By MICHAEL KITCH, LACONIA DAILY SUN
MEREDITH — The New Hampshire Department of Health and Human Services has begun introducing a major initiative to address the needs of those with mental health and substance abuse disorders, which was outlined to providers of physical and behavioral health and various social services at Inter-Lakes High School Tuesday night.
The initiative is in response to the New Hampshire Health Protection Program, which by expanding eligibility for Medicaid and provided benefits for substance abuse has increased demand for services in short supply. Currently, 92 percent of adults who require treatment for alcohol abuse and 84 percent of adults who require treatment for drug abuse go without it. At the same time, two of every three people with mental illness admitted to the New Hampshire Hospital spend more than one day waiting in an emergency room until a bed becomes available.
In January, the Centers for Medicare and Medicaid Services approved the state's request to fund a transforming the system for providing mental health and substance abuse services The so-called "transformation waiver" will provide $150 million over five years to apply toward offering integrated physical and behavioral health care, expanding capacity to address emergent behavioral health issues, and ensuring a continuum of care unbroken as patients pass from one provider to another.
The principal agents of the program will be seven "integrated delivery networks," or IDNs, one of which will consist of the Central and Winnipesaukeee public health networks, consisting of Belknap County, 18 towns in Grafton County and three towns in Merrimack County. The IDNs will organize and coordinate the providers within the network as well as receive and distribute funding to them. The partners in the networks must include primary care physicians, substance abuse providers, hospitals, community mental health centers, community and rural health centers, community organizations providing social services and county nursing and correctional facilities.
Lisa Morris of the Lakes Region Partnership for Public Health said that the Winnipesaukee Health Council has identified access to behavioral health care, including substance abuse treatment, as a priority in the region. In January, the Community Health Services Network, LLC was formed. The network includes LRGHeathcare, Speare Memorial Hospital, Genesis Behavioral Health, Horizons Counseling Center, HealthFirst, Lakes Region Partnership for Public Health, Lakes Region Community Services, Central New Hampshire Hospice and Visiting Nurse Association, Franklin Visiting Nurse Association and Community Action Program Belknap-Merrimack Counties.
"The Lakes Region is a step ahead," Morris said, explaining that the network represents the structure for the IDN.
The IDNs will pursue projects to expand the capacity for treating mental health and substance abuse, support patients transitioning from institutional to community settings and integrate physical and behavioral care by fostering collaboration between primary care physicians, behavioral health care providers and community social services.
Specific projects to serve these objectives will be chosen from a prescribed menu. For example, to expand capacity projects include supplementing existing personnel with additional staff and training, providing medically assisted therapy for substance abuse and offering treatment as an alternative to incarceration.
This year, $19.5 million, or 65 percent of the funding, will be applied to building capacity. In 2017, funding will begin to be apportioned among the IDNs according to their performance, beginning with 10 percent of all funds and rising to 25 percent before all funding will be based on outcomes in 2019 and 2020.