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EDITORIAL: Regulatory fallout: Steps are needed to get mental health and substance abuse caregivers online

Keene Sentinel - 2/12/2019

Feb. 12--It's common, and easy, to draw a line between substance abuse and mental health issues. The two often seem to overlap, and experience and studies have shown the interplay may work in either direction: Those suffering from mental illness seem often to fall prey to substance abuse, while misusing substances can result in lingering mental health issues.

The state's new 10-year plan for battling mental health issues relies heavily, in fact, on a centerpiece effort to combat substance abuse: a $48.5 million "hub and spoke" system to screen, assess and refer people struggling with substance misuse to treatment and support services.

Those services are, largely, mental health evaluators and counselors. It seems as likely an approach to fighting the opioid epidemic as any: Getting users into treatment and, eventually, a full recovery is seen by many as the best way to stem, and hopefully, reverse, the tide of addiction and opioid-related deaths in the state.

One hitch was highlighted in a news report last month from the Valley News of Lebanon. The story, which ran in The Sentinel Jan. 23, noted that with mental health professionals in higher demand than ever, regulatory glitches are holding up licensing for some. Just as Cheshire Medical Center is Keene's "hub," Dartmouth-Hitchcock Medical Center in Lebanon serves that purpose in the Upper Valley; and providers there say they're hindered by a shortage of licensed counselors and clinicians who would ideally provide the "spokes."

That's leading them to have to refer prospective clients elsewhere, delaying timely assessment and treatment.

The dynamic isn't new. The same issue was in play for several years as Granite State hospitals and other health providers struggled to fill nursing vacancies. Qualified nurses in neighboring states were willing to relocate or work here temporarily, but the state wouldn't allow it until they obtained New Hampshire licensing, and that itself was too often bogged down in bureaucratic red tape.

Eventually lawmakers passed a bill -- put forth by Keene Sen. Jay Kahn -- to let nurses with proper licensing elsewhere work provisionally in New Hampshire until their in-state licensing is dealt with. It hasn't solved all our nursing-shortage issues, but it's certainly helped.

That ought to provide a clear solution for mental health and substance abuse counselors as well. Toward that end, Kahn has proposed legislation to do just that, offering interim licensing if an application isn't acted upon within 60 days.

That's good news, and lawmakers ought to quickly pass it.

We'd further note Gov. Chris Sununu, whom we expect would sign it into law, ran on a platform of easing regulatory hurdles for businesses and consumers. He made a big splash early in his tenure by calling for a review of all regulations in every state department, and signing an executive order to eliminate up to 1,600 of them. He signed the order in Winchester, where regulatory overreach had threatened to put a local hair stylist out of business because a mock barber pole was painted on the outside of her building.

A lot of those regulations were either due to laws that had since been rewritten or expired, or were holdovers from days long since gone by. The bulk weren't actually in force anymore. But the gesture was, nonetheless, a pointed blow for trimming back bureaucracy and finding a better balance between protecting consumers and everyday citizens against malfeasance and fraud, and disrupting commerce and needed services in the name of caution.

The state can't -- and shouldn't -- lessen its standards for licensure of those in health care. But it ought to take a long, close look at whatever procedures are standing in the way of qualified caregivers actually performing their jobs.


(c)2019 The Keene Sentinel (Keene, N.H.)

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