CPP State Policy Feature: Arkansas
“CPP has emerged as the most frequently employed [early childhood evidence-based therapy] model in the state.”
-New Hampshire Senate Bill 444
150 providers*
Non-Profit NH CPP Provider Network
CPP Champion: Becky Whitley
2 annual state conferences
$700k* state training funds over 5 years
Outcomes database under development
Timeline
2008
First CPP training, sponsored by NCTSN grant.
2016
Privately-funded CPP TTT cohort for State LC trainer.
2021
IECMH report champions CPP strategy to state lawmakers.
Non-profit formed to support NH CPP provider network.
2022
First state funding allocated for CPP training.
Senate Bill 444 authorizes $700k for CPP sustainability
Statewide Non-Profit Organization
A connection hub, knowledge center, & funding vehicle
Non-profit organization formed in 2021 coordinates CPP sustainability across NH and facilitates flowthrough of state funds for CPP implementation. Staff connect with CPP agencies to understand successes and challenges and provide feedback to key stakeholders. They also support provider retention by creating a sense of community and by offering advanced trainings and therapy supplies.
Infusion of CPP Goals into Legislative Priorities
Policy partnerships lead to sustainability
A longstanding partnership with State Senator Becky Whitley, local foundations, and advocacy organizations marshalled insights from the CPP community to influence policy. A 2019 needs assessment report helped Whitley testify before New Hampshire legislature, where she pushed through three pieces of legislation.
Cross-Sector Training
Creating trauma-informed early childhood systems
Training on early childhood trauma helps non-mental health providers understand the needs of young children who have experienced adversity and fosters collaboration with CPP providers. These stakeholders then refer families to CPP services and jointly advocate for funding, policy changes, and additional workforce development.
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Key Organizations
CPP Non-Profit
The CPP Provider Network was formed in 2017 and is the “connective tissue” between CPP providers, systems, and funders. The non-profit was formed in 2021 and serves as the flowthrough for state funds to reach the CPP Provider Network.
CPP Funders:
New Hampshire Legislature (current award: SB 444)
Substance Abuse and Mental Health Agency (current award: SM-22-006)
New Hampshire Charitable Foundation (You Have Our Trust)
Key Resources
- CPP Time-Cost Study – Learn how the NH CPP Network used data to estimate the total cost (in time) of CPP treatment!
- CPP Workforce Sustainability Study – Learn how CPP state leadership created a crosswalk between New Hampshire’s IECMH needs and prospective CPP programming!
Additional Supportive Factors for CPP Sustainability
Advocacy Groups
Advocacy organizations–such as New Futures–play a crucial role in advancing CPP policy in New Hampshire. These organizations help raise awareness about the importance of trauma-informed care and the effectiveness of the model. By catalyzing legislative changes and funding support, they ensure that CPP is integrated into state policies and programs.
IECMH Legislation
In 2021, New Hampshire partnered with ZERO TO THREE to form an infant and early childhood finance strategy technical assistance group. This group created a comprehensive Medicaid benefit that included at-risk infants and children as well as their caregivers. The group also identified the 1915(i) Medicaid State Plan amendment (which appropriates funding for home visits to high-need children and families) as a foothold for the ACEs pilot program commissioned in SB 444.
Outcomes Database
CPP leaders in New Hampshire are partnering with the state to develop a CPP outcomes database. This funding is routed through both the official evaluator for the Systems of Care initiative and Cheshire County. One goal of the database is to streamline the reporting process, which can be burdensome to providers.
Compensation for Supervision and Continuing Training
State funding allows the CPP NH Network to compensate supervisors for their time and provide 46 CE credits at no cost.
Additional Challenges to Sustainability
Referral Time
One obstacle to CPP sustainability in New Hampshire is the long wait times for general referrals to reach the provider network. This is in contrast to high-priority patient populations (i.e., those involved in child welfare, ACEs response teams, or the Young Child System of Care)—here, the state funds CPP training for clinicians and agencies in exchange for their agreement to take CPP clients within 30 days of intake. To reduce overall referral times, state CPP leadership has designed an expedited screening model and is consulting with cross-system partners (e.g., Child Welfare, SOC) to identify cases for expedited referral.
Management of CPP Non-Profit
Having a non-profit has been pivotal to sustaining CPP in New Hampshire, but it is not without cost. Forming the non-profit and hiring staff was a massive undertaking, according to its executive director.
Future New Hampshire CPP Sustainability Considerations
- Secure funding to compensate supervisors for supervision time
- Secure funding to compensate clinicians for training time (in addition to the existing 46 CE credits)Develop an expedited referral process
- Enhance cross-systems collaboration around caregivers with substance use disorders and young children
- Develop the cultural brokers model
*Numbers are current as of March 2024.
The content of this document is intended for informational use only. If you are interested in becoming involved with CPP policy advocacy in your state, please fill out this survey.
The CPP Dissemination Team would like to thank Cassie Yackley, for providing context into CPP sustainability in New Hampshire, and Martha Robb and Beth Ketaineck, for their contributions and leadership on the training team.