NH’s “Building Capacity for Transformation” Waiver
On January 5, 2015, New Hampshire received approval from the Center for Medicare and Medicaid Services (CMS) for the Building Capacity for Transformation Waiver, a Medicaid Section 1115(a) demonstration waiver also referred to as DSRIP (Delivery System Reform Incentive Program). Under the special terms and conditions (STCs) of the demonstration, New Hampshire has access to up to $150 million in Medicaid funds over five years to expand community-based mental health, combat the opioid crisis, and drive delivery system reform for Medicaid beneficiaries.
The funds will be used to support Integrated Delivery Networks (IDNs) — networks of medical, behavioral health, substance use disorder (SUD) and social service providers – in undertaking projects aimed at furthering the objectives of the waiver and meeting performance metrics in seven service regions across New Hampshire. The projects all focus on building greater behavioral health capacity by:
Project Focus
- Delivering integrated physical and behavioral health care that better addresses the full range of individuals’ needs. NH is the first state whose 1115 waiver has a behavioral health (mental health/SUD) focus.
- Expanding capacity to address emerging and ongoing behavioral health needs in the appropriate setting.
- Reducing gaps in care during transitions across care settings by improving coordination across providers and linking patients with community supports.
- Moving 50% of Medicaid reimbursement to Alternative Payment Models by the end of the 5-year demonstration period (12/31/20).
In May 2016, the Partnership for Public Health (PPH) was awarded a contract to serve as the Administrative Lead of the DSRIP waiver in the Central and Winnipesaukee Region. Our region then formed a separate limited liability company named Community Health Services Network, LLC (CHSN) and hired Executive Director, Audrey Goudie, to oversee the waiver activities. CHSN has a robust and varied network of 31 partner agencies.
The overall intent of the DSRIP waiver is to reduce the cost of Medicaid and ultimately identify alternative payment models at the end of the 5-year waiver. NH’s DSRIP waiver is focused on integrating behavioral health and primary care with a specific focus on the Medicaid population. The success of our work will be measured by the NH Department of Health and Human Services (DHHS) based on process outcome measures. IDNs must report progress towards integration and capture data showing whether metrics are met. Meeting continued goals and metrics is critical in order for an IDN to receive incentive payments over the course of the waiver period.
Each of the seven regions across NH were required to participate in six projects. Two were mandated statewide projects (A1, A2), one a core competency project (B1), and three were chosen by the IDN from a menu provided based on regional needs assessments performed. CHSN-IDN 5’s projects are listed here:
STATEWIDE PROJECTS:
- A1- Prevention Strategies Workforce Capacity Development
- A2- Health Information Technology (HIT) Infrastructure to Support Integration
CORE COMPETENCY PROJECT:
- B1- Integrated Healthcare
COMMUNITY DRIVEN PROJECTS:
- C2- Community Re-Entry for Justice Involved Adults & Youth with SUD or Significant Prevention Strategies Issues
- D3- Expansion in Intensive SUD Treatment Options, Including Partial-Hospital and Residential Care
- E5- Enhanced Care Coordination for High-Need Populations
IDN Region 5: Winnipesaukee and Central Public Health Network Regions
(Serving the following towns within Belknap, Northern Merrimack and Southern Grafton Counties)
| Alexandria | Danbury | Laconia | Thornton |
| Alton | Ellsworth | Lincoln | Tilton |
| Ashland | Frankl in | Livermore | Warren |
| Barnstead | Gilford | Meredith | Waterville Valley |
| Belmont | Gilmanton | New Hampton | Wentworth |
| Bridgewater | Groton | Northfield | Woodstock |
| Bristol | Hebron | Plymouth | |
| Campton | Hill | Rumney | |
| Center Harbor | Holderness | Sanbornton |
ABOUT US: CHSN Board Members, Affiliate Partners and Staff
Maggie Pritchard, Chair
Lakes Region Mental Health Center
40 Beacon St. E., Laconia NH 03246
E-mail: mpritchard@genesisbh.org
Jacqui Abikoff, Vice Chair
Horizons Counseling Center
25 Country Club Rd., Suite 705 Gilford NH 03249
Email: jabikoff@gmail.com
Rebecca Bryant, Treasurer
Lakes Region Community Services
PO Box 509, Laconia NH 03247
E-mail: rebecca.bryant@lrcs.org
Lisa Dupuis, Secretary
Central NH VNA & Hospice
780 N. Main St., Laconia NH 03246
E-mail: ldupuis@centralvna.org
Bob MacLeod
Mid-State Health Center
101 Boulder Pt. Dr., Suite 1, Plymouth NH 03264
E-mail: rmacleod@midstatehealth.org
Tammy Carmichael
Partnership for Public Health
67 Water St., Suite 105, Laconia, NH 03246
E-mail: tcarmichael@PPHNH.ORG
Kevin Donovan
LRGHealthcare
80 Highland St., Laconia NH 03246
E-mail : kdonovan@lrgh.org
Russ Keene
HealthFirst Family Care Center
841 Central St., Franklin NH 03235
22 Strafford St., Laconia NH 03246
E-mail: rkeene@healthfirstfamily.org
Chandra Engelbert
Pemi-Baker Community Health
101 Boulder Pt. Dr., Suite 3, Plymouth NH 03264
E-mail: cengelbert@pbhha.org
Debra Peaslee
Lakes Region Visiting Nurse Association
186 Waukewan St. Meredith, NH 03253
E-mail: dpeaslee@lrvna.org
Jeanne Agri
CAP Belknap-Merrimack Counties
E-mail: jagri@bm-cap.org
Michelle McEwen
Speare Memorial Hospital
16 Hospital Rd., Plymouth NH 03264
E-mail: mmcewen@spearehospital.com
Deb Naro
Communities for Alcohol-and Drug-free Youth (CADY)
94 Highland St., Plymouth NH 03264
Email: dnaro@cadyinc.org
Tabitha Dowd
Franklin VNA & Hospice
75 Chestnut St., Franklin NH 03235
E-mail: tdown@franklinvna.org
Jennifer Rosene
Newfound Area Nursing Association (NANA)
214 Lake St., Bristol NH 03222
E-mail: jennr@nanainc.org
CHSN Affiliate Organizations
Ascentria
Belknap County
Bridge House
Community Bridges
Cornerbridge
Crotched Mountain Foundation
Easter Seals/Farnum North
Grafton County
Granite State Independent Living
Merrimack County
National Alliance on Mental Illness ‐ NH
Navigating Recovery of the Lakes Region
NH Alcohol and Drug Abuse Counselors Association
NH Veterans Home
Plymouth Area Recovery Connection
Riverbend Community Mental Health
CHSN Staff:
Audrey Goudie, CHSN Executive Director
67 Water St., Suite 105, Laconia, NH 03246
Office Phone: 603-707-5856
agoudie@pphnh.org
Quinn Tule, CHSN Data Analyst
603-707-5862
qtule@pphnh.org