mission is not only finding permanent housing, but also helping homeless people become part of the community again.

“Social inclusion is a key part of the work we do,” she said. “They are intimidated by the average population, but to get them back into complete, full lives we want them to get housing and join the greater community.”

Frost and Saunders-Jewett agreed that the impact of high fuel prices won’t be known until winter arrives, but both expect the homeless population to increase.

“It has been holding steady, but I anticipate it going up in the winter because the campgrounds will close and people won’t be able to afford heating their homes,” Saunders-Jewett said. “This isn’t a problem that will fix itself.”

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.

Help surges South

A local woman in Louisiana aiding victims

Published Sept. 4, 2008 in the Keene Sentinel
By Casey Farrar
Sentinel Staff
When Ashley A. Pushkarewicz arrived in Antrim five months ago as an AmeriCorps disaster services volunteer with the N.H. West Chapter of the American Red Cross, she knew she might be called on someday to help in case of a natural disaster.

And since Sunday, the 24-year-old Connecticut native has been working in crowded shelters in Louisiana as torrential winds and rain from Hurricane Gustav battered the Gulf Coast and worked their way inland.

Pushkarewicz, one of eight local volunteers down South, is now stationed in Alexandria, La., a city along the south bank of the Red River near the center of the state, between Shreveport and New Orleans.

Wednesday morning, as she and other volunteers assigned to assessing the storm’s damage holed up in a shelter at the headquarters of the Central Louisiana Red Cross offices to wait out a tornado watch, Pushkarewicz described the scene in an e-mail to family and friends.

“Though Hurricane Gustav has passed over us down in southern central Louisiana, we are still experiencing severe weather including flash flooding and tornado cells,” Pushkarewicz wrote. “If I look out the window of the shelter where we are in lockdown, there are SUVs and trucks stuck in about a foot of water.”

The Town Talk, the local newspaper in Alexandria, reported on its Web site this morning that 74 percent of homes in Rapides Parish, the county where the city is located, are still without power.

But as of 6:30 a.m. an executive order closing all non-essential businesses had been lifted, allowing residents and business owners to return, the newspaper reported.

Pushkarewicz said in a telephone interview with The Sentinel Wednesday that while the storm was less severe than originally projected, many local people are still afraid of what they’ll go back to in the weeks to come, making for a nervous, electric feeling throughout the shelters.

“It’s hard for a lot of people, because they’ve been through Katrina,” Pushkarewicz said. “We know the damage wasn’t what we expected, but when (evacuees) came (to the shelter), they didn’t know what would happen.”

Pushkarewicz said as soon as it is deemed safe to leave the shelter, she and about 50 other Red Cross volunteers will be heading out into Rapides Parish to assess the damage and begin planning for recovery efforts.

She said that winds on Monday had damaged water pumps, so large segments of the county were without water reserves Wednesday.

In her e-mail, Pushkarewicz described how those who waited out the storms in their homes had been affected:

“Last night I spoke on the phone to a woman in hysterics. Her power went out two days ago. She, like most of her neighbors, (has) run out of food for her six children, cannot afford a tank of gas; and even if she could, cannot get to any of our shelters because there are large trees obstructing all major roads into her community. This is the story we are hearing over and over again. Many people such as this woman are struggling to be able to get to any of our meal distribution areas …”

On Sunday, Pushkarewicz and another Monadnock Region volunteer flew together into New Orleans just as the city was closing down air travel. They were on a plane with about 30 other volunteers coming to the area to help with the evacuation, she said.

“Several people were deployed directly to shelters,” Pushkarewicz said. “I went directly from there to the MedExpress, which is the center where, before the storm hit, we were sending people on the highways to get information about where the shelters were.”

By Monday evening, all the shelters were in lockdown as the storm hammered the coast with rain and winds, according to Pushkarewicz.

On Tuesday, she and several volunteers traveled to Alexandria.

This is the first major disaster effort Pushkarewicz has been involved in, but in July she helped with clean-up efforts when a tornado swept through several New Hampshire towns.

Pushkarewicz, who previously worked for several development agencies in East Africa, living along the Congolese border for several months, said her past experiences, combined with the support of the Red Cross, have helped her get through the challenges of disaster relief.

“There’s an amazing support system with the Red Cross,” she said. “There are local volunteers here who are completely new to this and volunteers who have been doing it for more than 30 years.”

Pushkarewicz is scheduled to continue helping with the recovery efforts until Sept. 22, but said with storms looming in the Atlantic, she’s prepared to stay as long as the Red Cross needs her.

And she hopes people in New Hampshire will continue to volunteer their time or donate money to help out with recovery.

“This has drained the resources from the Keene chapter and a lot of the staff are now deployed here,” Pushkarewicz said. “So we still need people to help out locally.”

When she returns to New Hampshire, where she’s assigned until March 2009, Pushkarewicz said she will return to her community education work, teaching people in Cheshire, Hillsborough and Sullivan counties about disaster preparedness and fire prevention.

u For information on volunteering or donating to the N.H West Chapter of the Red Cross, visit www.newhampshirewest.redcross.org or call 352-3210.

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.