Analysis Area 1: Facilitate a cross-system data match between DHHS and county jails to identify the overlapping population of people who have behavioral health challenges who move through local criminal justice systems and identify high utilizers of both systems. CSG Justice Center staff will conduct an in-depth descriptive analysis of the matched Medicaid claims data to provide information on trends in services accessed in the community by people incarcerated in each participating jail. CSG Justice Center staff will also analyze county jail data related to demographic information, booking and release information, screening and assessment information, medications, and programming and treatment information to understand the criminal justice and behavioral health characteristics of locally incarcerated populations. Update: On April 6, 2023, CSG Justice Center staff met with the Governor’s Commission on Mental Illness and the Corrections System to present the final data analysis and policy recommendations. The final data analysis consisted of the jail data and Medicaid data match. Of the jail data, CSG Justice Center staff analyzed jail entrance frequencies, booking types, protective custody holds, demographics, lengths of stay, and costs related to the jail high utilizer population. Of the Medicaid data, CSG Justice Center staff analyzed the types of behavioral health claims (substance use disorders, mental health claims), housing needs, and costs related to the jail high utilizer population. The policy recommendations fell into five categories: (1) increase jail and reentry services, (2) coordinate care across systems, (3) clarify protective custody holds, (4) expand data collection and monitoring, and (5) pursue funding and sustainability. To continue building momentum for the policy recommendations, CSG Justice Center staff met with New Hampshire’s DHHS Medicaid Director Henry Lipman to share the final findings and policy recommendations. CSG Justice Center staff also began drafting the final report. Analysis Area 2: Conduct a qualitative assessment on the availability, quality, and data collection practices of jail-based mental health and substance use disorder programming and treatment. CSG Justice Center staff will conduct interviews and focus groups with superintendents, jail staff, and contracted behavioral health providers to provide information on the identification of people with behavioral health needs, services, programming, and options within jails for care coordination to support connections to community-based care. CSG Justice Center staff will review jail policies that guide the practice of identifying, tracking, and referring people with behavioral health conditions to services. This assessment will provide qualitative data on local trends in jail populations, behavioral health needs, and participation in jail-based treatment and services. Update: CSG Justice Center staff presented the information gleaned from the qualitative assessment on jail-based mental health and substance use disorder programing and treatment during the final presentation in New Hampshire on April 6. Prior to the final presentation, CSG Justice Center staff met with Superintendent Brackett (Stafford County House of Corrections) to discuss the jail data and cost analysis along with the policy recommendations. Analysis Area 3: Conduct a community-based behavioral health assessment with mental health center staff, substance use disorder treatment and recovery support service providers, housing and homeless service providers, and people with lived experiences. CSG Justice Center staff will identify and geographically map current behavioral health services, crisis response, and alternatives to incarceration programs to provide an overview of availability of services in each county. This assessment will inform stakeholders on the current gaps in behavioral health resources and care coordination with criminal justice systems. Update: In April, CSG Justice Center staff used the behavioral health assessment from Policy Research Associates (PRA) to inform the final presentation that was presented to the Governor’s Commission on Mental Illness and the Corrections System. As part of the final presentation, CSG Justice Center staff shared an interactive map that plotted the majority of the behavioral health services in the state and compared it to the jail populations. CSG Justice Center staff also shared this map during a Sequential Intercept Model (SIM) Mapping workshop in New Hampshire. Analysis Area 4: Connect with criminal justice stakeholders (law enforcement, judges, defense attorney, prosecuting attorneys, and community-based corrections) to examine the extent to which law enforcement, courts, and other criminal justice stakeholders have viable, evidence-informed community resources available for people in the criminal justice system who have behavioral health and housing needs, including access to effective crisis and treatment services. CSG Justice Center staff will also identify and geographically map current alternatives to incarceration programs to provide an overview of availability of options for criminal justice agencies in each county. This assessment will inform stakeholders on the current gaps in alternatives to criminal justice system for people with behavioral health conditions. Update: In April, CSG Justice Center staff met with Strafford County Attorney Thomas Velardi to preview the final presentation and discuss the policy recommendations. CSG Justice Center staff also attended the Merrimack County SIM Mapping workshop and presented the Medicaid match data analysis to inform their work.
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