Committee Summary for House Finance Division III (03/28/2025)

Bill/Time	Type	Title	Sponsor
HB2 2024-1176h 00:02:16.879 - 12:01:02 PM	General Working Session	relative to state fees, funds, revenues, and expenditures.	Weyler, Kenneth(R)[B+]2024
HB2 2024-1176h 04:16:41.279 - 4:15:27 PM	Executive Session	relative to state fees, funds, revenues, and expenditures.	Weyler, Kenneth(R)[B+]2024

HB2 2024-1176h: Unidentified Speaker Information Only00:02:16.879 - 12:01:02 PM; The speaker announced the start of Division 3's work session, emphasizing that this meeting is crucial for forming the division's recommendation on bills and budget allocations. They clarified that the subcommittee's recommendation would go to the full finance committee, and further actions would be taken by the house and senate. The speaker also mentioned the possibility of extending the session until 6:00 PM due to the number of expected testimonies.
HB2 2024-1176h: Unidentified Speaker Information Only00:04:23.520 - 12:03:09 PM; The speaker discussed the challenge of managing the state budget, noting that the governor's spending exceeded the available funds as determined by Ways and Means. They highlighted the need for tough decisions and innovative thinking to manage the budget effectively. The speaker also mentioned an HB2 item allowing organizations to donate up to a quarter million dollars to the state and encouraged audience members to come forward if they could contribute or if their organizations needed less funding.
HB2 2024-1176h: Unidentified Speaker Information Only00:05:08.639 - 12:03:54 PM; The speaker continued discussing resource management, emphasizing the importance of acquiring resources and the need to adjust funding based on actual needs due to limited resources. They mentioned that Representative Mlan and Dr. Ballard were present to discuss the first item on the agenda, amendment 1176, which is a replication of a bill recently passed by the House.
HB2 2024-1176h: Unidentified Speaker Information Only00:07:18.680 - 12:06:04 PM; The speaker clarified the agenda, stating they would start with amendment 1176, which is found on item 28 of the 'horse blanket' document. They noted that this amendment was incorporated into the budget following its passage by the House the previous day.
HB2 2024-1176h: Representative Mlan from Manchester Information Only00:08:37.360 - 12:07:23 PM; Representative Mlan discussed HB548FN, which passed the House with a roll call vote of approximately 200 to 157. The bill aims to open up competition in the healthcare system by extending the direct care model, previously applied to primary care, to healthcare facilities. He addressed concerns about the potential negative impact on critical access hospitals, citing the example of the Surgical Center of Oklahoma. He argued that the risk to critical access hospitals might be overstated, as the model has not led to widespread proliferation in Oklahoma.
HB2 2024-1176h: Representative Stringham Information Only00:15:52.639 - 12:14:38 PM; Representative Stringham expressed concerns about the financial impact on the state due to the tax payments made by critical access hospitals, and the potential for new facilities to cherry-pick the most profitable services, thus affecting the viability of existing hospitals.
HB2 2024-1176h: Representative Priest from Manchester Information Only00:17:38.480 - 12:16:24 PM; Representative Priest inquired about the acceptance of the direct pay model in other states, to which it was noted that Oklahoma is the primary example, putting New Hampshire at the leading edge if implemented.
HB2 2024-1176h: David Ross, Administrator of Hillsboro County Nursing Home, on behalf of the New Hampshire Association of Counties Oppose00:18:52.960 - 12:17:38 PM; David Ross opposed HB548FN due to its potential to remove the moratorium on nursing home beds, which could increase pressure on Medicaid rates and affect operational revenue for existing facilities. He requested that the moratorium on various types of beds be removed from the bill's language.
HB2 2024-1176h: Ben Bradley, Vice President of State Government Relations for the New Hampshire Hospital Association Oppose00:23:10.320 - 12:21:56 PM; Ben Bradley raised concerns about HB548 setting up a regulatory framework that differentiates facilities based on payment methods, potentially not following CMS conditions of participation, and creating a separate patient bill of rights, which could impact patient safety and quality standards.
HB2 2024-1176h: Representative Mlan from Manchester Information Only00:25:23.679 - 12:24:09 PM; Representative Mlan responded to the concerns raised, acknowledging the risks associated with HB548 but emphasizing the need for innovation in the healthcare system due to its current unsustainability. He supported the decision to remove the amendment from HB2 to allow for further discussion in the Senate.
HB2 2024-1176h: Representative Walner Information Only00:27:52.960 - 12:26:38 PM; Representative Walner agreed with the decision to let HB548 proceed as a standalone bill to the Senate, citing the lack of time for thorough deliberation within the HB2 process.
HB2 2024-1176h: Representative Stringham Information Only00:27:52.960 - 12:26:38 PM; Representative Stringham expressed concern over HB548 being a bill with a financial note that went through a single committee, indicating a need for further review.
HB2 2024-1176h: Representative Ferski Information Only00:29:13.679 - 12:27:59 PM; Representative Ferski made a motion to not accept or remove amendment 2024-1176h from HB2, which was seconded and passed with a unanimous vote of 9-0.
HB2 2024-1176h: Representative Ferski Information Only00:29:13.679 - 12:27:59 PM; Representative Ferski was finishing his discussion on the budget and amendment 2024-1176h to HB2.
HB2 2024-1176h: Unnamed Speaker Information Only00:30:06.720 - 12:28:52 PM; The speaker discussed the status of House Bill 751, which was voted down along party lines. The amendment 1253H related to this bill was not accepted.
HB2 2024-1176h: Representative Mlan Information Only00:30:55.279 - 12:29:41 PM; Representative Mlan thanked the committee for the opportunity to speak and mentioned the need to discuss the standing order bill, referencing amendment 1386H.
HB2 2024-1176h: Dr. Jonathan Ballard, Chief Medical Officer, New Hampshire Department of Health and Human Services Information Only00:32:32.159 - 12:31:18 PM; Dr. Ballard discussed the standing order amendment 1386H to HB2, which aims to extend the use of standing orders from Medicaid to non-Medicaid beneficiaries. This amendment would allow non-Medicaid beneficiaries to potentially receive lower-cost, medically equivalent products, depending on their insurance coverage. The amendment was discussed in relation to Senate Bill 119 FN, and it was clarified that it would not mandate coverage by insurers but provide flexibility.
HB2 2024-1176h: Unnamed Speaker Information Only00:35:43.359 - 12:34:29 PM; The speaker clarified the relationship between the amendment and Senate Bill 119 FN, ensuring that Senator Gray is aware of the distinction. The committee voted unanimously to accept amendment 1386H into HB2.
HB2 2024-1176h: Unnamed Speaker Information Only00:38:44.200 - 12:37:30 PM; The speaker introduced amendment 1402H to HB2, which deals with Medicaid cost sharing for outpatient procedures. The amendment was designed to fit within CMS regulations and provide incentives for choosing lower-cost settings for procedures.
HB2 2024-1176h: Unnamed Speaker Information Only00:41:03.280 - 12:39:49 PM; The speaker discussed the potential cost savings and the implementation of amendment 1402H, noting that it could encourage patients and managed care organizations to choose lower-cost settings for procedures. The committee voted unanimously to accept amendment 1402H into HB2.
HB2 2024-1176h: Unnamed Speaker Information Only00:48:13.280 - 12:46:59 PM; The speaker introduced amendment 1429, which revises amendment 1285 and deals with the transition of long-term care into managed care organizations. The amendment delays implementation until January 1, 2028, and establishes a commission to assess the viability of this transition. The amended analysis was read, and the purpose of the commission was explained.
HB2 2024-1176h: Unnamed Speaker Information Only00:51:47.760 - 12:50:33 PM; The speaker discusses the need to improve the delivery of care for getting people into CFI and suggests systemic issues are hindering the current status quo. They propose an alternative view involving a group of smart people, including leaders from MCOs, counties, and legislators, to discuss improvements to the current system or the proposed law. The intent of HB2 is to start a serious conversation and ongoing legislative effort to refine and potentially improve long-term supports in the state.
HB2 2024-1176h: Mr. Ross Information Only00:54:25.040 - 12:53:11 PM; Mr. Ross supports the establishment of a commission to review managed care for long-term supports and services (LTSS). However, he is concerned about the amendment's approach, suggesting it puts the cart before the horse by enacting legislation before the commission's findings. He believes the commission should be able to assess and recommend without pre-existing legislation.
HB2 2024-1176h: Unnamed Speaker Information Only00:55:48.319 - 12:54:34 PM; The speaker acknowledges Mr. Ross's point but defends the inclusion of the law in the amendment to provide a focus and deadline for the commission's work. They suggest that a concrete proposal helps guide the discussion and improve the system collegially.
HB2 2024-1176h: Mr. Ross Information Only00:56:57.520 - 12:55:43 PM; Mr. Ross agrees with the intent to set a finish line for the commission but suggests that the proposed members would be driven to achieve the same goal without pre-existing legislation. He recommends removing the law from the amendment to allow for a more open discussion.
HB2 2024-1176h: Chris Kennedy, Centene and New Hampshire Healthy Families Information Only00:57:52.000 - 12:56:38 PM; Chris Kennedy, representing a managed care organization, agrees with the need for a discussion without a gun but supports a clock on the conversation. He notes the historical context of long-term services and supports in managed care and believes the timeframe in the bill is reasonable. He expresses confidence in stakeholders' ability to work together on this issue.
HB2 2024-1176h: Melissa Saints, Chief Legal Officer for DHS Information Only00:59:52.720 - 12:58:38 PM; Melissa Saints raises a legal concern about the inclusion of MCOs in the commission due to potential conflicts of interest under state law. She suggests involving the Department of Justice to assess this issue and points out specific lines in the amendment that could be problematic.
HB2 2024-1176h: Unnamed Speaker Information Only01:00:55.920 - 12:59:41 PM; The speaker discusses the potential conflicts of interest in the commission's decision-making process, particularly around payment methodologies. They suggest removing certain language to address these concerns and ensure a fair process.
HB2 2024-1176h: Unnamed Speaker Information Only01:01:58.559 - 1:00:44 PM; The speaker acknowledges potential conflicts of interest but also mentions that the state and counties have vested interests. They highlight the need to consider financial responsibilities and payment streams for counties under any transition to managed care.
HB2 2024-1176h: Ray Bower, Strafford County Information Only01:04:11.599 - 1:02:57 PM; Ray Bower from Strafford County discusses the potential financial impact of transitioning to managed care on counties, specifically mentioning a significant tax increase for his county due to changes in funding streams like ProShare and MQUIP.
HB2 2024-1176h: Unnamed Speaker Information Only01:05:21.200 - 1:04:07 PM; The speaker clarifies the financial impact mentioned by Ray Bower and agrees that these issues should be discussed by the commission. They suggest removing the legislation from the amendment to allow for a more thorough review by the commission.
HB2 2024-1176h: Unnamed Speaker Information Only01:07:40.440 - 1:06:26 PM; The speaker concludes that the amendment is not ready to be recommended to the full House due to unresolved issues and suggests withdrawing it. They propose further discussion and refinement with the Senate.
HB2 2024-1176h: Unnamed Speaker Information Only01:08:58.679 - 1:07:44 PM; A motion is made to withdraw amendment 1429H, and it is seconded. The speaker discusses the need to improve system performance and mentions that the issue will be addressed by the County State Finance Commission.
HB2 2024-1176h: Christine Stoddard, Bi-State Primary Care Association Support01:14:01.120 - 1:12:47 PM; Christine Stoddard represents the 10 federally qualified health centers in New Hampshire and supports the family planning funding. She explains the importance of these funds for underserved communities and how their removal would impact health centers' ability to provide services.
HB2 2024-1176h: Gregory White, CEO of Lamprey Healthcare in Nashua, Newmarket, and Raymond Support01:15:02.159 - 1:13:48 PM; Gregory White supports the family planning funding, highlighting how it supports 22 positions at his organization and helps provide services to those without resources. He emphasizes the impact of defunding on the health centers' capacity to serve the community.
HB2 2024-1176h: Unnamed Speaker Information Only01:17:15.360 - 1:16:01 PM; The speaker discusses the budget constraints and prioritizes direct care obligations over family planning funding. They acknowledge the importance of family planning services but note the availability of alternative care options.
HB2 2024-1176h: Unnamed Speaker Information Only01:21:45.920 - 1:20:31 PM; The speaker questions the availability of alternative care for those at poverty levels and emphasizes the critical role of family planning clinics in preventing unintended pregnancies and reducing emergency room visits.
HB2 2024-1176h: Unnamed Speaker Information Only01:24:12.400 - 1:22:58 PM; The speaker discusses the impact of family planning services on preventing emergency room visits and reducing costs. They mention the number of patients served by the clinics and the importance of these services in preventing health issues.
HB2 2024-1176h: Unnamed Speaker Information Only01:26:21.080 - 1:25:07 PM; The speaker discusses the potential cost savings of preventive care through family planning services and acknowledges the budget constraints but appreciates the efforts of those who came to speak on the issue.
HB2 2024-1176h: Unnamed Speaker Information Only01:27:44.800 - 1:26:30 PM; The speaker introduces amendment 1392, which suspends the WIC Farmers Market program until funding can be found. They discuss the previous investment in the program and the need to keep it on the books for future consideration.
HB2 2024-1176h: Unnamed Speaker Information Only01:29:58.880 - 1:28:44 PM; The speaker clarifies the language in amendment 1392 and confirms with Commissioner Tilly that it provides flexibility to the department. The amendment is then voted on and passed.
HB2 2024-1176h: Unnamed Speaker Information Only01:31:18.880 - 1:30:04 PM; The speaker expressed a preference for computers over paper and discussed the refresh of another bill, which led to a date change for implementation to January 1, 2026. The amendment involves adding three unclassified staff attorney positions to provide court-appointed counsel to out-of-home placements, with the goal of potentially diverting children to more cost-effective care closer to home.
HB2 2024-1176h: Unnamed Speaker Information Only01:32:16.600 - 1:31:02 PM; The speaker discussed the financial aspects of the amendment, clarifying that there is no new appropriation but rather funds being redirected from an existing appropriation in the operating budget. They also expressed interest in tracking the impact of these attorney positions on out-of-state placements in the future.
HB2 2024-1176h: Marie Nunan, DCF Director Information Only01:34:18.159 - 1:33:04 PM; Marie Nunan, Director of DCF, confirmed that they track placements of youth, especially those out-of-state. She acknowledged the difficulty in isolating the impact of the new attorney positions from other efforts but affirmed that data would be available. She also discussed integrating this new process into their workflow and capturing relevant data.
HB2 2024-1176h: Unnamed Speaker Information Only01:35:21.760 - 1:34:07 PM; The speaker concluded the discussion on amendment 2025-1395H, noting the potential benefits for children in reducing out-of-home treatment. A motion to approve the amendment passed unanimously.
HB2 2024-1176h: Representative Walner Information Only01:36:45.159 - 1:35:31 PM; Representative Walner introduced amendment 2025-1391H, which requires the Department of Health and Human Services to report quarterly on child care fund expenditures to monitor potential shortfalls and utilize TANF funds to cover any gaps. Discussions clarified the use of TANF funds as a safety net, with a maximum set by federal government at 30% of the grant. The amendment was approved unanimously.
HB2 2024-1176h: Unnamed Speaker Information Only01:40:50.800 - 1:39:36 PM; The speaker introduced amendment 2025-1363H related to opioid abatement funds, which aims to ensure funds are available for the governor's commission on alcohol and drug abuse by not entering into new contracts or terminating existing ones post-May 1, 2025. Discussions highlighted the potential impact on existing contracts and the challenges of managing the opioid abatement fund. The amendment passed with a vote of 5 to 4.
HB2 2024-1176h: Unnamed Speaker Information Only01:40:50.800 - 1:39:36 PM; The speaker was finishing their testimony at 01:40:50.800, discussing the timeline and data related to the budget and amendment discussions. They mentioned that an email could be sent with further information.
HB2 2024-1176h: Unnamed Speaker Information Only01:46:54.320 - 1:45:40 PM; The speaker continued the discussion on the youth risk behavior surveys, mentioning a House bill that passed the previous day. They were trying to clarify the content of the bill and its impact on the amendment being discussed, specifically regarding the opt-out provisions and the requirement to publish the questionnaire.
HB2 2024-1176h: Unnamed Speaker Information Only01:47:44.639 - 1:46:30 PM; The speaker discussed the confusion around the amendment and the House bill, particularly about the requirement to make survey questions available online. They mentioned that they would need to review the language of the passed bill to ensure the amendment aligns with it.
HB2 2024-1176h: Unnamed Speaker Information Only01:48:58.119 - 1:47:44 PM; The speaker was trying to reconcile the amendment with the House bill, noting that the amendment should include the key sentence from the House bill about disclosing survey questions. They acknowledged the complexity and the need to review the amendment further.
HB2 2024-1176h: Unnamed Speaker Information Only01:50:12.960 - 1:48:58 PM; The speaker confirmed that the amendment included language about making surveys available for review, but they were unsure if it met their intent to include the House bill's language about email notification. They discussed the need to clarify the intent and possibly revise the amendment.
HB2 2024-1176h: Unnamed Speaker Information Only01:51:12.480 - 1:49:58 PM; The speaker identified House Bill 446 as the bill that passed, and they were trying to understand its impact on the amendment. They noted that the amendment did not include the new language from HB446 about email notification for surveys.
HB2 2024-1176h: Unnamed Speaker Information Only01:52:04.239 - 1:50:50 PM; The speaker clarified that the email notification in the amendment applied to the opt-out provision, not the survey itself. They discussed the intent to combine the amendment with the House bill's requirements.
HB2 2024-1176h: Unnamed Speaker Information Only01:52:57.440 - 1:51:43 PM; The speaker confirmed that the amendment was intended to be additive, including both the opt-out provision and the survey disclosure. They discussed the need to ensure the amendment met their intent.
HB2 2024-1176h: Unnamed Speaker Information Only01:54:07.199 - 1:52:53 PM; The speaker discussed the intent to include both the opt-out provision and survey disclosure in the amendment. They noted the need to clarify whether the email notification applied to both.
HB2 2024-1176h: Unnamed Speaker Information Only01:55:20.320 - 1:54:06 PM; The speaker confirmed that the amendment was close to their intent but needed further review. They discussed the need to withdraw the amendment to allow for further work with the Senate.
HB2 2024-1176h: Unnamed Speaker Information Only01:56:50.960 - 1:55:36 PM; The speaker discussed the confusion around the opt-in and opt-out provisions in the amendment and the House bill. They proposed withdrawing the amendment to allow for further work with the Senate.
HB2 2024-1176h: Unnamed Speaker Information Only01:58:14.320 - 1:57:00 PM; The speaker confirmed the withdrawal of the amendment and discussed the process of merging bills and amendments. They noted the need to ensure the Senate has a clean copy to work with.
HB2 2024-1176h: Unnamed Speaker Information Only02:00:20.159 - 1:59:06 PM; The speaker confirmed the withdrawal of two amendments from HB2 to ensure the Senate has a clean copy. They discussed the voting process and the need to clarify the withdrawal of both amendments.
HB2 2024-1176h: Unnamed Speaker Information Only02:01:21.040 - 2:00:07 PM; The speaker confirmed the withdrawal of both amendments from HB2 and discussed the next item on the agenda, amendment 1422, which was skipped earlier.
HB2 2024-1176h: Unnamed Speaker Information Only02:02:31.080 - 2:01:17 PM; The speaker introduced amendment 1422, which proposes a reduction in Medicaid provider rates by 3%. They discussed the financial implications and the potential impact on the budget.
HB2 2024-1176h: Ben Bradley, New Hampshire Hospital Association Information Only02:03:57.440 - 2:02:43 PM; Ben Bradley from the New Hampshire Hospital Association spoke about the concerns regarding the proposed 3% reduction in Medicaid rates. He highlighted the impact on hospitals, noting that they had previously relinquished a rate increase.
HB2 2024-1176h: Unidentified Speaker Information Only02:05:02.960 - 2:03:48 PM; The speaker discussed the impact of increasing hospital rates and how hospitals relinquished those increases last year, suggesting that the money should be directed to the community. They expressed concern about the proposed 3% Medicaid rate reduction and its potential impact on Medicaid enhancement tax revenue. They suggested that exempting hospitals from the rate reduction could be considered, but it would require further financial analysis.
HB2 2024-1176h: Unidentified Speaker Information Only02:06:08.080 - 2:04:54 PM; The speaker continued the discussion on the 3% Medicaid rate reduction, emphasizing the need for analysis due to the significant financial impact. They suggested that any necessary corrections could be made by the time the budget moves to full finance.
HB2 2024-1176h: Unidentified Speaker Information Only02:07:18.800 - 2:06:04 PM; The speaker proposed an amendment to exempt hospitals from the rate reduction, using language from the last budget cycle. They suggested holding hospital inpatient and outpatient services harmless from the reduction and asked for further discussion on the matter.
HB2 2024-1176h: Representative Stringham Information Only02:08:32.880 - 2:07:18 PM; Representative Stringham provided historical context on Medicaid rates, explaining the impact of inflation and the efforts to stabilize the system in the last biennium. They highlighted the potential 15-20% reduction in buying power for Medicaid rates due to the proposed cuts and the possible negative effects on access to services and increased costs in other areas.
HB2 2024-1176h: Unidentified Speaker Information Only02:12:09.360 - 2:10:55 PM; The speaker acknowledged the presence of the CEO from Lamprey Health Care and discussed the impact of the proposed cuts on providers who offer services to low-income individuals. They invited more feedback from providers in the room.
HB2 2024-1176h: Kellyanne Totten, Granite State Home Health and Hospice Association Oppose02:12:45.199 - 2:11:31 PM; Kellyanne Totten, representing Granite State Home Health and Hospice Association, opposed the 3% Medicaid rate reduction. She explained that the rate increase in the last budget cycle helped improve workforce retention and access to services. She warned that the proposed cut would harm the home care sector, potentially leading to service line eliminations and increased reliance on more expensive care settings.
HB2 2024-1176h: David Ross, Hillsboro County Nursing Home, New Hampshire Association of Counties Oppose02:17:20.638 - 2:16:06 PM; David Ross, representing Hillsboro County Nursing Home and the New Hampshire Association of Counties, opposed the Medicaid rate reduction. He highlighted the direct financial impact on taxpayers and the potential negative effects on community-based care. He expressed appreciation for the state's efforts in the last budget cycle but cautioned against any measures that would detract from those gains.
HB2 2024-1176h: Greg White, CEO, Lamprey Health Care Oppose02:18:35.599 - 2:17:21 PM; Greg White, CEO of Lamprey Health Care, opposed the Medicaid rate cuts, explaining their impact on primary care, behavioral health, substance use treatment, and prenatal care. He noted that the organization operates on a thin margin and that any reduction would significantly affect their capacity to provide services. He also mentioned the timing of their budget cycle and the potential impact of the cuts.
HB2 2024-1176h: Unidentified Speaker Information Only02:22:02.720 - 2:20:48 PM; The speaker discussed the financial analysis of excluding hospital rates from the Medicaid rate reduction, estimating the impact on general funds for state fiscal years 26 and 27. They clarified the total funds versus general funds impact and the potential reduction in the budget.
HB2 2024-1176h: Representative Walner Information Only02:24:14.240 - 2:23:00 PM; Representative Walner questioned why federal funds were not shown on the budget sheet and emphasized the importance of considering the full financial impact of the proposed cuts. They noted that the focus was on general funds due to the state's financial targets.
HB2 2024-1176h: Heidi Kroll, J Grimbleis Strategic Solutions, Life Coping Oppose02:26:14.000 - 2:25:00 PM; Heidi Kroll, representing Life Coping, opposed the proposed Medicaid rate reduction. She explained that Life Coping provides case management services and that the rate increase in the last budget cycle was crucial for staff retention. She expressed concern about the impact of the proposed cuts on their ability to provide necessary services.
HB2 2024-1176h: Jim Monahan, DuPont Group Information Only02:30:36.319 - 2:29:22 PM; Jim Monahan from the DuPont Group provided insights into the Medicaid rate increases from the last budget cycle and the potential impacts of the proposed cuts. He discussed the timing of budget cycles for community mental health centers and the federal changes affecting their budgets. He also highlighted the potential loss of federal matching funds and suggested revisiting revenue sources like tobacco and vaping taxes.
HB2 2024-1176h: Unidentified Speaker Information Only02:38:12.479 - 2:36:58 PM; The speaker discussed the need to find a way to reduce the back-of-the-budget cut to give the commissioner more flexibility. They emphasized the importance of identifying specific cuts rather than leaving large sums to be managed by the commissioner, which could lead to unintended consequences.
HB2 2024-1176h: Representative Stringham Information Only02:39:31.399 - 2:38:17 PM; Representative Stringham provided context on the Medicaid rate increases from the last budget cycle, which were initiated by the hospital association to improve the overall system. They acknowledged the effectiveness of those increases but noted the current budget constraints.
HB2 2024-1176h: Representative Seaworth Information Only02:41:15.280 - 2:40:01 PM; Representative Seaworth expressed concern about the back-of-the-budget cut, suggesting that specific cuts discussed openly are preferable to opaque cuts that could have unknown impacts. They emphasized the importance of transparency in budget decisions.
HB2 2024-1176h: Representative Turski Information Only02:42:30.160 - 2:41:16 PM; Representative Turski sought clarification on the impact of the proposed cuts on the developmental disabilities (DD) community, specifically whether they would face a double reduction. They discussed the need to understand the full impact of the proposed changes.
HB2 2024-1176h: Unidentified Speaker Information Only02:47:52.240 - 2:46:38 PM; The speaker discussed the proposal to delay MCO capitation payments to generate savings for the budget. They explained the concept as a 'gimmick' to shift payments by a month, reducing the need for back-of-the-budget cuts.
HB2 2024-1176h: Unidentified Speaker Information Only02:47:52.240 - 2:46:38 PM; The speaker finished discussing the implications of moving the last month of payment from the current biannium to the next, expressing concerns about the financial strategy and the potential impact on future budgets.
HB2 2024-1176h: Unidentified Speaker Information Only02:49:12.960 - 2:47:58 PM; The speaker proposed moving the last month of payment to the next biannium, describing it as 'kicking the can down the road' and expressing concern about deepening financial issues without an economic turnaround. They referenced amendment 1423 related to HB2, and Representative Stringham's input on the matter.
HB2 2024-1176h: Unidentified Speaker Information Only02:50:23.680 - 2:49:09 PM; The speaker questioned the legitimacy and accounting practices of the proposed amendment 1423 to HB2, which shifts payments between biannia. They noted that such strategies have been used in the past but expressed uncertainty about its appropriateness.
HB2 2024-1176h: Unidentified Speaker Information Only02:51:50.640 - 2:50:36 PM; The speaker explained the implications of amendment 1423, which would result in 11 payments in one fiscal year and 13 in the next, effectively shifting the financial burden to the next biannium. They discussed the increased burden and the lack of satisfactory solutions.
HB2 2024-1176h: Unidentified Speaker Information Only02:53:01.600 - 2:51:47 PM; The speaker facilitated a vote on amendment 1423 to HB2, with a roll call resulting in the amendment's approval. They then moved on to discuss another amendment, 1419 on line 53, related to developmental services.
HB2 2024-1176h: Unidentified Speaker Information Only02:54:09.439 - 2:52:55 PM; The speaker introduced amendment 1419, which suspends the requirement for the legislature to fully fund a developmental services wait list for the biannium. They discussed the historical full funding of the wait list and the potential ambiguity in the law.
HB2 2024-1176h: Unidentified Speaker Information Only02:55:14.800 - 2:54:00 PM; The speaker provided details on the financial impact of amendment 1419, which proposes a significant reduction in funding for the developmental services wait list, totaling about $50 million over two years. They sought further clarification on the proposal.
HB2 2024-1176h: Melissa Hardy, Division Director for Long-term Supports and Services Information Only02:57:19.279 - 2:56:05 PM; Melissa Hardy explained the impact of amendment 1419, which would eliminate the requirement to fund the developmental services wait list, potentially creating a wait list for new services. She highlighted the effects on new clients, particularly young adults transitioning from school-based services.
HB2 2024-1176h: Unidentified Speaker Information Only02:59:38.640 - 2:58:24 PM; The speaker discussed the carryover funds from the current year's budget, questioning how these could be used to reduce new spending while still covering services. They sought clarification on the financial strategy.
HB2 2024-1176h: Unidentified Speaker Information Only03:00:31.120 - 2:59:17 PM; The speaker provided further details on the carryover funds and their application in the budget, noting the increased spending rates and the potential for a wait list if the proposed reductions were implemented.
HB2 2024-1176h: Unidentified Speaker Information Only03:01:31.600 - 3:00:17 PM; The speaker discussed the history of the developmental services wait list, mentioning the closure of Laconia State School and the establishment of provisions to ensure equal access to services for people with disabilities.
HB2 2024-1176h: Will Walker, Hollis Oppose03:03:02.439 - 3:01:48 PM; Will Walker, representing families and working for Gateways Community Services, expressed opposition to the amendment, highlighting the fear and potential impact on families transitioning from school to adult services. He shared real-life examples of the consequences of not funding the wait list.
HB2 2024-1176h: Unidentified Speaker Information Only03:05:06.160 - 3:03:52 PM; The speaker sought to clarify the situation regarding carryover funds and their impact on the wait list, ensuring that those currently receiving services would not be affected unless they needed increased services.
HB2 2024-1176h: Unidentified Speaker Information Only03:06:16.000 - 3:05:02 PM; The speaker provided further details on the carryover funds and their application, noting the increased spending rates and the potential for a wait list if the proposed reductions were implemented.
HB2 2024-1176h: Unidentified Speaker Information Only03:07:24.560 - 3:06:10 PM; The speaker discussed the potential impact of the amendment on individuals needing new or enhanced services, noting the increased spending rates and the potential for a wait list if the proposed reductions were implemented.
HB2 2024-1176h: Chris Santelo, Associate Commissioner Information Only03:08:39.920 - 3:07:25 PM; Chris Santelo provided historical context, stating that the last wait list was in 2020 with 80 people on it, and since then, there has been no wait list.
HB2 2024-1176h: Will Walker, Hollis Oppose03:09:35.200 - 3:08:21 PM; Will Walker continued to express opposition, emphasizing the fear among families about the potential wait list and its impact on their lives, particularly for those transitioning from school to adult services.
HB2 2024-1176h: Unidentified Speaker Information Only03:10:38.960 - 3:09:24 PM; The speaker discussed the impact of changes in individual service budgets and the use of carryover funds to fund those changes, noting that with the depletion of carryover funds, individuals might have to wait for new services.
HB2 2024-1176h: Unidentified Speaker Information Only03:12:43.359 - 3:11:29 PM; The speaker reassured that the department is usually prepared for individuals transitioning from educational programs to developmental services, but noted that the proposed amendment would remove this security net.
HB2 2024-1176h: Representative Seaworth Information Only03:12:52.960 - 3:11:38 PM; Representative Seaworth sought clarification on the duration of a potential wait list for budget services, questioning if it would last the entire biennium or vary based on other factors. It was explained that currently, there is no wait list, but if one were to be implemented, its duration would depend on various factors including budget cycles and funding availability.
HB2 2024-1176h: Chris Santelo Information Only03:13:57.760 - 3:12:43 PM; Chris Santelo clarified that historically, wait lists could extend beyond two years, depending on funding and prioritization of needs. He noted that the current budget and the governor's recommended budget include provisions allowing the department to seek additional funds if necessary, which is a unique feature in the state's budget.
HB2 2024-1176h: Mr. Wyatt Information Only03:15:15.279 - 3:14:01 PM; Mr. Wyatt highlighted the flexibility in the budget concerning service class lines, noting that this flexibility is rare in other parts of the state budget. He emphasized that this feature allows for adjustments in funding if necessary.
HB2 2024-1176h: Representative Turski Information Only03:16:21.120 - 3:15:07 PM; Representative Turski discussed the potential impact of a wait list and Medicaid rate cuts on direct service providers and families. He shared an example of a family affected by a direct support professional's resignation due to wages, illustrating the immediate and severe impact on families requiring constant care.
HB2 2024-1176h: Unidentified Speaker Information Only03:18:26.560 - 3:17:12 PM; The speaker continued discussing the impact of potential wage cuts on direct support professionals, emphasizing the immediate and severe effects on families needing constant care. The discussion was cut short due to time constraints.
HB2 2024-1176h: Unidentified Speaker Information Only03:19:34.319 - 3:18:20 PM; The discussion shifted to real estate proposals, specifically the Terrell House in Manchester. The proposal was to sell the property, with initial estimates of the sale value ranging from $700,000 to less than $450,000 due to issues like asbestos and lead. The sale's proceeds were intended to be used for DHS general funds.
HB2 2024-1176h: Mr. White Information Only03:20:57.279 - 3:19:43 PM; Mr. White clarified that the Terrell House is currently leased to the City of Manchester at no cost, used as a homeless shelter until June 30, 2025. He noted the historical intent of the property's donor, Alice Terrell, to use it for people recovering from alcoholism.
HB2 2024-1176h: Representative Nelleno Information Only03:23:05.120 - 3:21:51 PM; Representative Nelleno suggested that if the Terrell House were to be sold, it should first be offered to the City of Manchester or the county, addressing concerns about the impact on services provided there.
HB2 2024-1176h: Unidentified Speaker Information Only03:24:30.880 - 3:23:16 PM; The committee voted on amendment 1420 regarding the sale of the Terrell House, with a motion to accept it passing with a vote of 9-1.
HB2 2024-1176h: Unidentified Speaker Information Only03:25:17.680 - 3:24:03 PM; The discussion moved to the Philbrook property, with a proposal to sell it for $5 million in the second year of the budget. It was noted that the property has been used for transitional housing during the pandemic and is currently used by NFI North for the same purpose.
HB2 2024-1176h: Katya Fox, Director of the Division for Behavioral Health Information Only03:26:31.439 - 3:25:17 PM; Katya Fox explained the use of the Philbrook Center for transitional housing, noting its role in alleviating ED boarding by providing a lower level of care for patients transitioning out of New Hampshire Hospital. She mentioned that the facility houses up to 16 individuals, and discontinuing its use would increase costs.
HB2 2024-1176h: Unidentified Speaker Information Only03:27:17.960 - 3:26:03 PM; Further discussion on the Philbrook property focused on the existing contract with NFI North, which is set to expire in June 2025 but can be renewed for up to two years. The impact of discontinuing the use of Philbrook on transitional housing services was discussed.
HB2 2024-1176h: Representative Walner Information Only03:28:35.120 - 3:27:21 PM; Representative Walner questioned the strategy behind using Philbrook for transitional housing to reduce the number of people at New Hampshire Hospital, emphasizing its role in the state's broader strategy to manage hospital capacity and patient care.
HB2 2024-1176h: Representative Seaworth Information Only03:31:08.800 - 3:29:54 PM; Representative Seaworth inquired about the potential costs of funding 16 beds without providing a building. The response indicated that such information would need to be gathered and presented later, highlighting the challenges in finding suitable locations for housing due to delays in renovations or finding facilities.
HB2 2024-1176h: Unnamed Speaker Information Only03:32:15.279 - 3:31:01 PM; The speaker discussed the zoning and potential resale of the Philbrook building near New Hampshire Hospital. They noted the challenges of reselling government property in that location and the potential for rezoning, though they expressed doubts about attracting buyers.
HB2 2024-1176h: Unnamed Speaker Information Only03:33:20.720 - 3:32:06 PM; The speaker discussed the potential use of the Hamstead campus, suggesting it could be developed into high-end homes or turned into a preserve in collaboration with the town of Hampstead. They mentioned a related House bill, HB1435, aimed at negotiating with Hampstead on the use of the campus, though no immediate financial benefits would be realized.
HB2 2024-1176h: Unnamed Speaker Information Only03:36:06.960 - 3:34:52 PM; The speaker discussed the CNU center, noting its potential sale value of $80 million but highlighted that the sale would not occur until the next budget cycle. They also mentioned an unsuccessful attempt to borrow against the property's equity due to bonding issues.
HB2 2024-1176h: Unnamed Speaker Information Only03:37:19.680 - 3:36:05 PM; The speaker shared their efforts to find additional funding sources, including the unsuccessful attempt to borrow against the CNU center's equity. They emphasized the ongoing challenge of finding more money to spend and the need to review budget items carefully.
HB2 2024-1176h: Unnamed Speaker Information Only03:38:30.720 - 3:37:16 PM; The speaker announced a recess and planned to review additional budget items upon return, aiming to finalize Division 3 recommendations for the full finance committee.
HB2 2024-1176h: Unnamed Speaker Information Only04:11:08.080 - 4:09:54 PM; After the recess, the speaker noted the time and urgency to conclude the session, mentioning a new item on the landscape document about funding community mental health programs at the highest level to date, with a reduction from the governor's budget.
HB2 2024-1176h: Unnamed Speaker Information Only04:11:57.920 - 4:10:43 PM; The speaker moved to approve line item one, which involved funding community mental health programs at $31 million per year, a reduction from the governor's budget. The motion passed with a vote of six to four.
HB2 2024-1176h: Unnamed Speaker Information Only04:13:22.800 - 4:12:08 PM; The speaker discussed line items 20 and 39, which together found an additional $134,000 in savings. Both items were approved unanimously.
HB2 2024-1176h: Unnamed Speaker Information Only04:15:06.040 - 4:13:52 PM; The speaker clarified the status of line item 28, noting that the WIC program had already been voted on and suspended. They then moved to approve line item 27, a reduction in epidemiology services, which passed with a vote of seven to three.
HB2 2024-1176h: Unnamed Speaker Information Only04:16:41.279 - 4:15:27 PM; The speaker proposed a reduction in funding for line item 33, suggesting a split of $500,000 over two years instead of the previously mentioned $2 million.
HB2 2024-1176h: Unnamed Speaker Information Only04:16:41.279 - 4:15:27 PM; The speaker finished discussing a previous topic and thanked the committee for their analysis, indicating that the analysis was helpful in catching something they wouldn't have noticed otherwise. They then moved on to line 33 of the budget, which was approved with a vote of 10 to 0, passing the Stratham amendment.
HB2 2024-1176h: Unnamed Speaker Information Only04:18:32.840 - 4:17:18 PM; The speaker discussed line 38, which was originally allocated for the Safe Stations program, which no longer exists. The funds have been used by the city of Manchester for the Rescue One program. After discussions with the mayor and fire department personnel from Manchester, it was agreed that the funding could be reduced from $256,000 to $192,000 per year, saving $64,000 annually. A motion to approve line 38 was made and passed with a vote of 6 to 4.
HB2 2024-1176h: Unnamed Speaker Oppose04:21:20.640 - 4:20:06 PM; The speaker expressed opposition to line 40, which proposes to eliminate the Choose Love program. They noted that the program contributes to social-emotional education and was passionate about by the previous governor following the Sandy Hook shooting. Despite their opposition, line 40 was approved with a vote of 6 to 4.
HB2 2024-1176h: Unnamed Speaker Information Only04:22:38.880 - 4:21:24 PM; The speaker introduced line 41, which involves cutting funding for Project Walk, an outpatient recreational-based physical therapy program in Stratham. There was some confusion and lack of detailed knowledge about the program among the committee members. A motion to approve line 41 was made and passed with a vote of 6 to 4.
HB2 2024-1176h: Unnamed Speaker Information Only04:24:40.319 - 4:23:26 PM; The speaker discussed line 42, which is a technical fix to allow the swapping of funds between the Education Trust Fund and general funds, as decided by Division 2. This action has no financial impact as it reallocates the same amount of money. The line was approved with a vote of 6 to 4.
HB2 2024-1176h: Unnamed Speaker Information Only04:25:39.760 - 4:24:25 PM; The speaker explained the background of the Education Trust Fund and the adjustments made to it in previous budgets, leading to the current proposal to move $3 million per year from the Education Trust Fund to general funds. This was described as a subset of the Wiler amendment from the previous budget cycle. Line 42 was approved with a vote of 6 to 4.
HB2 2024-1176h: Unnamed Speaker Information Only04:29:42.399 - 4:28:28 PM; The speaker discussed lines 43 and 44, which aim to reduce residential placements by 10%, saving over $5 million annually. Line 43, which includes two sub-accounts, was approved with a vote of 6 to 4. Line 44 proposes to reduce developmental services waitlist funding and eliminate the suspension of the DD waitlist as proposed in HB2. The speaker suggested adopting line 44 and withdrawing the HB2 amendment.
HB2 2024-1176h: Unnamed Speaker Information Only04:32:01.040 - 4:30:47 PM; The speaker clarified that the HB2 item, which would suspend the requirement to not have a wait list, will not be acted upon and will be withdrawn. However, the line item in HB1 will be recalibrated to reflect the savings from this decision. The department is still mandated to fulfill all needs without a wait list, and there is a fiscal committee option available if expenditures exceed appropriations.
HB2 2024-1176h: Unnamed Speaker Vote04:34:27.958 - 4:33:13 PM; The speaker proposed a motion to withdraw the HB2 item related to the DD waitlist suspension and to maintain the HB1 item with a reduction of $8.877 million in year one and $2.2499 million in year two. The motion was seconded and passed with a vote of 6-4.
HB2 2024-1176h: Unnamed Speaker Vote04:35:19.599 - 4:34:05 PM; The speaker proposed accepting line item 45 with a 3% cut and recalibration, which would reduce the budget cut and allow for Senate review. The motion was seconded and passed with a vote of 6-4.
HB2 2024-1176h: Unnamed Speaker Information Only04:36:53.680 - 4:35:39 PM; The speaker confirmed that the vote on delaying the June 2027 MCO payment until the start of 2028 had already been taken. They also discussed the sale of the Terrell House, which was voted on, and the Phil Brook Center, which was not voted on due to ongoing discussions.
HB2 2024-1176h: Unnamed Speaker Vote04:37:40.160 - 4:36:26 PM; The speaker proposed voting on amendment 1421, which would adjust the budget to reflect $5 million instead of the initially estimated $7 million for the Phil Brook Center. The amendment was moved, seconded, and passed with a vote of 6-4.
HB2 2024-1176h: Unnamed Speaker Vote04:39:00.438 - 4:37:46 PM; The speaker proposed amendment 1435 for Hamstead, which would initiate discussions on an oversized lot. The amendment was moved, seconded, and passed unanimously with a vote of 10-0.
HB2 2024-1176h: Unnamed Speaker Information Only04:40:39.120 - 4:39:25 PM; The speaker clarified that a vote on the status of budget action sheet on savings from the Medicaid 3% reduction had been taken, but not on the House Bill 2 amendment 1422H. They proposed a separate vote on this amendment, which was moved, seconded, and passed with a vote of 6-4.
HB2 2024-1176h: Unnamed Speaker Vote04:41:51.440 - 4:40:37 PM; The speaker proposed a motion to reconsider the vote on line 17 of HB1, which had deleted the family planning account. The motion was seconded but lost with a vote of 4-6.
HB2 2024-1176h: Unnamed Speaker Information Only04:43:02.600 - 4:41:48 PM; The speaker introduced a draft amendment that would require the department to reduce general funds by $23 million in fiscal years 2026 and 2027. They explained that this amendment, in combination with other actions, aims to meet the biennial reduction target of $290 million for Division 3.
HB2 2024-1176h: Unnamed Speaker Information Only04:44:14.240 - 4:43:00 PM; The speaker confirmed that the actions taken in Division 2 aligned with expectations, maintaining the $290 million target. They discussed the significant $46 million cut to the budget, emphasizing the exhaustive and collaborative efforts made with various state departments and the governor's office. The speaker moved to accept the draft amendment for the budget cut, which was seconded and passed with a vote of six to four.
HB2 2024-1176h: Unnamed Speaker Information Only04:45:30.240 - 4:44:16 PM; The speaker discussed the upcoming presentation to the full finance committee, mentioning the possibility of emailing the amendment. They also addressed a concern about the visibility of federal funds in the budget documents, explaining that federal funds related to Medicaid rate decreases and MCO payment delays would not be shown on the detailed change sheet but would be noted separately.
HB2 2024-1176h: Unnamed Speaker Information Only04:46:50.320 - 4:45:36 PM; The speaker elaborated on the federal fund reductions, noting that the standard Medicaid match is one for one, but other programs like CHIP and Granite Advantage have different federal matches. They expressed regret over the lack of a full picture of federal fund impacts in the budget.
HB2 2024-1176h: Representative Priest Information Only04:47:56.000 - 4:46:42 PM; Representative Priest agreed with the previous speaker's concerns about federal funds and suggested that future budget considerations should also include the number of people directly impacted by budget cuts, emphasizing the human aspect behind the numbers.
HB2 2024-1176h: Unnamed Speaker Information Only04:49:10.798 - 4:47:56 PM; The speaker concluded the session, noting that no further comments were solicited from the gallery. They apologized for any dissatisfaction and emphasized that the budget process would continue through the House and Senate.