Often, I start my weekly column with a recollection of a long ago connection to the place or issue I am writing about. That is true again this week.
Crotched Mountain Rehabilitation Center opened in 1951. In the year or so prior, there was a local fund-raising campaign to support the generosity and vision of Harry Gregg who was the force behind building of the center. While one would think there would be unanimity of support, I recall conversations in my own home about how impractical it was to build a hospital on the top of a mountain. How would an ambulance get up the mountain during a blizzard? That was a question I remember being raised.
The concept of the rehabilitation center on Crotched Mountain in Greenfield was not easy for some to understand. In fact, the idea of a rehabilitation center was very new. It was a response by Harry Gregg and others to the need for helping disabled veterans who had returned home from World War II as well as victims of the onslaught of polio.
The funds were raised, the center built and for more than 60 years Crotched Mountain’s mission has evolved and grown to meet the rehabilitation and education needs of thousands of clients. Today, the center works with clients with brain injuries, and others with physical disabilities, as well as major mental and behavioral challenges.
Don Shumway, the center’s president, took me on a three hour tour of the facility last week. The reason I wanted to learn more about the center is twofold: first, more than a third of the 800 employees live in the 8th senatorial district; second, more than 70 percent of Crotched Mountain’s annual budget comes from Medicaid, the state-federal partnership that pays for care when insurance and personal funds are exhausted. There are many significant public policy issues involved with funding institutions like Crotched Mountain that legislators need to understand.
There is too little space to take readers on the tour I had last week. But, here are a couple thoughts.
The school has 92 places and serves 30 New Hampshire school districts for placement of physically and behaviorally difficult students. It takes more than a one-to-one staff to child ratio to provide a safe environment and to be able to help children progress with their learning.
To an observer, the physical challenges of some students are very, very clear. The complexity and severity of the emotional and behavioral issues also become apparent quickly. It takes especially patient, compassionate and skilled teachers to work with these students.
On the hospital side, there are 62 beds. I saw volunteers and staff working with men and women who are wheelchair bound due to traumatic accidents. The profile of a client might be a young man injured in an automobile accident, likely in a coma for a time, and treated at one of our major medical centers, like Dartmouth Hitchcock Medical Center, for several weeks. Then he is transferred to Crotched Mountain for possibly six months.
The goal is to rebuild the capacity of the person to be ready to return to the community. The accident has been life changing; now the goal is to be able to live in a group or family setting after leaving Crotched Mountain. A class using clay was helping clients regain the use of their fingers and hands to manipulate the clay. Again, the skills and compassionate way of the staff, and volunteers, is remarkable.
To support the special physical needs of the hospital, there is a workshop where wheelchairs and other equipment are adjusted for unique needs of the clients. One has to be reminded that the needs of each person at Crotched Mountain are different and thus the equipment needs are different, too.
Some wheelchairs cost thousands of dollars. The center recycles chairs and in other cases has to reengineer or reupholster a chair to match the weight of different parts of the body to avoid pressure sores. To the visitor, of course, seeing the engineering shop helps to underline the complexity of the care provided.
The last area I visited was the wing for people who require a ventilator to breath. As I walked in, there was a woman who lives in my neighborhood. We chatted for a few minutes about who we knew, that she knew which house I lived in and about how she was doing. She is doing fine given the circumstances and is thankful that she is getting her strength and abilities back at a place like Crotched Mountain instead of a hospital.
Crotched Mountain fulfills its mission with a dedicated staff meeting the needs of children and adults with severe and complicated physical, emotional and behavioral issues. We are all thankful for that.
There are other benefits, too. One-third of the workforce at Crotched Mountain is funded by out-of-state dollars as the center takes in patients from other states. It is also less costly for government to have clients, such as those in the ventilator wing, treated at Crotched Mountain than at a large medical center. The savings can be as much as 70 percent. And some school districts have a way, at Crotched Mountain, to meet the required educational needs of some students that would not be possible in their schools.