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Bar News - January 15, 2014

Settlement Reached in Mental Health Class Action


A settlement expected to cost the state more than $30 million over the next three years was reached Dec. 19 in the class action lawsuit brought by the NH Disabilities Rights Center on behalf of New Hampshire residents with mental health conditions who were unnecessarily institutionalized or at risk for unnecessary institutionalization.

Subject to legislative appropriations, the settlement agreement in Amanda D. V. Hassan requires the state to institute enhanced supported employment and housing programs and create mobile crisis teams to help people suffering from serious mental illnesses.

“This settlement agreement, developed in conjunction with the New Hampshire Department of Health and Human Services, enhances the state’s mental health services to address the concerns of the plaintiffs and protect taxpayers from far greater potential liabilities,” Attorney General Joseph Foster said in a prepared statement.

The lawsuit, filed in federal court in February 2012, alleged that New Hampshire fails to provide community-based services to qualified people who have been diagnosed with mental health conditions in the most integrated setting appropriate to their needs, in violation of the federal Americans with Disabilities Act. The federal government intervened in support of the plaintiffs after a federal investigation led to similar concerns about New Hampshire’s mental health care system.

Under the settlement agreement, New Hampshire over the next four years will:
• Expand the multidisciplinary Assertive Community Treatment (ACT) teams to serve 1,500 people and be on call 24 hours a day in all parts of the state;
• Create three mobile crisis teams, in Manchester, Concord and Nashua, with accompanying crisis apartments, to help divert people experiencing mental health crises from emergency rooms and New Hampshire Hospital;
• Expand supported employment assistance for people with mental illness;
• Expand supported housing opportunities for people with mental illness; and
• Seek to divert more people from Glencliff Home, New Hampshire Hospital, and emergency rooms into community-based services.
Amy Messer, legal director of the Disabilities Rights Center and counsel for the plaintiff class, said the agreement would enable thousands of New Hampshire residents to get the help they need without admission to New Hampshire Hospital.

“Today’s settlement agreement is a real leap forward in the renewal of New Hampshire’s commitment to community-based mental health services,” she said in a press release.

Initial estimates from DHHS are that implementing the settlement agreement would require an additional $6 million from the state’s general fund in the current biennium for expanded mental health services, followed by $23.7 million in general funds for the FY16/17 biennium. Under the terms of the agreement, the state also agrees to pay $2.4 million for plaintiffs’ legal expenses.

If the Legislature does not appropriate funds for the services, plaintiffs have reserved the ability to reinstitute the court case.

The plaintiffs are represented by the Disabilities Rights Center, Devine Millimet, the Center for Public Representation, and the Judge David L. Bazelon Center for Mental Health Law. In September 2013, the US District Court certified the matter as a class action. Trial had been scheduled for June 2014.

“Access to community-based mental health services has long been proven to eliminate or reduce the needless institutionalization of people with serious mental illness,” said Dan Will of Devine Millimet. “Community services not only lead to a higher quality of life for individuals with disabilities, but also are far less costly than institutional care.”

For people with serious mental health conditions and complex medical needs who are residing at Glencliff, the state-run nursing home, New Hampshire will work to develop community settings 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.

A final hearing on the settlement agreement is expected to take place before US District Court Judge Stephen McAuliffe in February.

If you are in doubt about the status of any meeting, please call the Bar Center at 603-224-6942 before you head out.

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