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Mobile mental health unit to launch in region, as state boosts funding

Thanks to an increase in funding from the state, Monadnock Family Services plans to launch a mobile crisis response team by next year, aimed at helping people experiencing a mental health or substance-use emergency in the Monadnock Region.

“The investment on the part of the state for this kind of service is essential,” CEO Phil Wyzik said Tuesday.

Last week, the N.H. Executive Council unanimously approved $52.4 million in state and federal funds for the fiscal year that started July 1 for the state’s community mental health centers — Monadnock Family Services and nine others — which provide mental health services to residents of low income, including those on Medicaid.

Ninety percent of the additional funding will come from state general funds, with the remaining 10 percent picked up by the federal government.

The funding is projected to help about 43,000 residents statewide by July 2022, according to the data shown in the N.H. Department of Health and Human Services’ proposal to the council.

In addition to a mobile crisis team — first launched in Nashua, Manchester and Concord — each center will add six supported-housing beds, an employment counselor and services for people who are deaf or hard of hearing.

Monadnock Family Services’ overall budget is just shy of $13 million for this fiscal year, Wyzik said. With its new state contract, he said the maximum amount the organization can bill the state is about $1.4 million, with about $66,000 of that figure to be used to start the mobile crisis team.

Wyzik said, to his knowledge, the state hopes to implement these teams statewide by the end of the fiscal year.

The first step, he added, is to create a plan, which will need to be approved by the state health department by the end of July.

The two-person mobile crisis team (both of which will consist of Monadnock Family Services employees) will meet people having a mental health or substance-use crisis where they are — at home, work or other location — rather than sending them to the emergency room for help.

One of the team members will assess and treat the individual, while the other will assist with any additional resources the person may need in the days after the crisis.

“It’s very common that somebody in an emergency situation can get an initial service to help them, but the stress in their situation goes into the next day. It’s not like our conversation is going to take care of everything,” Wyzik said. “This is to put initial services in place ... and in the following days to help them with whatever they are facing.”

Currently, the nonprofit organization offers crisis services 24/7 at emergency departments, its offices and through telehealth visits.

Over the past 16 months, Monadnock Family Services has received 362 calls per month on average from people in crisis and has worked with a monthly average of 50 in person at Cheshire Medical Center’s emergency department in Keene and 16 others at the mental health agency’s offices in Keene and Peterborough.

“The need for mental health services is growing,” Wyzik said in an email. “As the pandemic ravaged the nation, people have been under more and more stress and disruption ... Even putting the pandemic aside, the nation has seen a rise in the rate of suicide, drug abuse, and violence. I think that the pandemic has taught all of us that our mental health is key to living a satisfying life, a healthy life.”

A majority of the additional funding, Wyzik said, will go toward staffing for the mobile crisis team and other service expansions under the state’s plan.

Monadnock Family Services has about 180 employees currently, with 13 full-time positions open along with a handful of part-time ones.

But, with all of the centers receiving this funding increase, Wyzik said it’ll be challenging to find people to hire in an already small pool of eligible workers in New Hampshire and beyond.

As of September 2020, only 45 percent of the state’s need for such professionals was being met, according to the most recent data available from the Kaiser Family Foundation.

“It worries a lot of people. We’re all ... going to be advertising and looking for people, so it’ll be a significant challenge in making such a necessary service come into being,” Wyzik said. “We’ll see.”


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Stepped-up efforts against invasives have area volunteers wading for water chestnut
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NORTH SWANZEY — Keene City Councilor Bobby Williams was chest-deep in muddy water. N.H. Rep. Sparky Von Plinksy was yanking at vegetation with a rake. Vernon Thornblad lost a rubber boot to the muck, and Jamie Doherty said she’ll never be able to wear her socks again.

So passed a mild Tuesday evening near Dillant-Hopkins Airport.

Wading amongst frogs and cattails, the four-person crew was tackling a water chestnut patch just a stone’s throw from the road. It’s the latest small gathering organized by Williams to remove invasive species in and around Keene.

A few years ago, Williams, who also serves on the Keene Conservation Commission, took a course with the N.H. Invasives Academy through UNH Cooperative Extension. He’s “had a bee in [his] bonnet” ever since. The conservation commission has been talking about taking on invasive species for about a year, and this summer they decided to take action, Williams said.

Von Plinsky, the commission’s chairman, explained that invasive species can choke out native species, eliminating food sources for certain insects and other animals while disrupting the greater ecosystem.

According to the National Invasive Species Information Center, water chestnut is native to Eurasia and Africa, and was brought to the U.S. in the 1870s for ornamental purposes. It has long roots, and the fan-shaped leaves form rosettes, radiating outward from a center stem. Collectively, these rosettes form a thick mat of greenery at the water’s surface.

Eloise Clark, vice chair of the conservation commission, was the one who first noticed the patch of water chestnut near Airport Road. Williams said this patch is the only one he knows of in the area, but it was important to remove it before it goes to seed — which it typically does in mid-July — and spreads farther across the wetland.

In May, Williams organized Garlic Mustard Pull Challenges to remove garlic mustard near Beaver Street in Keene. The invasive plant grows on land and has leaves that smell like garlic when crushed.

“There are significant effects on ecosystems beyond just taking up space,” Williams said. Garlic mustard — which was brought from Europe more than 150 years ago for food and medicinal uses — can actually change the soil it grows in, making it uninhabitable for other species.

Doherty, a volunteer helping remove water chestnut Tuesday evening, also participated in one of the garlic mustard pulls. She said the group wiped out a large swath of the plant in just an hour and a half. It can be an enjoyable endeavor, she added, especially as a break from her work as a web developer.

“You’re doing good, but you’re also blowing off steam,” she said.

Garlic mustard and water chestnut are easy enough to remove with simple tools and bare hands, Williams said, but other species like Norway maples and Japanese knotweed would require more manpower and advanced methods.

“I would love to get a group of regulars together,” Williams said, and he hopes to take what he’s learned from this summer and create a more formalized program in the future.

Von Plinsky admitted that given how omnipresent invasive species are, it can be overwhelming to think about trying to tackle everything.

“It’s about identifying what we can do with the resources we have,” Von Plinsky said. “You have to pick your battles.”

There are several invasive species across Keene, including Norway maples, Japanese knotweed, burning bush and bittersweet vines. Thornblad said he even has invasive bamboo in his yard.

Invasive species have many different ways of spreading to new regions, according to the National Invasive Species Information Center. Like water chestnut, many species are planted for decoration. However, some invasive plants are spread by humans unintentionally, such as when seeds are stuck to the hull of boats or a hiker’s backpack.

Williams said the conservation commission and volunteers can work on addressing the invasive species that grow in public spaces, but he wants to get the word out to private landowners too. He recommended that people interested in learning more about invasive species — and potentially addressing the problem in their own backyards — start with UNH Extension’s online resources.

Invasive species can’t be composted, as this could result in the seeds spreading even farther, so the plants are put in garbage bags to decompose. The uprooted water chestnut just needs to be kept away from water, Williams said, but the garlic mustard had to sit in bags for a month before the conservation commission felt it could be discarded without seeds taking root.

Just down the road from the airport, the crew moved methodically, using rakes and bare hands to pull up tendrils of water chestnut. The waterlogged leaves were loaded onto a boat, brought back to the bank, and then dumped to dry out on the grass. The muddy tangle of discarded roots and leaves continued to spread along the road, and after an hour of work the team had made a noticeable dent in the patch.

Williams said he’s not sure which invasive species he’ll try to take on next, but he’s still learning as he goes.

One lesson from Tuesday? What gear might be helpful in the future.

“I’ll be asking for waders for Christmas,” he said.


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Insurance carriers must cover mandated ultrasounds, commissioner says

New Hampshire health insurance carriers must cover the ultrasounds mandated by the state’s new abortion law, the state Insurance Department says.

In a memo sent to all of the state’s health insurers and released to the public July 1, Insurance Department Commissioner Chris Nicolopoulos said insurers must treat the ultrasounds as a “covered service.”

New Hampshire’s new two-year budget — signed into law by Gov. Chris Sununu in late June — includes a ban on all abortions after 24 weeks.

That change also includes a requirement that doctors determine whether a fetus being considered for abortion has reached the 24-week threshold, requiring doctors to employ “all such medical examinations, imaging studies, and tests” as are reasonably necessary, including ultrasounds.

Some abortion rights supporters, including Democratic Executive Councilor Cinde Warmington, had questioned whether the newly mandatory ultrasounds would create an additional cost burden for the insured. Warmington asked Nicolopoulos the question at a June 30 Executive Council meeting.

In his letter Thursday, Nicolopoulos said the newly required ultrasounds fall under the type of care that must be covered.

“Determining the gestational age of a fetus is part of routine prenatal and maternity care, and therefore is a covered service,” he wrote. “Insurers must cover all necessary medical examinations, imaging studies, and tests required to make a gestational age determination.”

Separately at the Executive Council, state Medicaid Director Henry Lipman seemed to indicate that the ultrasounds could be covered under Medicaid.

“Coverage of ultrasounds will be based on medical necessity,” he told the council. “That’s the criteria. So the position is if it were based on medical necessity, it would be covered. If there was an indication that it wasn’t medically necessary, then it might not be covered.”


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Rindge officials again postpone action on 20-home development
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RINDGE — The planning board has delayed its decision on a proposal to build 20 single-family homes near Route 119 until board members can review a wildlife-impact study of the site. This marks the second time the board has tabled the project in as many months.

After a hearing Tuesday night that grew testy at times over some residents’ concerns with the proposed development, the planning board voted unanimously to postpone a ruling until its Aug. 3 meeting.

That may also provide time for a town-hired wetlands expert to assess the Route 119 site, as Rindge’s conservation commission had requested last month. Planning board members said the third-party study, however, is not required for their final decision on the project.

The board had already tabled a subdivision plan for the 95-acre development at its June 1 meeting, when members asked for a wildlife assessment and an inquiry into possible soil contamination, while also waiting for a site walk held later that month.

The homes would be built over five years on vacant land — previously used for logging — behind Carol’s Ice Cream, with access via a cul-de-sac from the state highway, Kirk Stenersen of the Rindge engineering firm Higher Design said last month. Most of the lots would measure between 2 and 4 acres, though three of them, including a pair on Rugg Pond, at the north end of the site, would exceed 14 acres.

Stenersen, who also serves as the town’s planning director, told the planning board last month that landowners Shawn and Rodney Seppala, who run the Rindge interior design company Triumph Interiors, would live at the two houses on the pond. The brothers “aren’t really developers,” Stenersen said, but want to move from their current homes to larger properties.

They acquired the Route 119 property in June 2020 for $260,000, according to property records.

Stenersen told the planning board Tuesday that a 60-page wildlife-impact study submitted by the Seppalas didn’t identify any ecological issues with the area near Rugg Pond. Board members Holly Koski and Kim McCummings said they hadn’t been able to review the study before the meeting, however, and both suggested tabling the proposal until next month.

“I think there’s some value to be able to take a look at that and come back and be able to contribute to the conversation,” McCummings said. “I don’t have enough concrete information to do a decision right now.”

Delaying its decision until next month gives the planning board a “grace period” to read the wildlife-impact report, Chairman Jonah Ketola said.

Also on Tuesday, Stenersen said state officials monitoring the Route 119 site, which is near a defunct gas station, have found low levels of soil contamination and are testing wells in the area to make sure it doesn’t affect groundwater. Ketola added, though, that the contamination isn’t significant enough to trigger public-health regulations and that in some cases, the state can offer resources and equipment to help decontaminate water, if necessary.

“Obviously, that is a concern,” he said. “We don’t look at projects to approve the well, but it definitely is a concern for whoever buys it.”

Joel Kaplan, whose Letourneau Lane home abuts the development site, told the board he wants to have the area reassessed because he feels the residential project would encroach on his land. That dispute is over a boundary line that Kaplan said has been moved since he bought the property.

“I was under the impression that this is the land I’m purchasing, and it’s come in about 50 feet,” he said. “That’s a lot of land to give up.”

And Rindge resident Judy Unger-Clark reiterated concerns she voiced last month that it’s a conflict of interest for Stenersen to represent the developers while also serving as planning director.

“The planning board needs to realize that this is unethical,” she said. “… This creates an unfair representation of the cases before the Rindge Planning Board.”

Unger-Clark said Tuesday that she and nearly 70 residents have signed a petition urging the planning board to remove Stenersen from his job leading Rindge’s planning department. She plans to submit the petition to the town’s selectboard at its meeting Wednesday, she said.

Planning board members have said Stenersen isn’t advising them in his public role on the Route 119 development, given his personal involvement with the project. Ketola called Stenersen “an asset to the town” Tuesday, noting that his pay is much lower than previous planning directors earned due to budget cuts.

“He’s not doing it to benefit himself,” Ketola said. “He’s serving the town.”

Reached Wednesday morning, Stenerson declined to comment.

Noting that the planning board didn’t see the area near Rugg Pond on its June 15 site tour, Unger-Clark also asked board members to wait for a third-party wetlands study of that location — echoing the conservation commission’s request.

Richard Mellor, the commission’s vice chairman, said Tuesday an independent review is needed to verify the wildlife-impact study submitted by the Seppalas. Some of that report was conducted in the winter, when it’s more difficult to observe wetlands animals, according to Mellor.

“Whether or not it’s an adequate wildlife assessment, we don’t know yet,” he said. “I understand someone that buys 90 acres, they have a right to develop it … I just think we need to do this right.”

Mellor said he has asked environmental expert Rick Van de Poll, with whom Rindge has already contracted to study all of its wetlands, to assess the area near Rugg Pond this summer.

Planning board members said Tuesday they will review any report from Van de Poll but that his analysis isn’t required for their decision on the Route 119 project.


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