PAIMI Program

PAIMI Goals and Priorities: October 1, 2020 – September 30, 2021

DRC-NH receives PAIMI funds to serve adults and children with significant mental illnesses or emotional impairments, as determined by a mental health professional qualified under the laws and regulations of the State. DRC-NH helps with disability related legal issues in the priority areas outlined below.

Protection and Advocacy for Individuals with Mental Illness (PAIMI) Program

Monitor facilities where care is provided to individuals with significant mental illness including monitoring the impact of COVID-19 on residents of institution, including management of risk and quality of life issues

  • SPU
  • Children’s facilities based on restraint reports
  • Institutions serving people with mental illness where DRC-NH has reason to suspect abuse, neglect, the improper use of restraint or seclusion or other issues with the care of patients/residents with mental illness

Investigate significant abuse or death of an individual with mental illness in one or more of these facilities:

  • Any facility serving individuals with mental illness where DRC-NH has probable cause to suspect abuse or neglect

Monitor implementation of Amanda D v Hassan

  • Individual Representation regarding access to services as defined in the CMHA
  • Mediation or Legal Action to Enforce Settlement Agreement
  • Monitoring of transitions out of Glencliff and NHH

Protect DRC-NH’s access authority whenever it is in question

Ensure youth with significant mental illnesses in the foster care system can access needed mental health services in the least restrictive environment

Provide counseling and advice to eligible people with significant mental illness with problems in the broad areas outlined below. 

  • Protection against abuse or neglect
  • Conditions in NH’s emergency rooms or institutions
  • Access to appropriate supports and services for adults with mental illness in their homes and communities
  • Accessibility of communities and services
  • Appropriate supports for children in the least restrictive environment in schools and in the community
  • Children’s right to secure FAPE (free appropriate public education), compensatory education and extended school year services as a result of COVID-19Employment
  • Discrimination in housing
  • Bullying of children with disabilities
  • Access to due process rights in Medicaid denials, terminations and reduction
  • Opportunities to empower people with mental illness to make decisions including alternatives to guardianship

Provide limited or full representation to eligible people with mental illness in the following areas:

  • Access to services as outlined in the community mental health agreement
  • Access to appropriate mental health treatment for prisoners or patients with significant mental illness who are at risk of suicide
  • Access to community based mental health services to prevent or address unnecessary institutionalization for children and adults
  • Exclusions from school
  • Restraint and seclusion in school
  • Children’s right to secure FAPE (free appropriate public education), compensatory education and extended school year services as a result of COVID-19
  • Reasonable accommodations in hospital and facility visitor policies

In accepting cases for limited or full representation, DRC-NH will consider the following:

  • Does the case have legal merit?
  • Do we have the capacity, funding and expertise to provide quality representation?
  • Does the case fit within our priorities?
  • What is the likelihood that our advocacy would make a positive difference to people with disabilities?
  • Would our advocacy result in services being provided in a more integrated setting

Learn more about our case criteria and exclusions

Ensure policy makers are aware of the impact of laws and regulations on the rights of and issues impacting people with mental illness.

Funded only by PAIMI

  • Educate legislators and DHHS staff regarding effects of long-term commitment terms.
  • Educate legislators about CD revocations and impact on boarding population.
  • Analyze housing options for persons leaving NHH; educate legislators regarding housing impact on cost of institutional care.
  • Educate legislators about benefits of proper implementation of crisis, housing and other services consistent with principles of CMHA.
  • Monitor policy proposals with regard to SPU location and conditions, eligible populations, etc.  Related research and education of legislators.
  • Monitor efforts to modify competency to stand trial procedures.  Continued work with judiciary to improve practices and educate policymakers about impact of delayed diversion of persons with MH from the system.
  • Educate on the impact of proposed legislation on people with significant mental illness in NH as resources allow.
  • Educate on the impact of proposed regulations on people with significant mental illness in NH as resources allow.

Funded by PAIMI and other funding sources

  • School discipline
    • Educate legislators and DOE staff regarding effects of exclusionary discipline on children with disabilities.
    • In conjunction with ACLU and NHLA, analyze OCR and other available data on impact of discipline policies and practices in NH schools.
    • Monitor expected legislation on exclusionary discipline.
  • Juvenile justice
    • Analyze adequacy of current service system outside of SYSC.
    • Educate legislators and DHHS staff regarding same.
    • Monitor legislation in JJ area.
  • Restraint and Seclusion of children
    • Analyze adequacy of DHHS and DOE compliance with Chapter 126-U.
    • Educate DHHS and DOE staff regarding rulemaking requirements of same.

Other Systemic Advocacy

DRC-NH will monitor these issues and advocate for systemic improvements as resources allow.

  • Access to services for people with significant mental illness in nursing homes
  • State waiver to obtain Medicaid funding for substance use treatment in institutional settings
  • CFI systemic issues
  • Involuntary commitment
  • Compliance with RSA 126U
  • Emergency room boarding
  • Transfers from NHH to SPU
  • Rules that exceed federal minimums
  • Access to services for individuals with mental illness and intellectual disabilities
  • Alternatives to Guardianship
  • Disability issues in jails and prisons
  • Elder law issues
  • Implementation of Order of Selection in VR
  • Implementation of NH’s 10 year mental health plan
  • Use of solitary confinement in state prisons
  • Impact of COVID-19
    • Oversight of state and hospital crisis standards of care plans and triage guidelines
    • Discrimination in testing or prioritization of resources
    • Access to mental health services in the manner that best meets the need of the person with mental illness
    • COVID-19 treatment and care for people in long term care facilities


Ensure the PAIMI Advisory Council provides input into DRC-NH’s work on behalf of people with mental illness

Communicate to people with mental illness, family members and others regarding the rights of and issues impacting people with mental illness. 

  • Conduct outreach and training as limited resources allow.
  • Communicate via DRC-NH e-news, social media and website
  • Communicate via the media
  • Publish the RAP sheet
  • Develop and distribute brochures and written materials. Priority will be given to the development of written materials in areas where we are not providing representation.

Ensure DRC-NH collaborates with other groups and organizations on the rights of and issues impacting people with mental illness via committee work

  • Children’s Behavioral Health Collaborative
  • Access to Justice
  • MCAC
  • Incapacitated and Vulnerable Adult Fatality Review Commission