A Cheshire County program that provides 24/7 assistance and counseling to people with substance use disorders could be forced to shut down, unless New Hampshire’s Department of Health and Human Services acts quickly to establish a new funding strategy for it and similar programs across the state.
Southwestern Community Services, which runs the Coordinated Access Point Program, has not yet been told whether it will receive funding critical to the program’s continued operation, according to CEO John Manning.
CAPP offers a local hotline, which connects people struggling with addiction to a counselor who will provide a free evaluation as well as recommendations for and referrals to treatment.
CAPP also runs another program, the Cheshire County Addiction Assistance Recovery Initiative (ChAARI). That program deploys volunteer coaches, over the phone or in person at Cheshire Medical Center, to assist people after a drug overdose or while they’re experiencing severe withdrawal symptoms.
The ChAARI program draws on the cooperation of county police, fire departments and emergency room staff and has helped more than 200 people receive treatment for substance use disorders, according to statistics provided by the Keene Fire Department.
The Department of Health and Human Services has funded CAPP since 2016; that year, Southwestern Community Services received an 18-month grant for approximately $175,000 to run the program from May 2016 until the end of 2017, according to Manning.
Southwestern Community Services was expecting the state to eventually renew the grant, Manning said.
But in the spring, the agency learned it would no longer receive direct funding from the state to run CAPP, he said.
In May, the state health department posted a request for proposals that suggested the department was looking to streamline the way it funds New Hampshire’s regional access services — programs that, like CAPP, help connect people struggling with addiction to counselors and/or treatment options.
The state’s request for proposals sought bids from organizations to run a single, statewide regional access services program, eliminating the need to fund individual programs like CAPP, according to Manning.
Southwestern Community Services did not bid on the proposal, in large part because most of the agency’s staff isn’t focused on providing substance use disorder services, Manning said.
And while the streamlined system could have resulted in another organization taking over CAPP’s duties, Manning said it also could have had little to no effect on the program; the selected bidder, he said, could have simply given Southwestern money to continue to run it.
According to Manning, there were two bidders: Harbor Homes, a Nashua-based social services agency, and Granite Pathways, a Concord-based organization that already provides state-funded regional access services in 11 regions across the state.
Southwestern Community Services had expected the state health department to award a contract to one of those organizations over the summer, but that never happened, Manning said. In fact, the request for proposals was canceled in September, according to health department records available online.
Manning said he hasn’t received communication or clarity from the state on its funding plans, leaving CAPP’s and ChAARI’s economic viability uncertain.
“It’s mind-boggling, it’s frighteningly mind-boggling,” Manning said. “I can only assume that sometime between January 1 and the end of March, the regional access points throughout the state are going to shut down unless the state decides to fund it going forward somehow or other through an RFP.”
Few details available
In an emailed statement, N.H. Department of Health and Human Services spokesman Jake Leon said the department canceled its request for proposals in September, as it evaluates funding available for substance use disorder services.
“The Department understands local providers’ concerns about funding for SUD (substance use disorder) services. Although Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery funding was increased in this biennium, overall available funding for SUD services is less than in the previous budget,” Leon wrote. “As such, the Department is taking the opportunity to thoughtfully review available resources to ensure we are addressing the highest needs.”
Leon did not respond to a follow-up email requesting specificity about the decreased funding for substance use disorder services and comment on whether the health department is considering any other methods or requests for proposals to fund regional access services programs.
But in his first statement, Leon noted that state law is “strict around confidentiality” of the procurement process.
A spokesman for Gov. Chris Sununu did not respond to a request for comment Monday on the funding uncertainty.
Aside from Granite Pathways and Southwestern Community Services, two other organizations, Keystone Hall in Nashua and Serenity Place in Manchester, provide regional access services. Keystone Hall runs a 24/7 statewide addiction crisis line that is used to link other organizations, including Granite Pathways, with local callers, according to Granite Pathways Executive Director Doreen Shockley.
With the help of then-N.H. Sen. Molly Kelly, D-Harrisville, Southwestern Community Services secured funding for CAPP in 2015; the program launched the following May.
CAPP was pitched to the state health department as a “pilot” initiative — one that could be expanded and carried out by other social services agencies across the state — and was the first regional access services program in New Hampshire, Manning said.
The pitch for CAPP came amid an opioid crisis that continues to ravage the state with overdose deaths.
This year alone, at least 201 people have died in New Hampshire from opioid overdoses, with another 101 potential drug deaths pending toxicology testing, according to the latest data available from the Office of the Chief Medical Examiner. The office estimates there will be 460 drug deaths statewide this year, just under 2016’s record-breaking toll of 485. The clear majority of last year’s fatal overdoses and this year’s confirmed drug deaths were caused by opioids.
As of Oct. 3, Keene had tallied four confirmed opioid deaths since Jan. 1, according to Fire Chief Mark F. Howard.
In that same release of monthly data, Howard wrote that, between May 1, 2016, and Sept. 30, 2017, the ChAARI program assisted 497 clients with substance use disorders. Of those clients, 235 had received some form of treatment and two were on waiting lists for treatment, according to Howard. Manning said program clients are not required to enter treatment programs.
ChAARI and CAPP have been critical in encouraging people with substance use disorders to try treatment, who perhaps wouldn’t have done so without the programs, according to Manning.
“If you hear you need to get treatment from the people who are in your community and from your community, I think it has a bigger impact,” he said.
The state health department recently extended CAPP’s contract period until March 31, according to Manning; the program can operate until then with the funding it has already received from the state.
But beyond that date, Manning said the future of CAPP and ChAARI is unknown.
“We have no official idea as of today, as of now, what their plan is,” he said, of the state health department.
“We don’t know if someone is going to step in and continue this program in any way shape or form.”