Committee Summary for House Finance Division III (02/19/2025)

Bill/Time	Type	Title	Sponsor
HB1 00:05:45.639 - 9:04:51 AM	General Working Session	Unclear	Likely Text to Speech Error on Bill #

HB1: Nathan White, Chief Financial Officer, DHHS Information Only00:05:45.639 - 9:04:51 AM; Nathan White, the Chief Financial Officer for the Department of Health and Human Services (DHHS), provided an overview of the budget and operations of the Division of Finance. He highlighted the division's responsibilities, including financial data management, procurement, and contract administration. He noted that the division supports all other divisions within DHHS. White discussed the budget details, pointing out specific pages in the budget briefing book and the governor's budget. He emphasized the importance of the budget business intelligence tool in reducing federal fund lapses and improving budget accuracy. He also mentioned the implementation of Lean Six Sigma methodologies within the contracting team to enhance efficiency and effectiveness. Additionally, he discussed the use of IT systems like Salesforce for business intelligence and DocuSign for electronic signatures, noting that some of these tools are currently unfunded in the governor's budget.
HB1: Mike Lawless, Director of the Employee Assistance Program Information Only00:35:48.240 - 9:34:54 AM; Mike Lawless, Director of the Employee Assistance Program (EAP), provided an overview of the EAP's operations and its budget. He mentioned the program's growth from a pilot serving 900 employees in 1985 to supporting all state departments and their family members. Lawless detailed the EAP's resources, confidentiality, and its role in supporting managers and workgroups. He discussed the increase in satellite office hours and the use of telemedicine during the pandemic. He also highlighted the adoption of a new data management system to better track service delivery and predict trends. Lawless mentioned the EAP's response to the active shooter event at New Hampshire Hospital, indicating a spike in service requests following the incident.
HB1: David Weers, Chief Operating Officer for DHHS Information Only00:54:04.040 - 9:53:10 AM; David Weers, representing the Department of Health and Human Services (DHHS), began his presentation by discussing the role of the HR Bureau within DHHS. He highlighted that HR services are provided across 247 facilities and all department divisions, divided into five areas: payroll and benefits, workforce management, employee relations and engagement, organizational development and training services, and talent acquisition. Weers detailed the focus of each area, emphasizing payroll and benefits as crucial for timely and accurate payment to employees and compliance with state and federal laws. He also mentioned ongoing efforts to reclassify positions across the state, the challenges in employee relations due to staff shortages, and the importance of training and talent acquisition strategies, including recruitment via platforms like Indeed and LinkedIn.
HB1: Representative Stringham Information Only01:02:35.599 - 10:01:41 AM; Representative Stringham inquired about the hiring practices at DHHS, particularly about the impact of the position cap on recruitment. David Weers responded by providing a historical context, explaining that the current budget includes a reduction in general funds and a 3,000 position cap, which has not significantly impacted hiring due to a lower vacancy rate than in the previous biennium. However, he noted that a recent executive order by the governor imposes a hiring freeze on non-direct care positions, and there are unfunded positions in the upcoming budget that could affect hiring practices.
HB1: Representative Priest Information Only01:06:14.000 - 10:05:20 AM; Representative Priest asked about the specifics of the budget related to the Indeed subscription and the number of positions in each HR division. David Weers clarified that the $102,000 requested for the Indeed subscription was partially allocated to Indeed and LinkedIn, with specific amounts and expected increases detailed. He also provided the number of positions in each of the five HR divisions, totaling 30 FTEs, and mentioned additional positions at New Hampshire Hospital and Glencliff Home.
HB1: Representative Seor Information Only01:09:36.679 - 10:08:42 AM; Representative Seor sought clarification on the $102,000 budget item for the Indeed subscription, particularly the portion related to LinkedIn. David Weers explained that the department's share of the LinkedIn contract was about $20,000, which was not funded in the governor's budget. He noted that negotiations with vendors could lead to cost adjustments, but without state funding, the department would have to reconsider its participation in these contracts.
HB1: Representative Daniels Information Only01:14:17.760 - 10:13:23 AM; Representative Daniels asked about the specifics of the 3,000 position cap and its application. David Weers explained that the cap applies to full-time authorized positions, including both classified and unclassified employees, affecting roughly 2,800 filled positions at the last check.
HB1: Representative Alan Information Only01:15:06.719 - 10:14:12 AM; Representative Alan inquired about the HR department's probationary policy and the use of training materials. David Weers explained that classified employees have a 12-month probationary period, governed by state rules, and that while HR primarily uses in-house training materials, there is a budget for external resources as well. He confirmed that training materials are screened for content but are not specifically focused on diversity, equity, and inclusion (DEI) training.
HB1: Meredith Tus, Director of Division of Program Quality and Integrity for DHHS Information Only01:28:13.280 - 10:27:19 AM; Meredith Tus introduced the role of the Division of Program Quality and Integrity, emphasizing its support function for other department programs to ensure quality and integrity. She detailed the division's activities, including data management and analysis, vendor and contract management, and federal compliance activities. Tus highlighted the division's involvement in audits, both internal and external, and its role in ensuring compliance with federal regulations across various program areas.
HB1: Meredith Tus, Director of Division of Program Quality and Integrity for DHHS Information Only01:40:52.639 - 10:39:58 AM; Meredith Tus provided detailed information about the staffing and operational structure of the Division of Program Quality and Integrity within the Department of Health and Human Services (DHHS). She outlined the number of full-time and part-time staff in various units such as the Office of Internal Audit, Bureau of Program Quality, and Bureau of Program Integrity. Tus discussed the impact of unfunded positions on the division's operations, specifically mentioning a vacancy in the Bureau of Program Quality due to internal restructuring. She also highlighted recent achievements, including the migration to a new 5-year MCO contract, reduction in backlog of claims and investigations, and a decrease in single audit findings. Tus further explained the functions of the Office of Internal Audit, which include quality assurance reviews, investigations of potential fraud, compliance with Transparent New Hampshire, and liaison work for LBA audits. She detailed the roles of the Bureau of Program Integrity, which involves oversight to ensure compliance and reduce fraud and waste. Tus responded to questions about the state's vulnerability to fraud, the process of handling overpayments, and how recovery funds are managed within the state budget.
HB1: Franchesca Hennessy, Fraud Waste and Abuse Administrator under Meredith Tus Information Only01:50:06.440 - 10:49:12 AM; Franchesca Hennessy provided insights into the Medicaid provider fraud unit's operations, which fall under her responsibility. She confirmed the presence of fraud in the Medicaid program and noted that cases are referred to the Attorney General's office for further investigation. Hennessy discussed the number of ongoing investigations and the scale of recoveries, emphasizing that while the number of fraudulent providers is small relative to the total number of providers, the recoveries can be significant. She also clarified that the majority of financial issues arise from waste or abuse, such as poor billing practices, rather than outright fraud.
HB1: Unidentified Committee Member Information Only02:00:23.760 - 10:59:29 AM; An unidentified committee member asked questions about the budget and additional French benefits, which had been centralized to improve administrative efficiency. The member sought clarification on why funding was allocated for 2024 but not for 2026 and 2027, to which it was explained that the centralization was intended to maximize operating capacity.
HB1: Representative Mooney Information Only02:01:23.079 - 11:00:29 AM; Representative Mooney inquired about the primary sources of fraud detection and violations within the DHHS. Meredith Tus explained that while federal and state mandates are crucial, they also relate to third-party liability and the general integrity of the Medicaid program, including provider enrollment processes to prevent fraud.
HB1: Unidentified Committee Member Information Only02:07:12.400 - 11:06:18 AM; An unidentified committee member asked about cost-effective measures and cost savings achieved by the division. Meredith Tus referred to a graphic representing overpayments recovered and explained that cost savings, such as those from third-party liability, are difficult to quantify because they represent payments avoided rather than funds recovered. She emphasized the division's focus on improving internal controls and modifying behaviors to prevent fraud and waste.
HB1: Melissa Saint, Chief Legal Officer, Department of Health and Human Services Information Only03:01:33.800 - 12:00:39 PM; Melissa Saint introduced the session by outlining the agenda, which included discussing the Office of Legal and Regulatory Services. She directed attendees to the relevant pages in the Governor's operating budget and the DHHS briefing book. She explained that the Bureau of Licensing and Certification handles child care and health facility licensing, ensuring compliance with safety and health regulations. This includes inspections, licensing applications, and criminal background checks for child care workers. For health facilities, they manage licenses and certifications, which are essential for facilities receiving federal funding. Melissa also responded to questions about the certification process, staffing, and the nature of complaints received, emphasizing the regulatory requirements and the absence of a backlog in handling complaints.
HB1: Nathan White, Chief Financial Officer, Department of Health and Human Services Information Only03:02:19.239 - 12:01:25 PM; Nathan White provided financial context and answered questions about the budget. He clarified the funding for staff positions, explaining that most positions are funded by federal dollars. He also discussed the potential for additional funding to increase estate recoveries, estimating that with additional staff, they could recover an additional $2 million. Nathan confirmed that this issue was discussed in the agency phase with the governor's office but was not included in the budget due to concerns about increasing the number of authorized positions.
HB1: Unidentified Committee Member Information Only03:06:33.960 - 12:05:39 PM; An unidentified committee member asked questions related to the budget, specifically about the certification and licensing processes, the number of facilities inspected, and the nature of complaints handled by the Department. They also inquired about the funding sources for certain positions and the potential for increasing estate recoveries. The member expressed interest in understanding the department's approach to managing data privacy and the implementation of privacy impact assessments.
HB1: Dave Weers, Chief Operating Officer Information Only03:48:37.199 - 12:47:43 PM; Dave Weers provided information on data privacy and the department's approach to implementing privacy impact assessments. He explained that the department is working on a standard template for these assessments using a technology called One Trust, aiming to have it in place by March 2025. He also discussed the department's efforts to move towards an opt-in data collection policy and the challenges associated with it. Dave responded to questions about the department's data management practices and the potential use of AI to improve efficiency.
HB1: Ernie Gillan, Director for Information Services, Department of Health and Human Services Information Only04:04:10.439 - 1:03:16 PM; Ernie Gillan discussed the role of the Information Services department, focusing on strategic planning, reducing duplication, and the use of AI to improve departmental operations. He outlined the key platforms and systems managed by the department and discussed the project management office's efforts to train staff across the department. Ernie highlighted the department's accomplishments, such as implementing the enterprise resource planning and Cloud Suite solution, and the use of Salesforce to fill operational gaps. He also addressed the department's efforts to enhance privacy through the implementation of privacy impact assessments.
HB1: PRI Information Only04:28:29.760 - 1:27:35 PM; PRI inquired about the details of the New Heights efficiency consolidation and Salesforce development projects mentioned on page 10. Ernie Gillan explained that New Heights is an eligibility system used across the Department of Health and Human Services (DHHS) for various services. A large portion of the efficiency aspects was carved out and consolidated into New Heights to enhance efficiency and maintenance. Salesforce development has been beneficial for creating systems like the Incident Management System and the constituent inquiry and response system. These systems have been utilized in various divisions including New Hampshire Hospital, DCYF, Public Health, and DPQ. The integration of Salesforce with other systems, including EBI and document management, has provided significant benefits. When asked about a cost-benefit analysis, Gillan noted that while they do not have a formal analysis, the federal funds offset in the tens of millions of dollars is a significant benefit. He also mentioned the potential cost savings from using electronic signatures instead of wet ink signatures, which would save manpower and reduce delays.
HB1: Representative Priest Information Only04:35:59.599 - 1:35:05 PM; Representative Priest inquired about the use of AI within the DHHS. Ernie Gillan responded that while they are not yet using AI, they are focusing on policy and procedure development first, particularly with natural language processing tools for public data. The aim is to ensure privacy and security before moving forward with more sensitive data. The discussion then shifted to data sharing with federal agencies, with Gillan explaining that they follow specific state and federal laws and create data sharing agreements where necessary. Additionally, audits are conducted to ensure compliance with data sharing regulations.
HB1: Representative Stringham Information Only04:40:37.200 - 1:39:43 PM; Representative Stringham corrected the term HIPAA to HIPAA and inquired about alternative electronic signature solutions like PandaDoc, questioning if there are cheaper yet reliable systems that could be used to improve contract efficiency without necessarily using DocuSign. Ernie Gillan explained that while DocuSign was chosen during a crisis point, they are always looking to innovate and use the best products available. He highlighted the investment and training required when implementing new systems and the potential loss in productivity when switching. Additionally, Stringham requested a breakdown of consultant costs versus the fully loaded cost of state employees, which Gillan agreed to provide.
HB1: Tammy Nelson, Director of Facilities and Office Services Information Only04:46:19.520 - 1:45:25 PM; Tammy Nelson presented an overview of the facilities and office services at DHHS. She outlined their mission to provide safe, accessible, and efficient facilities, managing 26 lease agreements including 11 regional office locations. The district offices serve approximately 1,000 program staff across 229,000 square feet of leased space. Facilities management also includes oversight of 24/7 facilities with dedicated managers and maintenance staff. Key functions include lease administration, space utilization, compliance with safety and ADA regulations, and managing office services like mail, purchasing, and transportation. Notable projects include the relocation of the Claremont district office, upgrades to the New Hampshire Hospital lobby, and furniture upgrades. The geographic layout of district offices and 24/7 facilities was also detailed.
HB1: Representative Edwards Information Only04:50:20.160 - 1:49:26 PM; Representative Edwards inquired about the long-term plans for facilities, particularly regarding the Sununu Youth Development Center and Glencliff. Ernie Gillan explained that the new Youth Development Center in Hampstead is on track for completion in 2026, but operational funding for additional features like the cultural corridor and laundry services is needed before closing the old center. Regarding Glencliff, Edwards expressed concern about the maintenance costs of the aging buildings and requested a long-term plan, which Gillan noted would require broader discussion involving other department heads. Edwards also asked about potential consolidation opportunities due to remote work, to which Dave responded that they have been implementing shared workspaces and consolidating warehouse space since the onset of COVID.
HB1: Ruben Hampton, Director of the Office of Health Equity Information Only04:59:45.280 - 1:58:51 PM; Ruben Hampton presented the mission and key outcomes of the Office of Health Equity, which aims to identify and mitigate health disparities in New Hampshire. Key goals include ensuring equitable access to services through culturally and linguistically appropriate services, community outreach, and engagement. The refugee program focuses on settlement, integration, and self-sufficiency, including education, job training, and healthcare. In response to questions about the integration of Afghan refugees, Hampton noted the efforts to ensure cultural integration and meet family needs, with specific attention to women's integration. He also discussed the federal metrics used to track performance and the current status of refugee populations in New Hampshire, including a recent hold on new refugee arrivals.
HB1: Associate Commissioner Andrew Information Only05:06:01.440 - 2:05:07 PM; Associate Commissioner Andrew reiterated the efforts to integrate Afghan refugees, emphasizing the capabilities of resettlement agencies in providing cultural competency and meeting family needs. He confirmed that the agencies are well-equipped to handle integration and mentioned the federal metrics used to assess performance. Andrew also noted that there have been no unexpected cultural integration issues with other refugee populations and mentioned the current hold on new refugee arrivals under the new administration.
HB1: Representative Priest Information Only05:11:08.240 - 2:10:14 PM; Representative Priest requested a table detailing the refugees served in the last five years and their status in New Hampshire. Ruben Hampton agreed to provide the information, clarifying that 'status' refers to whether they are still living in the state or have migrated out.
HB1: Representative Nalo Information Only05:11:53.718 - 2:10:59 PM; Representative Nalo inquired about the distinction between equal and equitable access to services. Ruben Hampton explained that equal implies providing the same solution for everyone, while equitable means providing what each person needs based on their circumstances.
HB1: Representative Torki Information Only05:12:48.760 - 2:11:54 PM; Representative Torki sought clarification on the difference between equal and equitable access, particularly in the context of service access. Ruben Hampton explained that the goal is to ensure all individuals can access services in the same way, regardless of their specific circumstances.
HB1: Representative Seaworth Information Only05:14:20.798 - 2:13:26 PM; Representative Seaworth commended the small staff of the Office of Health Equity for their impact on refugees and inquired about employment initiatives. Ruben Hampton detailed the goals of ensuring economic mobility through training programs and partnerships with resettlement agencies, including a childcare training program with Greater Nashua United Way. He also mentioned a study showing that refugees contribute more in revenue than they cost in expenses.
HB1: Mr. White Information Only05:25:28.718 - 2:24:34 PM; Mr. White summarized the budget discussions, noting that the systems and people discussed support about 7% of the total budget. He mentioned that upcoming discussions would focus on Medicaid and other divisions. Representative Edwards inquired about proposed changes to Medicaid and the ones not accepted by the governor's office, which Mr. White agreed to address in future discussions. There was also a discussion about capital budget items and whether they include funds for necessary consultants, which Mr. White confirmed they do.