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New Hampshire Hospital credits Mission 0 and care-traffic control for shorter ED waits but reports a large discharge backlog
Summary
Hospital leadership told Division III that Mission 0 and an in-house care-traffic control center have reduced emergency-department boarding and improved bed flow, but roughly 90–100 residents remain at the hospital who could be discharged if more community placements and supported housing were available.
Ellen Lapointe, CEO of New Hampshire Hospital, and Brett Mason, the hospital’s CFO, briefed House Finance Division III on March 14 about operations, staffing, and the hospital’s role in Mission 0 — a statewide initiative to reduce emergency-department and hospital boarding of people with behavioral-health needs.
Lapointe said New Hampshire Hospital is a 185-bed facility that focuses on acutely ill adults and that the hospital coordinates referrals from emergency departments, corrections and other designated receiving facilities. She highlighted the hospital’s Care Traffic Control (CTC) unit, which coordinates statewide bed referrals. Lapointe said CTC has helped reduce average emergency-department wait times by 43 percent and, in recent months, has reduced the average wait to under two days; the statewide number of adults waiting in emergency departments has dropped from the 30s to low single digits at times.
Despite these improvements, Lapointe said the hospital currently has a sizable internal population — roughly 90 to 100 people who would be eligible for discharge but who cannot be safely placed in community settings because the requisite supported housing, group homes or other placements are not available. She said average length of stay is skewed by this population; while many admissions have 15–30 day stays, the average across the hospital is higher because some individuals remain for months and a few have been in place for a year or more.
Lapointe also described ongoing projects including a new high-security unit (construction delayed by additional foundation testing), and said the hospital is preparing operational staffing plans for occupancy in the next biennium. On staffing, the hospital reported a full-time vacancy rate around 17 percent; nursing and mental-health-worker vacancies are in the low 20s. The hospital said it maintains active recruitment programs and that referral hires accounted for about 64 percent of new staff in recent months; the hospital’s retention rate exceeded national averages according to testimony.
Members asked where the hospital’s discharge bottleneck could be relieved. Lapointe cited need for more community-based options such as group homes, supported housing, landlord incentives and other Mission 0 components. Committee members asked about the hospital’s per‑diem cost (Lapointe said $1,599 per day) and noted that many of the discharge-eligible patients could be placed in less expensive community settings if they were available, delivering both savings and better alignment of care to patient needs.
Ending: Lapointe and the department were asked to return to committee with additional, more granular data on the discharge-eligible population, a clearer breakdown of required housing/service types, and the fiscal impact of moving patients from hospital care to those community-based settings.
