NH Discretionary Funding Fiscal Year 2020

The New Hampshire (NH) COVID-19 Rapid Crisis Response Program (NH Rapid Response) will provide crisis intervention services, mental and substance use disorder treatment, and other related recovery supports for youth and adults impacted by the COVID-19 pandemic. The purpose of this program is to address the needs of individuals with SMI or SED, with substance use disorders (SUD), and/or co-occurring SMI/SED and SUD who are under- or uninsured. We will also provide crisis services for other individuals in need of behavioral health supports, including health care personnel. NH Rapid Response will be implemented within the existing NH community mental health system. The system will expand clinical staffing to provide crisis response assessments and evidence-based treatment, and peer support staff to facilitate engagement into services and ongoing care in response to the surge needs that are expected as a result of the COVID-19 situation.

Monadnock Expansion will ameliorate a fragmented, difficult to navigate system lacking basic services by implementing high-fidelity home-based family therapy, wraparound for children 0-5, and Multi-Tiered Systems of Support for Behavioral Health “MTSS-B.” It will enhance and coordinate the service array, embed system of care values, and provide strategic oversight and infrastructure for these programs in order to improve the mental health outcomes for children and youth, 0-21, with serious emotional disturbances, and their families. The entire project will directly serve an estimated 541 children/youth per year and 2,162 over four years with increased access to high-quality outpatient, community-based mental health services, improved youth well-being and functioning, enhanced caregiver well-being and functioning, and improved school culture and climate. It will benefit all of the 185,911 people who live in the rural catchment area of west-central and southwestern part of New Hampshire, where 4.2% are people of color, about 10% live in poverty, and 41.5% are vehicle-poor in an area with practically no public transportation. The focus of Monadnock Expansion is to broaden its programmatic scope and geographic reach. It will align with the state and other similar initiatives to achieve broader systems change needed to expand and sustain the SOC approach. All services provided through or in collaboration with Monadnock Expansion will be evidence-based, culturally competent, and family-driven.

Leveraging the innovative Integrated Delivery Networks (IDNs) created through New Hampshire’s 1115 Waiver Project and the corresponding Regional Public Health Networks (RPHNs), NAMI New Hampshire and its project partners have designed New Hampshire Nexus Project 2.0 (NHNP2), a cross-systems, collaborative approach to reduce suicide incidents among youth by improving pathways to care and offering comprehensive training to provide youth-serving organizations with the resources to identify, screen, refer, and treat at-risk youth. Population to be served: Based upon the most recent NH youth suicide data, NHNP2 will focus on youth/young adults ages 10-24 in IDN 2 (Capital) and IDN 7 (North Country/Carroll County). IDN 2 reported 14.5 youth suicides per 100,000, while IDN 7 reported 12.3 per 100,000. Both regions are higher than the US rate of 10.57 per 100,000. These 2017 rates indicate a 67% increase in Region 2, and a 50% increase in Region 7 since 2016. Strategies: 1. Leverage the infrastructure of NH’s IDNs to enhance functional inter-agency care systems and improve care coordination, continuity of care, and provider communication. 2. Enhance the ability of child and youth-serving organizations to recognize and engage youth at risk of suicide; establish referral pathways and cohesive procedures that connect high risk youth with appropriate services; and increase the capacity of communities to respond to suicide risk in a timely manner. 3. Build upon existing public/private partnerships to enhance the statewide capacity to recognize and respond rapidly and appropriately to suicide risk among youth/young adults. Goal: Reduce suicide incidents among youth/young adults by strengthening cross-systems collaboration, improving pathways to care, and offering comprehensive training opportunities that provide youth-serving organizations with the resources to identify, assess, refer, and treat at-risk youth. Measurable objectives: 1. Develop a Care Liaison role in each region to facilitate pathways to care for high-risk youth/young adults. 2. Leverage technology to advance screening and assessment and improve care coordination and cross-systems communication. 3. Convene and train regional implementation teams comprised of providers serving high-risk youth in suicide prevention/intervention/postvention. 4. Engage regional teams in planning to build infrastructure around best practices for suicide prevention/postvention. 5. Develop youth/young adult leadership in regional youth suicide prevention efforts. 6. Engage statewide organizations that interface with at-risk youth/young adults in suicide prevention/postvention training and planning. 7. Promote safe messaging in accordance with the NAASP framework. 8. Enhance and expand NSPL Lifeline follow up calls. Number to be served: The project will train an estimated 10,456 stakeholders and providers working in child and youth-serving organizations in suicide prevention, intervention, and postvention. The Care Liaison will work with approximately 60 high-risk youth/young adults annually. Approximately 10,756 individuals will be served over 5 years (Yr. 1 = 2,106; Yr. 2 = 2,302; Yr. 3 = 2,159; Yr. 4 = 2,038; Yr. 5 = 2,151).

New Hampshire System of Care SAMHSA Expansion and Sustainability Cooperative Agreements SM-20-007 Project Abstract: The Office of Social & Emotional Wellness within the Bureau of Student Wellness at the NH Department of Education has selected 7 local jurisdictions for implementing NH’s System of Care Expansion and Sustainability initiative: 1) Governor Wentworth School District in the Northern Region; 2) Hillsboro-Deering in the South West Region; 3) Hudson in the South Central Region; 4) Lincoln-Woodstock in the Northern Region; 5) Merrimack Valley in the Lakes Region; 6) Raymond in the South East Region; and 7) Sanborn Regional in the South East Region. These Local Education Agencies (LEAs) represent the entire state and the project’s population of focus: NH school-aged youth and their families experiencing or at risk for mental health challenges. The seven local jurisdictions identified for this project include an estimated student population of 12,443. The purpose of NH’s system of care expansion and sustainability efforts is to improve the clinical outcomes and functioning in home, school, and community for NH’s children and youth with Serious Emotional Disturbance (SED) and their families by strengthening local communities ability to respond. These efforts center largely on building strong collaboration between schools, families and children/youth, behavioral health providers, and their communities’, and using evidence-based frameworks to deliver high-quality supports and services. There are five primary goals of this effort: 1) Develop, enhance, and expand a statewide system to support the use of NH’s Multi-Tiered Systems of Support for Behavioral Health and Wellness (MTSS-B) model by Local Education Agencies (LEAs) and local communities to expand and sustain NH’s System of Care (SOC); 2) Enhance and expand the ability of the Department of Health and Human Services in partnership with the Community Mental Health System of NH and its providers to collaborate with and respond to the needs of LEAs and NH students; 3) Ensure that NH’s statewide system of care is culturally and linguistically appropriate for all of NH’s residents; 4) Develop, enhance and sustain Multi-Tiered Systems of Support for Behavioral Health and Wellness (MTSS-B) within participating Local Education Agencies (LEAs); and 5) Strengthen partnerships between participating Community Mental Health Centers and LEAs in order to leverage resources, create a common understanding, and increase access to high-quality mental health services and supports for NH students and their families.

Franklin Community Partners in Prevention is an initiative of the Franklin Mayor’s Drug and Alcohol Tasks Force (FMDATF), serving the 8,601 people living in Franklin, New Hampshire (NH) and surrounds. Our project will build upon our success as a Drug-Free Communities (DFC) coalition to address alcohol, marijuana and methamphetamine misuse among youth, young adults and high-risk adults in our community. FMDATF is a coalition of individuals and organizations from all sectors of the community addressing a common goal. We are passionate and highly effective in achieving, through community organizing and coalition building, our mission: To engage the community of Franklin in working together to promote positive alcohol and drug-free lifestyles for youth and families. Like many aging industrial cities, Franklin faces its share of socio-economic problems to which NH’s high rates of substance misuse add a toll. Our youth and young adults use marijuana at high rates compared to the rest of NH and the US overall. A majority of people admitted to drug and alcohol treatment programs in NH cite marijuana as primary or secondary reason for seeking treatment. The prevalence of marijuana use among Franklin youth is 38% higher than state average, and the number first using marijuana before age 13 is more than twice NH’s rate. At the same time, alcohol remains the most frequently misused substance among youth and adults in our region. A third of our youth currently drink alcohol, above state average, and the number having their first drink before age 13 is 75% higher than the NH average. Highly addictive Methamphetamine is increasing in use and impact in our region, presenting a range of harms to individuals, the community, and responders. Local law enforcement and EMS data show that methamphetamine is the single drug, other than alcohol, most often involved as primary or secondary contributor to drug-related health emergencies or offenses in Franklin. Among our youth, 44% more have used methamphetamine compared to the state average. To address these compelling issues, our goals are to: (1) Develop infrastructure to measure, target and address adult substance misuse; (2) Prevent increase in use and decrease in protective factors related to marijuana use among youth and young adults; (3) Develop infrastructure to address the growing impact of methamphetamine; (4) Address increasing substance-related risk and disenfranchisement among youth; and (5) Enhance youth and adult alcohol prevention. Franklin Community Partners in Prevention will build upon our vibrant coalition through enhanced infrastructure to propel FMDATF to the next level of effective, collaborative population-wide prevention, enabling us to address our community’s most pressing drug and alcohol problems. This infrastructure will expand our capacity to focus on additional, more complex prevention interventions targeting additional sub-populations and additional substances that put our community at highest risk. We will focus our population-level interventions on the more than 8,000 people who call Franklin home, each year, and over the life of the five-year project.

The ALL Together coalition of the Upper Valley of New Hampshire and Vermont is applying for the Drug Free Communities Competing Continuation grant opportunity. This funding will allow the regional coalition to sustain current initiatives and begin new comprehensive strategies to reduce the harms of alcohol, tobacco, marijuana and prescription drug misuse. ALL Together’s goal if awarded this funding is to decrease rates of 30-Day alcohol, tobacco, marijuana and prescription drug use among over 1,175 middle and over 2,700 high school students in our region, both annually and throughout the lifetime of the project by: providing information, education and training; through policy change efforts affecting ease of access, community and school enforcement and norms. We will do this by focusing on the following objectives: increasing the perception of parent disapproval of substance use; decreasing adult attitudes favorable toward youth substance use; increasing the perception that youth substance use is harmful; and decreasing youth access. All of these objectives will be measured by the Vermont and New Hampshire Youth Risk Behavior Survey. All Together has identified the following strategies and interventions to accomplish this goal: increase the prevention capacity in the region by joining, supporting and interlocking with existing coalitions and organizations; provide information and education via multi-media social marketing campaigns to parents and community across the region to strengthen protective parental/adult social norms; strengthen school and community policies related to substance use violations and improve the quality of policy implementation; community mobilizing for change on youth substance use by supporting healthy substance free activities for youth to socialize within the community; utilize community forums/town hall events to gain feedback from the communities on youth substance use issues and utilize this feedback to implement change; strengthen collaboration among communities, state and local governments to reduce substance misuse among youth and young adults. ALL Together’s Drug Free Communities Partnership Coordinator shares office space at Dartmouth-Hitchcock Medical Center with the Upper Valley Public Health Region’s Substance Misuse Prevention Coordinators. ALL Together is a workgroup of the Public Health Council of the Upper Valley and ALL Together staff are employees of Dartmouth-Hitchcock. This structure and these relationships allow for the aligning of and collaboration on prevention efforts and collective health goals for our region.

The ALL Together coalition of the Upper Valley of New Hampshire and Vermont is applying for the Sober Truth STOP Act Grant. The STOP funding will allow the regional coalition to expand current initiatives and begin new strategies to reduce underage drinking. This grant would support best practices in alcohol prevention for the coalition’s focus population of 2,700 high school age youth in five high schools, and over 1,175 middle school age youth in six middle schools in the Upper Valley. ALL Together’s goal if awarded this funding is to decrease rates of 30-Day alcohol use among high school students in our region by: providing information, education and training; through policy change efforts affecting ease of access, community and school enforcement and norms. We will do this by focusing on the following objectives: increasing the perception of parent disapproval of alcohol use; decreasing adult attitudes favorable toward youth alcohol use; increasing the perception that binge drinking is harmful; decreasing youth access. All of these objectives will be measured by the Vermont and New Hampshire Youth Risk Behavior Survey. All Together has identified the following strategies and interventions to accomplish this goal: provide information and education via a multi-media social marketing campaign Don’t Serve Teens to parents and community across the region to strengthen protective parental social norms and spotlight social host liability; strengthen school and community policies related to substance use violations and improve the quality of policy implementation; community mobilizing for change on alcohol by supporting positive substance free activities for youth to socialize within the community; utilize Town Hall events to gain feedback from the communities on underage drinking issues and utilize this feedback to implement change; strengthen collaboration among communities and state and local governments to reduce alcohol use among youth and young adults.

The Keene Family YMCA Community Coalition on Youth Substance Misuse was awarded a FY 2019 Drug-Free Communities Support Program grant in the amount of $125,000 by the White House Office of National Drug Control Policy, in cooperation with the Substance Abuse and Mental Health Services Administration. The Coalition serves Keene and Swanzey, NH, communities of 22,949 & 7,144 people respectively with high use of alcohol and tobacco products. The Keene Family YMCA Community Coalition on Youth Substance Misuse The goals of the coalition are to establish and strengthen community collaboration in support of local efforts to prevent youth substance use. The coalition will achieve its goals by addressing the underlying causes of youth use of alcohol and tobacco, especially vaping, including social norms, high stress and anxiety, lower parental protective factors and youth access. Strategies used include increasing knowledge, building skills, increasing access to positive youth opportunities, decreasing access to alcohol and tobacco, increasing disincentives to use, and modifying municipal and school policies and procedures. The coalition will impact 2,000 youth and their families in the first year and 30,000 people over the lifetime of the project.

Reality Check uses the SPF model of engagement to engage stakeholders to collectively prevent and reduce underage alcohol use in people ages 12-20, in south-central New Hampshire.

NH Department of Human Services seeks this grant to strengthen and expand a comprehensive approach to address NH's opioid and substance use disorder epidemic through various prevention, treatment, and recovery services. NH intends to increase services for individuals with OUD/SUD statewide and to include stimulant misuse. While services will be made available to anyone seeking assistance in NH, special populations will be made a priority for some of the program designs including children and young adults, pregnant women, Veteran and service members, individuals with or at-risk for HIV/AIDS, older adults caring for a minor child due to DCYF involvement, and justice involved individuals and those re-entering the community post incarceration.