New Hampshire Continues Justice Reinvestment Effort to Improve Conditions for People Who Are High Utilizers of Criminal Justice and Behavioral Health Systems
A significant portion of the prison population and admissions in New Hampshire is composed of people known as high utilizers who cycle in and out of the system repeatedly. Many of these people have substance use issues that have not been addressed effectively. Additionally, people who are revoked from parole account for more than half of prison admissions, and the prison population is aging.
To address these issues, the state has launched the second phase of a Justice Reinvestment Initiative (JRI) that began in 2022 to collect and analyze data and develop solutions. JRI is funded by the U.S. Department of Justice’s Office of Justice Programs’ Bureau of Justice Assistance, with support from Arnold Ventures.
Current Project Scope
Since December 2023, the CSG Justice Center has been working with the Governor’s Advisory Commission on Mental Illness and the Corrections System (Advisory Commission), a newly established implementation working group, the Department of Corrections (DOC), the Department of Health and Human Services (DHHS), and key stakeholders to conduct a cross-system data match between behavioral health-related Medicaid data from DHHS and the DOC’s data.
The data match will identify the behavioral health trends of people in the state corrections system, expanding on a prior county jail analysis to gain a more complete picture of this complex population.
The CSG Justice Center is also working with the state to engage community stakeholders and DOC clinical, field service, and reentry staff to better understand the challenges they encounter in identifying and addressing the complex behavioral health needs of people who are high utilizers of the county jail and state prison systems.
In February 2024, the Advisory Commission reviewed preliminary criminal justice trends identified through the CSG Justice Center’s analysis of DOC data:
- The average monthly state prison population decreased 29 percent between Fiscal Year (FY) 2014 and FY 2023.
- People who are high utilizers—people admitted to New Hampshire prisons 3 or more times from FY 2014 to FY 2023—accounted for admissions to prison and 1 out of every 6 people in prison.
- Between FY 2014 and FY 2023, an average of 40 percent of all prison admissions due to drug and alcohol controlling offenses (which are the primary offense, or the most serious charge associated with a sentence) were people who are prison high utilizers.
- Parole revocations represent a disproportionate amount of the New Hampshire prison population, accounting for 51 percent of prison admissions in FY 2023.
- New Hampshire has an aging prison population. In FY 2023, 23 percent of the average monthly prison population was 55 years or older, which is a 65 percent increase from 2013.
Additionally, CSG Justice Center staff are providing guidance to the implementation working group. This group, appointed by state leaders and composed of agency staff, is tasked with implementing the following key administrative policy recommendations stemming from the first phase of the project and supported by the Advisory Commission:
- Support New Hampshire to develop and roll out crisis stabilization centers.
- Assist DHHS to establish requirements for care coordination for people who are high utilizers of jail and behavioral health resources.
- Support the state in identifying funding mechanisms to cover in-reach into the jails.
- Identify methods of data coordination and capacity building to better and more quickly track criminal justice trends.
Project Background
In 2022, New Hampshire state leaders launched JRI to address the high prevalence of people with behavioral health needs in the criminal justice system and their use of public health and county jail resources. This project included an analysis of jail administrative data and behavioral health-related Medicaid claims for people who are high utilizers of the jail systems in 9 of the 10 New Hampshire counties, paired with intensive statewide stakeholder engagement.
In April 2023, the Advisory Commission reviewed the final county jail data and Medicaid findings. The Advisory Commission also worked with CSG Justice Center staff to identify key administrative policy recommendations for the state to consider. In October 2023, New Hampshire state leaders requested additional technical assistance to expand the data analysis and implement the administrative policy recommendations made by the Advisory Commission.
Next Steps
The Advisory Commission reviewed preliminary Medicaid behavioral health data, selected qualitative analysis, and preliminary budget policy recommendations in May 2024. The final presentation, including the completed data analysis and policy recommendations, will be reviewed by the Advisory Commission in July 2024.
The data collected and analyzed by CSG Justice Center staff, including the perspectives of corrections professionals and the people they supervise, will provide state leaders with the information needed to develop data-driven recommendations for reducing recidivism and improving supervision and reentry outcomes for people with behavioral health needs who are part of New Hampshire’s criminal justice system.
This project was supported by Grant No. 15PBJA-21-GK-04348-JRIX awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice’s Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.