Manchester officials to state DHHS: ‘Fix The Doorway’

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Mayor Joyce Craig flanked by, from left, Public Health Director Anna Thomas, Police Chief Carlo Capano and Fire Chief Dan Goonan. Photo/Pat Grossmith

MANCHESTER, NH – The state needs to fix its Doorway program, the statewide opiate treatment system so that Manchester doesn’t continue to be overwhelmed by people seeking help, city officials said at a news conference Friday.

“It’s time we have to start pushing back,” said Manchester Fire Chief Daniel Goonan, a self-described “tried and true” Republican.  “Enough playing nice. I am so done with politics. I am absolutely sick and tired of politics. This isn’t a competition. Give us some help here. We went up to ask the governor for some help. Now it’s a political thing. It’s ridiculous. It’s absolutely ridiculous.”

City officials set the record straight about how much funding the city has received from the state in the opioid battle, confirmed the city has three response plans to the opioid crisis and made it clear the city is taking the brunt of the state-wide drug epidemic because the Doorway system, implemented by the state, isn’t providing needed services across the state.

The news conference was in response to a press release issued by Gov. Chris Sununu after he met Thursday with New Hampshire Department of Health and Human Services Commissioner Jeffrey Meyers, Mayor Joyce Craig, Manchester Public Health Director Anna Thomson and two senior city health officials concerning the issues.  The Manchester delegation was unaware the Governor was going to be attending the meeting.

“The Governor and I had a constructive and positive meeting with the team in Manchester yesterday, and we look forward to implementing this newly established city-state coordinating team,” said Jeffrey Meyers, commissioner of the New Hampshire Department of Health and Human Services in a prepared statement issued Friday. “Tackling the opioid crisis requires cooperation between the City and the State, and we welcome Manchester City officials to join us in getting this done.”

Sununu’s news release Thursday said,  in part, “Upon learning from Mayor Craig that the City of Manchester does not currently have an opioid response plan, Governor Chris Sununu recommended forming a new coordinating team that will be composed of state and city officials to ensure cooperation between the City of Manchester and the State of New Hampshire on a variety of issues. This new team will be able to assist Manchester in formulating city-wide response plans and identify deployed financial resources to ensure there are no gaps in the system.”

Craig said the Governor is wrong, that she never said the city didn’t have a plan.  Craig said the city has three plans in place –  the Mayor’s Addiction Response Plan, and a plan initiated by former city health director Tim Soucy, and a plan that Thomas is now working on, subsidized through county funding.

“It’s not a plan on a shelf, its a plan we can work on and implement. Part of that plan involves something called CAST – Calculating Adequate Systems Tools, which looks at whether a community has adequate systems in place for treatment and recovery,” Craig said. “Manchester was the first U.S. city to complete the tool. In fact, it’s a deliverable of the substance use disorder continuum of care plan so the governor should know about that plan.”

Craig also said the governor’s press release makes it sound like he proposed a partnership plan with the city when it was the opposite.

The Governor also said the city received a total of $7.7 million.  Craig said $5 million of that was split with Nashua to start two Doorway programs in the cities.  Manchester never received the other $2.7 million.  The total amount the Manchester catchment area received was $2.5 million, according to the mayor.

“This is life and death,” said Craig during the news conference at the Manchester Fire Department’s central headquarters where the lauded Safe Station program to help those suffering from addictions originated.  Safe Station is being copied across the country, Goonan said, but not in New Hampshire where the program all began.

City officials cited The Doorway program, implemented in January by the Gov. Chris Sununu administration, as the reason Manchester is being inundated by people with mental illness, severe drug addictions and the homeless.

The mayor explained the idea behind Doorway was that those needing help would be within an hour’s drive of receiving treatment and close to their community.

Fire Chief Dan Goonan: “It’s time we start pushing back.” Photo/Pat Grossmith

Goonan said when the opiate crisis began, Manchester stepped up and began Safe Station where anyone seeking treatment could go and get connected to services.  The fire stations are open 24/7.  When the Doorway program began, Goonan said the city pushed back because Doorway operated on a 9 a.m. to 5 p.m. schedule.  In Manchester, Goonan said most of the people needing help arrive at Safe Station between 5 p.m. and 11 p.m.

Firefighters, in talking with people seeking treatment, have learned that the other hubs are telling people if they want help to go to Manchester.  Sometimes they arrive via Lyft or Uber, or by taxi after stepping off a plane at the Boston-Manchester Regional Airport. 

A Laconia grandmother arrived one day with her grandson after taking him to a Lake City hospital where he was given Narcan.   She asked what he was supposed to do if he was alone and overdosed.  She was encouraged to take her grandson to Manchester for help, which she did.

The result is people are coming to Manchester in droves for treatment and are staying here even if they relapse.  Now, the city’s homeless shelter is being overrun and earlier this week, it had to lock the doors because it was over capacity at 163, more than the 150 people that sheltered there during last winter.  That is unprecedented in summer, officials said.

Yet, there were 24 empty beds inside the shelter, beds for individuals not wanting to stay in the “wet” shelter.  They couldn’t be used, the mayor explained because New Horizons hadn’t received funding from the state to cover the staff’s wages because Sununu has vetoed the budget.

With the influx of people seeking treatment in the city, emergency calls to the shelter have also skyrocketed.  In 2015, an American Medical Response ambulance went to the shelter for opioid overdose calls three times. 

That number remained about the same through 2017.  Last year, AMR went to the shelter 5 times for overdose calls.  So far this year, they responded to 28 overdose calls at the shelter, more than five times for all of last year. 

For all medical calls to the 199 Manchester St. shelter in 2018, AMR responded 177 times and did 163 transports.  So far this year, AMR has gone to the shelter 374 times and did 328 transports, more than twice as many calls with four months left in the year.

The mayor said in 2018, Safe Station served 395 people from outside the Manchester hub including people from out-of-state.  This year so far, they’ve seen 585 people from outside the area, a 48 percent jump.

Manchester Police Chief Carlo Capano and Thomas both said they haven’t seen anything like it in the 25 years they’ve been working for the city.

Compounding the problem, according to Capano, is bail reform.  Police make arrests and before they can complete the paperwork, the individual is out on bail.  He said he arrested one man who had been arrested 13 times before for the same offense but was out on bail.  

He said those they arrest are skipping out on court hearings and not paying fines imposed. 

Craig said city officials have talked with state senators about what is happening to see if new legislation can be proposed.

Capano said people are also under the impression that police can make arrests of those hanging around public parks.   He said he will not allow his officers to violate the civil rights of those individuals.

“We need help here,” Goonan said.  “I told the President of the United States when he was here that we needed help.  This is the perfect storm.”