Warning: Bill numbers and names are based on text-to-speech transcript which may have errors due to transcription issues or ad hoc/incomplete language use by committee.
relative to consolidating the New Hampshire Health and Education Facilities Authority within the Business Finance Authority
Likely Text to Speech Error on Bill #
SB516
Information Only00:16:05.194 - 11:00:21 AM
Senator Long introduced SB 516, sponsored at the request of the New Hampshire Department of Health and Human Services. The bill amends RSA 94:1-a, I(b) to rename five unclassified supervising staff attorney positions established in HB 2 (Laws of 2023, Chapter 79:218). It corrects errors from HB 192 (2025), a Joint Committee on Employee Classification requested bill, by changing 'council CIL' to 'counsel SEL' on lines 4, 7, and 10. He introduced attorney Susan Larabee to speak further.
SB516
Information Only00:18:19.712 - 11:02:35 AM
Susan Larabee explained that SB 516 aligns statutory language with DCYF staff attorney positions and job descriptions. It renames grade EE attorneys on line 5 from 'supervising staff attorneys' to 'lead attorney,' reflecting experienced attorneys in the five largest district offices who do not supervise. It distinguishes them from the four supervising regional attorneys on line 8. The bill also fixes a scrivener's error changing 'counsel CIL' to 'counsel SEL.' She addressed committee questions on workload analyses, noting use of data dashboards, hiring challenges, caseload reductions but increased complexity, and ongoing evaluations for efficiency and support.
SB640
Information Only00:28:12.050 - 11:12:28 AM
Senator Pearl introduced SB 640 as amended, which has changed significantly from the original to strengthen it through stakeholder input. The bill prohibits unlicensed AI chatbots from providing services requiring licensure, such as therapy, to protect public safety while allowing responsible innovation. It requires licensed professionals to oversee care, permits use of compliant AI tools, and establishes a commission to review implementation and recommend improvements. He noted multiple work sessions with stakeholders due to the topic's complexity and suggested considering this bill alongside another AI study bill.
SB640
Support00:33:46.850 - 11:18:02 AM
Lynn Currier testified in favor of Senate Bill 640, expressing concerns about AI platforms providing therapy or mental health services without licensed professionals. She highlighted risks including unlicensed practice, potential harm leading to self-harm or suicide, and the lack of critical thinking, duty to warn, or mandated reporting in AI. She cited the tragic case of a 16-year-old boy who died by suicide after receiving harmful advice from ChatGPT. Currier noted that similar bills in Nevada and Illinois have restricted AI therapy platforms, providing consumer protections. She praised the amended language for clarity, avoiding unintended consequences, and allowing professionals to use AI tools. The bill establishes a commission for ongoing research and discussion while protecting New Hampshire residents from unregulated AI therapy.
SB640
Oppose00:37:35.000 - 11:21:51 AM
Nicholas Jacobson opposed SB 640 in its amended form, arguing it stifles innovation during a mental health crisis where many lack access to care, especially in rural New Hampshire. He described his work developing Therapod, a generative AI psychotherapy platform, backed by a randomized controlled trial published in the New England Journal of Medicine AI, showing symptom improvement. Ongoing trials in New Hampshire would be blocked by the bill, similar to how Illinois's HB 1806 halted their trial there. Jacobson criticized the bill for requiring licensed professional involvement in AI interactions, making scalable tools unscalable and impractical. He noted the bill is modeled after Illinois legislation and fails to regulate risky general-purpose chatbots like ChatGPT while blocking accountable, evidence-based systems. He proposed an alternative framework focusing on consumer risks, mandating safety protocols, age verification, and privacy, while exempting validated tools. During Q&A, he addressed concerns about AI safety, intelligence, enforcement, scope of practice, and federal regulation, emphasizing rigorous design and company accountability over clinician oversight. He offered to assist in a work session.
SB640
Oppose01:00:48.375 - 11:45:04 AM
Dr. Julie Walter, a licensed psychologist practicing teletherapy in New Hampshire, opposed the bill as written, echoing concerns raised by Dr. Jacobson. She noted that large language models like ChatGPT, Claude, and Character AI would not be covered, leaving many users unprotected despite widespread use, including by teens, and known risks like suicides. The bill constrains licensed professionals' use of AI tools and imposes unclear accountability. She highlighted issues with broad language, informed consent challenges due to AI's ubiquity in healthcare, and potential responsibility for patients' independent AI use. Walter mentioned problems with the Illinois bill, such as disrupting telehealth, and stressed the need for better consumer protections without overly restricting practitioners.
SB640
Support01:06:26.439 - 11:50:42 AM
Walter expresses concerns about clarity in the bill regarding who it applies to, noting inconsistencies in terminology like 'professionals' versus 'mental health professionals' and questions about healthcare professionals using FDA-approved digital therapeutics. She emphasizes NHPA's support for innovation in AI while advocating for effective guardrails rather than restrictive measures that might not fully address concerns. She suggests expanding the workforce group to include a broader range of healthcare professionals, AI experts, cybersecurity experts, and privacy specialists to comprehensively tackle the complex topic.
SB640
Information Only01:08:55.720 - 11:53:11 AM
Deidre provides detailed analysis of changes in section 3.10.13 on unlicensed practice, highlighting additions like 'including but not limited to individuals and entities' and 'or provides goods or services requiring professional licensure,' and the removal of 'states' from enforcement references. She discloses OPLC's assistance in drafting language to address therapy bots and unlicensed practice, without taking a position. She stresses the importance of paragraph two for recovering investigation costs in unlicensed cases to fund the office equitably. Notes that paragraphs three and four are narrowly tailored to mental health and oddly placed in the general unlicensed section. Supports the study committee and offers availability for questions or work group.
SB470
Support02:17:55.686 - 1:02:11 PM
Roachford introduces the bill based on personal experience on the Board of Pharmacy, describing a case where a pharmacist faced disciplinary action for an administrative disclosure violation, paid a fine, but later couldn't license in Florida due to the record. The board lacked authority to expunge non-safety-related discipline. The bill allows petitioning for expungement after seven years if no suspension/revocation, no further discipline, and compliance met, via a hearing process. Addresses concerns by excluding serious cases, worked with stakeholders including trial lawyers.
SB504
Support02:23:28.101 - 1:07:44 PM
Roachford details clean-up provisions: updating license display to 'readily retrievable' due to multi-location work; posting pharmacy permits practically; adding licensed advanced pharmacy technicians to remote work; removing pharmacist initials from controlled drug labels in 318B; allowing physicians to dispense up to 30-day supply of non-controlled oral anti-cancer drugs with guardrails like pharmacist consultation. Redefines practice of pharmacy clearly, including 'prescribe' within scope of training, not altering diagnoses, used in over 30 states variably. Updates collaborative practice agreements to remove board-imposed training; eliminates outdated jurisprudence exam; adjusts advanced pharmacy technician exam to ensure alignment with NH law, as current third-party exam is inaccessible and mismatched.
SB504
Support02:49:04.360 - 1:33:20 PM
Morrow urges support for SB 504, highlighting alignment with Rural Health Transformation Grant requiring expanded pharmacist scope. Notes PharmD requires 1,760 hours clinical experience including prescribing, monitoring, assessment per ACPE standards. Discussed Medical Society concerns, added guardrails via Senate amendment for Board of Pharmacy to determine standard of care. Standing orders limit adaptability to changes in technology/guidelines; bill modernizes to prevent suboptimal care. Emphasizes interprofessional overlap increases access without decreasing quality.
SB504
Oppose02:55:48.080 - 1:40:04 PM
Kathy Stratton expressed concerns primarily about the inclusion of prescribing authority for pharmacists in the bill. While acknowledging support for most provisions that enhance collaboration between physicians and pharmacists to improve patient care, she highlighted differences in practice settings, particularly community pharmacies lacking access to patient medical records and diagnoses. She advocated for guardrails such as limiting prescribing to minor, self-limiting conditions validated by testing, ensuring follow-up care and communication with physicians, and prohibiting prescribing of addictive Schedule 1-4 drugs or experimental treatments outside FDA guidelines. Stratton urged the committee to find the bill inexpedient to legislate (ITL) until these issues are addressed through amendments or a multi-phase implementation, emphasizing caution given the Rural Health Transformation Grant timeline.
SB504
Support03:13:12.648 - 1:57:28 PM
Bob Terrio strongly supported the bill, focusing on updating the definition of pharmacy practice to align with standards of care based on pharmacists' extensive training, including Doctor of Pharmacy degrees, residencies, and board certifications. He noted the diversity of pharmacy settings beyond hospitals and community pharmacies, such as oncology and ambulatory services. Terrio argued against rigid protocols or lists of allowable diagnoses, as they become outdated and hinder adoption, preferring broad standards to allow off-label prescribing and maintain currency. He addressed guardrails by supporting the board's authority to evaluate scope of practice and emphasized team-based medicine with communication, though patient privacy and information availability can limit sharing. He clarified the bill does not enable prescribing controlled substances, requiring a DEA license which pharmacists in New Hampshire cannot obtain.
SB504
Support03:20:43.378 - 2:04:59 PM
Allison Welsh, a recent pharmacy school graduate completing a residency in administration and leadership with a Master of Public Health, supported SB 504 for updating the statutory definition of pharmacy practice to better reflect modern education and training. She highlighted pharmacists' expanded roles in managing chronic diseases, patient education, vaccine administration, and collaboration with healthcare providers. Welsh emphasized practical benefits for public health, particularly in rural and underserved areas where pharmacists are often the most accessible professionals, improving medication management, closing care gaps, and enhancing patient outcomes as part of the healthcare team.
SB504
Support03:23:01.118 - 2:07:17 PM
Maureen Brady, a clinical pharmacist with nearly 20 years of experience, testified in support of Senate Bill 504 as amended. She shared her background, including obtaining her Doctor of Pharmacy in 2006, completing a residency at a VA medical center where pharmacists practice at the top of their license, managing chronic diseases and narrow therapeutic medications like warfarin. She then pursued academia, teaching and practicing under collaborative drug therapy management (CDTM) protocols at Berry Women's Hospital, which she helped develop. Currently, she works at Wentworth Douglas Hospital in an internal medicine practice with 16 providers, where the pharmacy team has grown significantly due to demand. Under collaborative practice agreements, pharmacists manage chronic diseases, start and stop medications, order and interpret labs, and administer drugs like Inclisiran for cholesterol. She highlighted improved access to care, such as controlling hypertension in 6-12 weeks versus 9-18 months, and assisting endocrinologists by seeing diabetes patients first to reduce wait times. Brady emphasized that the bill would enhance patient outcomes, access, medication safety, and affordability. During questioning, she confirmed that frequent pharmacist involvement reduces disease burden, improves A1C levels, streamlines processes like insurance-driven medication changes, and maintains strong communication with providers, noting that communication issues exist broadly in healthcare, not just with pharmacists.
SB504
Support03:32:26.079 - 2:16:42 PM
Bruce Berkey, representing the New Hampshire Association of Chain Drugstores, testified in support of Senate Bill 504. He deferred to prior testimony on the bill's details and proposed a minor amendment to the section on pharmacist administration of vaccines. The amendment is operational, adding certified pharmacy technicians to the list of those who may administer non-COVID-19 and non-flu vaccines, as they receive the same training as pharmacy interns and licensed advanced pharmacy technicians. This would help alleviate workload in pharmacies, especially with recent closures of community pharmacies due to bankruptcy. Berkey noted the amendment aligns with earlier legislative intent and hoped the committee would recommend passage with this amendment. During questioning, he confirmed technicians would only administer vaccines, not diagnose, and that the change would ease pharmacy operations amid reduced access options.
SB504
Support03:37:20.103 - 2:21:36 PM
David Chorney testified in support of Senate Bill 504, highlighting its alignment with the state's Rural Health Transformation Grant, a five-year, $1 billion federal award ($204 million in the first year). The state committed to increasing access to pharmacy and preventive care by allowing pharmacists to independently prescribe, administer drugs, and order lab tests, securing $20 million in funding. Implementation is required by December 31, 2027, per CMS. He explained how this enables pharmacists to handle issues like urinary tract infections by ordering labs and prescribing antibiotics on-site, improving access in rural areas. During questioning, he clarified the policy focuses on full scope of practice based on pharmacists' training but deferred deeper details on diagnosis to experts. Regarding the proposed amendment on vaccine administration, he was unaware if the governor had seen it but noted it does not conflict with the grant commitments.
SB56
Information Only03:41:42.786 - 2:25:58 PM
Representative Bailey briefly introduced Senate Bill 56 by its title, relative to consolidating the New Hampshire Health and Education Facilities Authority within the Business Finance Authority, as Senator Ennis was unavailable.
SB56
Support03:43:17.998 - 2:27:33 PM
James Key Wallace, Executive Director of the Business Finance Authority (BFA), testified in support of Senate Bill 56, which proposes merging the New Hampshire Health and Education Facilities Authority (HEFA) into the BFA. Both are self-supported quasi-state agencies focused on economic development through financing, with no taxpayer funds used. The BFA supports businesses and nonprofits via loans, guarantees, and conduit bonds for public-purpose projects at lower rates. HEFA does the same but specializes in healthcare and higher education. The merger, voluntary and supported by both organizations' staff and boards, aims to eliminate redundancies, save costs (e.g., shared IT, auditing), and improve efficiencies without job cuts. HEFA's small staff can focus on program delivery using BFA's infrastructure. Existing HEFA bonds remain as conduit obligations of borrowers, not the state or agencies. The process began about two years ago from staff discussions on overlaps and confusion for users, gaining board approval despite potential turf issues. Post-merger, processes like borrower presentations will be adopted via advisory committee, and operations melded for efficiency. The BFA operates on earned fees, guarantees (reserving fractions of loans), and has financed 6,000 entities over 30 years. Co-location is likely for minor rent savings, though leases will be evaluated. The legal structure keeps the BFA name, with potential DBA for nonprofits. No additional state agency mergers are foreseen due to mission differences. During extensive questioning, Wallace addressed funding sources, process differences, user confusion, financial exposure (none added, as bonds are borrower liabilities), and acronym considerations to avoid confusion with other state entities. The merger promotes economic development, tax base, and jobs without increasing risk.