For more than a decade, New Hampshire has been learning a simple lesson: children do better when we reach them early, serve them close to home and reserve locked facilities for only the most serious cases.
That lesson did not come out of nowhere. It grew out of years of reform efforts to reduce the number of children entering the juvenile justice system, and for those who do enter the system, reducing the number who are sent to the Sununu Youth Services Center, our state’s youth detention and commitment center. It reflects a broader recognition that a child in crisis is not just a legal issue, but a family, clinical, school and community issue to be understood.
New Hampshire has already acted on that understanding. In 2016, the state established its Children’s System of Care, designed to improve outcomes, limit costly out-of-home placements and coordinate support for children involved in multiple systems or at risk of court involvement. In 2021, lawmakers built on that foundation by making it easier for children who may have committed a crime to get needed mental health treatment, using pre-petition needs assessments and referrals to supports like Fast Forward to divert children from the juvenile justice system.
The approach is sound and straightforward: assess needs early, connect families to services, keep children safely in their homes and communities and reduce unnecessary court involvement. This is not soft-on-accountability policy. It is the difference between reacting after a crisis and preventing one from even occurring.
Programs like Fast Forward, New Hampshire’s high-fidelity wraparound program, reflect that approach, helping reduce hospitalizations and out-of-home placements through intensive, coordinated support. It reflects exactly the kind of intervention New Hampshire made clear it wanted when it chose diversion over default court involvement and community-based care over institutionalization. But access to these services remains uneven, and children with similar needs are not treated equally.
Today, children enrolled in Medicaid can receive wraparound services through existing pathways. Children with private insurance may not have comparable access, even when their needs are just as serious. As a result, families can face delays, gaps in care, access state-funded services or be forced to seek Medicaid coverage to get help.
As members of the House Children and Family Law Committee, we have seen firsthand how the gaps in our children’s system play out in real families. The families who appear before our committee are rarely there because of a single bad decision. They are there because a crisis went unaddressed too long, often because the right door was closed to their family at the wrong moment. A child’s insurance card should not determine whether they get help before that crisis deepens.
Senate Bill 498 addresses that gap. The bill would establish a dedicated funding mechanism through assessments on fully insured and self-funded plans. This will ensure that children can access the same level of care regardless of insurance status.
The stakes are practical as well as fiscal. New Hampshire has slowly recognized that large, institutional responses are costly and often poorly matched to what children need. In 2023, the state spent roughly $13 million to operate SYSC for about a dozen children, underscoring the cost after crises deepen. That same year, the legislature decided to close the current Sununu Youth Services Center and replace it with a smaller, trauma-informed treatment-based facility.
The issue is not whether to invest in children. It is when and how. When early supports are underfunded, the system pays more later through court involvement, residential placements and long-term outcomes.
SB 498 is about strengthening that front end. It aligns funding with the approach New Hampshire has already chosen: intervene earlier, serve children closer to home, coordinate care across systems and reduce reliance on the most restrictive and expensive placements.
New Hampshire has already defined its direction. The question now is whether it will fully support the system it has spent years building.
SB 498 is not just a children’s mental health bill. It is a juvenile justice bill, a family stability bill and a fiscal responsibility bill. It asks New Hampshire to follow through on its stated values for all children.
Progress should not depend on whether a child’s insurance card opens the right door. If the state believes children should receive the right care at the right time, SB 498 provides a path to make that principle real.
Rep. Kimberly Rice serves Hillsborough District 37, the towns of Hudson and Pelham. Rep. Alicia Gregg serves Hillsborough District 7 and represents the city of Nashua.