During my time as a New Hampshire State Senator, I learned that the most powerful voices at the State House are often those of Granite Staters who are willing to share deeply personal stories about why policy needs to change. Those moments stay with you. They put a human face on decisions that might otherwise feel abstract, and they remind us what is truly at stake.
So many of those stories have stayed with me, but I still think often about the young man who testified at a Senate hearing in 2024 in support of his little sister. He was a college student from Bedford who had experienced his own significant health issues. He was composed and thoughtful, but clearly not entirely comfortable sitting at a microphone in a Senate chamber sharing the most painful chapter of his family’s life. But he was there because his 12-year-old sister was suffering, and he wanted policymakers to truly understand what it looks like when a family is doing everything they can to hold itself together in the middle of a crisis.
He told us about Christmas Day, opening gifts with his family in a small meeting room at Hampstead Hospital, New Hampshire’s primary inpatient psychiatric facility for children and adolescents. Not at home, but in a clinical setting because his sister’s needs were too urgent and too complex to be safely managed anywhere else. He told us about Thanksgiving, how her condition had been so frightening that, at times, he regretted coming home from college because he didn’t know what he would find. He described spending his first semester not focused on classes or friendships, but living with constant worry, bracing for each phone call from home and fearing it would bring more difficult news.
I sponsored legislation that session because I had heard too many similar stories from families across New Hampshire who were doing everything they could to support a child in crisis, yet still struggling to access the kind of timely, effective care that helps children stabilize safely at home and in their communities. Because children deserve timely, effective care that responds before a crisis escalates to the point of hospitalization.
New Hampshire’s FAST Forward program, our state’s high-fidelity wraparound intervention, costs between $45,000 and $60,000 per child each year. By comparison, just three months of inpatient pediatric psychiatric care can exceed $180,000. But because private insurers do not cover FAST Forward, financial responsibility often shifts away from a patient’s private insurer once a child’s condition worsens to the point of hospitalization and they qualify for Medicaid coverage. Meaning that when early, community-based care is not consistently covered by insurers, costs are ultimately borne by taxpayers, and families who have paid insurance premiums are left without their carrier’s support at the most critical moment.
For more than five years, families, providers, insurers, advocates and policymakers have been attempting to work together to try to solve this problem without legislation and to build a pathway that ensures children can access high-quality wraparound behavioral health services when they need them. But while we have worked to find a voluntary solution, families have continued to struggle. Children have continued to cycle through crisis care settings. Providers have continued to face barriers to sustaining services that help children remain safely at home. The need has not diminished and the urgency has only grown.
This legislative session presents an opportunity to do better. The proposal before the legislature establishes a shared financing approach across commercial health insurance plans to directly support access to FAST Forward. It is a practical solution that helps ensure children can access care earlier, reduces the likelihood of costly hospitalizations, minimizes disruption for families and distributes responsibility more fairly across the system. Supporting children’s mental health is a shared responsibility, and this approach reflects the importance of working together to ensure families can access the care they need when they need it most.
Two years ago, the young man ended his testimony with a simple request. He said he needed his sister back. He needed her to feel like herself again. He needed his parents to feel safe and he needed to be the big brother he wanted to be.
Now it is time for all of us to come together to ensure that children and families in crisis are met with care, accountability and a system that works when they need it most. It’s past time to fix this.Â
Becky Whitley of Hopkinton is a state senator representing NH’s 15th district.