Committee Summary for Senate Health and Human Services (02/06/2025)

Bill/Time	Type	Title	Sponsor
SB119 00:03:40.599 - 9:02:46 AM	Public Hearing	relative to Medicaid pharmaceutical services.	Gray, James(R)[C+]2024
SB119 00:12:23.680 - 9:11:29 AM	Executive Session	relative to Medicaid pharmaceutical services.	Gray, James(R)[C+]2024
SB127 00:16:59.040 - 9:16:05 AM	Public Hearing	relative to the office of the public guardian and making appropriations to the department of health and human services.	Avard, Kevin(R)[C+]2024
SB135 01:25:49.880 - 10:24:55 AM	Public Hearing	relative to rate setting parity for Medicaid state plan case management services.	Avard, Kevin(R)[C+]2024
SB126 02:11:31.400 - 11:10:37 AM	Public Hearing	relative to notice of changes to provider contracts.	Avard, Kevin(R)[C+]2024
SB255 02:50:44.479 - 11:49:50 AM	Public Hearing	establishing and developing crisis stabilization services.	Avard, Kevin(R)[C+]2024

SB119: James Gray, Senator District 6 Support00:03:40.599 - 9:02:46 AM; Senator Gray introduced Senate Bill 119, emphasizing that the legislation aims to allow for cost savings in Medicaid by permitting the use of brand name drugs when they are cheaper than their generic counterparts due to various incentives. He highlighted the bill's purpose is to enable more economical choices for the state without compromising patient care. He mentioned his district covers Alton, Gilmanton, Rochester, and Strafford.
SB119: Henry Litman, State's Medicare Director Support00:05:20.160 - 9:04:26 AM; Henry Litman supported Senate Bill 119, explaining that the current 'generics first' policy does not always result in the lowest cost for Medicaid. He detailed that the bill would allow flexibility to choose the less expensive option between brand name and generic drugs, considering rebates. He mentioned potential savings to the state of $1.1 million in 2026, $3.4 million in 2027, and up to $4.5 million in 2028, without impacting patient benefits. He also discussed the rising cost of drugs in Medicaid and the need for such tools to manage these costs effectively, including provisions for moving drugs between prescription and over-the-counter categories when cost-effective.
SB119: Committee Members Support00:12:23.680 - 9:11:29 AM; In the executive session on Senate Bill 119, a motion was made and seconded to pass the bill. There was no opposition, and the committee voted to recommend the bill with consent. The session concluded with the decision to move forward with the bill.
SB127: Senator Kevin Avard, District 12 Support00:16:59.040 - 9:16:05 AM; Senator Kevin Avard introduced SB127, emphasizing the critical role of the Office of Public Guardian (OPG) in supporting incapacitated adults who lack family or friends to assist them. He highlighted the OPG's impact in helping those unable to manage finances, participate in healthcare, or care for themselves, including individuals languishing in hospitals due to incapacitation. Avard stressed the need for increased investment in the OPG as requested by the Department of Health and Human Services (DHHS) and mentioned his personal observations of elderly individuals in need of support, underscoring the importance of compensating OPG staff fairly to attract and retain quality personnel.
SB127: Lisa Britz Silski Stevens, Chief Executive Officer, Office of Public Guardian Support00:23:37.039 - 9:22:43 AM; Lisa Britz Silski Stevens expressed gratitude for Senator Avard's sponsorship of SB127, which aims to boost the Office of Public Guardian's capacity. She detailed the OPG's history and current role in serving over 1,400 Granite Staters with various incapacities. Stevens noted the underfunding and low compensation of OPG staff despite their dedication and the complexity of their work. She explained how the bill would address the issue of seniors stuck in hospitals due to the lack of guardianship services, and highlighted a scrivener's error in the bill that needs correction to ensure funding for both years of the biennium.
SB127: Melissa Neth, Department of Health and Human Services Information Only00:34:38.079 - 9:33:44 AM; Melissa Neth provided information on the DHHS's contracts with public guardianship agencies, including the Office of Public Guardian and Tri County CAP Guardianship Services. She clarified some confusion around the bill's appropriation section, suggesting it might be intended to align with the department's budget priorities rather than create additional funding. Neth expressed the department's support for increased investment in guardianship services but noted the need for clearer language in the bill.
SB127: Brian Clark, Bureau of Aging and Adult Services Information Only00:40:45.839 - 9:39:51 AM; Brian Clark discussed the implications of the proposed amendment to RSA 161-F:52, which would include people awaiting hospital discharge but noted that it does not expand the scope of Adult Protective Services (APS) guardianships due to the unchanged definition of protective services. He suggested that additional statutory changes are needed to achieve the bill's intended outcome, highlighting the complexity of aligning the bill with existing legal frameworks.
SB127: Brendan Williams, President and CEO, New Hampshire Healthcare Association Support00:49:58.319 - 9:49:04 AM; Brendan Williams expressed support for SB127, emphasizing its potential to alleviate the burden on hospitals by facilitating the discharge of patients who require guardianship services. He acknowledged the bill's potential changes and suggested that redefining neglect to include involuntary hospitalization could be a solution. Williams highlighted the collaborative effort needed among care providers and the challenges faced by nursing homes in accepting patients without adequate guardianship support.
SB127: Ben Bradley, Vice President of State Government Relations, New Hampshire Hospital Association Support00:51:54.440 - 9:51:00 AM; Ben Bradley expressed strong support for SB127, highlighting its importance in addressing guardianship resources for hospital patients who cannot make decisions for themselves. He mentioned that the bill is part of a broader effort to reduce barriers to patient transfers from inpatient hospital beds to more appropriate care settings. Bradley referenced a report that identified nearly 80 patients on a single day who no longer needed inpatient care but were waiting for placement, accumulating significant unnecessary hospital days. He emphasized the bill's potential to directly help patients, their families, and caregivers, as well as improve the overall healthcare system by freeing up beds for other patients in need.
SB127: Jessica Ryan, System Vice President for Care Coordination, Dartmouth Health Support00:55:44.720 - 9:54:50 AM; Jessica Ryan supported SB127 and discussed the daily challenges of managing hospital capacity and patient transfers. She highlighted that 12 patients in their system were seeking guardianship, leading to significant bed days of uncompensated care. Ryan stressed the impact of delayed transfers on other patients, such as those in emergency departments, and the financial burden on patients and the healthcare system. She emphasized the importance of the bill in improving patient throughput and ensuring acute care services are used appropriately.
SB127: Laura McIntyre, Sheenny Capital Group, representing Granite State Home Health and Hospice Association Support01:03:13.160 - 10:02:19 AM; Laura McIntyre spoke in support of SB127, representing the Granite State Home Health and Hospice Association. She highlighted the bill's role in providing timely access to public guardianship, which is crucial for ensuring patients receive appropriate care without delays. McIntyre discussed the impact of guardianship delays on patients needing hospice care and the importance of increased access to guardianship services to facilitate smoother transitions from hospital to home care.
SB127: Cheryl Steinberg, Director of the Justice and Aging Project, New Hampshire Legal Assistance Support01:05:52.680 - 10:04:58 AM; Cheryl Steinberg supported SB127 and emphasized the need for more guardianship slots to prevent harm to individuals who cannot make decisions for themselves. She shared a case where her organization had to file a guardianship petition due to the unavailability of public guardians, which was necessary to prevent a client from becoming homeless. Steinberg urged the committee to pass the bill to increase the availability of guardianship resources and protect vulnerable individuals.
SB127: Alish Dono, National Investigative Reporter Oppose01:10:52.920 - 10:09:58 AM; Alish Dono strongly opposed SB127, citing personal experiences with the New Hampshire Office of Public Guardianship. She described the poor conditions her sister was subjected to under state guardianship and alleged corruption and mismanagement by the guardianship office. Dono argued for the bill's rejection and suggested an investigation into the office's practices. She emphasized the negative impact on her sister's well-being and questioned the state's handling of guardianship cases.
SB135: Senator Kevin Avard, Prime Sponsor of SB135 Support01:25:49.880 - 10:24:55 AM; Senator Kevin Avard introduced SB135, which aims to establish annual rates for Medicaid State Plan Case Management Services and ensure rate parity within the program. He highlighted that the bill's requirements have been mandated by both federal and state regulations since 2018, but the Department of Health and Human Services has not complied. Avard emphasized the need for the bill to be passed to enforce compliance.
SB135: Caroline Virtue, Testifying alongside Senator Avard Support01:27:38.119 - 10:26:44 AM; Caroline Virtue supported SB135 and provided detailed information on the existing rate disparities for Medicaid services. She explained that parity is required by CMS and state law, but the current rates do not comply. Virtue presented study committee reports and a chart showing the rate disparities, arguing that the current rates do not support paying the Bureau of Labor Statistics wage. She urged the committee to pass the bill to enforce parity.
SB135: Henry Lipman, Medicaid Director, with Melissa Hardy, Division Director for Long-Term Supports and Services Information Only01:42:29.520 - 10:41:35 AM; Henry Lipman and Melissa Hardy provided information on the department's perspective regarding rate parity. They acknowledged the legislative intent to achieve parity but explained that the department's definition of parity differs from the bill's requirements. Lipman discussed the challenges in implementing rate changes due to budget constraints and the need for a cost report system to better align costs with payments. They committed to further discussions to address the issue and provide a fiscal note update.
SB135: Heidi Croll, UH J Grimus Strategic Solutions, representing Life Coping based in Nashua Support02:04:15.800 - 11:03:21 AM; Heidi Croll testified in support of SB135, representing Life Coping, a case management agency based in Nashua with a statewide footprint. She mentioned that they handed in written testimony and agree with the information and testimony shared by Miss Virtue. Croll emphasized the need for additional funding in the dad's rate and highlighted the low reimbursement rates for case managers providing Choices for Independence Services compared to other waiver services. She referenced past budget cycles where similar language was included to address parity among rates, including non-Medicaid rates, and expressed optimism about ongoing discussions to resolve these issues without repeating the cycle.
SB126: Senator Kevin Avard, prime sponsor of SB126 Support02:11:31.400 - 11:10:37 AM; Senator Kevin Avard introduced SB126, which regulates notice requirements regarding changes to contracts between health carriers and health providers. He clarified that the bill does not prohibit unilateral changes to provider contracts but instead sets a reasonable cadence for health insurance companies to make changes to their provider manuals four times a year, requires clear redline changes in the documentation for transparency, and mandates health insurance companies to submit good faith estimates for financial impacts of aggregate changes annually to the Department of Insurance and providers. Avard emphasized that the bill supports greater predictability, transparency, and accountability, resembling similar legislation passed in Maine.
SB126: Ben Bradley, Vice President of State Government Relations, New Hampshire Hospital Association Support02:14:21.280 - 11:13:27 AM; Ben Bradley from the New Hampshire Hospital Association testified in support of SB126, thanking Senator Avard and stakeholders for discussing its importance. He explained that private and commercial health insurance payment systems are based on HIPAA-required coding sets, which are periodically updated. Bradley highlighted that recent mid-contract policy changes by health insurance companies have had material financial impacts on providers, including hospitals. He outlined that SB126 modifies provider contract standards by setting a cadence for changes, requiring track changes for transparency, and mandating good faith estimates for financial impacts, aiming to reduce the administrative burden and increase predictability, transparency, and accountability.
SB126: Sabrina Dunlap, Senior Director of Government Relations, Anthem Oppose02:24:20.880 - 11:23:26 AM; Sabrina Dunlap from Anthem expressed opposition to SB126, noting that they had been approached by Ben Bradley about the bill. She explained that provider contracts include various attachments and ancillary documents, such as the provider manual, which is updated periodically with notice. Dunlap argued that the bill's limitations on updates are unworkable and that the existing statute already highly regulates provider contracting. She mentioned that a similar bill in Maine had been problematic, particularly the section requiring estimated costs. Dunlap suggested potential improvements to the bill but hoped the committee would find it inexpedient to legislate.
SB126: Cam La Pine, Orin Reno, representing SIGA Oppose02:32:07.040 - 11:31:13 AM; Cam La Pine, representing SIGA, spoke against SB126, describing it as legislative Groundhog Day due to its similarity to previously reviewed bills (SB320 in 2022 and SB131 in 2023). He highlighted that these bills were referred to interim study and not passed, arguing that the issue at hand involves private contracting between companies, not legislative intervention. He urged the committee to vote against the bill, referencing Senator Bradley's assertion that it's not a legislative matter.
SB126: Andrew Hosmer, representing Harvard Pilgrim Healthcare Oppose02:34:38.399 - 11:33:44 AM; Andrew Hosmer from Harvard Pilgrim Healthcare opposed SB126, stating that it would strain relationships between insurers and providers. He argued that the bill intervenes in private contractual agreements and is heavily weighted in favor of providers, potentially leading to administrative challenges for carriers. Hosmer also mentioned the difficulties faced in implementing similar legislation in Maine, suggesting that the proposed 60-day effective date is unmanageable and that the term 'proposed' in the bill is vague.
SB126: Nick Veis, CEO of Bedford Ambulatory Surgical Center, Orchard Surgical Center, National Empor Surgical Center Oppose02:41:46.920 - 11:40:52 AM; Nick Veis, CEO of multiple surgical centers, opposed SB126, emphasizing that it could hinder creative health plan designs that steer patients to lower-cost providers. He argued that the bill would not help those who can least afford healthcare and advocated for more free-market forces in healthcare. Veis highlighted the cost differences between providers and expressed concerns about the potential impact of the bill on patient navigation and affordability.
SB126: Keith Nyan, Deputy Commissioner at the Insurance Department, and Michelle Heaton, Director of Life and Health Division Information Only02:45:47.880 - 11:44:53 AM; Keith Nyan and Michelle Heaton from the Insurance Department provided neutral testimony on SB126. They acknowledged the bill's intent to set parameters for insurance carriers in making contract changes, recognizing the potential predictability it could bring. However, they noted the potential for cost shifting from providers to carriers and ultimately to consumers through higher premiums. They also expressed concern over the bill's lack of an enforcement mechanism and the Department's limited jurisdiction over private contracts.
SB255: Senator Kevin Avard, Prime Sponsor Support02:50:44.479 - 11:49:50 AM; Senator Kevin Avard introduced SB255, which aims to establish and develop crisis stabilization services. The bill creates a trust fund to promote awareness of Behavioral Health crisis service systems, a commission to oversee the fund, a crisis service telecommunication search charge, and a 988 license plate to fund these services.
SB255: Emma Sven, Children's Behavioral Health Policy Coordinator at New Futures Support02:51:32.080 - 11:50:38 AM; Emma Sven from New Futures expressed strong support for SB255, highlighting its role in establishing a sustainable funding source for 988 crisis call centers through a telecommunication search charge and a special 988 license plate. She emphasized the necessity of these services for reducing reliance on more intensive treatments and noted the increase in children and young people receiving mental health help since the introduction of 988. Sven also drew parallels to the 911 funding model, suggesting its proven effectiveness for funding emergency services.
SB255: Jenny O Higgins, Legislative Liaison and Senior Policy Analyst for Behavioral Health at DHHS Information Only02:57:47.239 - 11:56:53 AM; Jenny O Higgins from DHHS provided information on SB255, emphasizing its alignment with the department's roadmap and various state plans aimed at improving behavioral health crisis systems. She detailed the system's three pillars: someone to call, someone to respond, and somewhere to go, with the bill focusing on funding the 'someone to call' aspect through the 988 crisis call centers. Higgins noted the significant number of interactions facilitated by these centers and the partnership with law enforcement and 911. She also mentioned the fiscal implications, including the need for new positions to manage the fund, which would be covered by the revenue generated.
SB255: Sam Hawkins Information Only03:01:56.000 - 12:01:02 PM; Sam Hawkins began to testify but the transcript cuts off before providing any further details on his testimony regarding SB255.
SB255: Representative from NAMI New Hampshire Support03:01:59.040 - 12:01:05 PM; The speaker strongly supports Senate Bill 255, emphasizing the urgent need to address suicide rates in New Hampshire. They highlight the importance of the 988 Crisis Services System, which is modeled in the bill, and note its increasing utilization nationwide. The speaker explains that a surcharge similar to the 911 funding model has been adopted by 10 states, with five more considering it. They argue that this funding method reduces reliance on other funding streams, is less vulnerable to economic changes, and ensures local responses to mental health crises, promoting the effectiveness of a small fee to fund these vital services.
SB255: Karen Susi, Shenin Capital Group, representing CTIA Information Only03:04:35.279 - 12:03:41 PM; Karen Susi, representing CTIA, expresses support for the 988 designation but has concerns about the proposed fee, which they view as a tax. They suggest that if enacted, the scope of the fee should be limited to funding specific services similar to the 911 model. They propose that the tax amount be set by the legislature and managed by the New Hampshire Bureau of Emergency Communications. They mention that only nine states have funded these services through a new consumer tax and suggest the bill should be sent to Ways and Means for further deliberation.
SB255: Aaron Downey, Salem, New Hampshire Support03:10:00.080 - 12:09:06 PM; Aaron Downey, a 21-year-old resident of Salem, supports Senate Bill 255, emphasizing the importance of the 988 service for mental health crises similar to 911 for medical emergencies. He shares his personal experience with the 988 line and stresses its necessity for providing immediate support and resources, especially for young people who may not feel safe discussing their issues with parents. He advocates for the funding of 988 to ensure continued support for those in need.
SB255: Kevin Moir, Lebanon, New Hampshire Support03:11:52.319 - 12:10:58 PM; Kevin Moir from Lebanon supports Senate Bill 255, emphasizing the importance of mental health services. He states that without these services, many people would struggle to survive and access necessary support, underscoring the critical nature of the proposed funding for mental health crisis lines.
SB255: Katie Lyon-Pingry Support03:12:39.399 - 12:11:45 PM; Katie Lyon-Pingry shares a deeply personal testimony about her son Matthew's struggle with mental illness following a concussion. She describes the traumatic experiences her family endured due to the lack of accessible mental health crisis services, including emergency room visits and the eventual loss of her son to suicide. She strongly supports Senate Bill 255, highlighting how the 988 Crisis Line could have provided essential support and guidance during her family's crisis, potentially altering the outcome of Matthew's journey. She urges full funding of the 988 line to help other New Hampshire families.
SB255: Allison Palmer, Hope on Haven Hill in Rochester Support03:18:21.239 - 12:17:27 PM; Allison Palmer, a women's health and psychiatric nurse practitioner, spoke in support of Senate Bill 255. She highlighted her experience working with pregnant and postpartum women with substance use disorders at Hope on Haven Hill in Rochester. Palmer also mentioned her roles in various organizations related to maternal health and her personal experience with postpartum depression and anxiety. She emphasized the high prevalence of mental health conditions during pregnancy and postpartum, noting that suicide and overdose are leading causes of maternal death in New Hampshire. She discussed the financial and health impacts of untreated perinatal mental health conditions and the need for sustainable funding to support crisis care, which she believes Senate Bill 255 addresses by providing a framework for mental health support.
SB255: Bir Dees, New Hampshire Municipal Association Information Only03:22:17.479 - 12:21:23 PM; Bir Dees, representing the New Hampshire Municipal Association, provided information regarding Senate Bill 255. The association takes a neutral stance but pointed out a technical issue in the bill's text on page two, lines 21 and 22, concerning the prohibition of local or municipal governments from imposing taxes, fees, or surcharges on telecommunication services for 988 services. Dees expressed concern over the broad definition of 'telecommunication services' in the bill and its potential conflict with existing tax laws, particularly if the communication services tax were to be repealed. He suggested clarifications or updates to the relevant sections of the RSA to ensure clarity and avoid potential legal issues with telecommunications companies.

Rochefort, David(Chairman)(R)	Avard, Kevin(V Chairman)(R)[C+]2024	Birdsell, Regina(R)[C+]2024
Prentiss, Suzanne(D)[F]2024	Long, Pat(D)