Committee Summary for House Finance Division III (01/27/2025)

Bill/Time	Type	Title	Sponsor
Unclear 00:03:16.799 - 9:02:13 AM	General Working Session	Unclear

Unclear: Representative Edwards Information Only00:03:16.799 - 9:02:13 AM; Representative Edwards convened the hearing for Division 3 Finance, stating that the meeting is an informational session focused on programmatic issues of the Department of Health and Human Services (DHHS). He emphasized that the discussion should not involve budget figures but rather focus on program growth, plans, and effectiveness. He expressed appreciation for the transparency and honesty from DHHS in previous budget cycles and highlighted the upcoming budget cycle's challenges due to anticipated lower revenues. He stressed the importance of maintaining professionalism throughout the budget process.
Unclear: Lori Weaver, Commissioner of DHHS Information Only00:06:23.080 - 9:05:20 AM; Commissioner Weaver introduced herself and her senior team, including CFO Nathan White, and thanked the committee for the opportunity to discuss the department's functions without focusing on the budget. She explained the department's roadmap, a framework for priorities that has been developed over the last few years with internal and external stakeholders. The roadmap includes three main areas: culture, community, and customer service. She highlighted initiatives such as Mission Zero, aimed at reducing emergency department boarding, and efforts to improve access to community-based and residential Behavioral Health Services, emphasizing the importance of efficient resource use and strong customer service.
Unclear: Nathan White, CFO of DHHS Information Only00:14:52.600 - 9:13:49 AM; Nathan White discussed the complexity of the DHHS budget, explaining that it is prepared 10 months before implementation and includes assumptions about vacancies, client numbers, and expenditures. He highlighted that most of the budget is for Medicaid and direct services, and mentioned the use of a cost allocation system to leverage federal funds. He also addressed maintenance of effort requirements, such as those for TANF, which necessitate spending a certain amount of general funds to access federal funds.
Unclear: David Weers, Chief Operating Officer of DHHS Information Only00:33:29.720 - 9:32:26 AM; David Weers discussed the department's information systems, which support over 130 applications aimed at efficiency and automation. He explained the reduction of applications from 200 to 130 over six years and highlighted key platforms like the Medicaid Enterprise System and Granite Families. He also mentioned the use of portfolio management to manage initiatives and ensure they align with the department's roadmap.
Unclear: Patricia Tilly, Associate Commissioner of DHHS Information Only00:46:46.160 - 9:45:43 AM; Patricia Tilly and Chris Santanello, Associate Commissioners, discussed specialized services and population health. They emphasized the department's integrated and coordinated approach to service delivery, which aims to streamline services and improve efficiency. They mentioned initiatives like Mission Zero, which has successfully reduced emergency department boarding, and the focus on systems of care for children's Behavioral Health and healthy aging. They also noted the importance of data sharing and holistic service delivery.
Unclear: Ann Landry, Associate Commissioner, DHHS Information Only00:57:10.359 - 9:56:07 AM; Ann Landry provided an overview of the Medicaid Program in New Hampshire, highlighting its role as a crucial insurer for vulnerable populations such as low-income individuals, pregnant women, children, families, adults, people with disabilities, and the elderly. She explained that Medicaid covers both required federal benefits and optional state-approved benefits like dental care. Landry also discussed the delivery mechanisms for Medicaid services, including state plan amendments and federal waivers, and emphasized the interconnectedness of Medicaid funding with various departmental programs. She mentioned that further details on federal match funding and different program components would be covered in the upcoming 'Medicaid 101' presentation.
Unclear: Jonathan Balor, Chief Medical Officer, DHHS Information Only01:01:00.079 - 9:59:57 AM; Jonathan Balor spoke about accountability within the Medicaid program, emphasizing the importance of stewardship of taxpayer funds. He noted that New Hampshire's Medicaid population, while smaller than in many states, still faces significant health challenges. Balor detailed how the department uses contracts with Managed Care Organizations (MCOs) to drive accountability, focusing on cost reduction and efficient use of funds. He provided an example of using metrics like the percentage of patients with a primary care doctor to assess performance and manage costs.
Unclear: Representative Daniels Information Only01:05:36.960 - 10:04:33 AM; Representative Daniels asked a series of questions about the staffing details of the Department of Health and Human Services, specifically requesting a breakdown of full-time, part-time, and contract employees. He also inquired about the implications of federal penalties related to funding, the concept of a culture of belonging, age ranges for youth and older adults in different programs, and the differences between Medicaid and Medicare wellness visits. Daniels shared a personal experience regarding long-term care coordination and sought clarification on how such situations are handled currently.
Unclear: Chris Sello, Associate Commissioner, DHHS Information Only01:06:28.760 - 10:05:25 AM; Chris Sello clarified that the department is not currently in a penalty phase with TANF but acknowledged the complexity of such situations. He committed to providing more detailed information on staffing numbers and positions, including whether the figures include vacant positions. Sello also addressed the age ranges for youth and older adults, noting that these vary by program and promised to provide a detailed breakdown in future discussions.
Unclear: Representative Edwards Information Only01:12:05.920 - 10:11:02 AM; Representative Edwards sought clarification on the differences between Medicaid and Medicare wellness visits and expressed interest in understanding the cost distribution between children and adults within the Medicaid program. He noted that while children make up a significant portion of Medicaid recipients, their per capita costs might be lower compared to adults. Edwards also requested information on eligibility guidelines for children and adults and how New Hampshire's guidelines compare to other states.
Unclear: Representative Stringham Information Only01:15:14.159 - 10:14:11 AM; Representative Stringham inquired about the process for submitting written questions and was advised to give them to someone who could integrate them into the session's discussions.
Unclear: Clerk Information Only01:15:51.480 - 10:14:48 AM; The clerk requested assistance with the names of presenters to complete the meeting minutes accurately, indicating a need for support in their role.