Executive Council denies contract for rehabilitative program for health care workers
Many in the state’s medical community expressed concern about the winning bidder from out of state
New Hampshire Office of Professional Licensure and Certification Executive Director Lindsey Courtney (standing, center) and Attorney General John Formella (standing, right) brief Gov. Chris Sununu and members of the Executive Council on Wednesday. (Ethan DeWitt | New Hampshire Bulletin)
In a 4-1 vote, the Executive Council on Wednesday denied a contract for a rehabilitative program for health care workers following an outcry from the medical community in New Hampshire and beyond.
But the current contract, held by New Hampshire Professionals Health Program, is expiring, which left the council scrambling to find a solution and prevent a gap in potentially life-saving services for health care providers.
According to Councilor Cinde Warmington, a Concord Democrat, that interruption in services would have happened whether the council approved the contract on the table Wednesday or not.
“There is an interruption of services today even if we voted on this,” she said.
New Hampshire law requires the Board of Nursing to contract with an organization that runs a program for health care providers who are struggling with substance abuse and mental health. The program provider is charged with developing, administering, and monitoring a treatment plan.
But many in the medical community spoke in opposition when the Office of Professional Licensure and Certification awarded the contract to Parkdale Aftercare, a contractor based in Indiana that underbid the current in-state contractor, New Hampshire Professionals Health Program. The Executive Council still gets the final say on the contract, however.
“Now is not the time to transition to an out-of-state entity, which quite frankly lacks the ability to implement and fulfill the terms of this contract,” said Councilor Janet Stevens, a Rye Republican, before Wednesday’s vote.
Three other councilors agreed.
The council had voted down a similar contract with Parkdale last year in a 5-0 vote, which led to confusion among councilors about why the state office brought forward the contract again this year.
The Office of Professional Licensure and Certification sent a letter to the current contractor on June 29 informing the New Hampshire Professionals Health Program that it failed to comply with the contract by lobbying to keep it.
“The OPLC has learned that NHPHP sent an email to NHPHP participants asking those participants to contact New Hampshire’s executive councilors and lobby on behalf of NHPHP’s efforts to renew its contract with the OPLC,” says the letter, signed by Lindsey Courtney, executive director of the Office of Professional Licensure and Certification.
Deanne Chapman, the director of operations for the New Hampshire Professional Health Program, had sent a letter to program participants asking them to reach out to the Executive Council opposing the Parkdale contract. Courtney said this violated the confidentiality clause of the contract, but Warmington said that was a matter of opinion. Chapman could not be reached for comment.
Instead of granting the contract to Parkdale, the council gave New Hampshire Professionals Health Program the option to keep running the program “at risk,” which means it runs the risk of not getting repaid if a future contract isn’t approved.
The council plans to reimburse the program with a retroactive contract down the line. Stevens said she expects the item to get back on the council’s agenda in July.
According to Gov. Chris Sununu, it would take about 6 weeks before a new contract could be approved and go into effect. Sununu was skeptical about pursuing the “at risk” option, since it would put the state in an unfavorable negotiating position with the vendor.
Councilor David Wheeler, a Milford Republican, was the sole vote in favor of granting the contract to Parkdale.
Problems with Parkdale
Opponents of the Parkdale contract pointed to decades of trust the in-state program has built. They criticized a potential conflict of interest if the contract with Parkdale was approved, since Parkdale is also a treatment center and would potentially handle referrals, treatment, and monitoring.
“It’s really troublesome for a number of reasons,” Warmington said in an interview.
“This can really derail people,” she said. “A lot of their safety net is in this program.”
She said that pulling that safety net from underneath them would be detrimental. The program is both a public health measure and a way of providing potentially life-saving services to health care workers.
Warmington and other councilors were inundated with concerned calls from the medical community leading up to the vote. Members of the board of medicine, chief medical officers, the nurses association, and the Federation of State Physician Health Programs all opposed the Parkdale contract.
“They’re very upset,” said Warmington.
“The hospital and board need to have confidence in the program that they’re using,” she said.
Because the program determines when health professionals are ready to go back to work, that trust is crucial.
“When hospitals and colleagues are concerned that a health professional may be impaired, they make a referral to NHPHP knowing they can trust them to get it right,” Chris Bundy wrote in an email to the councilors. Bundy is a doctor and president of the Federation of State Physician Health Programs.
“When NHPHP endorses a rehabilitated health professional back to practice under monitoring, they know that the health professional is safe,” he said.
Bundy pointed to New Hampshire Professionals Health Program’s 30-year track record. Parkdale, in contrast, lacks this proven record of accountability and trust, he said.
Conflict of interest?
Concerns were also raised about a potential conflict of interest since Parkdale is a treatment provider, meaning it could refer patients to its own treatment center.
Of the two bids the Office of Professional Licensure and Certification received, the Parkdale contract was the cheapest. Parkdale bid $2.125 million for a 5-year contract. New Hampshire Professionals Health Program put in a bid for $4 million.
“They’re the low bidder, but this also could be a feeder program for them,” Warmington said. During Wednesday’s council meeting, Warmington said the conflict should disqualify Parkdale from bidding.
Others in the medical community share the concern.
“Parkdale provides evaluation and treatment for health professionals. This is a direct conflict of interest,” Bundy wrote in an email to the councilors.
Bundy said nothing in the contract would prevent Parkdale from requiring New Hampshire professionals to use their evaluation and treatment services.
“It is entirely possible that they have underbid the contract precisely because they intend to use the New Hampshire program as a referral stream for their treatment center,” he wrote. And he encouraged elected officials to consider the value of dollars they spend on the program.
New Hampshire Professionals Health Program, he said, “delivers Lexus service at Toyota cost.”
“With a health care workforce reeling in the aftermath of the COVID-19 pandemic, this is not the time to interrupt its safety net,” he said. “The people of New Hampshire and its health care workforce deserve the outstanding program that is already in place.”
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