Committee Summary for House Finance Division III (01/28/2025)

Bill/Time	Type	Title	Sponsor
HB519 00:00:53.079 - 9:59:19 AM	General Working Session	making an appropriation to the department of health and human services to fund and support the Waypoint youth and young adult shelter.	Wallner, Mary Jane(D)[CT]2024
Unclear 02:01:48.119 - 12:00:14 PM	General Working Session	Unclear

HB519: Mr. Ripple Information Only00:00:53.079 - 9:59:19 AM; Mr. Ripple confirmed that pink cards are not needed for a work session.
HB519: Chair Information Only00:01:50.680 - 10:00:16 AM; The chair convened the finance division 3 meeting for the 28th of January at 11:00 AM to discuss House Bill 519, which was introduced to the full Committee of Finance and is now in division 3 for continued follow-up work. The chair expressed general favorability towards supporting the organization Waypoint but noted that the bill would likely be suspended until budget work is completed.
HB519: Chair Information Only00:02:43.120 - 10:01:09 AM; The chair mentioned that the bill would likely be suspended until budget work is completed because the exact amount of money available is unknown. The chair then invited Kya Fox to speak.
HB519: Kya Fox, Director of the Division for Behavioral Health Support00:03:28.920 - 10:01:54 AM; Kya Fox expressed the department's support for House Bill 519 and the program it describes. The program was funded with available funds, with $100,000 allocated for 2024 and $400,000 for 2025. She discussed the oversight of the shelter through a contractual obligation, the unique services provided by the shelter, and its role in the department's mission zero initiative. The shelter helps provide a 'back door' for discharging patients from acute psychiatric care and a 'front door' to prevent unnecessary emergency department visits. It is also part of the children's system of care, aiding youth transitioning to adulthood. The funding details are on pages 3664 and 3665 of the budget request on the administrative services website.
HB519: Representative Walner Information Only00:08:57.360 - 10:07:23 AM; Representative Walner asked about the difference between the efficiency budget and the prioritized needs budget, to which Kya Fox responded that the program was not included in the efficiency budget due to funding being transferred from Medicaid to the Bureau of Children's Behavioral Health. She explained that the prioritized needs budget includes areas the department considers critical for continuing services.
HB519: Nathan White, Chief Financial Officer Information Only00:09:44.360 - 10:08:10 AM; Nathan White explained that the efficiency budget and prioritized needs are developed through a process involving the department and the governor's office. He noted that the program in question was not included in the efficiency budget due to the funding transfer from Medicaid.
HB519: Chair Information Only00:12:49.639 - 10:11:15 AM; The chair asked about the visibility of taxpayer money in Waypoint's operations, to which Nathan White responded that it would be transparent to the state until the next budget cycle.
HB519: Chair Information Only00:14:24.839 - 10:12:50 AM; The chair raised concerns about diversity, equity, and inclusion (DEI) policies and asked about the department's role in enforcing any potential prohibitions. Kya Fox stated that any new laws would be adhered to, but she was not prepared to answer the specific question at that time.
HB519: Bor Alvaretoo, CEO at Waypoint and Mandy Lancaster, Director of the Homeless Youth and Young Adult Department Information Only00:17:34.480 - 10:16:00 AM; Bor Alvaretoo and Mandy Lancaster provided detailed information about the shelter's operations, including age parameters, gender policies, and the lack of preferential treatment based on race or ethnicity. They emphasized the shelter's 14-bed capacity, the use of half pony walls for safety, and the presence of full-time staff. They noted that the shelter often turns away 20 young people each night due to capacity constraints. They also discussed the non-discriminatory nature of their services and the absence of reported sexual violence incidents.
HB519: Representative Daniels Information Only00:24:36.720 - 10:23:02 AM; Representative Daniels sought clarification on the definitions of youth and young adult, which were explained by Kya Fox and Mandy Lancaster. Youth is considered to be 12 to 17 years old, while young adults are 18 to 24 years old. The shelter is licensed only for adults 18 and over.
HB519: Representative Seaworth Information Only00:38:50.880 - 10:37:16 AM; Representative Seaworth inquired about the memorandums of understanding (MOUs) between Waypoint and licensed facilities for 12 to 17-year-olds. Mandy Lancaster explained that the MOUs include provisions for shelter beds and holistic programs with clinical staff and pro-social activities.
HB519: Bor Alvaretoo, CEO at Waypoint Information Only00:41:14.200 - 10:39:40 AM; Bor Alvaretoo discussed the financial implications of reducing the state's funding for the shelter. He explained that Waypoint has been providing services for youth and young adults experiencing homelessness for over 40 years and currently serves about 400 youth in Manchester alone. He noted that the shelter's annual cost is about $600,000, and without state funding, it would be unsustainable to keep it open.
HB519: Chair Information Only00:50:34.760 - 10:49:00 AM; The chair concluded the discussion by stating that HB 519 would likely be put into interim study or migrated into the budget discussions. He reassured that the issue would not be lost and encouraged continued communication with the committee.
Unclear: Chair Information Only02:01:48.119 - 12:00:14 PM; The chair opened the meeting for division 3 Finance, announcing an informational session on critical topics related to DHHS operations, including IT systems, quality and performance metrics, and public comment.
Unclear: Nathan White, Chief Financial Officer Information Only02:02:34.639 - 12:01:00 PM; Nathan White introduced the presentation on efficient stewardship of resources and strong customer service, focusing on IT systems, contracting, and quality and performance metrics. He highlighted the importance of these areas in delivering services effectively to New Hampshire citizens.
Unclear: David Weers, Chief Operating Officer Information Only02:03:21.560 - 12:01:47 PM; David Weers provided an overview of DHHS's technology support structure, detailing eight core service areas supported by various groups like Communications, Information Services, and Human Resources. He explained the role of technology in supporting these services and mentioned the use of platforms like Salesforce, SmartSheet, and SharePoint. He discussed the department-wide technology systems, including the Enterprise Business Intelligence System, New Hampshire Care Connections, and others, emphasizing their role in data management, analytics, and service delivery.
Unclear: Representative Stringham Information Only02:15:47.079 - 12:14:13 PM; Representative Stringham asked about the New Hampshire Care Connections system, specifically whether it is used by disability providers for submitting invoices and getting paid. David Weers clarified that developmental disabilities agencies use the New Heights system for case management, while New Hampshire Care Connections can be used for referrals to other services.
Unclear: Chair Information Only02:18:56.000 - 12:17:22 PM; The chair requested more information on the closed loop referral system, including its costs, integration with other systems, and privacy and security issues. David Weers agreed to provide an update in future budget presentations.
Unclear: Representative Priest Information Only02:22:33.120 - 12:20:59 PM; Representative Priest asked if Waypoint is a client in the closed loop referral system. David Weers noted that they would need to check with their contractor, Unitus, to confirm Waypoint's participation.
Unclear: Representative Mooney Information Only02:59:18.720 - 12:57:44 PM; Representative Mooney sought clarification on the capital budget and its relation to the department's budget. Nathan White explained that the capital budget is part of House Bill 25 appropriations and is not included in the department's operating budget.
Unclear: David Weers, Chief Operating Officer Information Only02:53:37.800 - 12:52:03 PM; David Weers discussed the stability and end-of-life issues of the Medicaid Enterprise System, noting it is about halfway through a 10-year replacement plan. He mentioned upcoming capital projects and their impact on operational expenditures. He also provided details on the Nexus and New Heights systems, explaining their stability, the need for upgrades, and their on-premise nature. He touched on the Behavioral Health System and its stable electronic medical record system.
Unclear: Chair Information Only03:06:21.160 - 1:04:47 PM; The chair requested that future presentations focus more on system profiles, including stability, end-of-life issues, interface challenges, and future capabilities, rather than functionality.
Unclear: Pitch Information Only03:07:30.760 - 1:05:56 PM; Pitch thanked the Chair and discussed the Department's centralized contracting functions within HHS. He highlighted the importance of providing a baseline understanding of the contracting process in New Hampshire, which typically involves the governor and executive council, but not directly the legislature. He detailed the creation of a central unit over a decade ago to streamline contract management, emphasizing the complexity and regulatory environment of contracting. Pitch also mentioned the volume of contracts and amendments processed annually, totaling over $2 billion, and the different types of solicitations used. He noted efforts to improve the process, such as reducing the number of contracts submitted at the last minute and utilizing technology like DocuSign to speed up contract execution. He discussed the importance of competitive and transparent solicitations and the role of the centralized team in developing standard templates and procedures.
Unclear: Meredith Tus, Director of the Division of Program Quality and Integrity, Department Information Only03:31:57.760 - 1:30:23 PM; Meredith Tus spoke about quality and performance in relation to fraud, waste, and abuse monitoring, financial integrity, and audits of providers. She detailed the department's methods to identify, deter, and recover from fraud, including working with Managed Care Organizations and conducting investigations. She mentioned the financial analysis and risk assessments performed on providers, the types of providers monitored, and the process for audits and active contract management. Tus also discussed the department's efforts to align performance metrics with strategy at the contract planning stage and the importance of clean and meaningful data in measuring success. She responded to questions about the department's capacity to manage risks and the potential for saving money through better auditing practices.