Committee Summary for Health and Human Services Oversight Committee (02/21/2025)

Bill/Time	Type	Title	Sponsor
Unclear 00:15:06.120 - 12:12:47 PM	General Working Session	Unclear

Unclear: Patricia Tilly, Associate Commissioner, Department of Health and Human Services Information Only00:15:06.120 - 12:12:47 PM; Patricia Tilly provided updates on several initiatives of the Department of Health and Human Services. She discussed the progress on the new Youth Development Center (YDC) in Hampstead, noting that construction has started with tree clearing and installation of temporary fences and stormwater management systems. She mentioned that the construction is expected to be completed by June 30, 2026, with the facility becoming operational by August 30, 2026. Tilly also addressed the ALS registry, explaining the department's efforts to explore existing data sets like hospital discharge data and all-payer claims data as alternatives to building a new HIPAA-compliant system, which had been estimated to cost around $750,000. She highlighted the challenges and limitations of using existing data for creating a registry and expressed willingness to continue working with the committee on cost-effective solutions.
Unclear: Senator Rosenwald Information Only00:22:48.200 - 12:20:29 PM; Senator Rosenwald inquired about the department's collaboration with the Rare Disease Advisory Council regarding the ALS registry. He mentioned previous discussions within the council about the feasibility and cost-effectiveness of establishing such a registry. Tilly responded that the department has been closely working with the council and exploring options, including potential involvement from Dartmouth, due to its significant data resources.
Unclear: Representative Woods Information Only00:24:58.600 - 12:22:39 PM; Representative Woods suggested exploring the possibility of sharing infrastructure with the existing cancer registry to reduce the costs associated with setting up an ALS registry. Tilly acknowledged the idea but noted that even adding a module to the existing system would still be expensive due to HIPAA compliance and other technical requirements. She mentioned ongoing discussions with the Rare Disease Advisory Council as a potential avenue for further exploring such options.
Unclear: Representative Weber Information Only00:27:17.799 - 12:24:58 PM; Representative Weber commented on the previous year's efforts to establish the ALS registry at Dartmouth, which did not succeed despite significant efforts. He suggested that the failure of those negotiations indicated the challenges involved in setting up such a system.
Unclear: Senator Rosenwald Information Only00:28:53.480 - 12:26:34 PM; Senator Rosenwald raised concerns about the operating budget increases for the new Youth Center in Hampstead, given the low census. Tilly clarified that the budget increases were related to staffing costs for running a 24/7 facility, not the construction costs, which are funded by ARPA funds. She also discussed the need for flexibility in the facility's design to accommodate different groups and ensure safety.
Unclear: Senator Gray Information Only00:32:47.440 - 12:30:28 PM; Senator Gray requested a report on the department's compliance with state and federal requirements, expressing interest in ensuring that all relevant laws are being followed. Tilly agreed to arrange a discussion with the audit team to provide the requested information at a future meeting.
Unclear: Representative McDonald Information Only00:34:00.880 - 12:31:41 PM; Representative McDonald asked about the complexity of tracking ALS compared to other diseases like cancer. Tilly explained that the complexity stems from not having a system in place and the challenges of using existing data sets to track ALS, which may not always directly indicate an ALS diagnosis. Representative Woods added that ALS's multi-system nature makes it more complex than cancer, which is identified by specific cell types.
Unclear: Jenny Horan, Alzheimer's Association, New Hampshire Information Only00:37:28.280 - 12:35:09 PM; Jenny Horan, Senior Public Policy Manager for the Alzheimer's Association in New Hampshire, expressed gratitude for being allowed to speak and for the additional time granted by the chairman. She mentioned the challenges of transcribing notes and asked speakers to slow down. She thanked Senator Avard for his leadership in the subcommittee focused on gathering information on Alzheimer's and dementia care in New Hampshire. The report they compiled includes data on types of dementia care, instances of abuse and exploitation, caregiver strains, and available services. She indicated that the next step is to identify gaps in the state's system and work on a state plan. Horan confirmed they are in early stages of developing a state plan and will continue to meet, with the next meeting planned for March. She agreed to send out an email about the meeting and to return for any follow-up questions after committee members review the report.
Unclear: Olivia May, Director of Medicaid Enterprise Development, Division of Medicaid Services, DHHS Information Only00:44:32.760 - 12:42:13 PM; Olivia May presented an update on the 12-month postpartum coverage in the Medicaid Program, which was extended from 60 days as per legislation in the 2024-2025 budget. The state plan amendment for this change was approved on November 3, 2023. New Hampshire, along with 47 other states, has implemented this extension. Initial data from women who delivered between August and October 2023 showed that 95% received medical services, 52.4% received mental health or substance use disorder treatment, 26.7% received preventative health visits, and 3.2% received heart or hypertension services. May is open to questions and expects more data in future reports.
Unclear: Michael Holt, Administrator, Therapeutic Cannabis Program, Department of Health and Human Services Information Only00:53:24.280 - 12:51:05 PM; Michael Holt presented the annual therapeutic cannabis program data report for 2024, required by RSA 126-X:10. The report covers active patients, caregivers, and certifying providers as of June 30, 2024. New Hampshire has the lowest number of patients per capita nationally for medical cannabis programs, with 1,475 patients registered. The growth of the program has slowed, with a 3.7% increase in 2024. Most patients are in their 50s and 60s, with the majority certified for pain conditions. New conditions added last session resulted in 450 new patients. The number of caregivers has doubled since 2020, and the program has waived or eliminated fees to reduce barriers. However, finding certifying providers remains challenging, especially for veterans who cannot be certified by VA providers. Holt highlighted that high prices in New Hampshire lead to cross-border purchases, with over 30% of registered patients never visiting an ATC. The ATCs have affordability programs benefiting nearly 30% of patients. Holt responded to questions about county disparities, the low uptake of the program, and potential cost reduction strategies, including legislative proposals on hemp-derived cannabinoids, greenhouse cultivation, and for-profit status for ATCs.
Unclear: Michael Holt, Administrator, Therapeutic Cannabis Program, Department of Health and Human Services Information Only01:16:02.280 - 1:13:43 PM; Michael Holt presented the annual report of the therapeutic cannabis medical oversight board for 2024. The board met three times, focusing on legislative activities and educational material. They reviewed proposed legislation and provided clinical guidance, supporting the addition of generalized anxiety disorder but not eating disorders as qualifying conditions. They also supported bills that enhance patient access, such as opposing limits on THC concentrations and supporting home cultivation. The board's educational focus was on the risks of cannabis use in adolescence, and they are developing materials to inform the public. Holt responded to questions about the board's activities and confirmed that legislative proposals discussed earlier were supported by the board.
Unclear: Senator Gray Information Only01:20:40.440 - 1:18:21 PM; Senator Gray suggested that the committee consider overseeing the budget of the Department of Health and Human Services (DHHS), noting a projected $47 million shortfall in lapses, with up to $15 million from DHHS. He proposed discussing budget oversight at the next meeting.
Unclear: Representative Weber Information Only01:22:13.199 - 1:19:54 PM; Representative Weber commented on the committee's heavy workload and the existing rigorous budget processes in both the House and Senate. He expressed reservations about the committee taking on budget oversight due to limited expertise but was willing to discuss it further if added to the agenda.
Unclear: Representative Woods Information Only01:23:46.600 - 1:21:27 PM; Representative Woods' comment was cut off, so no full summary could be provided.
Unclear: Unidentified Speaker Information Only01:23:54.480 - 1:21:35 PM; The speaker asked Senator Gray about specific areas where the committee's role could enhance the budget examination process. They mentioned the historical role of the Senate Finance Committee and questioned the oversight responsibilities, suggesting a possible need to split the committee or increase meeting frequency. They emphasized the importance of not duplicating efforts by the finance committees in the House and Senate, and suggested a smaller report might be manageable. They proposed involving the chairs of both House and Senate Finance Committees in future discussions.
Unclear: Senator Gray Information Only01:27:00.840 - 1:24:41 PM; Senator Gray agreed with the need for better oversight on spending over the two-year budget cycle. They pointed out challenges in getting cooperative responses from the executive branch, particularly regarding lapses in funding. They suggested that the committee should be involved to some degree in financial oversight, proposing a middle ground approach and suggesting a future discussion with Chairman Wer from the Finance Committee.
Unclear: Unidentified Speaker Information Only01:29:20.040 - 1:27:01 PM; The speaker emphasized the importance of the committee finding a middle ground in financial oversight, acknowledging the depth of budget exploration by the House Finance Committee, particularly Division 3. They stressed the need for better communication and process to avoid duplicating efforts already being made by other committees.
Unclear: Senator Rosenwald Information Only01:31:42.199 - 1:29:23 PM; Senator Rosenwald highlighted the importance of ongoing oversight throughout the budget cycle, noting a significant deficit in lapses. They questioned whether the current committee or finance committees should handle this oversight, suggesting a discussion to determine the appropriate place for such responsibilities.
Unclear: Representative Woods Information Only01:32:27.800 - 1:30:08 PM; Representative Woods expressed caution about taking on too much oversight for the current budget cycle but suggested that the committee could play a significant role in the next cycle if a focused mechanism were in place. They emphasized avoiding unnecessary disruption and suggested further discussion on the matter.
Unclear: Unidentified Speaker Information Only01:34:00.400 - 1:31:41 PM; The speaker asked if anyone could provide information on how much of the $47 million lapse was attributable to Health and Human Services, noting that no one present could answer the question. They suggested further inquiry and proposed a future meeting to discuss this topic outside of the regular monthly meetings.
Unclear: Representative Weber Information Only01:35:36.560 - 1:33:17 PM; Representative Weber clarified the roles of Democrats listed on the committee, particularly in Finance Division 3, and suggested consulting with Representatives Walner and Terski about the oversight responsibilities. They also mentioned their experience with Representative Walner's helpfulness in a previous finance meeting.
Unclear: Unidentified Speaker Information Only01:37:12.719 - 1:34:53 PM; The speaker agreed to schedule the oversight discussion as the last item on the next month's agenda, acknowledging the complexity and importance of the topic. They emphasized the need for a focused discussion without duplicating existing efforts.
Unclear: Senator Rosenwald Information Only01:37:57.960 - 1:35:38 PM; Senator Rosenwald suggested the creation of a Health and Human Services budget oversight subcommittee, which could include members beyond the current committee. They proposed scheduling the discussion at the end of the next meeting to allow interested members to stay longer and contribute to finding a solution.
Unclear: Unidentified Speaker Information Only01:39:30.320 - 1:37:11 PM; The speaker humorously mentioned owing time to the committee and suggested taking time off, ending with a light-hearted discussion about wine and cheese. They confirmed the next meeting date and adjourned the current meeting.