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The Keene SwampBats played for the first time at Alumni Field Friday night since winning the NECBL championship in 2019. Here, Zach Davidson pitches to the Upper Valley Nighthawks during the home opener. For more, see Sports, Page B1.

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Keene State to offer more faculty buyouts as budget gap swells to $14M
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Keene State College is offering a new round of faculty buyouts as part of a multiyear effort to adjust to a smaller student body and eliminate a budget gap that grew to $14 million this year as enrollment declined further due to the COVID-19 pandemic, President Melinda Treadwell said Friday.

With these voluntary departures, which Treadwell shared with faculty members Friday, the college hopes to eliminate 20 to 25 positions to bring Keene’s State’s student-to-faculty ratio to 16-to-1 compared to the current 13-to-1.

“We can’t be stable with a 13-to-1 [ratio],” Treadwell said in a Zoom interview. “If we can get to 16-to-1, we’re in a very, very good position to come out of this. And unlike competitors and other institutions eliminating dozens of programs, that’s not what we’re looking at. We’re trying to do very measured work where we have excess, to reduce some of that excess.”

Faculty members will have about two weeks to apply for a buyout, which includes 1½ years of salary and 5½ years of health insurance, Treadwell said. College leaders will meet with faculty members again Tuesday to answer specific questions about the buyouts, she added.

These voluntary separation packages, which follow the most recent round of buyouts that began last August as Keene State has grappled with declining enrollment and budget shortfalls for several years, are open to employees in all departments. The buyouts will be completed by early August, Treadwell said, with a focus on limiting their impact on students.

“It’s not about the programs, it’s about the size of the faculty and the student engagement and enrollment demand,” Treadwell said. “So we’re really going to be focused on, when those applications [for buyouts] come in, making decisions about saying no to some faculty who we can’t lose, saying yes to some faculty where we have some excess capacity, as we did in the fall, and also looking at very limited student impact.”

Treadwell announced near the beginning of the academic year that Keene State would cut 15 faculty positions and add seven new ones over the course of the year. Ultimately, she said Friday, 24 faculty members took buyouts as part of that plan for a net loss of 14 professors.

Around the same time last August, Keene State began restructuring its administrative staff, starting by eliminating six positions. This process continued throughout the school year, Treadwell said Friday, and a total of 88 staff members took buyouts, representing a 22 percent reduction in staff.

“The staff reorganization that we’ve completed this year has brought a reduction in our permanent payroll of about $6.4 million going into next year,” Treadwell said. “That was critical for us to close that budget gap. And everyone who left got a voluntary package, and we then restructured around those departures.”

Keene State is not alone in making these sorts of cuts this year. Throughout the University System of New Hampshire — which also includes UNH, Plymouth State University and Granite State College — 488 staff members took buyouts this year, according to Keene State spokeswoman Kelly Ricaurte.

The driving force behind these moves — the COVID-19 pandemic — is also not unique to Keene State, Treadwell added. The college saw an 8 percent drop in enrollment last fall compared to expectations based on the number of students who put deposits down at Keene State, she said. Over winter break, another 4 percent of students opted to remain at home for the second semester, either learning remotely or leaving the school entirely.

This dip in enrollment, which Treadwell attributed largely to students’ concerns over living on campus during the pandemic, led to Keene State finishing the year with about 2,900 students. But going into the fall, Treadwell said, the incoming class is expected to be bigger than the college’s budget projected, and many students who left campus due to the pandemic have said they are coming back.

To help boost enrollment, Keene State extended its deadline for incoming students to make their deposit to June 1. Other colleges have made similar moves, Treadwell said, as trends show high school seniors are waiting longer to choose their college.

“Students are waiting longer to make their decisions, and then they’re depositing really late,” she said. “And we’re not going to turn a student away if we can possibly accommodate their enrollment, we’ll get them in. And I think that’s the same on almost every college campus.”

Ultimately, the school hopes to return to an enrollment of 3,200 students, Treadwell said. Keene State had just under 3,350 students in the 2019-20 year, compared to nearly 5,000 students in the fall of 2013.

Treadwell took over as president in July 2017 at a time when Keene State faced a multimillion-dollar budget deficit and made about $7.5 million in cuts heading into the fall of that year. At the same time, the college began planning for how to make the institution financially viable in the long term, which included a previous round of faculty and staff buyouts.

Moving forward, Treadwell said Keene State hopes the latest round of buyouts will help close the budget gap by 2023.

“So, to come out of this year’s hit with COVID, within a year and a half, is remarkable,” she said. “And it’s the support of our board [of trustees] to try to help us with this last step that will get us there, but I am confident we’re on path.”

Ultimately, Treadwell added, she is optimistic about the future of Keene State, despite the difficult decisions college leaders have had to make in response to the financial hardships wrought by the coronavirus pandemic.

“This decision to have another voluntary reduction is a painful one,” she said. “Colleges don’t like to do it. We’re being very careful about it, and it’s very generous, so I’m hopeful people will understand it in the context that it’s a necessary step. Because we haven’t done enough to get to that right [student-to-faculty] ratio yet, and we’re going to be done this summer so this campus can look entirely forward, and students should have full confidence that the college is doing well.”

Proposal would change ER hold rules for mental health patients

The Department of Health and Human Services proposed last-minute legislation Friday that would allow hospitals — in addition to the state — to detain mental health patients in their emergency rooms for up to three days to determine whether they could be treated without an involuntary admission to the state hospital.

Hospitals, which like other mental health advocates say they were not consulted, fear the proposal would perpetuate long emergency room waits and make them a party to the boarding crisis the state Supreme Court recently called unlawful.

“(It) essentially continues the practice of allowing patients suffering an acute psychiatric crisis to be held in hospital emergency departments while awaiting transfer to New Hampshire Hospital or other facility appropriate for their care,” said Steve Ahnen, president and CEO of New Hampshire Hospital Association.

The proposed legislation was pitched to the Senate as an amendment to the budget, which is being voted on Thursday. The Senate ruled out that option and is reportedly considering bringing it up for discussion by attaching it to an unrelated bill set aside for possible reconsideration. Two-thirds of the Senate and House would have to agree to suspend the rules to do so.

No one could be reached at the Senate this week to comment on next steps for the proposal.

Commissioner Lori Shibinette said the department’s proposed “medical protective custody” law will address long waits in emergency departments by diverting people who do not require involuntary hospitalization to lower-level, more appropriate care. People whose mental health issues are tangled up with substance misuse may need only rehab, she said. Individuals suffering from dementia may do well in a long-term facility or at home with assistance and not need an involuntary admission.

“I think everybody can agree that having an (involuntary emergency admission) alternative is a good thing,” she said.

Shibinette said during her time as CEO of New Hampshire Hospital, 40 percent of petitions seeking involuntary commitments were rescinded once health care providers had time to determine the person did not require involuntary hospitalization. According to 2020 court records, nearly 476 of the 1,965 involuntary emergency admission petitions filed that year did not lead to hospitalization because they were withdrawn, dismissed, or did not demonstrate probable cause for ongoing detainment.

The problem, Shibinette said, is that current law gives hospitals only one option — an involuntary emergency admission petition — to detain someone against their will for further evaluation. The proposed medical protective custody law would create a second option that does not automatically lead to involuntary hospitalization, she said.

“It’s a big deal to have an involuntary commitment to a psychiatric hospital, and that should be the last step in the process,” she said.

Although the drafted language on the department’s website does not describe the process in such detail, DHHS spokesman Jake Leon said the proposed legislation would allow a “qualified medical provider” to hold someone for up to three days for treatment if they are a danger to themselves or others. The person would have the right to request a records review and challenge their detainment within 24 hours, according to the proposal. DHHS would have to perform the review within 24 hours, excluding Sundays and holidays. The person could remain in custody only if the department determined it was justified under the law. Otherwise the person would have to be released within three days of their arrival at the emergency department.

A few things remain unclear. Under the involuntary emergency admission process, a judge, not the department, reviews the case and decides whether there is probable cause to continue detainment. And, the language does not address the possibility hospitals will be unable to quickly find community treatment options like mental health counseling, safe housing, an opening in a rehab facility, or a bed in a long-term care setting. Those resources, like psychiatric beds, are limited and not meeting the need. The state is in the process of expanding community treatment options but doesn’t expect to have them in place for at least a few months.

In the Supreme Court case, NAMI New Hampshire joined the hospitals and the ACLU of New Hampshire in calling for an end to detaining people against their will for days without a due process hearing. Executive Director Ken Norton said that while people shouldn’t be held without a chance to challenge their detainment, they should also not be released just to meet a deadline if they need treatment. “We don’t want to see people being released because of a failure to comply with (the court ruling),” he said.

Shibinette said the state has interest or commitments from hospitals to add 25 in-patient psychiatric treatment beds. The state recently announced it would offer hospitals $200,000 annually for each bed it offered, nearly double what it offered previously. Long-term care facilities have agreed to provide another 25 beds for psychiatric care, again after the state significantly increased its payments.

By the end of the year, Shibinette expects to have doubled the number of community treatment programs, increased the number of transitional beds in local communities, and started the mobile crisis response team, she said. The state is also talking with neighboring states about providing short-term children’s services.

There has already been a significant drop in the number of adults being held in emergency rooms for psychiatric treatment. Thanks primarily to newly available beds in long-term care facilities, as of Wednesday there were three adults in emergency rooms. Two weeks ago, there were 33. The number of children waiting for voluntary admissions, meaning they are not being detained against their will, has jumped in that time, from 25 to 36.

Shibinette said the drop in the adult waitlist puts the state in compliance with the Supreme Court order that prohibits the department from boarding people in emergency rooms for days without a due process hearing.

Shibinette said the state shares responsibility for providing mental health care, but is not solely responsible. “It’s everybody’s responsibility,” she said.

The department’s proposed law change concerns not only the hospitals but also mental health advocates like Norton.

“I didn’t know anything about it when I was alerted during the weekend,” he said. “And I still don’t know the thinking behind it.” Like Ahnen of the hospital association, Norton isn’t convinced this will get people treatment quickly or spare them long waits in emergency rooms.

“The reality is that most hospitals don’t have the capability to provide anything other than minimal treatment,” he said. “We are not supportive of this medical protection suggestion. However, we might be willing if it were short-term and there were some specific goal that had to be achieved. If it were going to prevent harm from coming to people, perhaps we could be supportive of it.”

The state’s 10 community mental health centers, which contract with the state to provide low-cost mental health services, are concerned with another piece of the proposed legislation. It would allow the state to bring in private companies to join nonprofits in providing community mental health services. Roland Lamy, of the N.H. Community Behavioral Health Association, is worried doing so will lead to unintended consequences.

“This would further fragment care in each of our regions and potentially exacerbate our workforce issue if an external private entity came to do only certain services and hired our staff,” Lamy said. “Today the (community mental health centers) do a broad array of services and often subsidize services they provide because of many unfunded mandates. If a private entity does not have to meet all the conditions of a community mental health center but would be allowed to pick and choose what services they have interest in, it may jeopardize the system of care and create other downstream impacts to this important safety net provider in each region.”

Shibinette said all mental health providers who contract with the state, including private providers, will be held to the same rules.

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NH COVID cases keep falling; vaccine supply exceeds demand

The rate of new COVID-19 cases has fallen substantially, New Hampshire’s top infectious-disease doctor said this past week.

“We’re making great progress in bringing the number of new infections down,” State Epidemiologist Dr. Benjamin Chan said at a news conference Thursday.

As of Friday, the seven-day average for new cases was 51, down 37 percent in the last week. Chan also pointed to other improving metrics, including the less than 2 percent of tests coming back positive and the number of new COVID-linked deaths, which are now averaging less than one per day.

“All of these numbers point to dramatic decreases in the level of COVID-19 in our communities,” Chan said.

Hospitalizations have also decreased, with 32 confirmed COVID patients in Granite State hospitals as of Friday, down from 53 a week earlier.

New Hampshire exceeded 800 cases and 10 deaths per day at times during the winter surge, before both started falling sharply in January. Cases rebounded somewhat during March and April, hitting a daily average of more than 400, but have now been dropping steadily for more than six weeks.

Deaths have been fluctuating since early March, typically averaging between one and two reported per day, but did not see a large spike this spring as cases did. Many of the state’s more vulnerable residents had been vaccinated by then.

New Hampshire announced four new deaths over the past week, none residents of Cheshire County.

Vaccine supply outstrips demand

To keep cases down, Chan urged Granite Staters to get vaccinated, stressing that it protects them as well as others in the community.

Dr. Elizabeth Daly, chief of the N.H. Bureau of Infectious Disease Control, said the state receives about 50,000 first doses per week.

“At this point, our supply is exceeding demand and there’s plenty of vaccine available,” she said.

About 60 percent of New Hampshire’s population — including 68 percent of those eligible for the vaccine — have had at least one shot, according to state and federal data. About 50 percent are considered fully vaccinated.

The number of new people getting vaccinated each day has fallen significantly since April, when an average of more than 8,000 people per day received first doses, according to state data, to about 1,300 per day for the week ending Wednesday. (There was a small spike in May after children ages 12 to 15 became eligible.)

Vaccines are now available at more than 300 locations, including hospitals, pharmacies and clinics run by local public-health agencies, Daly said.

The state has also vaccinated more than 4,700 people through its program for homebound individuals, Daly said. Due to high demand, the program will continue to administer first doses throughout June. She encouraged anyone who qualifies to call 211 to set up an appointment.

In Keene, the Greater Monadnock Region Public Health Network is now offering vaccines at 62 Maple Ave. The network is also organizing several pop-up vaccine clinics in the coming days (see sidebar).

Other state, local data

As of Friday, the state had 402 known active cases of COVID-19, 22 of them in Cheshire County. Keene had eight. Other towns in The Sentinel’s coverage area with known active cases were Acworth, Antrim, Chesterfield, Dublin, Fitzwilliam, Hinsdale, Jaffrey, Rindge, Surry, Swanzey and Winchester, each with one to four.

More than 98,000 Granite Staters have tested positive for COVID-19 since the pandemic began, and 1,341 deaths related to the disease have been confirmed.