Committee Summary for Senate Finance (04/28/2025)

Bill/Time	Type	Title	Sponsor
Unclear 00:07:07.759 - 12:05:53 PM	General Working Session	Unclear
Unclear 00:55:15.359 - 12:54:01 PM	General Working Session	Unclear

Unclear: John Broadick, Administrator of the YDC Claims Fund Information Only00:07:07.759 - 12:05:53 PM; John Broadick, the administrator of the YDC Claims Fund, provided an overview of the fund's operations. He explained that the fund operates under the Department of Justice, with him as the appointed administrator and Jen Foley as the general counsel. They have submitted documents detailing the fund's activities, including the number of cases handled and settled. Broadick highlighted the use of a PowerPoint presentation to outline their operations, standards, and case statistics. He also mentioned the involvement of the judicial branch in providing infrastructure support, though not in processing claim files.
Unclear: Jen Foley, General Counsel for YDC Claims Administration Information Only00:08:17.800 - 12:07:03 PM; Jen Foley presented a detailed overview of the YDC Claims Administration's operations. She explained the fund's statutory basis under the Department of Justice, the role of the attorney general, and the involvement of the judicial branch. Foley outlined the claims administration process, including the two methods of settlement resolution: claim intake leading to hearings and direct settlements through the Attorney General's office. She also discussed the evaluation of claims, including eligibility, verification, and valuation guidelines approved by joint fiscal. Foley provided statistics on claims filed, resolved, and pending, as well as details on the budget and appropriations for the fund.
Unclear: John Broadick, Administrator of the YDC Claims Fund Information Only00:26:17.279 - 12:25:03 PM; John Broadick continued the discussion, emphasizing the need for a robust mediation process to speed up claim resolutions. He suggested that mediation could be an effective alternative to hearings, allowing claimants to resolve cases more quickly and respectfully. Broadick also noted a decrease in settlements by the Attorney General's office and stressed the importance of their engagement in resolving cases. He highlighted the cost-effectiveness of the fund compared to traditional court proceedings and the need to maintain a budget buffer for future claims.
Unclear: Dana Adurus, Executive Director at OPLC Information Only00:40:05.200 - 12:38:51 PM; Dana Adurus, the executive director at OPLC, discussed the agency's operations and budget. OPLC oversees over 50 occupational licensing boards and manages over 200,000 licenses. Adurus reported on the agency's financials, noting a proposed 10% increase in licensing fees to address a current net loss. She detailed changes proposed in HB2, including the transfer of mechanical and electrical inspectors to the Department of Safety and adjustments to cosmetology inspections. Adurus also discussed challenges, including a backlog of complaints and the development of a new licensing platform funded by ARPA.
Unclear: Heather Kelly, Director of Operations at OPLC Information Only00:40:05.200 - 12:38:51 PM; Heather Kelly accompanied Dana Adurus and provided additional information on OPLC's operations. She supported Adurus' statements on the budget and operational changes, emphasizing the need for the proposed fee increase to sustain operations and address the current deficit. Kelly also highlighted the importance of the new licensing platform to streamline processes and manage finances effectively.
Unclear: Nathan White, Chief Financial Officer, Department of Health and Human Services Information Only00:55:15.359 - 12:54:01 PM; Nathan White provided an overview of the Department of Health and Human Services budget, highlighting the comprehensive binder provided to the senators. He explained the structure of the presentations, which included detailed budget briefing books for accounting units over $1 million. He noted that the department would focus on changes from the current biennium to the next. He handed over to Marissa Hen, the deputy commissioner, to discuss further details related to the Office of the Commissioner.
Unclear: Marissa Hen, Deputy Commissioner, Department of Health and Human Services Information Only00:57:21.359 - 12:56:07 PM; Marissa Hen, standing in for Commissioner Weaver, introduced the department's work and its statutory responsibilities. She emphasized the integration of services across the department's seven core divisions and introduced the concept of a strategic roadmap guiding their work. She highlighted the department's commitment to improving customer service and efficiency, and expressed eagerness to work with the senators over the next two days.
Unclear: Nathan White, Chief Financial Officer, Department of Health and Human Services Information Only01:00:24.720 - 12:59:10 PM; Nathan White continued the budget discussion by detailing the complexities of federal funding, including the use of a public assistance cost allocation plan to maximize federal funds. He explained the maintenance of effort requirements and various funding models, such as Medicaid's matching fund models. He provided an overview of the department's budget, highlighting the general fund portion and other funds, and discussed the impact of legislative appropriations and budget reductions on the department's operations.
Unclear: Nathan White, Chief Financial Officer, Department of Health and Human Services Information Only01:07:35.039 - 1:06:21 PM; Nathan White discussed the department's personnel and position cuts, including a $30 million reduction and a $46 million back-of-the-budget cut. He explained that these cuts would require careful consideration to minimize harm to programs and services. He also detailed specific HB2 provisions affecting the department, such as Medicaid rate reductions and changes to the governor's commission funding. He highlighted the department's concerns regarding the sale of certain properties and the impact on services.
Unclear: Henry Litman, Medicaid Director, Department of Health and Human Services Information Only01:30:18.880 - 1:29:04 PM; Henry Litman provided detailed information on Medicaid budget changes, including general fund reductions, increased revenue from Medicaid enhancement tax, and the introduction of children's Medicaid premiums. He discussed the tightening of Medicaid eligibility requirements post-public health emergency and the potential impact of premiums on enrollment. He also addressed the Medicaid enhancement tax overperformance, contract line reductions, and the department's concerns about the administrative charge and potential federal changes to Medicaid funding.
Unclear: Henry Litman, Medicaid Director, Department of Health and Human Services Information Only01:57:13.960 - 1:55:59 PM; Henry Litman discussed potential budget impacts, particularly concerning Medicaid enhancements and uncompensated care. He highlighted that if certain legislative actions are passed, they would need to mitigate effects on families with multiple children and ensure provisions for individuals under treatment. He also mentioned the need to consult with CMS regarding these changes. He responded to a question about the realism of the House's 3% year-over-year growth projections, indicating that reaching an agreement would be crucial for those estimates.
Unclear: Unidentified Speaker Information Only01:58:38.560 - 1:57:24 PM; The speaker raised concerns about the impact of brand name drug usage on insurance premium taxes and how it would affect the state's Medicaid program. Henry Litman responded that it would result in a lower net cost to the program but the premium tax comes after the payment of capitation rates, affecting them.
Unclear: Senator Waters Information Only01:59:46.400 - 1:58:32 PM; Senator Waters questioned the potential federal action on the MET tax and its impact on nursing homes and Medicaid. Henry Litman explained that most states have a program at around 5.5% and a reduction to 5% could result in a significant decrease, approximately 35 million dollars.
Unclear: Unidentified Speaker Information Only02:02:37.840 - 2:01:23 PM; The speaker inquired about the proposed premium on children's Medicaid and the likelihood of collecting it. Henry Litman shared historical data from the New Hampshire Healthy Kids Corporation and emphasized the need to consider family size in setting premiums. He noted that the proposed premiums would be simpler without co-payments.
Unclear: Unidentified Speaker Information Only02:03:52.639 - 2:02:38 PM; The speaker asked about the cost to the department for administering the new changes in the Medicaid program. Henry Litman explained that they are looking at using existing state technology to manage the costs, which could impact the yield but should be covered within the conservative estimates.
Unclear: Unidentified Speaker Information Only02:06:04.560 - 2:04:50 PM; The speaker questioned the process for monitoring Medicaid members receiving benefits in multiple states. Henry Litman detailed the public reporting system and efforts to adjust payments and rates when dual coverage is identified, noting that New Hampshire's efforts have been effective in managing this issue.
Unclear: Unidentified Speaker Information Only02:09:45.800 - 2:08:31 PM; The speaker discussed the impact of rate decreases proposed in House Bill 2 on Medicaid revenues, particularly for hospitals. Henry Litman clarified that some payments like DSH would not be subject to the rate reduction and that directed payments could mitigate some of the decreases.
Unclear: Henry Litman, Medicaid Director, Department of Health and Human Services Information Only02:12:17.639 - 2:11:03 PM; Henry Litman expressed concerns about the lack of funding for the call center in the budget, which could affect the timely processing of eligibility and realization of savings. He highlighted the potential negative impact on customer service and eligibility determinations if a work requirement were added.
Unclear: Ellen Le Point, CEO, New Hampshire Hospital and Glencliff Home Information Only02:14:03.840 - 2:12:49 PM; Ellen Le Point and Brett Mason provided an overview of Glencliff Home's operations, budget, and services. They detailed the facility's efforts to support residents and the budget's focus on personnel and Medicaid payments. They discussed changes in funding and positions at the House phase of the budget.
Unclear: Unidentified Speaker Information Only02:18:42.160 - 2:17:28 PM; The speaker inquired about the current census at Glencliff Home and its changes over the years. Ellen Le Point explained the decrease was due to efforts to ensure the facility is used for individuals needing that level of care and a focus on community-based options.
Unclear: Unidentified Speaker Information Only02:19:58.160 - 2:18:44 PM; The speaker asked about funding changes during the House phase for Glencliff Home. It was explained that $486,000 was added, with some funds redirected from the Prescription Drug Affordability Board after its funding was unfunded.
Unclear: Ellen Le Point, CEO, New Hampshire Hospital and Glencliff Home Information Only02:21:02.240 - 2:19:48 PM; Ellen Le Point provided an overview of New Hampshire Hospital's services and highlighted the coordination of patients across the state's designated receiving facilities (DRFs). She detailed the success of mission zero in reducing the emergency department queue and discussed the hospital's budget and challenges with patient discharges.
Unclear: Unidentified Speaker Information Only02:24:25.200 - 2:23:11 PM; The speaker noted the reduction in wait times for patients in emergency departments. Ellen Le Point confirmed a 42% reduction in wait times and discussed the hospital's budget and staffing challenges.
Unclear: Unidentified Speaker Information Only02:26:46.080 - 2:25:32 PM; The speaker inquired about the House's addition of $5,000 to personnel expenses and the sale of the Philbrook building. Ellen Le Point explained the building's use and the need for alternative locations for its residents and staff.
Unclear: Unidentified Speaker Information Only02:27:58.720 - 2:26:44 PM; The speaker discussed the challenges of securing transitional housing and the cost of housing. Ellen Le Point mentioned NFI's efforts to find alternative properties and the need for contingency plans if the Philbrook building is sold.
Unclear: Unidentified Speaker Information Only02:30:02.240 - 2:28:48 PM; The speaker asked about the staff housed at the Philbrook building. Ellen Le Point explained the need for these departments to be near the hospital and the challenges of relocating them.
Unclear: Unidentified Speaker Information Only02:32:28.479 - 2:31:14 PM; The speaker questioned the number of patients eligible for transitional housing at New Hampshire Hospital. Ellen Le Point noted the variety of needs among these patients, with approximately 110 individuals currently in need.
Unclear: Ellen Le Point, CEO, New Hampshire Hospital and Glencliff Home Information Only02:33:19.840 - 2:32:05 PM; Ellen Le Point discussed the addition of $5,000 for the future high security or maximum security addition at New Hampshire Hospital. She also detailed the accounting units for administration, facility, and patient support, noting no significant changes.
Unclear: Unidentified Speaker Information Only02:36:17.359 - 2:35:03 PM; The speaker suggested sharing pharmacists between the state prison and New Hampshire Hospital to cut costs. Ellen Le Point agreed to explore this possibility.
Unclear: Ian Wad, Director for the Division of Public Health Services Information Only02:38:01.600 - 2:36:47 PM; Ian Wad, Director for the Division of Public Health Services, provided an overview of the division's core functions and budget needs. He highlighted the division's role in protecting public health through clean air, water, and food, disease prevention, and emergency response. Wad emphasized the division's reliance on federal and other funds, noting that over 80% of their budget comes from these sources. He discussed the impact of recent federal funding cuts and the division's efforts to maximize state and local resources. Wad also addressed the proposed 5% surcharge on dedicated funds, listing several funds that should be exempt due to statutory requirements and the potential impact on services. He detailed the functions of various bureaus within the division, including public health statistics, environmental programs, family health, infectious disease control, laboratory services, emergency preparedness, and prevention of chronic diseases. Wad expressed concerns about the elimination of the tobacco prevention program and the state loan repayment program, which could affect healthcare access and outcomes.
Unclear: Senator Rosen Information Only02:41:39.040 - 2:40:25 PM; Senator Rosen inquired about the status of an $80 million cut in federal funds, to which Ian Wad responded that the state had filed an administrative appeal, and the matter was now with the federal government for adjudication. Senator Rosen also asked about the timing of the appeal process, but Wad was unable to provide a specific timeline.
Unclear: Senator Bzo Information Only02:52:53.960 - 2:51:39 PM; Senator Bzo requested clarification on the contracts related to the family planning program, which Ian Wad listed as Amos Health, Lamprey Healthcare, the Community Action Program of Belknap and Merrimack County, and Coos County Family Health. These contracts operate seven sites, with a focus on the northern part of the state, particularly in Coos County and Laconia.
Unclear: Senator Waters Information Only02:54:13.279 - 2:52:59 PM; Senator Waters discussed the potential impact of cutting the family planning program on STI investigations and treatment costs. Ian Wad confirmed that such cuts could lead to increased disease spread and higher treatment costs. Senator Waters also inquired about the possibility of other providers absorbing patients from the seven sites if funding were cut, to which Wad expressed concerns about the existing capacity and access issues, particularly in rural areas.
Unclear: Trish Tilly, Associate Commissioner Information Only03:00:18.240 - 2:59:04 PM; Trish Tilly provided information on the status of birthing centers in the northern part of the state, noting that Androscoggin Valley Hospital in Coos County and Littleton Hospital in Grafton County still provide labor and delivery services. She mentioned that several critical access hospitals across the middle of the state have closed, affecting access to care.
Unclear: Marissa Hen, Deputy Commissioner Information Only03:27:03.520 - 3:25:49 PM; Marissa Hen addressed a question about Hamstead Hospital and the PRTF rejecting New Hampshire children. She explained that the hospital prioritizes New Hampshire youth and has a comprehensive admissions process to ensure clinical appropriateness. While some children may be denied admission due to not meeting the criteria, the hospital remains committed to ensuring that youth receive appropriate care.
Unclear: Unidentified Speaker Information Only03:20:22.720 - 3:19:08 PM; The unidentified speaker discussed the acquisition and operational changes at Hamstead Hospital and Residential Treatment Facility. They noted that the state entered into a sole source contract with a provider in 2022, and later with Dartmouth for clinical services. The facility's budget was adjusted following a lease agreement with Mary Hitchcock Memorial Hospital, which now oversees operations. The speaker highlighted a unique provision in the lease requiring the state to match capital investments up to $3 million, and mentioned Senate Bill 118 as a solution to fund this obligation. They also mentioned a payment to the town of Hampstead to offset lost tax revenue due to the state's purchase of the facility.
Unclear: Senator Waters Information Only03:29:12.000 - 3:27:58 PM; Senator Waters discussed Senate Bill 59, which was tabled and involves changes to the recruitment and retention program to include dispatchers and allow certificate courses. He questioned the procedure for handling bills that were passed and tabled, suggesting they could be incorporated into the budget or removed from the table for further action.
Unclear: Unidentified Speaker Information Only03:32:21.399 - 3:31:07 PM; The unidentified speaker discussed the handling of House bills within House Bill 2, explaining that bills in policy committees would be considered after the committees finish with them. They mentioned that bills passed by the Senate and sent to the House could be removed from House Bill 2 if they are already enacted or if they have no budget implications. The speaker also addressed the potential need to include funding for Hamstead Hospital's capital improvements in the budget if Senate Bill 118 passes.

Gray, James(Chairman)(R)[C+]2024	Innis, Daniel(V Chairman)(R)[C+]2024	Carson, Sharon(R)[C]2024
Watters, David(D)[CT]2024	Birdsell, Regina(R)[C+]2024	Lang, Timothy(R)[C+]2024
Rosenwald, Cindy(D)[CT]2024	Pearl, Howard (R)[C+]2024