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Divisive-concepts law hangs over discussion on training for Keene councilors
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Members of a Keene City Council committee voted Thursday to recommend that the council move forward with a proposal for councilors to undergo training on professional ethics and other topics. But amid questions about a controversial new state law, the training’s focus could be narrowed to initially exclude implicit bias, diversity and inclusion.

During its meeting Thursday night, the council’s Finance, Organization and Personnel Committee heard from Councilor Andrew Madison, who proposed that councilors be required to undergo training on these subjects, as well as on professional ethics, sexual harassment and gender sensitivity. But City Attorney Tom Mullins said that a measure included as part of New Hampshire’s recently passed two-year budget casts doubt on whether government institutions may train people on topics related to race and gender.

Among other things, the so-called ”divisive concepts” law bars public employees from teaching “that an individual, by virtue of his or her age, sex, gender identity, sexual orientation, race, creed, color, marital status, familial status, mental or physical disability, religion, or national origin, is inherently racist, sexist, or oppressive, whether consciously or unconsciously.”

In addition to being panned by many people and organizations as a measure stifling free speech and academic expression, the law has been criticized as too broad. And despite a clause noting that such topics can be taught in an “objective manner,” the law has left many questioning exactly what it means.

“It’s a very difficult bill to navigate through to determine what is and what is not permissible under the bill,” Mullins said. “The catch phrase that is at the end of the bill essentially says that nothing [contained in the bill] should restrict the objective presentation of these issues. So the question at that point becomes who determines that something is objective?”

Currently, Keene has no mandatory training like what Madison has proposed for councilors, according to City Manager Elizabeth Dragon. Madison previously said there was a voluntary sexual-harassment training session for councilors a few years ago, but that it wasn’t particularly well attended, which is why he’s asking that the training be required.

Madison first proposed the training in a June 25 letter to Mayor George Hansel and the City Council. He said the proposal stems in large part from recent events and movements related to racial and gender equality.

“With the Black Lives Matter protests of last year and the Me Too Movement of a few years prior, I felt it was appropriate for the council to ... take action on that,” Madison, who has represented Keene’s Ward 3 since April, told The Sentinel after last week’s council meeting, “to set an example for the rest of the community by undertaking that training ourselves so that we can identify ways we can better serve our constituents and better work with our city staff, and better work with each other.”

In addition to the potential complications posed by the divisive-concepts law, Dragon said she was unsure about whether the training could be mandated. She said such a change might best be implemented as an amendment to the council’s rules of order to avoid enforcement issues.

Madison had originally proposed implementing the training in 2022 to give the city a full year to determine how to do so. But Councilor Raleigh Ormerod asked if it would be possible to include some of the proposed training topics in the council’s next orientation in January.

Dragon recommended the council move forward with the topics that are not expected to be affected by the divisive-concepts law.

“I recommend sexual harassment and gender sensitivity along with professional ethics,” Dragon said, “only because the implicit bias, diversity, inclusion conversation is going to still need to unfold at the state level before we’re going to be able to implement training of any sort on that.”

Assistant City Manager Elizabeth Fox recommended using the phrase “workplace harassment” rather than “sexual harassment” to allow for a broader discussion.

The three of five committee members present Thursday — Councilors Bettina Chadbourne, Thomas Powers and Ormerod — voted unanimously to recommend that city staff begin the process of implementing the professional ethics and harassment training in the orientation procedure. The motion also included asking staff to investigate the city’s ability to require implicit bias, diversity and inclusion training at a later date.

Melissa Wilks of Keene photographed this critter from The Caterpillar Lab during a recent event with the Troy-based Girl Scouts Troop 12716.

New Hampshire among nine states still opposing Purdue Pharma deal

Fifteen states have reached a deal with Purdue Pharma on the company’s bankruptcy organization plan. New Hampshire is not among them.

The deal moves the states and company a step closer to a $4.5 billion opioid settlement. Plaintiffs in the case are trying to hold the company and its owners, the Sackler family, responsible for their role in the opioid crisis. Nationally, more than 500,000 people have died from opioid overdoses caused by either prescription or illegal drug use since 1999.

And the opioid crisis has taken a serious toll in New Hampshire, where the rate of deaths caused by overdose has consistently been among the highest in the country.

Purdue Pharma has made and marketed OxyContin, which was introduced into the market in the late 1990s. Public health experts link the drug to the opioid epidemic across the country.

Purdue Pharma pleaded guilty to federal criminal charges on its opioid marketing practices, both in 2007 and 2020.

New Hampshire filed a lawsuit against Purdue Pharma in 2017.

While the states had previously been united in their opposition to the settlement, the release of millions of documents and $50 million more from the Sackler family was enough to get 15 states on board as of late Wednesday.

Massachusetts Attorney General Maura Healey pointed to the importance of these documents, which would force the Sackler family “to turn over their secrets.”

The documents will include “evidence from lawsuits and investigations of Purdue over the past 20 years, including deposition transcripts, deposition videos, and 13 million documents,” according to Healey’s statement.

But the agreement doesn’t include any finding of liability or wrongdoing on the part of the Sacklers. It would shield the family from further opioid-related lawsuits, and they would remain one of the wealthiest families in the United States.

The New Hampshire Attorney General’s Office called the current version of the bankruptcy settlement “deeply unfair.”

“This settlement plan allows the Sacklers to walk away as billionaires with a legal shield for life. To add insult to injury, they don’t even have to apologize,” said Associate Attorney General James Boffetti in a written statement.

“The Sackler family made at least $11 billion from Purdue while New Hampshire families suffered as a result of their conduct,” he said. And Boffetti said that the legal shield would prevent the Sacklers from being held accountable in a court of law. The position of the New Hampshire Attorney General’s Office is that the Sacklers should pay back the $11 billion in full and apologize to families that have been harmed.

Opposing the settlement will not prevent New Hampshire from receiving its share of the settlement funds if the bankruptcy deal is ultimately accepted.

Three thousand plaintiffs will now vote on the proposal, which was filed late Wednesday in U.S. Bankruptcy Court in White Plains, New York. Voting will close at 4 p.m. on July 14.

Judge Robert Drain is expected to certify the plan after a hearing in August.

The other eight states still opposing the plan are California, Connecticut, Delaware, Maryland, Oregon, Rhode Island, Vermont, and Washington. The District of Columbia is also opposed.

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HCS expands palliative care team, adding clinical expertise
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For many people living with a chronic illness, assistance such as comfort care is hard to come by, with most insurance-covered programs only for patients at the end of their lives.

So about 10 years ago — with the help of grant and donor funding — Home Healthcare, Hospice and Community Services (HCS) launched a palliative care program, a social-work-led service aimed at helping patients with a range of illnesses improve their quality of life.

To further help those patients, the program expanded last month by hiring Lana Moore, an advanced-practice nurse practitioner, adding clinical expertise.

“This leads to much more advanced end-of-life planning, so patients can actually start to talk about what they really want to achieve, like getting out of the house, taking a vacation, and ... address both the physical symptoms the patient might be having as well as the social factors,” HCS CEO Maura McQueeney said.

While both hospice and palliative care are aimed at relieving pain and symptoms, the prognosis for patients and goals of care tend to be different.

Hospice is for patients who no longer have treatment options or have chosen not to pursue treatment because the side effects outweigh the benefits.

Palliative care, by contrast, provides patients relief from their symptoms, as well as the physical and mental stress of a serious or life-altering illness. Palliative care can be used at diagnosis, during treatment and at the end of life.

The palliative care program at HCS — which has locations in Keene, Charlestown and Peterborough and provides services to the Monadnock Region and beyond — works with people living with diseases such as cancer, congestive heart failure, kidney failure, ALS, dementia and liver disease.

Palliative care is available to patients receiving HCS’ home-based visiting nurse or rehabilitation services, according to its website, and requires a physician’s order. The service may be covered under some insurances, but those who are uninsured or underinsured may qualify to have it covered by HCS.

Prior to the program’s expansion, it was run solely by social worker Evelyn Erb, who said she has a caseload of about 30 patients.

She helps them with the social elements of their lives by informing them of local resources such as financial assistance or support groups for isolation.

Moore can do a physical assessment, discuss the patient’s treatment goals and help manage symptoms, usually with a hope of reducing their need to visit their primary care doctor or seek emergency-room care.

“In other words, managing things well in advance of a progression ... where a patient needs to go to the hospital,” McQueeney said.

Erb said she and Moore see different patients, but often will consult each other, depending on the person’s needs.

As of Thursday, Moore said she had about eight patients. “It’s off and running pretty well so far,” she said.

The frequency of visits depends on the patient, but typically, Erb and Moore will see patients more often as they are getting to know them, and then shift to check-ins once every one or two months.

Erb said palliative care should always be delivered in a “multidisciplinary” approach, making Moore’s addition beneficial for HCS’ patients.

“The goal is to ease or address any type of pain,” Erb said, “whether that’s physical or existential.”

For more information on the palliative care program, Home Healthcare, Hospice and Community Services can be reached at 352-2253.

COVID-19 vaccination rate
Many Monadnock Region towns below state average COVID vax rate

New Ipswich, Rindge, and Greenville are in the bottom tenth percentile of all New Hampshire towns reporting a percentage of fully-vaccinated residents, according to statistics compiled by the Department of Health and Human Services. That means vaccination rates are lower in those towns than 90 percent of the 233 towns statewide with published data.

The New Hampshire Department of Safety emailed town vaccination rates to local emergency management directors on June 25. Percentages of residents fully vaccinated against COVID-19 were calculated by comparing the town’s 2019 population estimate with vaccine administrations attributed to that town as provided by vaccine recipients. The spreadsheet also calculated the percent of town residents with at least one dose of a COVID-19 vaccine.

Of the 233 New Hampshire towns represented in the report, New Ipswich ranked 223rd, with 1,367 residents — just 30.5 percent of townspeople— fully vaccinated. New Ipswich’s town population was 5,375 as of the 2019 census numbers used by DHHS in compiling the data; the vaccination numbers are a snapshot of the state’s status as of June 23.

Statewide, 55 percent of residents were fully vaccinated as of July 2, according to the state’s COVID-19 dashboard, but, when broken out by town, reported vaccination rates went as low as 11.3 percent, in Columbia, to 100 percent, in Waterville Valley and Littleton, where more people completed vaccinations than were listed as permanent residents. Such discrepancies belie the potential for error in the estimates: A dataset explanation in the June 25 email by Department of Safety Director Jennifer Harper noted the beyond-100 percent vaccination rates could be a result of inaccurate Census counts, new arrivals to town since 2019, or people using a second home to access vaccination.

Furthermore, data for the state’s 26 towns with populations under 100 were not reported to protect individuals’ identities, according to the spreadsheets.

Towns had a median full-vaccination rate of 49.2 percent. In the Monadnock region, New Ipswich, Rindge, and Greenville had the lowest vaccination rates, at 30.5, 33.5, and 34.5 percent of residents fully vaccinated, respectively.

Most area towns were below the 50th percentile, however: Mason and Bennington lie below the state’s 25th percentile at 38.2 and 40.6 percent fully vaccinated. Lyndeborough, Greenfield, Jaffrey, Antrim, Francestown, Wilton, and Temple lie between the 25th and 50th percentiles at 42.9, 43.1, 43.7, 45.5, 47.4, 47.5, and 48 percent fully vaccinated respectively.

Peterborough and Sharon achieved vaccination rates above the 50th percentile, at 51.1 and 53.1 percent of residents fully vaccinated. Dublin landed above the 75th percentile, with 60.5 percent of residents fully vaccinated.

Hancock is the only local town in the state’s 90th percentile, with 66.1 percent of residents fully vaccinated.

Each town’s percentage of partially vaccinated residents was higher than their fully vaccinated numbers by about four percent.