Committee Summary for Health and Human Services Oversight Committee (01/24/2025)

Bill/Time	Type	Title	Sponsor
Unclear 00:01:29.000 - 12:00:30 PM	General Working Session	Unclear

Unclear: Representative Edwards Information Only00:01:29.000 - 12:00:30 PM; Representative Edwards nominated Representative Mark Pearson for the position of chair for the coming term during the Department of Health and Human Services oversight committee meeting. This action was part of the organizational proceedings of the committee.
Unclear: Representative Edwards Information Only00:02:20.160 - 12:01:21 PM; Representative Edwards seconded the motion to approve the minutes of the oversight meeting from November 22nd. He also mentioned having spoken to an aide about Senator Avard's excused absence due to a business emergency.
Unclear: Representative Edwards Information Only00:03:06.760 - 12:02:07 PM; Representative Edwards provided additional information regarding the absence of Representative Jessica Lontine, stating it was excused as she was preparing for her mother's 90th birthday celebration. He also noted the workload of the speaker's office in assigning bills to committees.
Unclear: Senator Rosenwald Information Only00:04:18.120 - 12:03:19 PM; Senator Rosenwald abstained from voting on the minutes because she was not present at the previous meeting.
Unclear: Representative Woods Information Only00:04:18.120 - 12:03:19 PM; Representative Woods also abstained from voting on the minutes for the same reason as Senator Rosenwald, indicating absence from the previous meeting.
Unclear: Patricia Tilly, Associate Commissioner, Department of Health and Human Services Information Only00:05:08.080 - 12:04:09 PM; Patricia Tilly introduced herself as an associate commissioner and discussed the challenges faced by the staff in transitioning children from the Division of Children, Youth and Families (DCYF) to the adult services system. She highlighted a collaborative effort using a Kaizen event to improve the process, involving multiple bureaus and agencies, and emphasized the importance of continuous quality improvement and better integration within the department.
Unclear: Chris Santinello, Associate Commissioner, Department of Health and Human Services Information Only00:05:08.080 - 12:04:09 PM; Chris Santinello, another associate commissioner, further elaborated on the Kaizen event's outcomes. He discussed the mapping of processes to streamline the transition of youth from DCYF to adult services, the current limitations of the department's IT systems, and the future potential for better system integration to support the workflow. He also expressed agreement on the need for IT system improvements to enhance productivity.
Unclear: Representative Edwards Information Only00:11:46.800 - 12:10:47 PM; Representative Edwards inquired about the integration of IT systems to support the new workflow established by the Kaizen event. He expressed concern about the potential need to work around the IT systems instead of having them support the workflow and highlighted the importance of IT system improvements for productivity.
Unclear: Representative Weber Information Only00:15:40.880 - 12:14:41 PM; Representative Weber asked a clarifying question regarding the spelling of the acronym 'lean' used in the context of the Kaizen event, showing interest in understanding the terminology used.
Unclear: Senator Rosenwald Information Only00:15:52.360 - 12:14:53 PM; Senator Rosenwald posed a hypothetical question about the impact of potentially splitting the Department of Health and Human Services on the effectiveness of the processes discussed. The associate commissioners responded that the integration within the same department facilitates better communication and process improvement, suggesting that splitting could hinder these efforts.
Unclear: Unnamed Speaker 1 Information Only00:16:57.959 - 12:15:58 PM; The speaker inquired about the effectiveness of a program, questioning if it has successfully addressed its intended issues and whether it has introduced new problems. They expressed a concern that while the program sounds good, its actual impact and potential for creating new bureaucratic layers needed clarification.
Unclear: Unnamed Speaker 2 Information Only00:17:45.240 - 12:16:46 PM; The speaker responded to the query about the program's effectiveness, suggesting that success could be measured through youth transitions and monthly meetings. They argued that the program does not create new bureaucratic layers but instead streamlines and aligns processes to reduce bureaucracy.
Unclear: Unnamed Speaker 3 Information Only00:18:31.679 - 12:17:32 PM; The speaker expressed concern about the transition team potentially lengthening the time to achieve desired outcomes. They were reassured that the program aims to streamline processes and prevent delays by ensuring quick action through monthly meetings and clear roles and responsibilities.
Unclear: Unnamed Speaker 4 Information Only00:20:04.360 - 12:19:05 PM; The speaker confirmed understanding that no new bureaucracy was created but rather an improvement in inter-departmental collaboration. They appreciated the efforts to provide a more secure route for youth transitioning into adulthood. As a CASA volunteer, they thanked the committee for the increased attention to vulnerable youth without familial support.
Unclear: Unnamed Speaker 5 Information Only00:21:36.320 - 12:20:37 PM; The speaker agreed with the sentiment that having departments under the same roof facilitates better communication and collaboration. They noted improvements in engagement with loved ones of individuals with developmental disabilities and a resolution to previous issues with delayed responses.
Unclear: Kristin Hansen, Administrator, Division of Public Health Services Information Only00:22:21.559 - 12:21:22 PM; Kristin Hansen provided an update on Healthcare Acquired Infections (HAI). She highlighted that New Hampshire has been actively reducing HAIs since 2007 and presented data from 2023 showing that hospitals, ambulatory surgery centers, dialysis centers, and long-term care facilities reported fewer infections than predicted based on national data. She also discussed vaccination rates, program activities, and costs, emphasizing efforts to enhance data accessibility and infection prevention training.
Unclear: Unnamed Speaker 6 Information Only00:30:52.720 - 12:29:53 PM; The speaker inquired about the reasons behind the reduction in infections, asking if it was due to intentional actions. Kristin Hansen responded by noting a continuous decline in infection ratios over 14 years, attributing it to collaborative efforts across the state. She emphasized the program's role in reducing the transmission of antibiotic-resistant organisms.
Unclear: Senator Rosenwald Information Only00:33:37.720 - 12:32:38 PM; Senator Rosenwald asked about the delay in receiving 2023 data and the variance in flu vaccination rates between different facilities. Kristin Hansen explained the data reconciliation process and staffing challenges causing delays. She noted that vaccination rates vary due to facility policies and reporting practices, and the department is working to improve these.
Unclear: Senator Gray Information Only00:38:12.880 - 12:37:13 PM; Senator Gray requested analysis on whether the improvements in infection rates were statistically significant. Kristin Hansen confirmed that the department has the resources to perform such an analysis and would look into it further.
Unclear: Unnamed Speaker 7 Information Only00:39:43.359 - 12:38:44 PM; The speaker, a part-time CEO of a medical facility, expressed interest in implementing successful practices to reduce infections based on the data presented. Kristin Hansen agreed to look into identifying impactful measures.
Unclear: Representative Edwards Information Only00:40:30.400 - 12:39:31 PM; Representative Edwards questioned the correlation between flu vaccination rates and infection rates, noting a discrepancy in the data. Kristin Hansen clarified that vaccination rates are a best practice measure but not directly correlated with the specific infections reported, suggesting further research might be needed.
Unclear: Representative Woods Information Only00:43:35.640 - 12:42:36 PM; Representative Woods sought clarification on how ambulatory surgeries are categorized and how infections post-surgery are tracked. Kristin Hansen explained the criteria and licensing distinctions, emphasizing the importance of understanding these differences as more surgeries transition to outpatient settings.
Unclear: Representative Weber Information Only00:48:14.440 - 12:47:15 PM; Representative Weber asked if the report included data on influenza outbreaks. Kristin Hansen confirmed that it does not, as it's not required under the current law, but offered to pull data on outbreaks if requested.
Unclear: Senator Wal Information Only00:49:01.040 - 12:48:02 PM; Senator Wal followed up on Representative Edwards' question about flu vaccines, inquiring about influenza death rates in long-term care facilities. Kristin Hansen explained that influenza is not a reportable condition, but outbreaks are tracked, and they could provide data on outbreaks if requested.
Unclear: Unnamed Speaker 8 Information Only00:51:17.559 - 12:50:18 PM; The speaker cautioned against conflating correlation with causation when analyzing data, emphasizing the importance of being mindful of this distinction in committee discussions.
Unclear: Whitney Hammond, Interim Deputy Director, Division of Public Health Services Information Only00:51:57.319 - 12:50:58 PM; Whitney Hammond, along with Dr. Dave Nagel, provided an update on the State Health Assessment and State Health Improvement Plan (SHA-SHIP). They discussed the council's establishment, its broad representation, and the development of the SHA and SHIP. The department has prioritized heart disease, maternal and child health, childhood mental health, sexually transmitted infections, and environmental health as part of their internal plan aligned with the SHIP. They emphasized ongoing efforts to improve specific health outcomes and public health delivery.
Unclear: Elizabeth NE, Adolescent Program at DCYF, Youth Engagement Specialist Information Only01:03:59.359 - 1:03:00 PM; Elizabeth NE introduced herself and mentioned her broad role, which includes managing the tuition waiver program. She did not provide detailed testimony but confirmed her position and connection to the program.
Unclear: Fred Coello Support01:04:17.039 - 1:03:18 PM; Fred Coello discussed the success of the tuition waiver program, highlighting its expansion due to House Bill 2FN. He mentioned the increase in the number of waivers from 15 to 35 per system, the age limit increase from 23 to 26, and eligibility expansion for youth in guardianship or out-of-state placements. He reported a significant increase in certified applicants for the program, with all university system waivers taken and ongoing processing for community college waivers. He shared a personal story about how the program has helped his grandson, James, pursue higher education in architecture, expressing gratitude for the financial support provided.
Unclear: Representative Edwards Information Only01:09:57.880 - 1:08:58 PM; Representative Edwards inquired about the possibility of successful program beneficiaries donating back to the program to help future students. The suggestion was well-received, but it was noted that such a mechanism does not currently exist.
Unclear: Wayne Whitford, President, New Hampshire Health Officers Association Information Only01:13:04.000 - 1:12:05 PM; Wayne Whitford presented the annual report of the New Hampshire Health Officers Association, covering the period from November 1, 2023, to October 30, 2024. He highlighted the increase in health officers from 305 to 325 and discussed their focus on collaboration and readiness to respond to public health threats. He mentioned the involvement in training initiatives and the various roles health officers play in the community.
Unclear: Sophia Johnson, Administrator, Health Officer Liaison Program at the Department Information Only01:16:34.480 - 1:15:35 PM; Sophia Johnson elaborated on the health officer readiness report, emphasizing its origin from a legislative requirement in 2021 to assess local health officer preparedness. She detailed the collaborative effort between the health officer association and the department to produce the report. She highlighted the training initiatives for health officers, many of whom are volunteers or serve in multiple roles, and discussed the department's focus on building comprehensive training collaborations with other state programs. She also mentioned that the report was generated from surveys of local health officers, identifying public health threats and capacity issues.
Unclear: Unnamed Committee Member Information Only01:20:25.159 - 1:19:26 PM; An unnamed committee member asked how to find the local health officer in their represented towns. Sophia Johnson explained that the department publishes monthly reports with health officer contact information, which can be accessed via a link.
Unclear: Representative Weber Information Only01:21:10.600 - 1:20:11 PM; Representative Weber inquired if issues like bed bug infestations in rental housing fall under the health officers' purview. Sophia Johnson confirmed that they do.
Unclear: Senator Gray Information Only01:21:56.760 - 1:20:57 PM; Senator Gray asked for clarification on whether the 19 vacancies listed in the report referred to health officers or deputy health officers. Sophia Johnson explained that the number represents communities without a primary health officer and mentioned that adjacent health officers can respond in emergencies in these towns. She also clarified the process for shared health officers between communities.
Unclear: Representative McDonald Information Only01:25:07.800 - 1:24:08 PM; Representative McDonald discussed the report on local health offices' collaborations, emphasizing the extensive list of partners including the Department of Public Health Services and infectious disease staff. He noted that health officers are typically not involved in outbreaks other than rabies and mosquito-borne diseases but must undergo confidentiality training if they are involved in other infectious disease situations. He also inquired about the selection criteria for focusing on rabies and arboviral diseases, which was explained as being due to above-average activity in certain areas.
Unclear: Representative Edwards Information Only01:27:28.800 - 1:26:29 PM; Representative Edwards raised concerns about the enforcement powers of health officers, noting that they have authority under RSA 147 to enforce public health nuisances, specifically failed septic systems. He suggested that future reports should clarify the limits and extent of these enforcement powers to address public concerns about state enforcement in New Hampshire.
Unclear: Senator Gray Information Only01:29:50.119 - 1:28:51 PM; Senator Gray proposed the idea of having a county health officer to be shared among communities, suggesting it could be more efficient and cost-effective. He mentioned the potential for full-time positions at the county level with a background in environmental health issues, and this suggestion was received positively with plans to explore its feasibility.
Unclear: Representative Edwards Information Only01:32:07.880 - 1:31:08 PM; Representative Edwards discussed the need for a systematic approach to handling constituent requests and follow-ups with the Department of Health and Human Services (DHHS). He suggested receiving regular reports on the number of constituent cases processed and the outcomes, and inquired about existing standard operating procedures for these processes.
Unclear: Patricia Tilly, Associate Commissioner at DHHS Information Only01:34:25.880 - 1:33:26 PM; Patricia Tilly explained the current process for handling constituent concerns, highlighting Kathy Capron as the go-to person for routing inquiries within the department. She mentioned ongoing efforts to develop a more systemic approach, including a constituent relationship database, and confirmed that they are working on enhancing the process to provide the requested metrics.
Unclear: John Williams, DHHS Information Only01:36:44.639 - 1:35:45 PM; John Williams provided insights into the current system for handling constituent inquiries, emphasizing his role in connecting legislators with the appropriate department personnel. He discussed the existing process through Kathy Capron and the potential for providing metrics on constituent cases, while also highlighting the importance of direct communication and problem-solving within the department.
Unclear: Representative Weber Information Only01:44:31.199 - 1:43:32 PM; Representative Weber expressed concerns about the proposed changes to the constituent response system, emphasizing the current efficiency and responsiveness of the system. She argued against additional reporting requirements that could slow down the process, stating her personal experiences with quick resolutions to constituent issues.
Unclear: Representative Edwards Information Only01:46:47.760 - 1:45:48 PM; Representative Edwards reiterated the need for a simple process to help new legislators support their constituents effectively. He suggested a yearly summary report on the handling of constituent inquiries without personal data, focusing on the overall effectiveness and resolution rates of these inquiries.
Unclear: Representative McDonald Information Only01:48:58.920 - 1:47:59 PM; Representative McDonald confirmed the process for handling benefit denials, noting that individuals receive a notice of decision with reasons for denial. He verified that the 30-day appeal period to the administrative unit remains unchanged.
Unclear: John Williams, DHHS Information Only01:50:30.119 - 1:49:31 PM; John Williams provided an overview of the upcoming agenda for the next committee meeting, including the commissioner's update, reports from various councils and committees, and the scheduling considerations due to the Senate's break. He confirmed the meeting date and time and noted potential agenda items for March.