HB 480 — relative to restoration of competency to stand trial for criminal defendants.

(d) Assisting the defendant in obtaining and receiving any recommended services for competency restoration or that would facilitate competency restoration services.

(e) Assisting the defendant in reducing barriers to accessing and maintaining treatment and services.

(f) Sharing information with the parties and the court regarding the defendant’s progress in and adherence to treatment.

(g) Sharing information with the parties and the court relating to changes in the defendant’s condition relative to competency, restorability, or dangerousness.

(h) Receiving and disseminating treatment information from all mental health treatment facilities and providers with the parties and the court.

(i) Providing updates to the parties and the court as outlined in RSA 135:17 and RSA 135:17-a on the progression of competency restoration.

(j) Communicating and coordinating care with court-ordered providers.

HB 480 - VERSION ADOPTED BY BOTH BODIES - Page 3 - (k) Performing any other appropriate duties as assigned by the department.

IV.

The FL is entitled to all past and present relevant records and information relating to the defendant’s competency.

The defendant shall provide authorization for the FL to obtain all necessary mental health records.

If the defendant does not provide the FL with relevant records or access to records, the FL shall notify the parties who may petition the court for an order requiring the provision of such records.

All materials received by the FL shall be confidential and exempt from disclosure under RSA 91-A.

The FL shall provide access to relevant records to the parties and the court for the sole purpose of assessment and evaluation of competency.

Such records shall be kept confidential by the parties and the court and shall not be used for any purpose other than determination of competency, except that in the case of a person deemed not competent, not restorable, and dangerous per RSA 135:17-a, V, in which case the records shall be available to the state for the purpose of initiating a guardianship or involuntary admission.

Information provided by the FL to the parties and the court regarding the defendant’s treatment, or adherence thereto, shall be sealed.

The court may unseal such records or updates at its discretion.

V.

The FL may be ordered to appear in any proceeding in which the court determines the FL is necessary.

In all cases, the parties and the court are entitled to file motions based upon reports made to them by the FL.

VI.

For each year of the pilot program, the FL shall report to the department the number of cases received, the number of cases in which competency restoration was effectuated, and any recommendations to improve the competency restoration system in New Hampshire.

The department shall present this report to the health and human services oversight committee.

VII.

The department shall not be required to implement the pilot program established in paragraph II until such date that the program is sufficiently funded to meet the requirements of this section.

4 Effective Date.

HB 480 - VERSION ADOPTED BY BOTH BODIES LBA 25-0779 5/14/25 HB 480- FISCAL NOTE AS AMENDED BY THE HOUSE (AMENDMENT #2025-0061h) AN ACT relative to restoration of competency to stand trial for criminal defendants.

FISCAL IMPACT:

This bill does not provide funding, nor does it authorize new positions.

Estimated State Impact FY 2025 FY 2026 FY 2027 FY 2028 Revenue $0 $0 $0 $0 Revenue Fund(s) None $1.02 to $1.22 $1.05 to $1.25 Expenditures* $0 million million $0 Funding Source(s) General Fund Appropriations* $0 $0 $0 $0 Funding Source(s) None *Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill METHODOLOGY:

This bill directs the committee to study restoration of competency to submit any additional proposals on or before July 1, 2025 and requires, once adequate funding is received, the department of health and human services to establish a 2-year pilot program to create the position of one or more forensic liaisons, who will assist in competency proceedings of criminal defendants.

The Department of Health and Human Services (DHHS) indicates New Hampshire currently does not have a competency restoration program.

The Office of the Forensic Examiner is tasked with performing competency evaluations.

DHHS states the bill would have a significant fiscal impact.

DHHS would be required to establish a two-year pilot restoration of competency program in a county in New Hampshire.

The bill requires DHHS to add “one or more” Forensic Liaison positions and to hire, train, and supervise of these positions.

Since the DHHS has never been involved in the adult criminal justice system or with restoration of competency for individuals in the criminal system, it does not know how many staff would be needed.

DHHS has no information on the number of individuals or their needs.

Establishing a pilot program to service those in the criminal justice system would take significant time and resources and would involve establishing the proper number of positions and their supervisory responsibilities, hiring and training such staff, and implementing the program.

The bill also requires contracting for services necessary for competency restoration not otherwise covered by a third-party payer.

DHHS states there is no way to estimate the need for contracted services currently.

DHHS provided the following additional information:

· Competency restoration within NH has never been formally studied from a health plan coverage perspective.

Whether Medicare, Medicaid, commercial insurance, and other health plan providers are willing to pay for restorative services is unknown and may differ by plan.

It is not likely that federal dollars would be available for the State’s restoration program.

The Insurance Department will need to be engaged to identify coverage concerns and issues related to such a program from a health plan perspective.

· DHHS would need to renegotiate the Managed Care Organization contracts to ensure the coverage of such services for the Medicaid expansion population, commercial insurance contracts would need to be renegotiated for New Hampshire Hospital, and community mental health centers, and others that may provide these services.

These costs are indeterminable but are expected to be significant.

· Certain mental health services provided by licensed practitioners may be covered by insurance.

Restoration of competency is not solely mental health treatment and requires additional expertise and skills.

Aside from the Office of the Forensic Examiner, DHHS does not know if such expertise exists within the state.

The Office of Professional Licensure and Certification does not have administrative rules within their boards relative to the proper treatment and provision of these services.

To meet some of the program objectives in the bill, such as assisting the defendant in obtaining and receiving services, the State will need to spend money to develop standards for clinicians to provide proper restorative services from NH licensed clinicians or engage out-of-state contracts for provision of certain services.

· DHHS does not receive information from the criminal justice system currently.

The Office of the Forensic Examiner performs competency evaluations.

DHHS would need to coordinate with the Judicial Branch and the Office of the Forensic Examiner regarding individuals found incompetent to stand trial.

DHHS is unable to determine if an existing system is available or if a system would be necessary to facilitate this coordination.

DHHS provided a cost estimate assuming the workload would require four new positions:

a Forensic Case Manager, a Forensic Liaison and two Psychologists.

The estimated salary and benefit costs for these positions is $616,194 in FY 2026 and $646,994 in FY 2027.

In addition to salaries and benefits there would be administrative costs including transportation, documentation, courier, postage, contracting for services, supervisory responsibilities, and administrative rule changes.

These costs are indeterminable at this time but estimated to be between $400,000 and $600,000.

It is assumed that any fiscal impact would occur after FY 2025.

AGENCIES CONTACTED:

Department of Health and Human Services