Community Mental Health Agreement – Expert Reviewer Report Number Thirteen

Former Governor Maggie Hassan signs the CMHA while sitting at large desk surrounded by advocates.

The Community Mental Health Agreement (CMHA) is a landmark settlement agreement to help people diagnosed with serious mental illness live successfully in the community rather than institutions. According to the CMHA, New Hampshire must provide community-based services and supports to people who would otherwise be unnecessarily institutionalized at New Hampshire Hospital or Glencliff Nursing Home.

These community-based resources include mobile crisis teams and crisis apartments, assertive community treatment (ACT), permanent supported housing (e.g., the Bridge Housing Subsidy), supported employment, and peer and family supports.  Compliance with the CMHA is monitored by an Expert Reviewer, who summarizes his findings in semi-annual reports.

The Expert Reviewer’s Thirteenth Report was issued on January 27, 2021

Summary of progress to date
“Most of calendar year 2020 has been dominated by the response to the health risks associated with COVID-19 and by the restrictions necessitated by COVID-19. As will be seen in the subsequent sections of this report, most elements of the services system defined by the CMHA have remained relatively stable. Understandably, there has been little measurable progress, but there has also been a relatively consistent level of service delivery and performance. The State is to be congratulated for maintaining services to the CMHA Target Population during these very difficult circumstances. Nonetheless, it is important to emphasize that the pandemic has not altered the terms of the CMHA nor diminished the State’s obligations to members of the Target Population. Moreover, the delays and restrictions caused by COVID-19 necessarily require extension of the time periods for the State to complete its responsibilities under the CMHA.”
Complete summary and report are available here 

Major areas of continued non-compliance include:

  • Failure to expand access to and improve the quality and fidelity of Assertive Community Treatment (ACT), which provides mental health and wraparound services to individuals in their homes and communities, helping people with serious mental illness avoid hospitalization.
  • Failure to provide effective transition planning and related activities to residents of Glencliff (the state nursing home).  Transition planning is critical in helping residents return to integrated community settings when appropriate.
  • Failure to provide equal access to supported employment services throughout the state.  These services help people with mental health diagnoses to work in integrated community settings.

Learn more about the CMHC:


Disability Rights Center – New Hampshire is a statewide non-profit organization dedicated to eliminating barriers for people with disabilities across New Hampshire. DRC is the federally designated protection and advocacy agency for New Hampshire and has authority under federal law to conduct investigations in cases of probable abuse or neglect.

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