20241217-143100-71

Priority Area 1: Facilitate a cross-system data match between the Department of Health and Human Services (DHHS) and DOC to identify the overlapping population of people who have behavioral health challenges in the state and move through the county and state criminal justice system and to identify high utilizers of these systems. CSG Justice Center staff will conduct an in-depth analysis of the matched Medicaid claims data to provide information on trends in services accessed in the community by people who are incarcerated and a qualitative assessment on the behavioral health interventions and programming that are available for people who have behavioral health needs and are part of the state corrections system.
Background: County and state officials report a high prevalence of people with behavioral health needs moving through local county department of corrections (jails) and state prisons, with an increasing reliance on using incarceration at the local level to address behavioral health challenges. Following the Phase I data analysis and Medicaid match on county jail level data, state officials requested additional analysis to include the state corrections-level data. County and state officials are interested in understanding the criminal justice journey of the high utilizer population to inform funding and policy decisions.
Update: In July, CSG Justice Center staff developed the final presentation, containing the data analysis, qualitative analysis, and policy recommendations, and delivered it to the Advisory Commission on July 11. During the July site visit, CSG Justice Center staff provided a comprehensive summary of the findings to legislators, leadership in DHHS, and the Attorney General's office. Additionally, CSG Justice Center Research staff continued to add to the internal website, which serves as a central repository of information about the project. CSG Justice Center staff also drafted the one-pager, which contains an overview of the data findings and policy recommendations.
Priority Area 2: Support DHHS in developing and rolling out Crisis Receiving Centers (CRCs)--facilities embedded in New Hampshire communities that provide no-wrong-door access to mental health and substance use disorder care and accept all walk-ins, ambulance, fire, and police drop-offs--by facilitating stakeholder engagement to align community need with program resources.
Background: New Hampshire has limited community-based interventions for the high utilizer population, leading to inappropriate use of protective custody holds by law enforcement. New Hampshire has committed to developing and implementing CRCs as an alternative to hospitals and incarceration. DHHS has identified two locations for CRC pilots, hosted by Lakes Regional Community Mental Health Center in Plymouth and Center for Life Management in Derry. DHHS and community agencies convened a working group (WG) in January 2024, and CSG Justice Center staff will help facilitate the necessary stakeholder engagement to ensure their successful implementation.
Update: In July, CSG Justice Center staff discussed the care coordination portion of the new policy recommendations with DHHS while on the site visit, such as funding for a Medicaid navigator role and enhancing Medicaid availability. There was no update on the CRCs for July.
Priority Area 3: Assist DHHS in establishing requirements and identifying funding for care coordination, including in-reach to the jails for people who are high utilizers of jail and behavioral health resources.
Background: New Hampshire Community Mental Health Centers (CMHCs) indicated varying levels of access to the county jails to connect with people prior to release and establish rapport to encourage continued care in the community. Providers indicated barriers to providing in-reach including the extensive paperwork to access the county jails, their lack of relationship with the county jails, and staffing shortages in varying areas of the state. To address these barriers, CSG Justice Center staff will facilitate a WG of agency representatives to explore barriers, solutions, and funding streams.
Update: In July, CSG Justice Center staff discussed the final policy recommendations related to care coordination and jail in-reach with the Advisory Commission, DHHS, and state legislators. The response was positive in that most stakeholders want to see care coordination increased across the system. The approval of New Hampshire's Medicaid 1115 reentry waiver and funding on July 16 2024 will support an increase in services.
Priority Area 4: Assist in identifying ways in which New Hampshire agencies could improve their capacity for collecting and sharing data to better and more quickly track criminal justice trends.
Background: New Hampshire does not have a unified data sharing system between the county jails, DHHS, state prisons, law enforcement, and other agencies. New Hampshire is one of 12 states that does not use a state identification number (SID number) in their criminal justice system, making tracking trends much more difficult. The systems in New Hampshire are siloed, and data sharing is limited between agencies. CSG Justice Center staff will support agencies' efforts to update their data systems and data sharing processes across the criminal justice system.
Update: During the site visit in July, the Advisory Commission, DHHS, and state legislators showed interest and support for the data coordination policy recommendations. With the approval of the Medicaid 1115 reentry waiver, it was noted by New Hampshire DHHS that several of the data coordination policy recommendations may come to fruition as they are written into the waiver.