On February 12, 2014, Judge Steven J. McAuliffe issued a final order in the case of Amanda D. v. Hassan, approving the landmark class action settlement agreement for expanded community mental health services known as the Community Mental Health Settlement Agreement (CMHA). The order gave the State a green light to begin implementing the new service provisions, provisions which were expected to impact thousands of people with serious mental illness throughout New Hampshire.
The plaintiffs, represented by DRC-NH, Devine Millimet, the Center for Public Representation, the Judge David L. Bazelon Center for Mental Health Law, the United States Department of Justice, and the New Hampshire Attorney General’s Office, filed the agreement with the court in December 2013.
Under the approved agreement, New Hampshire will expand its supported housing to include a minimum of 450 supported housing units, add Assertive Community Treatment (ACT) to serve 1,500 people, and significantly expand supported employment programs, creating opportunities for individuals to join the workforce, engage in productive activities, and improve the quality of their lives. The agreement also introduced mobile crisis services in the Concord, Manchester, and Nashua regions, as part of an effort to better serve people with mental illness and to divert individuals from hospitals and institutions by building capacity through community-based alternatives proven effective at reducing the need for emergency room and inpatient beds.
The provisions of the agreement gained widespread support from class members and stakeholders alike, including the named plaintiffs, the Office of Public Guardian, Tri-County Guardianship Services, the National Alliance on Mental Illness (NAMI), former DHHS commissioner Donald Shumway, and Dartmouth Psychiatric Research Center director, Professor Robert Drake, MD, PhD.
“Having worked in social services planning and administration for over forty years, and being deeply involved in and committed to developing community mental health services for individuals with serious mental illness, I wholeheartedly support the Settlement Agreement and believe it will significantly benefit the class members in this case,” said Don Shumway, President and CEO of Crotched Mountain Foundation and former DHHS Commissioner.
“NAMI NH fully supports the Settlement Agreement and believes it will be beneficial to individuals with serious mental illness in New Hampshire,” said Ken Norton, Executive Director of NAMI NH.
The services included in the Agreement are proven, cost-effective measures that lead to recovery and the ability of people with serious mental illness to live successful and fulfilling lives in the community. The central components of the services include:
- Assertive Community Treatment (ACT): a multi-disciplinary team of professionals that are available around the clock and provide a wide range of flexible services, including case management, medication management, psychiatric services, assistance with employment and housing, substance abuse services, crisis services and other services and supports to allow individuals to live independently in the community. ACT teams are mobile, providing services in individuals’ homes and in other community settings.
- Supported Housing: integrated, scattered-site, permanent housing, coupled with on-going mental health and tenancy support services provided by ACT, case management, and/or a housing specialist.
- Supported Employment: helps individuals with disabilities find and maintain competitive employment at integrated job sites in the community, reducing the risk of institutionalization, and enabling individuals to support themselves and their families.
- Mobile Crisis Teams: are able to respond to individuals in their homes and communities 24/7 and include access to new crisis apartments, where individuals experiencing a mental health crisis can stay for up to seven days, as an alternative to hospitalization.
For individuals with serious mental illness and complex medical needs residing at the Glencliff Home, the state-run nursing home, New Hampshire will work to develop community settings that are able to address their unique needs. The proposed 16 community residence beds may include enhanced family care, supportive roommate, or other non-congregate settings to help achieve integration back to the community for those who cannot cost-effectively be served in supported housing.
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