NH DHHS Seeks Demonstration Amendment To Expand Treatment Capacity For Adults With Serious Mental Illness

Concord, NH – As part of New Hampshire’s comprehensive effort to ensure timely and appropriate medical care for people experiencing a mental health crisis, the New Hampshire Department of Health and Human Services (DHHS) announces its intent to request from the Centers for Medicare and Medicaid Services (CMS) an amendment to the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver.

The proposed amendment will expand the scope of the waiver to include coverage for short-term inpatient and residential treatment services for beneficiaries with Serious Mental Illness (SMI), and would allow Medicaid to pay for short-term stays in Institutions for Mental Disease (IMDs) for beneficiaries ages 21-64 with SMI who are approved for full Medicaid benefits under the State Plan.

“This amendment gives New Hampshire the opportunity to transform delivery and access to mental health services and make a real difference in the lives of thousands of Granite Staters experiencing mental health crises,” said DHHS Commissioner Lori Shibinette. “Along with continued investment in community-based alternatives to inpatient care and enhanced support for patients transitioning among different levels of care, improving access to short-term stays in IMDs is critical to addressing the state’s challenges related to psychiatric ED boarding.”

The proposed amendment will enhance the flexibility and availability of mental health services and support the comprehensive and integrated continuum of mental health treatments and care provided in New Hampshire. Through this amendment, the state aims to achieve the following objectives:

• Reduce utilization and lengths of stay in Emergency Departments (EDs) among Medicaid beneficiaries with SMI while awaiting mental health treatment in specialized settings;
• Reduce preventable readmissions for mental health to acute care hospitals and residential settings;
• Improve availability of crisis stabilization services, including services made available through call centers and mobile crisis units, intensive outpatient services, and services provided during acute short-term stays in residential crisis stabilization programs, psychiatric hospitals, and residential treatment settings;
• Improve access to community-based services to address the chronic mental health care needs of Medicaid beneficiaries with SMI, including through increased integration of primary and behavioral health care; and
• Improve care coordination, especially continuity of care in the community, following episodes of acute care in hospitals and residential treatment facilities.

Prior to submitting the amendment request to CMS, DHHS is seeking comment from the public. The 30-day public comment period is from Monday, August 2, 2021 until Tuesday, August 31, 2021. All comments must be received by 4:30 p.m. (Eastern) on August 31, 2021.

DHHS will host two public hearings during the public comment period:

• Monday, August 9, 2021, from 5:30-7 p.m., DHHS, Brown Building Auditorium, 129 Pleasant St., Concord
• Wednesday, August 11, from 6:00 – 7:30 p.m., Harbor Homes, 77 Northeastern Blvd., Nashua

Comments will also be considered at the Medical Care Advisory Committee (MCAC) meeting on August 16. All MCAC meetings are open to the public.