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DHHS outlines roadmap focused on community care, workforce and ‘Mission 0’ to reduce emergency boarding

January 27, 2025 | Finance - Division III, House of Representatives, Committees , Legislative, New Hampshire


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DHHS outlines roadmap focused on community care, workforce and ‘Mission 0’ to reduce emergency boarding
At an informational Division III Finance hearing, Commissioner Lori Weaver of the Department of Health and Human Services outlined the department’s multi-year roadmap, emphasizing community-based behavioral health, workforce stability and an initiative known as “Mission 0” to reduce emergency-department boarding for people with acute mental-health needs.

Weaver said the roadmap is intended to “tell the story of the department without having you glaze over and us go line by line,” and she asked committee members to reserve detailed dollar questions for later budget sessions. Representative Edwards, who convened the hearing, cautioned members that this will be a difficult budget cycle and said “it is our deep obligation as a finance committee to deliver a budget that stays within the available revenues.”

The department presented high-level figures to give the committee context: a roughly $3.6 billion total budget (federal, state and other funds), about $1.217 billion in general funds, and personnel costs that the department estimates are less than 11 percent of its total budget. Weaver told the committee that DHHS staffing represents roughly one-quarter of all state positions and that the department did not request new positions this cycle except where required by legislation.

Weaver described the roadmap’s three themes—culture, community and customer service—and highlighted goals to “promote thriving communities” by increasing access to specialized services and reducing reliance on institutional care. She identified Mission 0—an effort to end ED boarding for people experiencing mental-health crises—as a priority and said the department has made progress but that sustaining gains is challenging because the work draws on multiple funding streams and external partners.

Several members asked for more connective detail between the roadmap and line-item budget documents. Representative Edwards and other members requested a way to “pivot” HB 1 line items under the strategic-plan bullets so the committee can see what personnel and dollar resources support each roadmap priority. Commissioner Weaver agreed to produce further crosswalks and to surface performance measures in subsequent, deeper presentations.

On workforce, Weaver said the department has reduced its vacancy rate over the past two years (from about 22 percent to about 14 percent) and stressed that maintaining adequate direct-care staff is essential to sustain services. She told members DHHS has roughly a 3,000 position legislative cap and that the department is monitoring attrition and the recently announced hiring freeze.

The presentation repeatedly linked the roadmap goals to contracting, data and IT work the department says will improve service delivery and accountability. Representative Rich Nalivanco asked for specifics on “environmental threats” referenced in the roadmap; Associate Commissioner Patricia Tilly replied that the public-health presentation will cover PFAS, lead (including lead in homes and water), food safety and support for local health officers.

The department said it will return with deeper dives on performance metrics, Medicaid interactions with other programs, and costs associated with prioritized initiatives such as Mission 0. Weaver asked members to collect detailed questions during the session so the department can provide written or follow-up responses in later briefings.

The hearing was informational; no formal committee actions or votes were taken on the roadmap during this session.

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Scribe from Workplace AI
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