Investing in people and culture, promoting thriving communities and improving customer service are three core commitments included in a new roadmap for 2024-25 released by the state’s health department. 

The plan lays out initiatives and goals for the next year, including placing a renewed emphasis on improving mental health resources and support across the state. It also targets the overall health and well-being of New Hampshire residents, including seniors.

“This plan is the culmination of months of work with our partners and the people we serve to create a bold plan of action that will set us on the course to enhance key systems and policies to improve the health of our state,” Department of Health and Human Services Commissioner Lori Weaver said in a statement.

One of the primary mental health initiatives aims to eliminate  the practice of boarding patients with acute psychiatric needs in hospital emergency rooms, something the state is under court order to accomplish. Currently, patients often have to wait several days or even weeks without appropriate care until a bed becomes available.

Following a federal court ruling last year, the state was told to end this practice in May but requested additional time to comply.

Through the “Mission Zero” plan, the roadmap sets goals to increase the number of beds at psychiatric facilities statewide.

By December, the state plans to have all 185 beds at New Hampshire Hospital fully operational. Currently, 15 of these beds are offline due to staffing issues and renovations. Additionally, Dartmouth Health is projected to add five more beds by the end of the year.

In August, the state will also begin constructing the New Londonderry Joint Venture behavioral hospital, which is expected to open in 2026.

The roadmap also seeks to expand supportive and transitional housing for individuals recovering from mental illness. Currently, many patients clinically ready for discharge remain in inpatient facilities due to a lack of appropriate housing, occupying valuable beds and causing delays for patients waiting in hospital emergency rooms.

As of Thursday, 67 patients were waiting for more than 15 days for discharge from the New Hampshire Hospital because of a lack of supportive housing.

Peter Ames, executive director of the Foundation for Healthy Communities, expressed strong support for the state’s plan and said, “Our collaboration with hospitals, health systems and providers facilitates the integration of crucial mental health services, ensuring comprehensive care for all individuals.”

Workforce shortage

New Hampshire has been struggling with vacancies in many healthcare areas, leading to delays in patient care, especially in connecting with counselors and therapists, which can take weeks or even months.

The state aims to reduce the current vacancy rate for all full-time authorized positions by 3%, from 15.4% in May 2024 to 12.4% by June 2025.

Efforts include developing academic partnerships with the community college system, universities and colleges to increase hires of new graduates, students, and interns interested in healthcare employment.

Additionally, the state plans to streamline the certification and contact process for candidates and develop a robust retention strategy.

Other focus areas

Transitioning individuals from the prison system back into the community is also a focus, with plans to leverage federal funding to provide a limited benefit package of pre-release medical and social services to support their reintegration.

Reducing preterm births and maternal deaths of pregnant women and new mothers is another critical goal.

According to a state report between 2018 and 2022, 52.5% of pregnancy-related deaths were due to substance overdoses involving fentanyl, cocaine, heroin and other substances.

To have better outcomes for mothers and babies, the state will increase the number of perinatal health practitioners in the state trained to screen, treat, and refer to services for perinatal mental health conditions and substance use disorders by March 2025.

Furthermore, the plan focuses on increasing the percentage of people receiving home and community-based services instead of care in nursing facilities as well as improving access and service delivery that is consistent and equitable for individuals with developmental disabilities.

“It is vital to ensure that as we age, living longer more productive lives, needed services are available and accessible across New Hampshire,” said Rebecca Sky, executive director of the State Commission on Aging. “The prioritized goals once realized will support all of us so that we and our family members can not only age well but thrive in our later years.”

Given the increasing awareness of the impacts of per- and poly-fluoroalkyl substances (PFAS), commonly known as "forever chemicals," on human health, ensuring that bottled water manufacturers adhere to testing requirements for these substances is also a target area for the state department.

“We know that these initiatives and goals are bold,” Weaver said. “But we remain confident that, together, we can make the ambitions of the DHHS Roadmap 2024-2025 a reality.”