Shawn LaFrance

Shawn LaFrance at The Doorway, Cheshire Medical Center’s hub for addiction treatment services, on Marlboro Road (Route 101) in Keene.

Cheshire Medical Center’s new hub for addiction services — The Doorway — has been open for two days.

And though the county and state are grappling with a substance-misuse epidemic that killed 488 people in New Hampshire in 2017, no one called the referral center Thursday morning. Statistics for 2018 aren’t yet finalized, but state officials most recently forecast 437 drug-related deaths for the year.

The new center at 640 Marlboro Road (Route 101) in Keene resembles a nondescript doctor’s office, complete with a waiting room overlooked by a receptionist’s area. A long hallway leads to offices. When clients come, they will meet with addiction specialists, who will help them with anything from finding stable housing to getting into a treatment program that suits their needs.

No would-be clients called the center Wednesday either, according to Shawn LaFrance, who is overseeing the hub’s rollout.

But the service is still new, LaFrance noted, and getting the word out will take time.

The new Keene center is a rung in a sweeping statewide effort to create a “hub and spoke” system to screen, assess and refer people struggling with substance misuse to treatment and support services in the community. The hubs will be staffed by professionals — addiction counselors and others — whose goal will be not only to link people to resources, but to follow up with them as they advance through recovery services provided by the spokes — rehab centers, sober homes, peer support agencies and other organizations.

LaFrance, who is vice president of population health and health system integration at the hospital, said the new model will not disrupt existing paths to recovery; instead, it will create a network with more obvious connections, so people in recovery can move seamlessly through support services.

“From a client or patient perspective, it means that patients can still go knock on the door at Phoenix House in Keene or they could go to Groups (a Keene-based support agency for people with substance use disorders) downtown,” LaFrance said.

But if people seeking recovery don’t know where to begin, he explained, they can call the statewide 211 hotline or walk to the hub, where staff will connect them to resources — ideally in less than two days.

For now, it is unclear how many people will use the service, LaFrance said. According to data LaFrance got from the N.H. Department of Health and Human Services, the state hotline received 74 calls from people in the Monadnock Region seeking services from January to November 2018.

The $48.5 million effort, funded by a two-year federal grant from the Substance Abuse and Mental Health Services Administration, also set up eight other hubs across the state. Upon announcing the initiative in October, Gov. Chris Sununu said he expected the hubs to open this month. The program was modeled after a Vermont initiative that began in 2014 and was designed to increase access to support drugs that aid in recovery from opioid addiction.

The contracts between the state and the eight hub providers were finalized in November, leaving Cheshire Medical Center and the other hub providers just about eight weeks to set the plan into motion.

According to Cheshire Medical’s contract with the state, the Dartmouth-Hitchcock affiliate expects to staff the Keene hub with eight people, including a director, who will work as a clinician; three additional clinicians — social workers, psychologists or counselors; two recovery support workers; a data analyst and an administrative assistant.

Also hosting hubs are Berlin, Concord, Dover, Hanover, Laconia, Littleton, Manchester and Nashua.

LaFrance said the Keene-based team envisioned an easily accessible location near downtown, but opted to rent the Marlboro Road site in the short term because the spot they wanted — Cheshire Medical’s audiology clinic, at 117 Railroad St., is not yet available.

The audiology clinic will move in April, at which point the hub will relocate to that space, he added.

The other part of the state’s plan is strengthening the community organizations that will serve as the spokes, N.H. Department of Health and Human Services spokesman Jake Leon said in October. Since then, the state has sought requests for proposals for programs and services that would bolster recovery housing, peer support and health-care workforce development.

Cheshire Medical Center, for its part, is also seeking to increase its capacity for treating people with substance use disorders in the coming year, according to LaFrance. He said the organization already has eight providers who can prescribe support medications, such as buprenorphine, to people who misuse opioids, though these providers are working with a limited number of patients. LaFrance said Cheshire Medical aims to expand this capacity and integrate prescribing support medications into the primary care setting.

For now, the next step is to finalize the hiring of staff for the hub; Cheshire Medical is in the final states of the hiring process for some of the positions, LaFrance said. And to get the word out about the new center, the Keene hospital will hold a public information session on Monday, Jan. 14, from 9:30 to 11 a.m. in the auditorium at 580 Court St.

But on Thursday afternoon, LaFrance was still waiting for  callers.

“This whole thing is still a work in progress,” he said.

The Doorway at Cheshire Medical Center is at 640 Marlboro Road in Keene (the Curran Building on Route 101) and is open Monday through Friday from 8 a.m. to 5 p.m. Support through the state’s 24/7 hotline is available at 211.

Liora Engel-Smith can be reached at 352-1234, extension 1439, or

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