You're too kind, seriously I'm humbled 🫡

Why hello haha, I hope I can be of some assistance here! So a few thoughts:

1. Your suspicion on a convergence to higher QPF (liquid precip equivalent) has certainly occurred over the past 36 hours for portions of NH. This has been focused in three areas: SE exposures of the Whites, eastern NH near the inverted trough axis, & ESE exposures along the Mondanock Region
2. Big reason for the uptick in precip is from convective bursts set to form along the inverted trough axis forming in the Gulf of Maine and extending into ME. My thesis focused on similar events and found mesoscale models are far better resolving this (obviously) than the GFS or ECMWF.
3. I'm not surprised a number of TV stations are lazily ripping whatever the ECMWF forecasts without really trying, this is a major gripe I've had lately.
4. Snow ratios are going to vary with the event by location, so using the 10:1 static ratio will get you into trouble here away from the Seacoast & lower Merrimack Valley. Lift through the dendritic growth zone isn't wildly impressive but I can absolutely see snow ratios average to 12-15:1 across interior NH, especially northern Strafford, all of Carroll, and the Whites.
5. We've been all over this at the company I work for, here's the gridded forecast we were giving clients this afternoon. This is a dynamic ratio forecast using a superensemble approach with an emphasis on the mesoscale model data. I'm convinced locations in/north of Effingham get pasted and someone comes close to 12" there. We starkly contradicted the NWS in a number of areas and feel confident we will be successful in doing so: https://imgur.com/gallery/cP6GD3r

I think your misunderstanding something though. “Once medically cleared” means just that. They are no longer being held. When they are on a 72 hour hold when they are “cleared” that means they are allowed to go. Not be held to transfer somewhere else. If they are being held it is because they were not cleared and will be going to a bed when available. If your talking medically cleared while awaiting a bed, as in a medical issue being treated while also awaiting a psych bed, then yes they can be held until one is available. I think your confusing the two.

The closure of Rockingham Park opened up a vast swath of land in the center of town to new development.

One. We have one. The rest we shit down years ago which is what led to this issue

He's toned down his rhetoric considerably since then. I believe he'll sign it, but gripe about it while doing so, or perhaps let it become law without his signature.

Well darn. Correct me if I'm wrong, but it sounds like there isn't enough money to take care of everyone who is seeking emergency mental help so the current policy is to hold them if they seem like a danger to themselves or others at the ER until there are resources available at a hospital. Essentially, there aren't currently enough resources to handle everyone who needs help, no one wants to take responsibility for the unprofitable endeavor and the ERs have been forced to do what little they can. Now, whoever is behind these lawsuits wants to clear them out of ERs entirely.

Edit: I'll be keeping an eye on this and hopefully see where it goes in a month.

That how mill owners got to be so rich. Labor was almost free.

Just curious as to your background/qualifications on this matter? For what it's worth the state has been trying various things, most recently they've started holding hearings on the EDs which has definitely helped a good bit. There are many brilliant minds in the NH hospital system and the community mental health centers, and this should give them more resources/access to solutions from hospital administrators(VPs CEOs etc) and politicians.

They've done this before, the feds have. I can assure you: there will be no plan and the state will be found out of compliance. I can't say this loud enough: THERE IS NO QUICK OUTPATIENT CARE. Might as well wait for the easter bunny to bring them all candy baskets. Psych is already involved and has been since they started doing this about 12-15 years ago. They're all local community mental health centers, non-profit organizations that haven't been able to keep up with demand for years now. They already have outreach teams that go to the hospital and try to develop a safe discharge solution. They already have staffed crisis apartments for people who aren't safe in their homes. That's the problem: it isn't enough. The local psych providers literally can't handle the numbers and haven't been able to for a very long time. This ruling is basically the equivalent of asking someone with 15 maxed-out credit cards to get another credit card so they can pay off their existing credit card debt. There's nothing more left to provide. It's a simple money and numbers issue. State psych providers have been out of both for years.

...did...did you read the article? Keeping psych patients at the ER once they're medically cleared (so once they've been triaged) is now no longer allowed. And as someone who used to work on those units I can tell you with certainty that the vast majority of those people will NOT be kept in jail because they aren't criminals.

You're not getting it, this isn't the first go around with a federal judge and the NH mental health system. There isn't going to be a plan. Who's coming up with the plan? The state? The state hasn't had a plan for mental health in decades. One of their most recent plans was literally fewer psych hospital beds. New Hampshire Hospital? They can't even fully staff their units, you think they'll have a plan in the next 30 days? There won't be a plan, so then it will become "Well you're not in compliance with the federal courts, so now you're getting hit with another federal lawsuit (like I said, not the first time we've seen this). Also, you can't keep these people at the ER anymore so even if you don't have a plan, keeping them there is now officially illegal." People are gonna get sent home, dude.

To me it's like a bunch of people profiling other people by the book cover. Both sides of the government caused that.

I read it as come up a plan. There is no easy or straight forward solution to this issue. However boarding patients in the ED for weeks at a time isn't a good solution. I have seen pedi waiting for over a month. This sounds like trying to get pysch involved or providing quick outpatient care rather than boarding them in a room and making their mental worse.

We basically still have them they're called mental hospitals some people stay in them for life.

Substantially better.

There's only one New Hampshire Hospital.

Yeah I'm not gonna explain the entire article to them that's why I posted it, but good on you. As I understand it, they can't be held at all. Once they're medically cleared for hospitalization, they go to the hospital. And wheb there are no beds? Well right now it would seem starting in April they'll just be going home to wait. Of course the president of the NH Hospital association is supporting it. If ever you needed confirmation this was gonna be a cluster fuck, look no further than that endorsement. This "law" isn't going to help anyone because if you know anything about how the state handles mental health you know they have no answers...becuase they've never had answers. Their answer is going to be what it always has been: them looking at the CMHCs and asking "...so what's the answer?" Sadly, given the current state of the local CMHCs I highly doubt they have another rabbit to pull out of their hat this time.

A lot of these people if they aren't kept in the hospital's emergency room waiting they'll be kept jail. Also most of the major hospitals in New Hampshire have special emergency rooms for psychiatric patients that are safety-proofed.

Start opening up asylums again. Closing them was a huge mistake. We've obviously found out you can't medicate everyone into society.

I haven't seen any for snow since that's not my strong suit, but I've seen it a couple time for severe thunderstorm events up here

Literally everyone in govt is a tyrant what’s your point? Y’all get so bent out of shape over one thing 😂 maybe don’t let your lives hinge on it or just do it and don’t get caught. And. Awayyyyy you go!

Why?

Well, for starters let's do some Math. See here NH's official statistics on housing by type.

EDIT i fixed my math because I included manufactured homes which are traditionally single family. If we remove all single family (not the most accurate because there IS rental single family but this is the closest option I have access to) and simply factor in multi unit dwellings, we're left with (by unit count), for the entire state, 198,471 Apartments at any given time.

Now, per this source, At any time We have 0.5% of our apartments available as rentals. Which, means, assuming or original State sponsored figure is accurate or, yah know, close enough, at any given time here we have 992 apartments to rent in a state of 1,100,000 people. Nice.

And if we further explore this, New Hampshire maintains consistent population growth through internal and external migrations. Basically, more people move here than leave here. To the tune of 6,000+ a year.

And finally. Assachusetts ranked (shockingly) was rated as the 7th most fled from State in the union. They lost 57,000 bodies alone between 2021 and 2022. One of their data sources is a moving compamy that helpfully sources What percentage of moves were incoming and outgoing. They also offer income data, which is neat if you're interested.

And finally, according to NHPR there was just about 4,700 homeless individuals and families in the granite state. Which means if just 1/3rd are actively seeking housing at any given time, that 1600 people within the state need immediate shelter and are actively competing for the 1,168 units that are potentially available for the year.

So why do I assume these would be taken over by transplants? It's simple math. If 1600 NH people and 6,000 new bodies applied, just by odds alone, those places are almost 5x as likely to be occupied by someone from out of state. That's not factoring in Anecdotal experience of living on the seacoast and looking for a new rental recently. Does that answer your question?

To try to clarify this rant,

This is about preventing emergency departments in any hospital in NH from holding patients for an extended time (not sure what timeframe this is, guessing >24 hrs?) in the ED for psych issues which in this case primarily would relate to issues of suicide risk. Ideally such patients would transfer to an inpatient psych unit for appropriate treatment that they can’t receive in an emergency department setting. Unfortunately there are not enough inpatient psych units or beds in those units for the need. Patients in the ED where a physician is concerned about suicide risk may be held in the ED and not allowed to leave because the physician is responsible if they leave the ED and immediately harm themselves or someone else.

As someone in medicine, I don’t think there is an easy answer to this problem and this law may help or may make things worse but if the president of the NH Hospital Association is supporting it, I’d be wary of it. Hospital associations around the country are worried about maximizing profits, not much else.

Is a mouthful of sawdust better or worse than a mouthful of arsenic?