Union Leader – April 15, 2026
By ANDREA BROCHU
No parent imagines their child will struggle with mental health. No parent pictures themselves unable to access help, unsure where to turn, or being told to wait while their child is actively falling apart. We assume these things happen to other families — until one day, they happen to ours.
That day came for my family. And when it did, the system was not there to catch us.
I am not a parent who didn’t know how to ask for help. I have spent more than 15 years working across nonprofit organizations and social service systems throughout New Hampshire and beyond. I knew the language. I understood how funding streams worked. I knew how to push back when someone told me no.
And I was still lost.
Despite advocating relentlessly for my son, I ran into closed doors, waiting lists, and a system that seemed to require us to fall further before help would arrive. If I — with all of my knowledge, experience, and access — could not navigate this system, imagine the families who don’t have these tools. Their children don’t just fall through the cracks. The cracks are the system.
Here is what made our situation all the more absurd: both my son’s father and I were employed. Our son had private insurance. And yet the only way to access wraparound services — the intensive, community-based care coordination that ultimately stabilized our child and our family — was to apply for Medicaid.
That should stop you in your tracks.
Wraparound, sometimes called FAST Forward in New Hampshire, is a Tier 3 intensive care coordination service. It meets families where they are, builds individualized plans, and brings together schools, providers, and community supports around a child with complex behavioral health needs. It works. And right now, it is almost exclusively funded through Medicaid — meaning privately insured families like mine, and like 67 percent of children in New Hampshire, must take a harder path to access it.
This is not a funding solution. It is a structural failure.
Private insurers have little incentive to cover Wraparound because they know that if a child’s needs escalate enough — reaching psychiatric hospitalization, a Tier 4 or Tier 5 crisis — the child will likely qualify for Medicaid, and taxpayers will absorb the cost. Children with private insurance are left without care at Tier 3, but once they escalate and qualify for Medicaid, they can access Tier 3 as a step-down following hospitalization. These children are suffering unnecessarily.
Senate Bill 498, currently before the New Hampshire House of Representatives, would begin to fix this. The bill establishes a Children’s Behavioral Health Association that would assess private insurance carriers, stop-loss carriers, and third-party administrators for the cost of Wraparound services — spreading the responsibility across the private insurance market rather than offloading it entirely onto Medicaid. It would create a dedicated fund to support care management entities serving privately insured children, bringing New Hampshire closer to a sustainable, equitable system.
The problems my family faced were not rooted in income or neglect. They grew from the intersection of genetics, environment, and an educational system not equipped to support my son. Mental health does not check your insurance card before showing up at your door.
Wraparound met us without judgment. It offered safety when we were scared, a team when we were depleted, and a roadmap through a system that felt impossible to navigate alone. We built a plan — and then adjusted it, because real life doesn’t fit into rigid service models.
When we entered Wraparound, we had nearly lost our son. Today, he is thriving. In the right educational environment, he became a straight-A student and a leader among his peers. He has a part-time job, graduated early, and is pursuing trade school. He is confident, capable, and hopeful about his future.
That outcome did not happen because we were lucky. It happened because Wraparound works.
Programs like this reduce long-term public costs by preventing school failure, psychiatric hospitalization, juvenile justice involvement, and long-term unemployment. They keep parents in the workforce, reduce crisis-level interventions, and build stability where instability would otherwise persist and compound. Yet we continue to jeopardize this program — and the children who benefit from it — by allowing private insurers to free-ride on public dollars.
I understand that legislative decisions come down to the bottom line. So here is mine: why would we continue to require families in crisis to draw from an overburdened Medicaid system when a smarter, more sustainable solution is available? Why would we limit access to a program that strengthens children, families, communities, and — ultimately — the economy?
When you invest in Wraparound, you invest in healthier children, stronger families, safer communities, and a more resilient future for New Hampshire.
Pass Senate Bill 498.
Andrea Brochu works in education and resides in Jefferson.