Committee Summary for Senate Health and Human Services (02/18/2025)

Bill/Time	Type	Title	Sponsor
SB246 2024-1453h 00:06:47.840 - 8:06:38 AM	Public Hearing	providing maternal depression screening for new mothers, increasing access to health care services for new mothers, and relative to job protection within the employer-sponsored New Hampshire paid family and medical leave plan.	Ricciardi, Denise(R)[C-]2024
SB124 01:36:25.719 - 9:36:16 AM	Public Hearing	relative to continuing care retirement communities.	Ricciardi, Denise(R)[C-]2024
SB246 01:30:48.400 - 9:30:39 AM	Public Hearing	providing maternal depression screening for new mothers, increasing access to health care services for new mothers, and relative to job protection within the employer-sponsored New Hampshire paid family and medical leave plan.	Ricciardi, Denise(R)[C-]2024
SB124 01:36:25.719 - 9:36:16 AM	Public Hearing	relative to continuing care retirement communities.	Ricciardi, Denise(R)[C-]2024
SB243 02:08:27.320 - 10:08:18 AM	Public Hearing	relative to the child care scholarship program.	Ricciardi, Denise(R)[C-]2024
SB253 02:36:49.000 - 10:36:40 AM	Public Hearing	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB243 02:23:52.279 - 10:23:43 AM	Public Hearing	relative to the child care scholarship program.	Ricciardi, Denise(R)[C-]2024
SB253 02:36:49.000 - 10:36:40 AM	Public Hearing	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB253 05:39:31.638 - 1:39:22 PM	Executive Session	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB253 03:24:47.399 - 11:24:38 AM	Public Hearing	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB253 05:39:31.638 - 1:39:22 PM	Executive Session	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB253 03:24:53.160 - 11:24:44 AM	Public Hearing	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB253 05:39:31.638 - 1:39:22 PM	Executive Session	relative to participation in the federal 340B Drug Pricing Program.	Reardon, Tara(D)
SB118 05:46:04.400 - 1:45:55 PM	Public Hearing	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB118 2025-0295s 05:53:03.080 - 1:52:54 PM	Executive Session	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB118 2025-0295s 05:46:04.400 - 1:45:55 PM	Public Hearing	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB118 2025-0295s 05:53:03.080 - 1:52:54 PM	Executive Session	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB118 2025-0295s 05:47:54.920 - 1:47:45 PM	Public Hearing	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB118 2025-0295s 05:53:03.080 - 1:52:54 PM	Executive Session	relative to the personal needs allowance of residents of nursing homes.	Birdsell, Regina(R)[C+]2024
SB249 05:54:28.600 - 1:54:19 PM	Public Hearing	relative to the uncompensated care and Medicaid fund.	Birdsell, Regina(R)[C+]2024

SB246 2024-1453h: Senator Denise Rashard, District 9 Support00:06:47.840 - 8:06:38 AM; Senator Rashard, representing 13 towns from Bedford to Hinsdale, introduced Senate Bill 246, referred to as 'Momnibus 2.0'. She explained that this legislation builds on the success of 'Momnibus 1.0', which she co-sponsored two years ago, aimed at enhancing maternal services in New Hampshire. The bill has received unanimous support in the Senate and was signed into law with bipartisan backing. 'Momnibus 2.0' focuses on improving maternal mental health, expanding family supports, strengthening workforce protections, and offering support across the state. Key elements of the bill include allowing providers to bill for maternal depression screenings, creating a provider-to-provider consult line, providing emergency labor and delivery training to EMS in rural areas, studying opportunities for independent birth centers, and ensuring moms can attend postpartum and pediatric appointments. The bill reflects stakeholder feedback and includes amendments to adjust language and effective dates, including changes such as eliminating fertility and PFML job security, adding pediatric appointments, and moving the study of birth centers to the Department of Health and Human Services. Senator Rashard emphasized the bipartisan support for the bill, which she introduced with Senator Apprentice.
SB246 2024-1453h: Senator Apprentice Support00:12:13.000 - 8:12:04 AM; Senator Apprentice supported the introduction of 'Momnibus 2.0', highlighting the importance of thriving moms and babies for the well-being of New Hampshire families and communities. He pointed out the rise in maternal mortality linked to mental health and substance abuse issues, and explained how 'Momnibus 1.0' extended Medicaid coverage to address these issues. 'Momnibus 2.0' is described as a comprehensive approach to maternal health, focusing on areas like emergency medical services training and support for independent birthing centers, which have been closing across the state. He stressed the importance of these services, especially in rural areas, and the need for a collaborative approach to health care for families. Senator Apprentice called for support to help bring 'Momnibus 2.0' to successful completion.
SB246 2024-1453h: Representative Paige Bosman, Hillsboro 3, Nashua Ward 4 Support00:18:54.679 - 8:18:45 AM; Representative Bosman, a nurse with 15 years of experience in maternal child health and certified in perinatal mental health, supported 'Momnibus 2.0'. She highlighted the prevalence of perinatal mental health conditions, which affect up to 20% of pregnant individuals, compared to other common conditions like gestational diabetes. She emphasized the lack of screening for these conditions despite their severity and shared examples of severe cases she encountered in her practice. Bosman stressed the importance of early detection and treatment to improve outcomes for moms, babies, and families in New Hampshire.
SB246 2024-1453h: Heather Martin, Dartmouth Health Pediatrics, Manchester Support00:22:04.720 - 8:21:55 AM; Heather Martin, a maternal mental health navigator at Dartmouth Health Pediatrics in Manchester, strongly supported 'Momnibus 2.0'. She explained the importance of screening for maternal mental health in pediatric settings, as well as the need for peer support networks for new moms. Martin shared a personal story about her sister's struggle with postpartum psychosis and the need for better support systems, including a psychiatry access line for healthcare providers. She also mentioned a recent initiative funded by the governor to establish a resource center for moms, which she believes will greatly help in closing gaps in maternal mental health care.
SB246 2024-1453h: Dr. Danielle Albuskes, OBGYN Support00:25:47.520 - 8:25:38 AM; Dr. Albuskes, an OBGYN with over 20 years of experience in New Hampshire, supported 'Momnibus 2.0' and discussed its practical benefits. She highlighted New Hampshire's high rates of maternal depression and anxiety and was excited about the proposed peer-to-peer consult line, which would assist providers in managing complex cases. She also praised the bill's provisions for perinatal peer support and home visits, which would help combat isolation and logistical challenges faced by new moms. Dr. Albuskes noted the importance of these services in addressing high blood pressure and other postpartum health issues.
SB246 2024-1453h: Paige Bosman, Representative from Hillsborough 3, Nashua Ward 4, Nurse and Maternal Child Health Specialist Support00:18:58.840 - 8:18:49 AM; Paige Bosman, a nurse with 15 years of experience in maternal child health, testified in support of SB246. She highlighted her certification in perinatal mental health and her experience in building perinatal mental health programs across different healthcare settings. Bosman emphasized the prevalence of perinatal mental health conditions, noting that up to 20% of pregnant people develop such conditions, which is higher than other common pregnancy complications like gestational diabetes or high blood pressure. She stressed the lack of screening for perinatal mental health despite its high incidence and its status as the leading cause of pregnancy-related deaths. Bosman shared a case of a mother who suffered severe postpartum depression due to late diagnosis and treatment, underscoring the need for early intervention to improve outcomes for mothers, babies, and families in New Hampshire.
SB246 2024-1453h: Heather Martin, Maternal Mental Health Navigator at Dartmouth Health Pediatrics in Manchester Support00:22:04.720 - 8:21:55 AM; Heather Martin, the first maternal mental health navigator in the Dartmouth system and across the US, spoke in favor of SB246, dubbed Momnibus 2.0. She emphasized the importance of screening and peer support as outlined in the bill, sharing her experience and the need for a support network to reduce maternal mortality. Martin also mentioned the initiative to establish a maternal mental health resource center with funding from the governor, which is currently in progress. She stressed the urgency of implementing the bill's provisions to address the ongoing crisis of maternal mental health, citing a personal story of her sister's struggle with postpartum psychosis.
SB246 2024-1453h: Dr. Danielle Albuskes, OBGYN Support00:25:47.520 - 8:25:38 AM; Dr. Danielle Albuskes, an OBGYN with over 20 years of experience in New Hampshire, supported SB246, focusing on practical implications of the bill. She discussed the high rates of depression and anxiety among New Hampshire mothers and highlighted the importance of the peer-to-peer consult line proposed in the bill. Albuskes explained how this resource would benefit OBGYNs when dealing with patients with complex behavioral health issues beyond their local resources. She also emphasized the value of peer support groups and home visits for new mothers, which would help address issues like isolation and logistical challenges faced by many women.
SB246 2024-1453h: Allison Palmer, Nurse and Nurse Practitioner in Women's Health and Reproductive Psychiatry Support00:30:23.480 - 8:30:14 AM; Allison Palmer, with nearly 30 years as a nurse in high-risk labor and delivery and a nurse practitioner in women's health, supported SB246. She shared her personal experience with perinatal depression and anxiety, which motivated her to start a support group and standardize screening practices. Palmer underscored the need for evidence-based and innovative approaches to maternal mental health, pointing out the gaps in psychiatric training and the fragmented care system that leaves mothers vulnerable. She advocated for a perinatal psychiatry access line and certified peer support as crucial components of the bill to provide timely and effective care.
SB246 2024-1453h: Paige Bosman, Representative from Hillsborough 3, Nashua 4, and Maternal Child Health Nurse Support00:18:58.840 - 8:18:49 AM; Paige Bosman, a nurse with 15 years of experience in maternal child health and certified in perinatal mental health, spoke in support of the bill. She highlighted the prevalence of perinatal mental health conditions, stating that about 20% of pregnant people develop such conditions, which is higher than the prevalence of gestational diabetes or high blood pressure during pregnancy. She emphasized the lack of screening for perinatal mental health despite its being the most common complication of pregnancy and the leading cause of pregnancy-related deaths in the U.S. Bosman shared a case of a single mother whose depression was not caught until it severely impacted her life and family, underscoring the need for early diagnosis and treatment to improve the health of moms, babies, and families in New Hampshire.
SB246 2024-1453h: Heather Martin, Maternal Mental Health Navigator at Dartmouth Health Pediatrics in Manchester Support00:22:04.720 - 8:21:55 AM; Heather Martin, the first maternal mental health Navigator embedded in Pediatrics in the U.S., expressed support for the bill. She discussed the importance of screening in pediatrics and the need for peer support, noting that moms want to connect with other moms who have experienced similar challenges. Martin shared a personal story about her sister's struggle with postpartum psychosis and stressed the need for a psychiatry access line for healthcare providers to consult about maternal mental health issues. She also mentioned ongoing efforts to establish a resource center for moms, funded by ARPA, which is expected to be operational within the next few months.
SB246 2024-1453h: Dr. Danielle Albushees, OBGYN with over 20 years of experience in New Hampshire Support00:25:47.520 - 8:25:38 AM; Dr. Danielle Albushees supported the bill, emphasizing its practical benefits. She highlighted New Hampshire's high rates of maternal depression and anxiety and was excited about the proposed peer-to-peer consult line, which would be beneficial for complex cases beyond her usual scope of practice. Albushees also praised the bill's provisions for peer support groups and home visits, noting their potential to address isolation, loneliness, and logistical challenges faced by new mothers. She stressed the importance of these resources in improving maternal care and outcomes.
SB246 2024-1453h: Allison Palmer, Nurse and Nurse Practitioner in Women's Health and Reproductive Psychiatry Support00:30:23.480 - 8:30:14 AM; Allison Palmer, who has nearly 30 years of experience in high-risk labor and delivery, shared her personal experience with perinatal depression and anxiety to support the bill. She described feeling alone and overwhelmed despite being a medical professional, underscoring the need for better support systems. Palmer discussed her initiative in starting a support group and standardized screening practices 18 years ago and emphasized the need for evidence-based, innovative approaches in New Hampshire. She advocated for a perinatal psychiatry access line and certified peer support, noting the fragmented care system that often leaves mothers without clear paths to care during vulnerable times.
SB246 2024-1453h: Janet Perkins, Howand Information Only00:34:14.159 - 8:34:05 AM; Janet Perkins from Howand began to speak, but the transcript snippet ends before her testimony is fully captured. No specific details about her stance on the bill or her testimony are available in this snippet.
SB246 2024-1453h: Dr. Danielle Albushies, OBGYN Support00:25:47.520 - 8:25:38 AM; Dr. Danielle Albushies, an OBGYN with over 20 years of experience in New Hampshire, expressed strong support for the bill, particularly highlighting the peer-to-peer consult line, perinatal peer support groups, and home visits. She noted that New Hampshire has one of the highest rates of maternal depression and anxiety in the country. Dr. Albushies explained that the peer-to-peer consult line would be beneficial for patients with complex issues, such as substance use disorders, who are outside her usual scope of practice. She also discussed the importance of up-to-date resources for support groups and the necessity of extending home visits not only for mental health but also for other conditions like high blood pressure. She responded to questions about the causes of high maternal depression rates in New Hampshire and factors that could predict postpartum depression.
SB246 2024-1453h: Allison Palmer, Nurse Practitioner Support00:30:23.480 - 8:30:14 AM; Allison Palmer, a nurse practitioner with nearly 30 years of experience in high-risk labor and delivery, and a specialist in women's health and reproductive psychiatry, shared her personal experience with perinatal depression and anxiety. She emphasized the isolation and lack of resources many mothers face, and highlighted her initiative to start a support group and standardized screening practices 18 years ago. She strongly supported the bill for its evidence-based and innovative approaches, noting the high prevalence of psychiatric issues among women and the lack of specialized training for psychiatrists in managing these during and post-pregnancy. She detailed the need for a perinatal psychiatry access line and certified peer support to provide timely and appropriate care, connecting mothers with others who have similar experiences.
SB246 2024-1453h: Janet Perkins, Holland Support00:34:19.800 - 8:34:10 AM; Janet Perkins from Holland, an OB in New Hampshire since 1998, expressed enthusiastic support for the bill, emphasizing the awareness it brings to maternal and postpartum care issues. She pointed out the high rates of postpartum depression and anxiety and the significant number of patients missing their six-week check-ups, particularly those with transportation or work-related challenges. Perkins discussed the importance of the bill's components, including screening, home visits, and psychiatric care, which she believes can be lifesaving. She shared anecdotes about the rural challenges and the need for EMS training, as well as employee protection concerns, noting a patient's fear of reprisal for revealing pregnancy. She concluded by stressing the need to support mothers and families to address the declining birth rate in New Hampshire.
SB246 2024-1453h: Allison Palmer Support00:30:23.480 - 8:30:14 AM; Allison Palmer, a nurse with nearly 30 years of experience in high-risk labor and delivery and a specialized nurse practitioner in women's health and reproductive psychiatry, shared her personal experience with perinatal depression and anxiety. She emphasized the isolation and lack of clear support for new mothers, highlighting her initiative to start a support group and standardized screening practices 18 years ago. Palmer advocated for the bill, citing the need for evidence-based and innovative approaches like those in other states. She stressed the high prevalence of perinatal depression, the lack of specialized education for psychiatrists in managing psychiatric illness during and post-pregnancy, and the fragmented care system that leaves mothers vulnerable. She proposed two solutions: a perinatal psychiatry access line for real-time guidance and certified peer perinatal peer support to provide human connection and support.
SB246 2024-1453h: Janet Perkins, Holland Support00:34:19.800 - 8:34:10 AM; Janet Perkins from Holland, an OB since 1998, expressed enthusiastic support for the bill, emphasizing its role in raising awareness about pregnancy and postpartum care, particularly related to maternal mortality due to postpartum depression and anxiety. She noted the high rate of missed six-week appointments among vulnerable patients, underscoring the potential lifesaving impact of the bill's components like screening, home visitation, and psychiatric care providers. Perkins also highlighted challenges in rural areas, sharing an anecdote about a mother's difficulty reaching a hospital. She concluded by discussing the need for employee protection, citing a patient's fear of reprisal for taking necessary recovery time after childbirth, and stressed the importance of supporting mothers and families amidst New Hampshire's declining birth rate.
SB246 2024-1453h: Sophia Fontaine Support00:37:14.040 - 8:37:05 AM; Sophia Fontaine, a preschool teacher and daycare provider with five years of experience, spoke in support of the bill, emphasizing the link between maternal health and family health. She noted that maternal depression and anxiety can lead to significant challenges for children, including behavioral issues, cognitive delays, and diminished academic performance. Fontaine stressed the isolation felt by many mothers, who often feel unable to seek help from their providers or caregivers, and advocated for increased access to maternal care to support families as a whole.
SB246 2024-1453h: Jessica Crowley, Hampton Support00:38:46.880 - 8:38:37 AM; Jessica Crowley from Hampton shared her personal story of struggling with postpartum depression after a challenging pregnancy and NICU experience. She described the emotional isolation she felt during her baby's critical first weeks, highlighting the absence of mental health support during this period. Crowley emphasized how her focus on her baby's survival overshadowed her own mental health needs, and how this bill could have provided the support she needed during her journey to motherhood. She urged the committee to pass the bill as a way to show that New Hampshire's moms matter.
SB246 2024-1453h: Allison Palmer, Nurse Practitioner Support00:30:23.480 - 8:30:14 AM; Allison Palmer, a nurse with 30 years of experience in high-risk labor and delivery and a specialized nurse practitioner in women's health and reproductive psychiatry, shared her personal experience with perinatal depression and anxiety. She highlighted the isolation and lack of support she felt despite her professional background, which motivated her to establish a support group and standardized screening practices. Palmer emphasized the need for New Hampshire to adopt evidence-based and innovative approaches to perinatal mental health, pointing out the high prevalence of psychiatric issues in women, particularly during and after pregnancy. She proposed the implementation of a perinatal psychiatry access line and certified peer support to address the fragmented care system and improve outcomes for mothers.
SB246 2024-1453h: Janet Perkins, OB from Holland Support00:34:14.159 - 8:34:05 AM; Janet Perkins, an OB from Holland, expressed her enthusiastic support for the bill, appreciating its focus on raising awareness about maternal health issues. She discussed the high rates of postpartum depression and anxiety, which often go unnoticed or unaddressed. Perkins noted the significant number of patients missing their six-week checkup, particularly those with transportation or work issues, and stressed the importance of screening, home visitation, and psychiatric care as potentially life-saving measures. She also shared challenges faced by mothers in rural areas and the need for better employee protections, especially post-C-section, to support mothers and families amidst declining birth rates in New Hampshire.
SB246 2024-1453h: Sophia Fontaine, Preschool Teacher and Daycare Provider Support00:37:14.040 - 8:37:05 AM; Sophia Fontaine, a preschool teacher and daycare provider, spoke in favor of the bill, highlighting the impact of maternal health on family health. She noted that maternal depression and anxiety affect children's behavioral challenges, cognitive development, and academic performance. Fontaine emphasized the reluctance of mothers to discuss their feelings and the isolation they experience, underscoring the need for increased access to maternal care to support families holistically.
SB246 2024-1453h: Jessica Crowley, Hampton Support00:38:46.880 - 8:38:37 AM; Jessica Crowley from Hampton shared her personal story of a challenging journey to motherhood, marked by a difficult pregnancy and an extended NICU stay for her baby. She described feeling abandoned and unsupported by mental health professionals during her ordeal, despite her background in psychology. Crowley stressed the importance of the bill in providing the support and protections she lacked as a new mother, urging the committee to pass it to help future New Hampshire families and communities.
SB246 2024-1453h: Mackenzie Nicholson, Senior Director of Mom's Rising in New Hampshire Support00:41:53.359 - 8:41:44 AM; Mackenzie Nicholson, representing Mom's Rising, a grassroots organization, endorsed the bill by presenting a letter with 77 comments from supporters across New Hampshire. She emphasized the economic and familial benefits of supporting maternal health, urging the committee to pass Senate Bill 246 to enhance the well-being of families and the state's economy.
SB246 2024-1453h: Janet Perkins Holland, OB from New Hampshire Support00:34:19.800 - 8:34:10 AM; Janet Perkins Holland, an OB who has worked in New Hampshire since 1998, expressed enthusiastic support for the bill, referred to as 'mnos 2.0.' She highlighted the importance of the bill in raising awareness about pregnancy and postpartum care, particularly in relation to maternal mortality linked to postpartum depression and anxiety. She noted the high rates of postpartum depression and the challenges many patients face in attending their six-week checkup, especially those with transportation issues or who must return to work early. Holland praised the bill's components like screening, home visitation, and access to psychiatric care as potentially lifesaving. She shared an anecdote about a mother in the North country who had to use a sled and snowmobile to reach the hospital, underscoring rural challenges. Holland also discussed the importance of EMS training and employee protection, citing a case where a patient feared job reprisal for needing recovery time after a C-section. She concluded by emphasizing the need to support mothers and families amid declining birth rates in New Hampshire.
SB246 2024-1453h: Sophia Fontaine, preschool teacher and daycare provider from New Hampshire Support00:37:14.040 - 8:37:05 AM; Sophia Fontaine, who has worked in child care for five years, spoke in full support of the bill, emphasizing the connection between maternal health and family health. She explained that maternal depression and anxiety can lead to behavioral challenges, cognitive delays, and diminished academic performance in children. Fontaine stressed the common feeling among mothers of being alone and unable to express their struggles, which she sees frequently in her work with families. She advocated for the bill as a means to increase access to maternal care, thereby helping families as a whole.
SB246 2024-1453h: Jessica Crowley from Hampton, NH Support00:38:46.880 - 8:38:37 AM; Jessica Crowley shared her personal story as a mother to support the bill. She described her traumatic experience during her first pregnancy, where she faced a distressing wait for test results and later spent five weeks alone with her newborn in the NICU. Crowley highlighted the lack of mental health support during these critical times, noting that she suffered from undiagnosed postpartum depression. She expressed that the bill would have been beneficial during her own struggles and could help other New Hampshire families. Crowley concluded by urging the committee to pass the bill as a way to show that mothers and families matter.
SB246 2024-1453h: Mackenzie Nicholson, Senior Director of Mom's Rising in New Hampshire Support00:41:53.359 - 8:41:44 AM; Mackenzie Nicholson reiterated her support for the bill, referred to as 'mom nibus 2.0.' She mentioned submitting a letter with 77 comments from New Hampshire residents in support of the bill. Nicholson emphasized that supporting mothers leads to a thriving economy and healthier families. She urged the committee to pass Senate Bill 246.
SB246 2024-1453h: Perkins Holland, OB in New Hampshire Support00:34:19.800 - 8:34:10 AM; Perkins Holland, an OB since 1998, supports the bill, particularly for its focus on increasing awareness of maternal health issues. She emphasizes the high rates of postpartum depression and anxiety, which are often misunderstood or overlooked. She discusses the challenges of ensuring patients attend their six-week check-ups, especially those with transportation or employment issues. She also highlights the importance of the bill's components like screening, home visitation, and psychiatric care, which she believes can be lifesaving. Holland shares an anecdote about a mother needing a sled and snowmobile to reach the hospital, illustrating rural healthcare challenges. She also mentions the importance of employee protections, citing a patient's fear of taking time off after a C-section. She concludes by noting New Hampshire's declining birth rate and the need to support mothers and families.
SB246 2024-1453h: CS Lewis, Healthcare Professional Support00:35:05.280 - 8:34:56 AM; CS Lewis shares insights from their practice, noting that up to 50% of patients miss their six-week appointments, particularly those with vulnerabilities like work or transportation issues. They stress the importance of the bill's provisions for screening, home visitation, and psychiatric care, which could be critical for these patients. Lewis also mentions their involvement in EMS training in the North Country, praising the eagerness of the trainees and their appreciation for the training. They touch on the issue of employee protection, recounting a patient's fear of having a C-section due to insufficient recovery time and fear of employer reprisal for being pregnant. Lewis concludes by emphasizing the need to support mothers and families in light of New Hampshire's declining birth rate.
SB246 2024-1453h: Sophia Fontaine, Preschool Teacher and Daycare Provider Support00:37:14.040 - 8:37:05 AM; Sophia Fontaine, with five years of experience in childcare, supports the bill, emphasizing that maternal health is crucial for family health. She explains how maternal depression and anxiety can affect children's behavioral challenges, cognitive delays, and academic performance. Fontaine shares observations from her work where mothers often feel isolated and unable to express their feelings to healthcare providers or caregivers. She strongly supports the bill for increasing access to maternal care, believing it will benefit families as a whole.
SB246 2024-1453h: Jessica Crowley, Hampton Support00:38:46.880 - 8:38:37 AM; Jessica Crowley shares her personal experience as a mother to support the bill. She recounts the emotional distress of waiting for test results during her pregnancy and the lack of mental health support during that time. After her baby's birth, she spent five weeks in the NICU, feeling alone and unsupported mentally. Crowley reflects on not recognizing her own postpartum depression until years later, underscoring the need for the bill's provisions. She emphasizes how the bill could have helped her during her journey to motherhood and would benefit New Hampshire families and communities.
SB246 2024-1453h: Mackenzie Nicholson, Senior Director of Mom's Rising in New Hampshire Support00:41:53.359 - 8:41:44 AM; Mackenzie Nicholson, representing Mom's Rising, supports the bill, emphasizing the organization's grassroots support across New Hampshire. She presents a letter with 77 comments from state residents supporting the bill and underscores the importance of maternal support for the state's economy and families. She urges the committee to pass Senate Bill 246, highlighting its potential to help New Hampshire thrive.
SB246 2024-1453h: DJ Boncourt, Commissioner of the New Hampshire Insurance Department Support00:42:38.680 - 8:42:29 AM; DJ Boncourt, along with Michelle Heaton from the life and health division, supports the legislation. He praises the collaborative effort in developing the bill and highlights the importance of focusing on postpartum mental health. Boncourt mentions the department's excitement about federal funding for a women's health grant, which will supplement the bill's goals. He notes the removal of the mental health parity piece but assures continued work on this issue due to formed partnerships. He concludes by emphasizing the bill's practical approach and its support for advancing New Hampshire's mental health system.
SB246 2024-1453h: Sophia Fontine, preschool teacher and daycare provider Support00:37:14.040 - 8:37:05 AM; Sophia Fontine, a preschool teacher and daycare provider with five years of experience in childcare, testified in support of the bill. She emphasized the critical connection between maternal health and family health, noting that when mothers struggle, the entire family is affected. She highlighted how maternal depression and anxiety can lead to behavioral challenges, cognitive delays, and diminished academic performance in children. Fontine also pointed out the isolation mothers often feel, unable to express their feelings or seek help, and stressed that increased access to maternal care would benefit families as a whole.
SB246 2024-1453h: Jessica Crowley, Hampton Support00:38:00.240 - 8:37:51 AM; Jessica Crowley from Hampton shared her personal story as a mother to support the bill. She recounted the traumatic experience of learning about potential health issues with her baby during pregnancy and the subsequent isolation and lack of mental health support during her child's time in the NICU. Crowley expressed how she was not fine despite saying so, suffering from postpartum depression without realizing it until years later. She stressed the need for the bill, which she believes would have provided crucial support during her time as a new, scared mother, and would help other New Hampshire families and communities.
SB246 2024-1453h: Mackenzie Nicholson, Senior Director of Mom's Rising in New Hampshire Support00:41:53.359 - 8:41:44 AM; Mackenzie Nicholson, representing Mom's Rising in New Hampshire, expressed strong support for the bill. She highlighted the organization's grassroots nature and the widespread support among moms in the state for 'Momnibus 2.0'. Nicholson submitted a letter containing 77 comments from supporters and urged the committee to review them, emphasizing that access to maternal support is crucial for the thriving of families and the state's economy.
SB246 2024-1453h: DJ Boncourt, Commissioner of the New Hampshire Insurance Department Support00:42:38.680 - 8:42:29 AM; DJ Boncourt, Commissioner of the New Hampshire Insurance Department, spoke in support of the bill, commending the collaborative efforts in its development. He emphasized the importance of mental health, particularly postpartum mental health, and praised the legislation for advancing this area. Boncourt noted the bill's alignment with ongoing departmental efforts, including the potential to draw down federal funding for a women's health grant. He mentioned the removal of the mental health parity piece from the original proposal but assured continued work in that area due to new partnerships formed during the process.
SB246 2024-1453h: Holly Stevens, Director of Public Policy at NAMI New Hampshire Support00:47:27.800 - 8:47:18 AM; Holly Stevens, representing NAMI New Hampshire, supported the bill, focusing on the documented link between postpartum depression and higher rates of depression in children during their teen years. She stressed the importance of mental health screenings and treatments for mothers to reduce maternal deaths and negative outcomes for children. Stevens proposed waiving co-pays to encourage mothers to prioritize their mental health over financial constraints. She also highlighted the benefits of peer support in mental health treatment, suggesting it could be crucial in reducing maternal mortality rates in New Hampshire.
SB246 2024-1453h: Mackenzie Nicholson, Senior Director of Mom's Rising in New Hampshire Support00:41:53.359 - 8:41:44 AM; Mackenzie Nicholson, representing Mom's Rising in New Hampshire, expressed support for Senate Bill 246, also referred to as Momnibus 2.0. She highlighted the significance of maternal support for the well-being of New Hampshire's economy and families. She submitted a letter with 77 comments from Granite Staters in favor of the bill and urged the committee to pass it.
SB246 2024-1453h: DJ Bonc, Commissioner of the New Hampshire Insurance Department Support00:42:42.079 - 8:42:33 AM; DJ Bonc, Commissioner of the New Hampshire Insurance Department, testified in support of Senate Bill 246. He praised the collaborative efforts in drafting the legislation and emphasized the importance of mental health, particularly postpartum mental health. He noted that the bill would supplement ongoing department efforts and mentioned the potential to draw down federal funding for women's health. He also addressed the removal of the mental health parity piece from the original proposal but affirmed that the department would continue this work through new partnerships formed during the legislative process.
SB246 2024-1453h: Michelle Heaton, Head of the Life and Health Division at the New Hampshire Insurance Department Support00:45:01.319 - 8:44:52 AM; Michelle Heaton, accompanying DJ Bonc, provided additional support for the legislation. She discussed the fiscal impact of the amendment, stating that the changes would result in a minimal fiscal impact for insurance. She noted that many services are already covered and that the amendment would clarify existing language without significantly increasing premiums.
SB246 2024-1453h: Holly Stevens, Director of Public Policy at NAMI New Hampshire Support00:47:27.800 - 8:47:18 AM; Holly Stevens, representing NAMI New Hampshire, spoke in favor of Senate Bill 246. She discussed the link between postpartum depression and higher rates of depression in children during their teen years. She stressed the importance of mental health screenings and treatment for postpartum women, suggesting that waiving co-pays could encourage more women to seek necessary care. Stevens also highlighted the benefits of peer support programs, like the FastForward program at NAMI New Hampshire, in reducing maternal mortality rates.
SB246 2024-1453h: DJ Bonc, Commissioner of the New Hampshire Insurance Department Support00:42:42.079 - 8:42:33 AM; DJ Bonc expressed support for the legislation, highlighting the importance of collaboration with sponsors, stakeholders, and various departments. He praised Kate Lipman for her role in refining the bill through stakeholder engagement. Bonc emphasized the critical need to address postpartum mental health, noting that the legislation will complement ongoing departmental efforts, including a federal women's health grant. He mentioned the removal of the mental health parity piece from the original proposal but assured continued departmental work in this area, facilitated by new partnerships formed during the legislative process.
SB246 2024-1453h: Holly Stevens, Director of Public Policy at NAMI New Hampshire Support00:47:27.800 - 8:47:18 AM; Holly Stevens testified in support of SB246, focusing on the impact of postpartum depression on both mothers and their children. She highlighted the link between postpartum depression and increased depression rates in children during their teenage years, underscoring the importance of mental health screenings and treatments to reduce maternal deaths and negative outcomes for children. Stevens advocated for waiving co-pays to encourage mothers to prioritize their mental health. She also discussed the benefits of peer support in mental health treatment, drawing from NAMI New Hampshire's experience with the FastForward program, suggesting similar support could help reduce maternal mortality rates in New Hampshire.
SB246 2024-1453h: DJ Boncort, Commissioner of the New Hampshire Insurance Department Support00:42:42.079 - 8:42:33 AM; Commissioner DJ Boncort expressed support for the legislation, emphasizing the importance of collaboration with sponsors and stakeholders. He highlighted the significance of mental health, particularly postpartum mental health for women and mothers, suggesting that the bill would help address this critical area. He also mentioned the department's excitement about drawing down federal funding for a women's health grant, which would supplement the bill's objectives. Despite the removal of the mental health parity piece from the original proposal, he assured that the department would continue working on it, leveraging new partnerships formed during the legislative process.
SB246 2024-1453h: Michelle Heaton, Head of Life and Health Division, New Hampshire Insurance Department Information Only00:45:01.319 - 8:44:52 AM; Michelle Heaton provided information regarding the fiscal impact of the bill after the amendment. She explained that the changes would result in a minimal fiscal impact for insurance, as many of the services mentioned are already covered. She noted that they would draft a new fiscal note based on the amendment, but anticipated no significant increase in premiums.
SB246 2024-1453h: Holly Stevens, Director of Public Policy at NAMI New Hampshire Support00:47:27.800 - 8:47:18 AM; Holly Stevens spoke in support of the bill, emphasizing the link between postpartum depression and higher rates of depression in children during their teen years. She stressed the importance of mental health screenings and treatment for postpartum mothers to reduce maternal deaths and negative outcomes for children. Stevens advocated for waiving co-pays to encourage mothers to prioritize their health. She also highlighted the benefits of peer support for mothers experiencing postpartum mental health issues, drawing from NAMI New Hampshire's experience with the FastForward program.
SB246 2024-1453h: John Reynolds, State Director for the National Federation of Independent Businesses in New Hampshire Oppose00:51:56.599 - 8:51:47 AM; John Reynolds expressed concerns about the bill, particularly focusing on the leave mandate in section nine. He mentioned the applicability threshold being set at 20 or more employees, which is lower than other significant employment regulations. Reynolds highlighted the potential compliance costs for small businesses and the ambiguity in the reinstatement provision and definitions such as 'medical appointments for postpartum care.' He also raised questions about the application of the leave policy to part-time employees with multiple employers.
SB246 2024-1453h: Holly Stevens, Director of Public Policy at NAMI New Hampshire Support00:47:27.800 - 8:47:18 AM; Holly Stevens testified in support of SB246, emphasizing the importance of addressing maternal mental health. She highlighted the documented link between postpartum depression and higher rates of depression in children during their teen years. Stevens stressed the necessity of mental health screenings and treatments for postpartum to reduce maternal deaths and negative outcomes for children. She suggested that waiving co-pays could encourage mothers to seek necessary screenings and appointments, as they often prioritize their children's needs over their own. Additionally, she discussed the benefits of peer support through NAMI New Hampshire's FastForward program and suggested that similar peer support could be crucial for reducing maternal mortality rates in New Hampshire by providing support from individuals with similar experiences.
SB246 2024-1453h: John Reynolds, State Director for the National Federation of Independent Businesses in New Hampshire Information Only00:51:56.599 - 8:51:47 AM; John Reynolds provided testimony on behalf of the National Federation of Independent Businesses in New Hampshire, representing over 1700 small employers across the state. He expressed that while the organization supports the goals of SB246 for promoting employee health, they have concerns regarding the leave mandate in section nine of the amendment. Specifically, he highlighted the issue with the applicability threshold set at 20 employees, which differs from other federal regulations like the Affordable Care Act and the Family and Medical Leave Act, both set at 50 employees. Reynolds argued that the cost of compliance with leave mandates becomes significantly more challenging for businesses with fewer than 50 employees. He also pointed out ambiguities in the language of the amendment, such as the reinstatement provision and the definition of medical appointments for postpartum care, which could lead to confusion and frustration for both employers and employees. Additionally, he raised concerns about how the leave would be managed for part-time employees with multiple employers.
SB246 2024-1453h: Senator Long Information Only00:49:19.880 - 8:49:10 AM; Senator Long inquired about the age of children affected by maternal postpartum depression, expressing interest in understanding if there is a specific age group more commonly impacted. The senator requested further information to be provided to the committee, indicating an ongoing investigation into the matter.
SB246 2024-1453h: Jessica Car Information Only00:50:06.880 - 8:49:57 AM; Jessica Car shared her experience of having concerns about her baby in utero and not receiving adequate follow-up. She discussed the importance of screenings at doctor's offices to detect issues early and provide necessary resources. She mentioned the potential role of a hub in supporting mothers, though she acknowledged her limited knowledge on the resources available.
SB246 2024-1453h: Senator Britell Information Only00:50:53.559 - 8:50:44 AM; Senator Britell asked if the bill would provide care for pregnant women suffering from depression or anxiety. It was clarified that the bill includes provisions for screenings during pregnancy and postpartum to detect and address such conditions.
SB246 2024-1453h: John Reynolds, State Director for the National Federation of Independent Businesses in New Hampshire Oppose00:51:56.599 - 8:51:47 AM; John Reynolds expressed concerns about the proposed amendment to SB246, particularly regarding the leave mandate in section nine. He highlighted the threshold of 20 employees as too low compared to other employment regulations like the Affordable Care Act and the Family and Medical Leave Act, which set thresholds at 50 employees. He also raised issues about the ambiguity in the reinstatement provision and the applicability to part-time employees with multiple employers, suggesting these could lead to confusion and operational challenges for small businesses.
SB246 2024-1453h: Tara Ryan, small business owner and leader for the Chamber of Mothers Support00:57:07.839 - 8:56:58 AM; Tara Ryan shared her personal experience with infertility and the subsequent challenges of finding adequate childcare, which she connected to broader issues of maternal mental health. She emphasized the need for peer-to-peer support and in-home care to alleviate the pressures on new mothers, advocating for the passage of SB246 as a means to address the maternal health crisis intertwined with the childcare crisis in New Hampshire.
SB246 2024-1453h: John Reynolds, National Federation of Independent Businesses in New Hampshire Oppose00:51:56.599 - 8:51:47 AM; John Reynolds, representing the National Federation of Independent Businesses in New Hampshire, expressed concerns about the proposed amendment to SB246. While acknowledging the intent of the bill to support employee health and well-being, Reynolds highlighted issues with the leave mandate in section nine. He pointed out that the threshold of 20 employees is lower than other significant employment regulations like the Affordable Care Act and the Family and Medical Leave Act, which set the threshold at 50 employees. This lower threshold could impose significant compliance costs on small businesses. Additionally, Reynolds raised concerns about the ambiguity in the reinstatement provision and the definition of medical appointments for postpartum care, which could lead to confusion and frustration for both employers and employees. He also questioned the implications for part-time employees with multiple jobs and how they might access leave across different employers.
SB246 2024-1453h: Tara Ryan, small business owner and leader for the Chamber of Mothers Support00:57:07.839 - 8:56:58 AM; Tara Ryan, a small business owner and leader for the Chamber of Mothers, shared her personal experience with infertility and the challenges of securing childcare post-birth. She highlighted how the lack of wraparound care and peer-to-peer support exacerbated her family's struggles, connecting these issues to the broader maternal mental health crisis in New Hampshire. Ryan emphasized the importance of SB246 in addressing these challenges and urged the committee to pass the bill to support families facing similar situations.
SB246 2024-1453h: Representative Kim Cabana Support00:59:50.079 - 8:59:41 AM; Representative Kim Cabana emphasized the importance of SB246 for supporting young families in New Hampshire, which has the highest percentage of workers aged 55 and older in the country. She argued that attracting young families is crucial for the state's economic growth and that the bill provides necessary protections for parents, preventing them from having to choose between employment and caring for their children's health needs.
SB246 2024-1453h: Courtney Tanner, Senior Director of Government Relations at Dartmouth Health and Dr. Alana Cass, Chair of OBGYN at Dartmouth Hitchcock Medical Center Support01:01:21.200 - 9:01:12 AM; Courtney Tanner and Dr. Alana Cass from Dartmouth Health expressed strong support for SB246. Dr. Cass highlighted the closure of 42% of birthing centers in New Hampshire over the past 25 years, which has shifted much of the obstetric care to emergency services. She emphasized the bill's potential to enhance training and collaboration in these centers. Additionally, Dr. Cass underscored the importance of addressing maternal mental health, noting that substance use overdose is the leading cause of death for pregnant people in the state. The bill would enable uniform screening for depression and provide earlier access to care, which is crucial for both patient health and workforce retention at Dartmouth Health.
SB246 2024-1453h: Karin Benfield, Insurance Department Information Only01:04:08.760 - 9:03:59 AM; Karin Benfield from the Insurance Department began to speak but the transcript snippet ends before a full summary of her testimony can be provided.
SB246 2024-1453h: John Reynolds, National Federation of Independent Businesses in New Hampshire Oppose00:51:56.599 - 8:51:47 AM; John Reynolds, representing the National Federation of Independent Businesses in New Hampshire, expressed support for the goals of the bill but had concerns about the leave mandate in section nine. He highlighted the issue with the applicability threshold set at 20 or more employees, which is lower than other regulations like the Affordable Care Act and the Family and Medical Leave Act, which set it at 50 employees. Reynolds noted that the cost of compliance with leave mandates increases significantly for businesses with fewer than 50 employees. He also raised concerns about ambiguities in the reinstatement provision and the definition of medical appointments for postpartum care, which could lead to confusion and frustration for both employees and employers. Additionally, he questioned the applicability of the leave for part-time employees with multiple employers.
SB246 2024-1453h: Tara Ryan, Chamber of Mothers Support00:57:07.839 - 8:56:58 AM; Tara Ryan, speaking as a mother, small business owner, and leader for the Chamber of Mothers, shared her personal story of infertility and the subsequent challenges of child care. She explained that despite being on multiple daycare waitlists, her family did not secure a full-time spot until her daughter was 14 months old, highlighting the child care crisis in New Hampshire. Ryan connected this crisis to the maternal mental health crisis and supported the bill, stating it would help address these issues. She urged the committee to pass the bill on behalf of families who could not attend the hearing.
SB246 2024-1453h: Representative Kim Cabana Support00:59:50.079 - 8:59:41 AM; Representative Kim Cabana emphasized the importance of the bill in supporting young families in New Hampshire, which has the highest percentage of workers aged 55 and older. She stressed the need to attract young families to the state and protect parents from choosing between employment and necessary child care. Cabana views the bill as a strategic move to empower and attract families to New Hampshire.
SB246 2024-1453h: Courtney Tanner, Dartmouth Health Support01:01:21.200 - 9:01:12 AM; Courtney Tanner, Senior Director of Government Relations at Dartmouth Health, introduced Dr. Alana Cass, Chair of OBGYN at Dartmouth Hitchcock Medical Center. Dr. Cass endorsed the bill, highlighting the closure of 42% of birthing centers in New Hampshire over the past 25 years, which has shifted obstetrics care to emergency services. She emphasized the bill's importance in providing enhanced training, collaboration, and access to care. Dr. Cass also noted the significance of the bill in addressing mental health, particularly in light of substance use being the leading cause of death for pregnant people in the state. She stressed the bill's role in workforce retention and early access to care.
SB246 2024-1453h: Karen Benfield, State Work or Play New Hampshire Support01:04:15.400 - 9:04:06 AM; Karen Benfield, Executive Director of State Work or Play New Hampshire, expressed support for Senate Bill 246, emphasizing its importance in attracting and retaining young people in New Hampshire. She highlighted the comprehensive support the bill offers to young families and mentioned that detailed reasons for their support could be found in her submitted letter. Benfield then yielded her time to Courtney Stret, the marketing coordinator at State Work or Play, who was returning from maternity leave and had a personal story to share.
SB246 2024-1453h: Unidentified Speaker, New Hampshire Information Only00:54:25.079 - 8:54:16 AM; The speaker clarifies the employment threshold set by the amendment to the bill. The amendment sets the applicability threshold at 20 employees, but caps the leave at 25 hours, which is seen as a compromise. The speaker discusses the challenges faced by small businesses when managing leave for employees below the 50-employee threshold, as set by other federal regulations like the ACA and FMLA. They express concerns about the complexity of scheduling adjustments when employees return from leave, and the uncertainty regarding employees with multiple part-time jobs accessing leave.
SB246 2024-1453h: Tara Ryan, Bedford, NH, Chamber of Mothers Support00:57:07.839 - 8:56:58 AM; Tara Ryan, a mother and small business owner from Bedford, speaks in support of the bill. She shares her personal story of struggling with infertility and the challenges of finding child care, which impacted her mental health. Ryan connects the child care crisis to the maternal mental health crisis in New Hampshire, emphasizing the need for peer-to-peer support and in-home care. She urges the committee to pass the bill to address these issues and support families.
SB246 2024-1453h: Representative Kim Cabana, New Hampshire Support00:59:50.079 - 8:59:41 AM; Representative Kim Cabana supports the bill, highlighting the importance of attracting young families to New Hampshire, given its aging workforce. She emphasizes the need to protect parents from choosing between work and caring for their children, suggesting that the bill will empower and attract families to the state.
SB246 2024-1453h: Courtney Tanner, Senior Director of Government Relations, Dartmouth Health, Lebanon, NH Support01:01:21.200 - 9:01:12 AM; Courtney Tanner introduces Dr. Alana Cass, who speaks in support of the bill. Dr. Cass, Chair of OBGYN at Dartmouth Hitchcock Medical Center, emphasizes the closure of obstetric units in New Hampshire and the shift of care to emergency services. She supports the bill for enhancing training and collaboration, improving mental health screening, and aiding in workforce retention.
SB246 2024-1453h: Karen Benfield, Executive Director, State Work or Play New Hampshire Support01:04:15.400 - 9:04:06 AM; Karen Benfield supports Senate Bill 246, emphasizing its importance for attracting and retaining young people in New Hampshire. She yields her time to Courtney Stret, a marketing coordinator from the same organization, who shares her recent experience of motherhood.
SB246 2024-1453h: Courtney Stret, Marketing Coordinator, State Work or Play New Hampshire Support01:05:11.640 - 9:05:02 AM; Courtney Stret shares her personal story of becoming a new mother, highlighting the challenges and isolation of early parenthood. She discusses her postpartum checkup, where mental health was only briefly mentioned, and emphasizes the need for early mental health support for new mothers. Stret supports the bill as a step towards better postpartum care and mental health support for new parents in New Hampshire.
SB246 2024-1453h: Tara Ryan, Chamber of Mothers, New Hampshire Support00:57:07.839 - 8:56:58 AM; Tara Ryan, representing the Chamber of Mothers, shared her personal journey with infertility and the challenges of finding child care in New Hampshire. She highlighted her struggle with infertility and the subsequent birth of her daughter through IVF. Ryan emphasized the difficulty of securing a daycare spot, which took 14 months, and connected this struggle to the broader maternal mental health crisis in the state. She supported the bill, arguing it would provide necessary support like peer-to-peer and in-home care, which could alleviate some of the pressures on new mothers.
SB246 2024-1453h: Representative Kin Cab, New Hampshire Support00:59:50.079 - 8:59:41 AM; Representative Kin Cab, as a mother of four, supported the bill, emphasizing its importance for New Hampshire's aging workforce and the need to attract young families. She highlighted the necessity of protecting parents from choosing between employment and attending to their children's health needs, suggesting the bill would be a strategic move to empower and attract families to the state.
SB246 2024-1453h: Courtney Tanner, Senior Director of Government Relations, Dartmouth Health Support01:01:21.200 - 9:01:12 AM; Courtney Tanner introduced Dr. Alana Cass, who further elaborated on the support for the bill. Tanner's role was to facilitate Dr. Cass's testimony, indicating strong institutional support from Dartmouth Health.
SB246 2024-1453h: Dr. Alana Cass, Chair of OBGYN, Dartmouth Health Support01:01:21.200 - 9:01:12 AM; Dr. Alana Cass endorsed the bill, focusing on three key points: the closure of obstetric units in New Hampshire, the importance of mental health screening for new mothers, and the need to retain the obstetric workforce. She highlighted the strain on emergency services due to the lack of obstetric facilities and the critical role of the bill in providing training, collaboration, and access to care. She also stressed the high rate of substance use overdose among pregnant women in the state and the isolation and mental health issues new mothers face, which the bill aims to address.
SB246 2024-1453h: Karen Benfield, Executive Director, State Work or Play New Hampshire Support01:04:15.400 - 9:04:06 AM; Karen Benfield expressed support for Senate Bill 246 on behalf of State Work or Play New Hampshire, emphasizing the organization's mission to attract and retain young people in the state. She highlighted the bill's critical supports for young families and deferred further elaboration to her letter, instead giving her time to Courtney Stret, who had recently returned from maternity leave.
SB246 2024-1453h: Courtney Stret, Marketing Coordinator, State Work or Play New Hampshire Support01:05:11.640 - 9:05:02 AM; Courtney Stret shared her personal experience as a new mother, highlighting the challenges of postpartum life, including the lack of mental health support. She emphasized the importance of mental health checks for new mothers, noting her own experience of being asked about her mental well-being only at the end of her checkup. Stret supported the bill, seeing it as a step towards improving postpartum care and mental health support for new mothers in New Hampshire.
SB246 2024-1453h: Paula Rogers, America's Health Insurance Plans Support01:08:27.238 - 9:08:18 AM; Paula Rogers provided general support for the legislation on behalf of America's Health Insurance Plans, noting that insurers were largely comfortable with the bill. She pointed out some confusion around drafting and terminology but highlighted the bill's focus on maternal depression screening, perinatal mental health and substance use treatment, and perinatal home visiting services. Rogers mentioned potential areas of uncertainty regarding peer support and community-based services but overall supported the bill.
SB246 2024-1453h: Bob Dunn, Director of Public Policy, Roman Catholic Diocese of Manchester Support01:11:40.239 - 9:11:31 AM; Bob Dunn testified in support of the bill on behalf of Bishop Petashi and the Roman Catholic Diocese of Manchester. He aligned the bill with the US Conference of Catholic Bishops' advocacy for maternal health, emphasizing the long-term health benefits for mothers and children and describing the legislation as pro-life due to its potential to save lives.
SB246 2024-1453h: Briana Hanel, American Academy of Pediatrics Support01:14:09.320 - 9:14:00 AM; Briana Hanel, representing the American Academy of Pediatrics, was unable to provide detailed testimony but delivered a letter of support for the bill.
SB246 2024-1453h: Representative Kim Cappuccio, Manchester Support00:59:50.079 - 8:59:41 AM; Representative Cappuccio emphasized the importance of SB246 for supporting young families in New Hampshire, highlighting the state's aging population and the need to attract young families. She pointed out that while many employers are understanding, some are not, and this bill provides crucial protection for parents who might otherwise have to choose between employment and attending to their child's health needs. She sees this legislation as a strategic move to empower and attract families to New Hampshire.
SB246 2024-1453h: Courtney Tanner, Dartmouth Health Support01:01:21.200 - 9:01:12 AM; Courtney Tanner introduced Dr. Alana Cass, the chair of OBGYN at Dartmouth Hitchcock Medical Center, and expressed support for the bill. Dr. Cass then elaborated on the significance of SB246, highlighting the closure of 42% of birthing centers in New Hampshire over the last 25 years, which has shifted care to emergency departments. She emphasized the bill's role in enhancing training, collaboration, and access to obstetric care. Additionally, she noted the importance of addressing mental health, especially given that substance use overdose is the leading cause of death for pregnant people in New Hampshire. Finally, she stressed the bill's importance for workforce retention in obstetrics.
SB246 2024-1453h: Karen Benfield, Stay Work Play New Hampshire Support01:04:15.400 - 9:04:06 AM; Karen Benfield expressed support for SB246 on behalf of Stay Work Play New Hampshire, noting its critical support for young people in the state. She deferred her time to Courtney Street, a marketing coordinator at Stay Work Play, who had recently returned from maternity leave.
SB246 2024-1453h: Courtney Street, Stay Work Play New Hampshire Support01:05:11.640 - 9:05:02 AM; Courtney Street shared her personal experience as a new mother, describing the challenges of postpartum life and the importance of mental health care. She highlighted her own postpartum checkup where mental health was only briefly mentioned at the end, underscoring the need for more comprehensive mental health screenings and support for new mothers. She emphasized that early mental health care could significantly ease the postpartum period for many mothers in New Hampshire.
SB246 2024-1453h: Paula Rogers, America's Health Insurance Plans Support01:08:27.238 - 9:08:18 AM; Paula Rogers, representing America's Health Insurance Plans, expressed general support for SB246, noting that while there might be some confusion around certain terms, insurers are largely comfortable with the legislation. She highlighted the bill's focus on maternal depression screening, perinatal mental health and substance use treatment, and prenatal home visiting services. She raised a concern about the potential ambiguity around peer support services and suggested further discussion might be needed.
SB246 2024-1453h: Bob Dunn, Roman Catholic Diocese of Manchester Support01:11:40.239 - 9:11:31 AM; Bob Dunn testified in support of SB246 on behalf of the Roman Catholic Diocese of Manchester, aligning the bill with the U.S. Conference of Catholic Bishops' advocacy for maternal health. He emphasized the long-term health benefits for mothers and children and framed the bill as pro-life legislation due to its potential to save lives.
SB246 2024-1453h: Annie Hopkins, Portsmouth Support01:14:13.639 - 9:14:04 AM; Annie Hopkins, a mother and pelvic floor physical therapist, shared her personal and professional support for SB246. She recounted her experience with an outdated New Hampshire law that forced her to transfer to a hospital during labor despite not needing it. She also discussed her struggle with postpartum depression after returning to work, underscoring the need for better mental health support for new mothers. She emphasized that mental health is public health and urged support for the bill.
SB246 2024-1453h: Rebecca Vichosky, New Futures Support01:18:06.520 - 9:17:57 AM; Rebecca Vichosky from New Futures strongly supported SB246, highlighting its importance in expanding access to critical services like home visiting. She noted that 76% of New Hampshire births are covered by private insurers, and the bill addresses the gap in support for privately insured mothers. She emphasized the value of home visiting services in assessing both baby and maternal health concerns and urged the committee to support the bill for the sake of New Hampshire's mothers.
SB246 2024-1453h: Karen Benfield, State Work or Play New Hampshire Support01:04:15.400 - 9:04:06 AM; Karen Benfield, the executive director of State Work or Play New Hampshire, expressed support for Senate Bill 246. She highlighted the organization's mission to attract and retain young people in New Hampshire and emphasized that the bill offers critical support for the state's youth. She provided a letter detailing the reasons for their support but chose to yield her speaking time to Courtney Stret, the marketing coordinator, who had recently returned from maternity leave.
SB246 2024-1453h: Courtney Stret Support01:05:11.640 - 9:05:02 AM; Courtney Stret shared her personal experience as a new mother, discussing the challenges of postpartum life and the importance of mental health support. She described the physical and mental demands of caring for a newborn and the pressure of returning to work shortly after giving birth. Stret advocated for better mental health checks during postpartum care, suggesting that early intervention could significantly ease the transition for new mothers. She expressed strong support for Senate Bill 246, believing it would help improve the postpartum experience for mothers in New Hampshire.
SB246 2024-1453h: Paula Rogers, America's Health Insurance Plans Information Only01:08:27.238 - 9:08:18 AM; Paula Rogers, representing America's Health Insurance Plans, provided general comments on Senate Bill 246. She stated that insurers are largely comfortable with the legislation but noted some confusion around drafting and terminology. Rogers pointed out that the bill includes three sections directly affecting insurers: maternal depression screening coverage, perinatal mental health and substance use treatment, and perinatal home visiting services. She raised concerns about the clarity of peer support services within the bill and suggested further discussion on how these services align with insurance coverage.
SB246 2024-1453h: Bob Dunn, Roman Catholic Diocese of Manchester Support01:11:40.239 - 9:11:31 AM; Bob Dunn, representing the Roman Catholic Diocese of Manchester, spoke in support of Senate Bill 246. He emphasized the diocese's commitment to supporting mothers and families, aligning the bill with national efforts by the US Conference of Catholic Bishops to address maternal health issues, specifically mental health, substance abuse, and postpartum depression. Dunn highlighted the long-term benefits of the bill for both mothers and children and described it as a pro-life measure aimed at saving lives.
SB246 2024-1453h: Briana Hanel, American Academy of Pediatrics Information Only01:14:09.320 - 9:14:00 AM; Briana Hanel, representing the American Academy of Pediatrics, submitted a letter in support of Senate Bill 246 since a direct representative could not attend the hearing. The letter was acknowledged and accepted by the committee.
SB246 2024-1453h: Annie Hopkins, Portsmouth, NH Support01:14:13.639 - 9:14:04 AM; Annie Hopkins, a mother and perinatal healthcare provider from Portsmouth, NH, shared her personal and professional experiences in support of Senate Bill 246. She recounted her challenging experience with a home birth due to an outdated New Hampshire law and her subsequent struggle with postpartum depression and anxiety. Hopkins emphasized the importance of mental health support for new mothers and the need for better access to services like home visiting, urging the committee to support the bill to improve maternal health outcomes.
SB246 2024-1453h: Andrew Hosmer, Harvard Pilgrim Healthcare Information Only01:20:01.280 - 9:19:52 AM; Andrew Hosmer from Harvard Pilgrim Healthcare, New Hampshire's largest nonprofit health insurer, stated that their organization is officially neutral on Senate Bill 246. While they applaud efforts to strengthen maternal health services, they expressed concerns about the mandate language in the bill. Hosmer noted that many services discussed are already covered by their plans but suggested working with senators and stakeholders to clarify language and mandates. He requested a copy of the amendment to review and discuss further.
SB246 2024-1453h: Courtney, new mother Support01:05:11.640 - 9:05:02 AM; Courtney, a new mother, shares her personal experience with motherhood and the challenges of the postpartum period. She discusses the lack of mental health care during her postpartum checkup, highlighting the need for more thorough mental health assessments for new mothers. She expresses gratitude for her support system but emphasizes the pressure of returning to work and the high cost of child care, which add to the challenges of new motherhood. Courtney supports SB246, advocating for improved mental health checks for new mothers as a crucial step toward better postpartum care.
SB246 2024-1453h: Paula Rogers, America's Health Insurance Plans Information Only01:08:27.238 - 9:08:18 AM; Paula Rogers, representing America's Health Insurance Plans, provides an overview of the insurer's perspective on SB246. She indicates that the insurers are largely comfortable with the legislation, though there might be some confusion around the drafting and terminology. Rogers points out that the bill addresses the missing component of mental health care in the existing 1997 New Hampshire law on women's health care. She mentions specific sections of the bill that affect insurers and expresses concerns about the expectations around peer support, suggesting that some aspects may require further discussion with insurers.
SB246 2024-1453h: Bob Dunn, Roman Catholic Diocese of Manchester Support01:11:40.239 - 9:11:31 AM; Bob Dunn, representing the Roman Catholic Diocese of Manchester, supports SB246, aligning it with the US Conference of Catholic Bishops' advocacy for maternal health. He emphasizes the bill's long-term health benefits for both mothers and children and describes it as a pro-life bill due to its potential to save lives. Dunn highlights the importance of addressing mental health, substance abuse, and postpartum depression as outlined in the bill.
SB246 2024-1453h: Annie Hopkins, mother and perinatal healthcare provider, Portsmouth, NH Support01:14:13.639 - 9:14:04 AM; Annie Hopkins, a mother and perinatal healthcare provider from Portsmouth, NH, supports SB246 based on her personal and professional experiences. She shares her story of needing to transfer to a hospital due to an outdated state law during childbirth, and her struggle with postpartum depression after returning to work. Hopkins advocates for the bill's provisions on independent birthing centers, maternal mental health screenings, and home visiting services, emphasizing the importance of mental health care in public health.
SB246 2024-1453h: Rebecca Vykovsky, New Futures Support01:18:06.520 - 9:17:57 AM; Rebecca Vykovsky from New Futures supports SB246, emphasizing its importance in expanding access to critical services like home visiting for privately insured mothers. She notes that New Hampshire has made progress in supporting Medicaid-covered families, but the majority of births are covered by private insurers, which this bill aims to address. Vykovsky highlights the need for a connected system of care for all mothers and supports the bill's efforts to ensure access to services that assess both baby and maternal health.
SB246 2024-1453h: Andrew Hosmer, Harvard Pilgrim Healthcare Information Only01:20:01.280 - 9:19:52 AM; Andrew Hosmer from Harvard Pilgrim Healthcare, while officially neutral on SB246, expresses general support for the bill's efforts to strengthen maternal health. He applauds the work of the bill's sponsors but raises concerns about the mandate language, suggesting a need for clarification to ensure the services meet the needs of their members and fit within the healthcare model. Hosmer requests to review the amendment to the bill and work with the senators and stakeholders to refine the language.
SB246 2024-1453h: Devin Quinn, New Hampshire Women's Foundation Support01:21:52.760 - 9:21:43 AM; Devin Quinn from the New Hampshire Women's Foundation supports SB246 and emphasizes the extensive stakeholder engagement that went into crafting the bill to address concerns and ensure its effectiveness. She discusses the amendment's role in clarifying insurance-related language and highlights the importance of the bill's provisions, such as maternal depression screenings and home visiting, which are generally already covered by insurance plans. Quinn also discusses the stakeholder engagement on pediatric visits, noting the business community's input on the number of hours allowed for such visits.
SB246 2024-1453h: Paula Rogers, America's Health Insurance Plans Information Only01:08:27.238 - 9:08:18 AM; Paula Rogers, representing America's Health Insurance Plans, provided general comments on behalf of insurers in the state. She stated that member plans are largely comfortable with the legislation, although there was some confusion around drafting and terminology. She highlighted three sections of the bill that directly affect insurers: maternal depression screening coverage, perinatal mental health and substance use treatment, and perinatal home visiting services. Rogers expressed some uncertainty about the bill's language regarding peer support, suggesting that further discussion might be needed on community-based services and insurance coverage.
SB246 2024-1453h: Bob Dunn, Roman Catholic Diocese of Manchester Support01:11:40.239 - 9:11:31 AM; Bob Dunn, director of public policy for the Roman Catholic Diocese of Manchester, expressed support for the legislation on behalf of Bishop Petashi. He aligned the bill with the US Conference of Catholic Bishops' call for radical solidarity with mothers and babies, particularly highlighting the focus on mental health, substance abuse, and postpartum depression. Dunn emphasized the long-term benefits of the bill for both the mother and child's lifespan and described it as a pro-life bill that could save lives.
SB246 2024-1453h: Annie Hopkins, Portsmouth, NH Support01:14:13.639 - 9:14:04 AM; Annie Hopkins, a mother and pelvic floor physical therapist from Portsmouth, New Hampshire, supported the bill based on her personal and professional experiences. She shared her story of an unnecessary hospital transfer during childbirth due to an outdated New Hampshire law and her struggle with postpartum mental health issues. Hopkins emphasized the importance of the bill's provisions for independent birthing centers, mental health screenings, and home visits, urging the committee to support the bill to help many mothers.
SB246 2024-1453h: Rebecca Vyhovsky, New Futures Support01:18:06.520 - 9:17:57 AM; Rebecca Vyhovsky, child and family policy director at New Futures, strongly supported SB246 for expanding access to critical services like home visiting. She highlighted that 76% of New Hampshire births are reimbursed through private insurers, and the bill addresses the need to support privately insured moms with wraparound care. Vyhovsky stressed the importance of home visiting for assessing both baby and maternal health and urged the committee to support the bill for the sake of New Hampshire's moms.
SB246 2024-1453h: Andrew Hosmer, Harvard Pilgrim Healthcare Information Only01:20:01.280 - 9:19:52 AM; Andrew Hosmer, representing Harvard Pilgrim Healthcare, stated that although the insurer is neutral on the bill, they applaud the efforts to strengthen maternal health, particularly maternal depression screening and access to healthcare services. He echoed Paula Rogers' concerns about the mandate language, emphasizing the need for specificity to ensure the services meet the needs of their members. Hosmer requested to work with the Senators and stakeholders to clarify the language and mandates.
SB246 2024-1453h: Devin Quinn, New Hampshire Women's Foundation Support01:21:52.760 - 9:21:43 AM; Devin Quinn, director at the New Hampshire Women's Foundation, expressed support for the bill and highlighted the extensive stakeholder engagement that went into crafting it. She noted that the amendment language addressed concerns from insurance carriers, particularly regarding individual markets and fiscal impact. Quinn also discussed the stakeholder engagement on pediatric visits, which resulted in a consensus on 25 hours of leave in the first year of life, supported by employers. She emphasized balancing the impact on carriers and businesses while saving mothers' lives and keeping babies healthy.
SB246 2024-1453h: Jenny O'Higgins, Rob Barry, Courtney Keane, Department of Health and Human Services (DHHS) Information Only01:27:22.159 - 9:27:13 AM; Jenny O'Higgins, Rob Barry, and Courtney Keane from the Department of Health and Human Services provided information on the bill's impact. They expressed conceptual support for the bill's components and discussed the fiscal impact, noting that the appropriation for the perinatal psychiatric consultant line would not result in additional fiscal impact, and the perinatal peer supports section is a report with no direct appropriation. They also mentioned that Medicaid already provides the services mentioned in the bill, expecting minimal to no fiscal impact from changes in billing.
SB246 2024-1453h: Annie Hopkins, Portsmouth, NH Support01:14:13.639 - 9:14:04 AM; Annie Hopkins testified in support of SB246, highlighting her personal experience with maternal health care in New Hampshire. She shared her story of undergoing IVF and planning a home birth, but being forced to transfer to a hospital due to state law, which she described as antiquated and not evidence-based. She also discussed her struggle with postpartum depression and the lack of support she received after the initial care window, emphasizing the need for better mental health services for new mothers. Hopkins urged the committee to support the bill, stating that mental health is public health and crucial for mothers.
SB246 2024-1453h: Rebecca Vyhovsky, New Futures Support01:17:19.520 - 9:17:10 AM; Rebecca Vyhovsky, representing New Futures, strongly supported SB246. She emphasized the importance of expanding access to critical services like home visiting, which is currently underutilized in New Hampshire. Vyhovsky pointed out that 76% of births in the state are covered by private insurers, and stressed the need for better support for privately insured mothers. She highlighted the bill's potential to address these gaps by ensuring access to home visiting and other essential services for all mothers, regardless of insurance type.
SB246 2024-1453h: Andrew Hosmer, Harvard Pilgrim Healthcare Information Only01:20:01.280 - 9:19:52 AM; Andrew Hosmer, representing Harvard Pilgrim Healthcare, provided information on the company's neutral stance on SB246. He praised the efforts of Senators Ricardi and Apprentice in strengthening maternal health services, including depression screening and increased healthcare access for new mothers. Hosmer expressed concerns about the bill's mandate language and the need for clarity to ensure the services meet the needs of their members. He indicated a willingness to work with the senators to refine the language and mandates.
SB246 2024-1453h: Devin Quinn, New Hampshire Women's Foundation Support01:21:52.760 - 9:21:43 AM; Devin Quinn from the New Hampshire Women's Foundation spoke in support of SB246, emphasizing the extensive stakeholder engagement that went into crafting the bill. She noted that the amendment addressed insurance concerns, ensuring that the bill would not significantly impact fiscal notes or individual markets. Quinn also discussed the outreach to the business community regarding pediatric visits, which resulted in a consensus on providing 25 hours of leave in the first year of life. She urged the committee to support the bill for the sake of mothers and babies.
SB246 2024-1453h: Jenny O'Higgins, Rob Barry, Courtney Keane, Department of Health and Human Services (DHHS) Information Only01:27:22.159 - 9:27:13 AM; The representatives from the Department of Health and Human Services (DHHS) provided information on the fiscal impact of SB246. They stated that the department supports the bill's components, which align with their goal of healthy moms and babies. They noted that the appropriation for the perinatal psychiatric consultant line would not result in additional fiscal impact for the department, and the perinatal peer support section is a report with no direct appropriation. They mentioned that Medicaid services mentioned in the bill are already provided, and any changes would likely have minimal fiscal impact.
SB246 2024-1453h: Pam Denapoli, Manchester, NH, New Hampshire Nurses Association Support01:30:48.400 - 9:30:39 AM; Pam Denapoli, a registered nurse from Manchester and a member of the New Hampshire Nurses Association, testified in strong support of SB246. She shared a story from the association's president about her struggles with ectopic pregnancies and postpartum depression, highlighting the importance of support groups like the Elliot postpartum group. Denapoli emphasized that such services are crucial and rare in New Hampshire, urging the committee to pass the bill to improve access to these services across the state.
SB246 2024-1453h: Andrew Hosmer, Harvard Pilgrim Healthcare Information Only01:20:01.280 - 9:19:52 AM; Andrew Hosmer from Harvard Pilgrim Healthcare, New Hampshire's largest nonprofit health insurer, provided a neutral stance on the bill but expressed general support for strengthening maternal health, particularly in maternal depression screening and increasing access to healthcare services for new mothers. He highlighted concerns about the mandate language in the bill, noting that many of the services discussed are already covered by their plans. He requested clarification on the language and mandates within the bill and amendment and expressed interest in reviewing the amendment.
SB246 2024-1453h: Devin Quinn, New Hampshire Women's Foundation Support01:21:52.760 - 9:21:43 AM; Devin Quinn from the New Hampshire Women's Foundation expressed strong support for the bill, highlighting the extensive stakeholder engagement that went into crafting it. She noted that the amendment addressed concerns from the insurance industry, particularly regarding individual markets and fiscal impact. Quinn also discussed the stakeholder engagement for pediatric visits, which involved significant outreach to the business community, resulting in a consensus on 25 hours of leave for the first year of life. She emphasized the balance achieved between the impact on carriers, businesses, and the health of mothers and babies.
SB246 2024-1453h: Jenny O'Higgins, Rob Barry, Courtney Keane, Department of Health and Human Services (DHHS) Information Only01:25:44.199 - 9:25:35 AM; Representatives from DHHS, including Jenny O'Higgins, Rob Barry, and Courtney Keane, provided information on the department's stance on the bill. They expressed conceptual support for the components within the bill, which align with their goal for healthy moms and babies. They discussed the fiscal impact, noting that there would be no additional fiscal impact to the department due to the appropriation for the perinatal psychiatric consultant line and the report on perinatal peer support. They mentioned they had not yet seen the formal version of the amendment.
SB246 2024-1453h: Pam Denapoli, Manchester, NH, New Hampshire Nurses Association Support01:30:48.400 - 9:30:39 AM; Pam Denapoli, a registered nurse from Manchester and a member of the New Hampshire Nurses Association, expressed strong support for the bill on behalf of the association. She shared a personal story from the association's president about her experience with postpartum depression and the importance of support groups like the Elliot postpartum group. Denapoli emphasized the rarity of such groups in New Hampshire and urged the committee to pass the bill to improve access to these services across the state.
SB246 2024-1453h: Devin Quinn, New Hampshire Women's Foundation Support01:21:52.760 - 9:21:43 AM; Devin Quinn, the director at the New Hampshire Women's Foundation, expressed strong support for SB246 and its amendment. She highlighted the extensive stakeholder engagement, which included insurance carriers, the Department of Insurance, and the business community, ensuring the bill's effectiveness and feasibility. Quinn noted that the amendment addressed concerns about the individual market and fiscal impact, with carriers already covering services like maternal depression screenings and home visiting. She emphasized the importance of the 25-hour pediatric visit provision in the first year of life, as recommended by employers and HR professionals, and raised concerns about potential increases to 30 hours without clear justification. She also discussed the peer support aspect, which is currently set for study by DHHS rather than immediate implementation.
SB246 2024-1453h: Jenny O'Higgins, Rob Barry, Courtney Keane, Department of Health and Human Services (DHHS) Information Only01:27:22.159 - 9:27:13 AM; Representatives from DHHS, including Jenny O'Higgins, Rob Barry, and Courtney Keane, provided information on the fiscal impact of SB246. They noted that the department's roadmap includes a goal for healthy moms and babies, aligning with the bill's components. They mentioned a pending fiscal note worksheet due to the high volume of requests but assured that the appropriation for the perinatal psychiatric consultant line would not result in an additional fiscal impact. They also discussed the perinatal peer supports section, indicating it involves a report rather than a direct appropriation, hence no fiscal impact. Rob Barry added that Medicaid services mentioned in the bill are already provided, with potential minimal fiscal impact due to changes in billing.
SB246 2024-1453h: Pam Denapoli, Manchester, NH, New Hampshire Nurses Association Support01:30:48.400 - 9:30:39 AM; Pam Denapoli, a registered nurse from Manchester and a member of the New Hampshire Nurses Association, strongly supported SB246. She shared a personal story from the association's president about her struggles with postpartum depression and the vital role that support groups played in her recovery. Denapoli emphasized the scarcity of such groups in New Hampshire and urged the committee to pass the bill to improve access to these essential services statewide.
SB246 2024-1453h: Senator Long Information Only01:25:44.199 - 9:25:35 AM; Senator Long expressed concerns about the clarity of coverage under the bill, specifically whether individuals might mistakenly expect to be covered for services that are not included. They asked if these issues were addressed in conversations regarding the bill. The response highlighted the limitations of state legislation in impacting federally regulated insurance plans and emphasized efforts to maximize coverage for mothers within the state's legislative capabilities.
SB246 2024-1453h: Jenny O'Higgins, DHHS, Rob Barry, DHHS, Courtney Keane, DHHS Information Only01:27:22.159 - 9:27:13 AM; Jenny O'Higgins, Rob Barry, and Courtney Keane from the Department of Health and Human Services (DHHS) provided information on the bill's impact. They expressed conceptual support for the bill's components aimed at improving maternal health. They discussed the fiscal note worksheet, indicating no additional fiscal impact for the department due to the bill's appropriation for perinatal psychiatric consultants and perinatal peer support reporting. They also noted that Medicaid services related to the bill are already being provided, with minimal to no fiscal impact expected from changes in billing.
SB246 2024-1453h: Pam Denapoli, Manchester, NH, New Hampshire Nurses Association Support01:30:48.400 - 9:30:39 AM; Pam Denapoli, representing the New Hampshire Nurses Association, strongly supported the bill, describing it as one of the most important pieces of legislation for the year. She shared a personal story from the association's president about her struggles with postpartum depression and the critical role of support groups like the Elliot postpartum group in her recovery. Denapoli urged the passage of the bill to extend such services to more parts of New Hampshire.
SB124: Denise Rardy, District 9 Support01:36:25.719 - 9:36:16 AM; Denise Rardy introduced Senate Bill 124, which aims to enhance the regulatory framework for Continuing Care retirement communities (CCRCs) in New Hampshire. She explained the CCRC model's benefits, including a continuum of care for seniors, and highlighted the financial risks associated with operating such facilities. Rardy detailed the insurance department's analysis over the past three years, leading to the bill's proposal for an early warning system to mitigate financial distress in CCRCs, thereby protecting vulnerable seniors.
SB246: Pam Denapoli, Manchester, New Hampshire Nurses Association Support01:30:48.400 - 9:30:39 AM; Pam Denapoli, a registered nurse from Manchester and a member of the New Hampshire Nurses Association, spoke in strong support of Senate Bill 246. She highlighted its importance and the association's collaboration with the Women's Health Foundation in advocating for the bill. She shared a personal story from the president of their association about her struggles with ectopic pregnancies and postpartum depression, emphasizing the critical role of support groups like the Elliot postpartum group in Manchester. Denapoli urged the committee to pass the bill to ensure more residents of New Hampshire have access to similar services.
SB124: Denise Rardy, District 9 Support01:36:25.719 - 9:36:16 AM; Senator Denise Rardy introduced Senate Bill 124, aimed at improving the regulatory framework for Continuing Care Retirement Communities (CCRCs). She detailed the structure and benefits of CCRCs, which offer a continuum of care from independent living to skilled nursing, allowing seniors to age in place without relocating. Rardy highlighted the financial risks associated with CCRCs and the need for legislative action following financial challenges faced by some facilities over the past 15 years. She explained that SB124 proposes an early warning system for financial distress to protect residents.
SB124: DJ Benton, Commissioner of the New Hampshire Insurance Department Support01:39:56.679 - 9:39:47 AM; Commissioner DJ Benton of the New Hampshire Insurance Department supported Senate Bill 124, emphasizing the need for updated oversight of CCRCs. He noted that the current statute, over 30 years old, fails to address modern challenges faced by CCRCs. Benton stressed the importance of consumer protection, especially for vulnerable seniors, and discussed the department's recent experiences managing financial crises at CCRCs. He advocated for an early warning system to prevent future crises and mentioned ongoing collaboration with CCRCs to refine the legislation, with a forthcoming amendment expected to reflect this work.
SB124: Denise Rardy, District 9 Support01:36:25.719 - 9:36:16 AM; Senator Denise Rardy introduced Senate Bill 124, which aims to enhance the regulatory framework for Continuing Care Retirement Communities (CCRCs) in New Hampshire. She explained that CCRCs offer a range of living options and care services for older adults, allowing them to transition between different levels of support as needed without relocating. However, she noted the significant financial risks associated with these communities, such as entrance fees and ongoing monthly fees, which could fluctuate. Over the past 15 years, the New Hampshire Insurance Department has faced challenges with financially troubled CCRCs, prompting a three-year analysis to develop Senate Bill 124. The bill proposes an early warning system for financial distress to protect vulnerable seniors.
SB124: DJ Benton, Commissioner of the New Hampshire Insurance Department Support01:39:56.679 - 9:39:47 AM; Commissioner DJ Benton supported Senate Bill 124, highlighting three reasons for the need for additional oversight: the outdated statute, consumer protection, and the financial distress of some CCRCs. He explained that the current statute, over 30 years old, fails to address the challenges CCRCs face. The department's mission is to protect consumers, particularly vulnerable seniors. He detailed past instances where CCRCs faced financial crises, emphasizing the catastrophic consequences for residents if a CCRC fails. The bill aims to implement an early warning system to act proactively and avoid such crises, balancing regulation with the needs of the industry.
SB124: Steve Ninger, New Hampshire Insurance Department Support01:45:51.679 - 9:45:42 AM; Steve Ninger from the New Hampshire Insurance Department discussed the regulatory framework for CCRCs and the specifics of Senate Bill 124. He explained that CCRCs require substantial upfront payments and monthly fees, necessitating regulation to ensure solvency. The amended statute allows for quick reaction to financial issues through quarterly reporting by CCRCs. He stressed the importance of acting swiftly in financial distress situations, drawing from his experience as a bankruptcy trustee. The bill includes tools for the department to intervene if necessary, while not overly burdening well-performing CCRCs. An upcoming amendment will address specific issues without changing the bill's overall intent.
SB124: Denise Rardy, District 9 Support01:36:25.719 - 9:36:16 AM; Senator Denise Rardy introduced Senate Bill 124, which focuses on the regulatory framework for Continuing Care Retirement Communities (CCRCs) in New Hampshire. She explained that CCRCs offer a range of living options for older adults, from independent living to skilled nursing care, all within one location. This setup provides a continuum of care, allowing residents to transition as their needs change without relocating. Rardy noted that while CCRCs are popular, they pose significant financial risks to residents due to substantial entrance and ongoing fees. She discussed the New Hampshire Insurance Department's analysis over the past three years, which identified the need for proactive measures to protect seniors from financial crises in these facilities. Senate Bill 124 proposes an early warning system for financial distress to enable prompt action by the insurance department.
SB124: DJ Benton, Commissioner of the New Hampshire Insurance Department Support01:39:56.679 - 9:39:47 AM; Commissioner DJ Benton supported Senate Bill 124, emphasizing the need for updated oversight tools for CCRCs. He highlighted three reasons for the bill: the outdated statute, consumer protection, especially for vulnerable seniors, and the need for early detection of financial distress. Benton shared experiences of managing financial crises at CCRCs, including a recent instance where a facility had only 10 days of cash on hand. He stressed the importance of an early warning system to prevent such crises and noted that the bill had broad support from CCRCs, with an amendment forthcoming to reflect ongoing collaboration.
SB124: Steve Ninger, New Hampshire Insurance Department Support01:45:51.679 - 9:45:42 AM; Steve Ninger provided detailed insights into the regulatory framework for CCRCs, emphasizing the need for quick action to manage financial risks. He explained that CCRCs require significant upfront payments from residents, necessitating strong regulation to ensure solvency. Ninger outlined the bill's focus on an early warning system and quarterly financial reporting by CCRCs, which would allow the department to act swiftly in case of financial trouble. He also noted that the bill is designed not to burden well-performing CCRCs with excessive regulation, but to intervene only when necessary.
SB124: Denise Rardy, District 9 Support01:36:25.719 - 9:36:16 AM; Denise Rardy introduced and provided testimony on Senate Bill 124, which addresses the regulatory framework for Continuing Care Retirement Communities (CCRCs) in New Hampshire. She explained that CCRCs are residential facilities designed for older adults, offering a range of living options and care services in one location, including independent living, assisted living, and skilled nursing care. The CCRC model provides a continuum of care, allowing residents to transition between different levels of support as needed without relocation. However, she noted that CCRCs often require substantial entrance and ongoing monthly fees, which can fluctuate. Rardy highlighted the financial risks and challenges CCRCs have faced over the past 15 years, such as funding issues, actuarial risks, mismanagement, and housing market volatility. She mentioned that the New Hampshire Insurance Department conducted a comprehensive analysis of the legislative framework governing CCRCs over the past three years, leading to Senate Bill 124. This bill aims to enhance oversight by implementing an early warning system for financial distress, allowing the department to act promptly and safeguard residents' interests.
SB124: DJ Benton, Commissioner of the New Hampshire Insurance Department Support01:39:56.679 - 9:39:47 AM; Commissioner DJ Benton, supported by Steve Ninger, explained the need for additional oversight tools through Senate Bill 124. He outlined three reasons for the request: the need to update the over 30-year-old statute, a commitment to consumer protection, particularly for vulnerable seniors, and the response to serious financial distress experienced by some CCRCs. Benton described how the current statutory framework only alerts the department to financial distress once it has escalated into a crisis, making it a retroactive approach. He shared his department's experience managing three CCRCs facing major financial crises, including one with only 10 days of cash on hand. He emphasized the catastrophic consequences of a CCRC failing and the importance of the bill's early warning detection process to manage financial challenges proactively. An amendment to the bill, developed in collaboration with CCRCs, was also mentioned.
SB124: Steve Ninger, New Hampshire Insurance Department Support01:45:51.679 - 9:45:42 AM; Steve Ninger elaborated on the specifics of Senate Bill 124, focusing on the regulation of Continuing Care Retirement Communities (CCRCs). He explained that CCRCs are a long-term care option for older adults, requiring a significant entrance fee and ongoing monthly payments, with the possibility of a refund upon the resident's death depending on the contract type. Ninger emphasized the need for regulation due to the high upfront costs and the importance of ensuring the solvency of these enterprises. He highlighted the bill's provision for quarterly financial reporting by CCRCs, which allows for quick action in case of financial distress. Ninger drew from his experience as a bankruptcy trustee to underscore the importance of acting swiftly in financial crises. He also noted that the bill aims to balance regulation with not burdening well-performing CCRCs, focusing on early detection and intervention.
SB124: Andrew Hosmer, representing Riverwoods Support01:50:50.760 - 9:50:41 AM; Andrew Hosmer, representing Riverwoods, expressed gratitude for the work done by the Department of Insurance and stakeholders on Senate Bill 124. He highlighted Riverwoods as a nonprofit operating three CCRC facilities in Exeter, Manchester, and Durham, serving approximately 1150 residents. Hosmer supported the bill as a step forward in maintaining stability and accountability for CCRCs. He suggested amendments to the bill, specifically regarding the expectations of affiliates in financial distress situations. He proposed changes to ensure clarity and objectivity in the commissioner's evaluation of potential affiliates, emphasizing the need for full disclosure and ensuring the affiliate's ability to maintain financial stability and service levels. Hosmer offered to continue working with the Department of Insurance on these amendments.
SB124: DJ Benton, Commissioner of the New Hampshire Insurance Department, joined by Steve Ninger Support01:39:56.679 - 9:39:47 AM; Commissioner DJ Benton expressed strong support for Senate Bill 124, emphasizing the need for updated oversight tools for Continuing Care Retirement Communities (CCRCs). He highlighted three main reasons for the bill: the need to update a 30-year-old statute to address changes in CCRCs, the Department's commitment to consumer protection especially for vulnerable seniors, and the necessity to respond proactively to financial distress seen in some CCRCs. Benton detailed past instances where his department had to intervene in financial crises, including placing a CCRC into receivership. He stressed the importance of early warning systems to prevent such crises, noting that the bill aims to balance regulation with industry needs. An amendment is forthcoming, reflecting ongoing collaboration with CCRCs.
SB124: Steve Ninger Information Only01:45:51.679 - 9:45:42 AM; Steve Ninger provided clarification on the forthcoming amendment to Senate Bill 124, stating that it addresses discrete issues throughout the bill without altering its overall intent. He mentioned that written comments would be provided to the committee for further review.
SB124: Andrew Hosmer, representing Riverwoods Support01:51:17.320 - 9:51:08 AM; Andrew Hosmer, representing Riverwoods, a nonprofit system of continuing care communities in New Hampshire, expressed gratitude for the efforts of the Department of Insurance and stakeholders on Senate Bill 124. He acknowledged the bill as a significant step toward ensuring accountability and stability for CCRCs. Hosmer suggested amendments to clarify the expectations and criteria for potential affiliates involved in distressed CCRCs, emphasizing the need for objectivity in the process. He highlighted the charitable mission of nonprofit providers like Riverwoods and the necessity for them to adapt through growth, diversification, and affiliation to sustain their operations. Hosmer offered three specific amendment suggestions to enhance the bill's effectiveness.
SB124: Andrew Hosmer, Riverwoods Information Only01:51:17.320 - 9:51:08 AM; Andrew Hosmer, representing Riverwoods, a nonprofit organization operating continuing care retirement communities in Exeter, Manchester, and Durham, expressed gratitude towards the Department of Insurance for their efforts in addressing the financial stability of CCRCs. He highlighted the need for amendments in the bill to clarify the expectations and roles of potential affiliates in the event of a CCRC facing financial distress. Hosmer emphasized the importance of affiliates as potential 'white knights' that could stabilize struggling communities. He also stressed the necessity for CCRCs to grow, diversify, and affiliate to ensure sustainability given the challenging business environment. Specific amendments suggested included adding clarity to the commissioner's role in evaluating affiliates and ensuring that any transfer of operations does not impair financial stability or diminish services to current residents.
SB124: Lisa Henderson, Leading Age Maine in New Hampshire Information Only01:56:10.880 - 9:56:01 AM; Lisa Henderson, Executive Director of Leading Age Maine in New Hampshire, provided testimony on behalf of an association representing all 14 licensed nonprofit CCRCs in the state. She neither supported nor opposed SB124 but highlighted the association's engagement with the insurance department to modernize regulations. Henderson emphasized the shared goals of consumer protection and financial strength but expressed concerns about overreach that might impede nonprofit organizations' business activities. She noted the trend towards multi-site organizations and the benefits they bring, such as attracting better talent and more efficient operations. Henderson also mentioned the readiness of their members to comply with more regular financial reporting to ensure transparency and uphold their financial acumen.
SB124: Michael Flarity, Taylor Community Support02:01:00.000 - 10:00:51 AM; Michael Flarity, President and CEO of Taylor Community, expressed general support for SB124. He operates three CCRCs in the Lakes Region, including one recently absorbed from financial distress, which has benefited their community and protected its residents. Flarity emphasized the collaborative effort with the Department of Insurance in crafting the legislation, which he believes achieves its objective of protecting residents who invest in these communities and safeguarding organizations from poor management. While acknowledging that the bill is not perfect, he supports it as a good, solid piece of legislation.
SB124: Andrew Hosmer, Riverwoods Group Support01:51:17.320 - 9:51:08 AM; Andrew Hosmer, representing the Riverwoods Group, expressed gratitude towards the Department of Insurance and other stakeholders for their efforts in addressing the issues faced by Continuing Care Retirement Communities (CCRCs) in New Hampshire. He highlighted the importance of the bill as a first step towards bringing more accountability and maintaining stability for CCRCs. Hosmer also mentioned specific areas where Riverwoods would like to see amendments, particularly regarding the expectations and clarity around affiliates who may purchase assets of financially distressed CCRCs. He emphasized the nonprofit nature of Riverwoods and their commitment to serving current and future residents while navigating a challenging business environment. Hosmer suggested amendments to the bill to ensure that potential affiliates are thoroughly vetted to protect the interests of residents and the financial stability of the CCRC.
SB124: Lisa Henderson, Leading Age Maine in New Hampshire Information Only01:56:10.880 - 9:56:01 AM; Lisa Henderson, Executive Director of Leading Age Maine in New Hampshire, testified neither in support nor opposition to SB124. She described their association's engagement with the Department of Insurance and their shared goals of protecting consumers and ensuring the financial strength of CCRCs. Henderson expressed concerns about potential overreach in the bill that could impede the rights of nonprofit organizations. She highlighted the trend of CCRCs moving towards multi-site organizations for operational efficiency and mentioned the example of Taylor Community's involvement in rescuing a troubled community. Henderson also affirmed that their members are willing to comply with the more regular financial reporting requirements proposed in the bill.
SB124: Susan Buckton, State Long-Term Care Ombudsman Support02:02:38.159 - 10:02:29 AM; Susan Buckton, the State Long-Term Care Ombudsman, testified in support of SB124. She emphasized the importance of the bill in providing additional protections for individuals investing in CCRCs. Buckton shared her experience as a patient care Ombudsman during a CCRC bankruptcy in Keene, underscoring the distress experienced by residents when their investments are not secure. She praised several aspects of the bill, including the requirement for additional information in the certificate of authority, financial reporting requirements, and the creation of a resident Bill of Rights. Buckton suggested a need for clarification on the term 'just cause' in relation to contract termination within different living situations in CCRCs and offered to submit language to help clarify this.
SB243: Denise Ricciardi, State Senator for District 9 Support02:08:27.320 - 10:08:18 AM; Denise Ricciardi introduced Senate Bill 243, emphasizing its importance in improving New Hampshire's child care scholarship program. She described the program as an investment in children's future, workforce stability, and the state's economy. Ricciardi highlighted four solutions proposed by the bill: presumptive eligibility, application streamlining, prospective payments to providers, and simplified reporting. She argued that these changes would reduce administrative burdens, enhance access for families, and encourage more providers to participate. Ricciardi also noted that the bill aligns with federal requirements, allowing the state to leverage federal matching funds, and stressed that SB243 would benefit parents, providers, and the state's economy.
SB243: Andrew Hosmer, representing Riverwoods Information Only01:51:17.320 - 9:51:08 AM; Andrew Hosmer, representing Riverwoods, a nonprofit organization managing continuing care communities in New Hampshire, expressed gratitude for the efforts of the Department of Insurance and other stakeholders in addressing issues related to Continuing Care Retirement Communities (CCRCs). He highlighted the importance of the proposed bill in bringing accountability and stability to CCRCs. Hosmer suggested potential amendments to the bill, focusing on clarifying expectations for affiliates involved with financially distressed CCRCs. He emphasized the charitable mission of nonprofit senior living providers and the need for them to affiliate or transfer operations to ensure sustainability. Hosmer offered specific recommendations for amendments to enhance objectivity and clarity in the process of affiliate involvement in CCRC asset acquisition.
SB243: Lisa Henderson, Executive Director of Leading Age Maine in New Hampshire Information Only01:56:10.880 - 9:56:01 AM; Lisa Henderson, representing Leading Age Maine in New Hampshire, provided an overview of the association's role in supporting mission-driven aging service providers, including CCRCs. She outlined the association's engagement with the Department of Insurance in the bill's development, sharing goals of consumer protection and financial strength. Henderson highlighted concerns about potential overreach in the bill that could impede nonprofit organizations' business activities. She discussed the trend towards multi-site organizations among CCRCs, suggesting it benefits operational efficiency and talent attraction. Henderson confirmed members' willingness to comply with more regular financial reporting as proposed in the bill, emphasizing the strength and consumer-serving model of CCRCs.
SB243: Michael Flarity, President & CEO of Taylor Community Support02:01:00.000 - 10:00:51 AM; Michael Flarity, President & CEO of Taylor Community, expressed general support for the bill. He shared the community's experience with absorbing a financially distressed CCRC, which strengthened their operations. Flarity acknowledged the bill's collaborative development with the Department of Insurance and praised its objectives of protecting residents and managing poor organizational management. He considered the bill a good, solid step forward despite not being perfect.
SB243: Susan Buckson, State Long-Term Care Ombudsman Support02:02:38.159 - 10:02:29 AM; Susan Buckson, representing the State Long-Term Care Ombudsman and the New Hampshire State Commission on Aging, supported the bill for providing additional protections for CCRC investors. She detailed her experience with a CCRC bankruptcy and emphasized the bill's role in offering greater certainty for residents. Buckson highlighted valuable aspects of the bill, such as enhanced disclosure, financial reporting requirements, and the establishment of a resident Bill of Rights. She also suggested clarifications to the bill, particularly around the definition of 'just cause' for contract termination in different living situations within a CCRC.
SB243: Denise Ricciardi, State Senator for District 9 Support02:08:27.320 - 10:08:18 AM; Denise Ricciardi, the bill's sponsor, introduced Senate Bill 243, emphasizing its importance for New Hampshire's families, child care providers, and the economy. She outlined the bill's objectives to streamline the child care scholarship program, making it more accessible and effective. Ricciardi detailed four solutions proposed by the bill: presumptive eligibility, application streamlining, prospective payments, and simplified reporting. She stressed the bill's alignment with federal requirements to maximize state investments and its potential to benefit families, providers, and the workforce.
SB243: Paige Bosman, representing Hillsborough 3 Nashua Ward 4 Support02:12:27.079 - 10:12:18 AM; Paige Bosman, a representative from Hillsborough 3 Nashua Ward 4, supported Senate Bill 243, drawing from personal experiences as a mother. She highlighted the financial burden of child care and the challenges faced by families navigating the current child care scholarship program. Bosman emphasized the program's importance to New Hampshire's families and economy, advocating for the bill's solutions to ease administrative burdens and support working families.
SB243: Lisa Henderson, Executive Director of Leading Age Maine in New Hampshire Information Only01:56:10.880 - 9:56:01 AM; Lisa Henderson, representing Leading Age Maine in New Hampshire, provided an informational testimony on SB243. She stated that their association, which represents all 14 licensed Continuing Care Retirement Communities (CCRCs) in New Hampshire, engaged in discussions with the insurance department about the modernization effort of the bill. The goal is to protect consumers and ensure the financial strength of CCRCs, which they share. However, they expressed concerns about potential overreach that might impede the operations of nonprofit organizations. She highlighted the shift from standalone CCRCs to multi-site organizations, which now make up 72% of CCRCs, suggesting this trend could lead to better talent attraction and operational efficiency. Henderson mentioned that their members are willing to comply with more regular financial reporting and are proud of their financial management, emphasizing the strength of the CCRC model.
SB243: Michael Flarity, President and CEO of Taylor Community Support02:01:00.000 - 10:00:51 AM; Michael Flarity, President and CEO of Taylor Community, spoke in general support of SB243. He mentioned that his organization operates three CCRCs in the Lakes Region and recently absorbed a financially distressed community, which helped protect its residents. Flarity emphasized the collaborative effort with the Department of Insurance in drafting the legislation. He believes the bill effectively protects residents who invest in these communities while also safeguarding organizations from poor management. Although he acknowledged the bill is not perfect, he views it as a solid piece of legislation that achieves its objectives.
SB243: Susan Buckton, State Long-Term Care Ombudsman and member of the Commission on Aging Support02:02:38.159 - 10:02:29 AM; Susan Buckton, the State Long-Term Care Ombudsman and a member of the Commission on Aging, testified in support of SB243. She explained her office's role in resolving issues related to health, safety, welfare, and rights of individuals in long-term care facilities. Buckton highlighted the importance of CCRCs as an attractive alternative for managing later-life care needs and shared her experience as the patient care Ombudsman during a CCRC bankruptcy in Keene, which underscored the need for the protections outlined in the bill. She praised the bill's provisions for requiring additional financial information, quarterly financial calculations, and a resident Bill of Rights. However, she suggested that the term 'just cause' in the contract termination section needs clarification, and offered to submit language to address this.
SB243: Denise Ricciardi, State Senator for District 9 Support02:08:27.320 - 10:08:18 AM; Senator Denise Ricciardi introduced SB243, emphasizing its importance for New Hampshire's families, child care providers, and the economy. She outlined the bill's aim to improve the child care scholarship program by addressing barriers that hinder access to its benefits. Ricciardi detailed four key solutions in the bill: presumptive eligibility, application streamlining, prospective payments to providers, and simplified reporting. She argued that these changes would reduce administrative burdens, enhance access for families, encourage more providers to participate, and align the state with federal requirements to leverage federal matching funds. She urged support for the bill, viewing it as a vital step to remove obstacles for families and providers.
SB243: Paige Bosman, Representative for Hillsborough 3 Nashua Ward 4 Support02:12:27.079 - 10:12:18 AM; Paige Bosman, a representative from Hillsborough 3 Nashua Ward 4, spoke in support of SB243, emphasizing her personal experience as a mother of three children. She highlighted the high costs of child care and the difficulties families face with the current scholarship program, such as cumbersome processes and strict hour-counting requirements. Bosman is involved with the Nashua Family Network and other organizations focused on perinatal and early childhood health. She stressed that child care is a vital issue for financial health and the economy, urging the committee to support families by improving the child care scholarship program.
SB243: Karen Hebert, Director for the Division of Economic Stability at DHHS Information Only02:14:47.920 - 10:14:38 AM; Karen Hebert, Director for the Division of Economic Stability at the Department of Health and Human Services (DHHS), provided information about the fiscal impact of SB243, which is estimated at $371,000 due to system changes and a study to improve the application process. She suggested amendments to the bill, including language to ensure that the presumptive eligibility pilot would not commence if there is a waitlist for the child care scholarship program. Hebert also proposed changing the completion date for the application process study from May 1st, 2026, to November 1st, 2026, due to procurement timelines. Additionally, she noted that changes in the bill would require federal approval for amendments to the state plan.
SB243: Denise Ricciardi, State Senator for District 9 Support02:08:27.320 - 10:08:18 AM; Senator Ricciardi introduced Senate Bill 243, emphasizing its importance for New Hampshire's families, child care providers, and the economy. She highlighted the bill's role in enhancing the child care scholarship program by addressing barriers and offering solutions such as presumptive eligibility, application streamlining, prospective payments, and simplified reporting. She stressed that these changes would benefit children, parents, and providers, aligning with federal requirements to maximize state investments.
SB243: Paige Bosman, Representative for Hillsborough 3, Nashua Ward 4 Support02:12:27.079 - 10:12:18 AM; Representative Bosman shared her personal experiences with child care costs and the challenges families face. She emphasized the importance of the child care scholarship program and the difficulties with the current process, including the cumbersome application and the impact of sick days on reimbursement hours. She urged support for the bill to help families and the state's economy.
SB243: Karen Hebert, Director for the Division of Economic Stability at DHHS Information Only02:14:47.920 - 10:14:38 AM; Karen Hebert provided information on the fiscal impact of the bill, estimating costs at $371,000 for system changes and a study on the application process. She proposed language regarding the presumptive eligibility pilot to ensure it does not commence or would be suspended if there is a waitlist. She also noted that the study evaluation date should be adjusted to November 1st, 2026, due to procurement processes, and that changes would require federal approval.
SB243: Janet Perkins Holland, OB in New Hampshire Support02:18:42.799 - 10:18:33 AM; Janet Perkins Holland expressed strong support for the bill, citing her experiences with young families and the stress caused by child care issues. She highlighted anecdotes illustrating the impact of child care on workforce participation and family finances, including a single mother who had to decline a job due to child care gaps and a family spending more on child care than their mortgage. She emphasized the bill's potential to support families and boost the economy.
SB243: Susan Buckson, State Long-Term Care Ombudsman, Office of the Long-Term Care Ombudsman, New Hampshire State Commission on Aging Support02:02:38.159 - 10:02:29 AM; Susan Buckson, the State Long-Term Care Ombudsman, testified in support of Senate Bill 124, which focuses on additional protections for investments in Continuing Care Retirement Communities (CCRCs). She highlighted her experience during the 2021 Chapter 11 bankruptcy of a CCRC in Keene, where she served as the patient care Ombudsman. She emphasized the distress faced by residents due to their substantial investments not being as secure as promised. Buckson praised the bill for offering greater legal protections and certainty for future investors, specifically mentioning the value of requiring additional information for certificates of authority, enhanced financial requirements in annual reports, quarterly financial calculations, priority of resident claims in receivership, and the establishment of a resident Bill of Rights with a complaint mechanism.
SB243: Denise Rardy, State Senator for District 9 Support02:08:27.320 - 10:08:18 AM; Senator Denise Rardy introduced Senate Bill 243, emphasizing its significance for New Hampshire's families, child care providers, and the economy. She described the Child Care Scholarship Program as an investment in the future of children, workforce stability, and state prosperity. Rardy highlighted the bill's aim to address barriers within the program, proposing solutions such as presumptive eligibility, streamlined applications, prospective payments to providers, and simplified reporting. These changes, she argued, would reduce administrative burdens, enhance access for families, encourage more providers to participate, and align the state with federal requirements to maximize state investments.
SB243: Paige Bosman, Representative for Hillsborough 3, Nashua Ward 4 Support02:12:27.079 - 10:12:18 AM; Paige Bosman, speaking as a mother and a representative, supported Senate Bill 243. She shared her personal experience with the high costs of child care, even after her children were out of daycare. Bosman is involved in the Nashua Family Network and various organizations focused on parental and early childhood health. She highlighted that the current Child Care Program is cumbersome and complicated, with issues like counting hours and the impact of sick days on reimbursement. Bosman stressed the importance of the bill for the financial health of New Hampshire families and the economy, urging support to help parents return to work.
SB243: Karen Hebert, Director for the Division of Economic Stability at DHHS Information Only02:14:47.920 - 10:14:38 AM; Karen Hebert provided information on the fiscal impact of Senate Bill 243, noting a cost of $371,000 for system changes and a study on the application process. She proposed amendments to the bill, including language to ensure that the child care scholarship presumptive eligibility pilot would not commence or would be suspended in the event of a waitlist. Hebert also suggested changing the deadline for the application process study from May 1st, 2026, to November 1st, 2026, due to procurement timelines. She emphasized the need for federal approval for state plan changes and offered to provide the committee with language regarding the pilot and waitlist.
SB243: Janet Perkins Holland, OB in New Hampshire Support02:18:42.799 - 10:18:33 AM; Janet Perkins Holland expressed strong support for Senate Bill 243, highlighting her experiences as an OB in New Hampshire for nearly 30 years. She noted that child care is a significant stressor for young families and emphasized the importance of legislation that supports families, addresses declining birth rates, and attracts young families to the state. Holland shared personal anecdotes, such as her own struggles with daycare waitlists and stories from patients who faced financial barriers to returning to work due to child care costs. She praised the bill's provisions for bridge funding and expanded scholarship programs as crucial for supporting families and strengthening the community.
SB243: Lanna Lorden, Chief Operating Officer at White Birch Center, Henniker Support02:20:42.040 - 10:20:33 AM; Lanna Lorden, representing White Birch Center, a nonprofit child care organization in Henniker, testified in support of Senate Bill 243. She explained how the bill's provisions, such as presumptive eligibility and prospective payments, would benefit both the center and the families it serves. Lorden discussed the challenges faced by the center, including families accruing balances during application processes and the complexities of back billing and account management. She emphasized that the bill would allow for smoother operations and more efficient support for families, urging the committee to support Senate Bill 243.
SB243: Paige Bosman, Hillsborough 3, Nashua Support02:12:27.079 - 10:12:18 AM; Paige Bosman, a mother of three and a representative from Nashua, testified in support of SB243. She highlighted the high costs of child care, sharing her personal experience of spending $2,000 monthly when her children were in daycare, and the current summer costs of $3,000 for all three children. As part of the Nashua Family Network, she emphasized the community's need for better child care support. She discussed the cumbersome and complicated nature of the current child care program, particularly the challenges of counting hours for reimbursement, which can be impacted by children's illnesses. Bosman stressed the importance of the bill for the financial health of New Hampshire families and the state's economy, urging support for families to enable them to work.
SB243: Karen Hebert, Director, Division of Economic Stability, DHHS Information Only02:14:47.920 - 10:14:38 AM; Karen Hebert, Director at the Division of Economic Stability at DHHS, provided information on the fiscal impact and operational details of SB243. She noted a fiscal impact of $371,000 related to system changes and a study on the application process. Hebert proposed language to ensure the presumptive eligibility pilot does not commence or would be suspended if there is a waitlist for the Child Care Scholarship Program. She also suggested changing the deadline for the application process study from May 1st, 2026, to November 1st, 2026, due to procurement timelines. Additionally, she mentioned that the bill's changes require federal approval of amendments to the state plan.
SB243: Janet Perkins Holland, OB, New Hampshire Support02:18:42.799 - 10:18:33 AM; Janet Perkins Holland, an OB in New Hampshire, expressed strong support for SB243. She highlighted the stress child care places on young families and how it affects the state's declining birth rate and efforts to attract young families. Perkins Holland shared personal anecdotes about the challenges of securing child care and how the lack of accessible daycare prevents talented individuals from entering the workforce. She praised the bill's provisions for bridge funding and expanded scholarships, emphasizing their potential to improve families' economic situations and contribute to New Hampshire's economic future.
SB243: Lanna Lorden, Chief Operating Officer, White Birch Center, Henniker Support02:20:42.040 - 10:20:33 AM; Lanna Lorden, COO at White Birch Center in Henniker, testified in support of SB243. She explained how the bill would streamline the New Hampshire Child Care Scholarship for parents and providers. White Birch Center, serving children from six weeks to 14 years old, has seen a significant increase in scholarship enrollment since the market rate survey and income eligibility changes. Lorden discussed the challenges faced by families during the application process and how presumptive eligibility and prospective payments would alleviate financial burdens for both the center and families, allowing for smoother operations and better support for working families.
SB243: Carisa Cho, Executive Director of Education, YMCA of Greater Nashua Support02:23:52.279 - 10:23:43 AM; Carisa Cho, representing eight YMCAs across New Hampshire, expressed strong support for SB243. She highlighted the importance of the YMCA's child care programs for the well-being of children and the stability of working families. Cho discussed the barriers families face when applying for financial assistance, including the complexity and red tape, and how SB243 would simplify the process. She emphasized the need for removing the requirement to track hours, which wastes valuable resources, and the importance of upfront payments for financial stability. Cho concluded that the bill would significantly improve the child care landscape in New Hampshire, making care more accessible and sustainable.
SB243: Trina Engelfinger, New Futures Support02:26:57.640 - 10:26:48 AM; Trina Engelfinger from New Futures testified in support of SB243, emphasizing the significant barriers to accessing the Child Care Scholarship Program. She noted the cost-effectiveness of the program, with federal funds covering 57 cents on the dollar, and cited a report from the New Hampshire Fiscal Policy Institute showing that every dollar invested yields more than a dollar in returns. Engelfinger highlighted the underutilization of the program, with only 7% of eligible families accessing it. She specifically praised the presumptive eligibility provision, explaining how it would help families manage the wait time and costs associated with the scholarship application, enabling them to return to work more easily.
SB243: Karen Heer, Director for the Division of Economic Stability at DHHS Information Only02:14:47.920 - 10:14:38 AM; Karen Heer discussed the fiscal impact of SB243 on the Department of Health and Human Services, estimating a cost of $371,000 for system changes and a study on the application process. She proposed including language in the bill to suspend the Child Care scholarship presumptive eligibility pilot in the event of a waitlist. She also noted that the current deadline for the application process study by May 1, 2026, is unrealistic and suggested November 1, 2026, as a more feasible date due to state procurement processes. Additionally, she highlighted the need for Federal approval for changes to the state plan.
SB243: Janet Perkins Holland, OB in New Hampshire Support02:18:42.799 - 10:18:33 AM; Janet Perkins Holland expressed strong support for SB243, emphasizing the stress child care places on young families. She shared personal experiences and anecdotes about the difficulty of finding affordable and safe child care, and how it affects workforce participation. She highlighted the bill's provision for 60 days of bridge funding and the expansion of the Child Care scholarship program as critical for supporting families and New Hampshire's economic future.
SB243: Lanna Lorden, Chief Operating Officer at White Birch Center, Henniker Support02:20:42.040 - 10:20:33 AM; Lanna Lorden testified in support of SB243, stating its benefits for White Birch Center and the families they serve. She discussed the challenges faced with the current Child Care scholarship program, including families paying full tuition during application processing and the center's struggles with late payments. She supported the bill's provisions for presumptive eligibility and prospective payments, which would improve financial stability and efficiency for providers and ease the burden on families.
SB243: Carisa Cho, Executive Director of Education at the YMCA of Greater Nashua Support02:23:52.279 - 10:23:43 AM; Carisa Cho voiced strong support for SB243 on behalf of all eight YMCAs in New Hampshire. She highlighted the importance of their child care programs for children's well-being and family stability. She discussed the barriers families face when applying for financial assistance and the administrative burden of tracking attendance. She endorsed the bill's provisions for simplifying the application process, removing the need to track hours, and implementing upfront payments and presumptive eligibility, which would enhance accessibility and sustainability of child care services.
SB243: Laquisha Gart, Bristol Support02:30:15.600 - 10:30:06 AM; Laquisha Gart shared her personal experience of migrating from Massachusetts to Bristol, New Hampshire, and the challenges she faced in finding child care. She was on multiple waiting lists for over a year, which prevented her from working full or part-time jobs. She stressed the importance of the Child Care scholarship program in helping her family and strongly supported SB243, noting its necessity for young families seeking better opportunities.
SB243: Janet Perkins, Highland Support02:18:42.799 - 10:18:33 AM; Janet Perkins, an OB from Highland, New Hampshire, strongly supports SB243. With nearly 30 years of experience, she has seen firsthand the stress that child care places on young families. She believes the bill will help address the declining birth rate and attract young families to New Hampshire. Perkins shared her personal experience of struggling to find daycare and highlighted the importance of affordable, safe child care. She also mentioned two anecdotes from her practice: a single mother who had to decline a job due to child care gaps, and a patient whose child care costs exceeded their mortgage. Perkins believes that the bill's provisions for bridge funding and expanded scholarships would significantly benefit families and the state's economic future.
SB243: Lanna Lorden, White Birch Center, Henniker Support02:20:42.040 - 10:20:33 AM; Lanna Lorden, the Chief Operating Officer of White Birch Center in Henniker, supports SB243. The nonprofit child care organization provides care for children from six weeks to 14 years old and participates in the New Hampshire Child Care Scholarship program. Lorden explained how the bill would streamline the scholarship process by introducing presumptive eligibility and prospective payments. These changes would help families avoid paying full tuition during the application process and allow child care centers to operate more efficiently. She also discussed the challenges of managing tuition and enrollment under the current system and how the proposed changes would significantly benefit both the center and the families it serves.
SB243: Carisa Cho, YMCA of Greater Nashua Support02:23:52.279 - 10:23:43 AM; Carisa Cho, the Executive Director of Education at the YMCA of Greater Nashua, spoke in strong support of SB243 on behalf of all eight YMCAs in New Hampshire. The YMCAs provide child care to thousands of children and are vital to working families and the economy. Cho emphasized the need to simplify the scholarship application process, as many eligible families struggle with the complexity and red tape. She also highlighted the burden of tracking hourly attendance, despite providers being reimbursed based on enrollment. Cho praised the bill's provisions for upfront payments and presumptive eligibility, which would provide financial stability to child care providers and encourage more participation in the scholarship program. She believes these changes will improve child care accessibility and reliability, ultimately strengthening the workforce and the economy.
SB243: Trina Engelfinger, New Futures Support02:26:57.640 - 10:26:48 AM; Trina Engelfinger, representing New Futures, supports SB243, stating that it will help working families in New Hampshire access the child care they need. She mentioned that listening sessions and interviews conducted by New Futures and partner organizations revealed significant barriers to accessing the child care scholarship program. Engelfinger highlighted the cost-effectiveness of the program, noting that federal funds cover a majority of the costs and that every dollar invested yields more than a dollar in returns. She emphasized the importance of presumptive eligibility, which would help families avoid the steep costs of paying for child care while waiting for scholarship approval, thus enabling them to return to work more quickly.
SB243: Laquisha Gart, Bristol Support02:30:15.600 - 10:30:06 AM; Laquisha Gart, a resident of Bristol, New Hampshire, supports SB243. She moved to New Hampshire from Massachusetts seeking better opportunities for herself and her daughter. Gart shared her struggle with finding accessible and safe child care, mentioning that she was on waiting lists for over a year and a half. She credited the DHHS scholarship program for helping her find reliable child care, which allowed her to sustain her family. Gart believes the scholarship program is essential for young families migrating to New Hampshire in search of a better life.
SB243: Coralin Hoppy, Rochester Child Care, Rochester Support02:32:17.319 - 10:32:08 AM; Coralin Hoppy, the Executive Director of Rochester Child Care in Rochester, supports SB243. She described the financial challenges her center faced, including a $600,000 loss last year and the need to operate like a business. Hoppy highlighted the difficulties of the scholarship application process and the financial strain of waiting for payments, which led to increased insurance costs and operating at a loss. She stressed the importance of receiving funds prior to providing services, similar to a subscription model, to cover overhead costs and maintain the center's operations. Hoppy warned that without such support, Rochester Child Care, a vital resource for the community, could shut down, impacting the local economy.
SB243: Lanna Lorden, White Birch Center, Henniker Support02:20:42.040 - 10:20:33 AM; Lanna Lorden, the chief operating officer at White Birch Center, a nonprofit child care organization in Henniker, testified in support of SB243. The bill aims to streamline the New Hampshire Child Care Scholarship for parents and providers. White Birch Center provides child care for children from six weeks to 14 years old. The center accepts the New Hampshire Child Care Scholarship, which helps families pay for child care. Lorden highlighted the benefits of presumptive eligibility and prospective payments proposed in the bill. Currently, families must pay full tuition or stay home during the application process, leading to financial strain. The center has seen a significant increase in scholarship enrollment, but still faces challenges with claims and billing delays. The proposed changes would allow the center to receive payments while processing applications, easing financial burdens for both the center and families.
SB243: Carisa Cho, YMCA of Greater Nashua Support02:23:52.279 - 10:23:43 AM; Carisa Cho, the executive director of education at the YMCA of Greater Nashua, testified in strong support of SB243. She represents all eight YMCAs across New Hampshire, which provide various child care programs crucial for children's well-being and working families. The YMCA's Marac Branch alone cares for over 480 children daily. Cho emphasized the barriers families face when applying for financial assistance, which often leads them to abandon the process due to complexity. SB243 would simplify the application process, remove the need for hourly attendance tracking, and provide upfront payments, enhancing financial stability for providers and accessibility for families.
SB243: Trina Englefinger, New Futures Support02:26:57.640 - 10:26:48 AM; Trina Englefinger from New Futures testified in support of SB243, emphasizing the significant barriers to accessing the child care scholarship program. She highlighted the program's cost-effectiveness, with federal funds covering about 57% of costs, and noted that only 7% of eligible families currently access the program. Englefinger specifically supported the bill's provision for presumptive eligibility, which would help families balance child care and work without the burden of waiting for scholarship approval. She stressed the importance of the bill for working families and urged its support.
SB243: Laquisha Gart, Bristol Support02:30:15.600 - 10:30:06 AM; Laquisha Gart, a resident of Bristol, testified in support of SB243, sharing her personal experience as a parent who migrated from Massachusetts seeking better opportunities. She faced significant challenges finding accessible and safe child care, with her daughter on a waiting list for over a year and a half. Gart emphasized the importance of the child care scholarship program in enabling her to find reliable care and support her family. She strongly supported SB243, believing it would help families like hers access needed child care resources.
SB243: Coralin Hoppy, Rochester Child Care, Rochester Support02:32:17.319 - 10:32:08 AM; Coralin Hoppy, the executive director of Rochester Child Care, testified in support of SB243. She described the center's services for children from six months to 14 years old and the financial struggles it faced, including a $600,000 loss the previous year. Hoppy detailed the difficulties with the current scholarship application process and the impact on her center's finances, including being dropped from insurance and operating at a loss. She stressed the importance of prospective payments to cover overhead costs and maintain the center's operations, which are crucial for the local economy and community services.
SB253: Tera Reen, Senate District 15, Concord, Bow, and Hopkinton Information Only02:36:49.000 - 10:36:40 AM; Senator Tera Reen introduced SB253, which aims to protect participation in the federal 340b drug pricing program. The program allows eligible entities like hospitals and health centers to purchase drugs at reduced prices, stretching federal resources and benefiting more patients. Reen explained the importance of contract pharmacies, especially for rural hospitals without in-house pharmacies, and highlighted issues with pharmaceutical manufacturers restricting the program. SB253 would make it an unfair trade practice for manufacturers to discriminate against contract pharmacies. Reen deferred questions to experts following her testimony.
SB243: Carisa Cho, YMCA of Greater Nashua, representing all eight YMCAs across New Hampshire Support02:23:52.279 - 10:23:43 AM; Carisa Cho, representing all eight YMCAs across New Hampshire, strongly supports SB243 which aims to improve the child care scholarship program. She highlighted the YMCA's role as one of the largest youth-serving organizations in the state, offering early childhood education, before and after school programs, and summer camps to thousands of children. Cho stressed the importance of these programs for the well-being of children and the stability of working families. She discussed the current barriers families face when applying for financial assistance, such as complexity and red tape, which SB243 aims to simplify. She also mentioned the burden of tracking attendance hours, which the bill proposes to remove, allowing providers to focus more on care. Additionally, Cho supported the bill's proposal for upfront payments to providers to ensure financial stability, and praised the presumptive eligibility pilot for its potential to help families and encourage more providers to participate in the program. She concluded by emphasizing that SB243 would enhance the accessibility and reliability of child care for families and sustainability for providers, ultimately boosting the workforce and economy.
SB243: Trina Engelfinger, New Futures Support02:26:57.640 - 10:26:48 AM; Trina Engelfinger from New Futures spoke in support of SB243, emphasizing its importance for working families in New Hampshire. She briefly discussed the organization's findings from listening sessions and interviews with stakeholders, highlighting significant barriers to accessing the child care scholarship program. Engelfinger pointed out the program's cost-effectiveness, noting that federal funds cover about 57% of the costs, and according to a recent report from the New Hampshire Fiscal Policy Institute, every dollar invested yields more than a dollar in returns by year-end. She also addressed the underutilization of the program, with only 7% of eligible families currently accessing it. Engelfinger specifically endorsed the bill's provision for presumptive eligibility, explaining how it could help families balance securing child care spots with returning to work, thereby reducing the wait time and costs associated with the scholarship application process.
SB243: Laquisha Gart, Bristol, NH Support02:30:15.600 - 10:30:06 AM; Laquisha Gart, a resident of Bristol, New Hampshire, spoke in favor of SB243, sharing her personal experience as a parent who migrated from Massachusetts seeking better opportunities. She detailed the challenges of finding accessible and safe child care, mentioning her daughter's part-time pre-school attendance and the lengthy waitlists they encountered. Gart was on three separate child care waiting lists for a year, which prevented her from working full-time or part-time. She credited the DHHS scholarship program for eventually helping her secure reliable child care, emphasizing its necessity for young families like hers who move to New Hampshire for a better, safer, and healthier life. Gart expressed strong support for SB243, believing it would address the issues she faced.
SB243: Coralin Hoppy, Executive Director, Rochester Child Care Support02:32:17.319 - 10:32:08 AM; Coralin Hoppy, Executive Director of Rochester Child Care, spoke in support of SB243. She described the center's services for children aged 6 months to 14 years, serving around 130 in the center and 250 school-age children, with 168 on scholarship. Hoppy recounted the financial struggles of the previous year, including a $600,000 loss, and the necessity to operate the center more like a business. She explained the cumbersome process of applying for scholarships, which took about 20 hours and often resulted in delays and families being unlined from scholarships, putting her agency in the red. Hoppy also mentioned the increased insurance costs due to being dropped from standard policies, and the necessity to keep rates at the state minimum, yet still facing a loss of $144,000 after six months. She stressed the importance of upfront payments as proposed in SB243 to cover overhead costs, which are critical for maintaining a functioning economy and providing safe child care. Hoppy concluded by underscoring the importance of Rochester Child Care to the local community and economy, urging support for the bill to ensure the center's sustainability.
SB243: Laquisha Gart, Bristol, New Hampshire Support02:30:15.600 - 10:30:06 AM; Laquisha Gart spoke about her personal experience migrating to Bristol, New Hampshire from Massachusetts in search of better opportunities for herself and her daughter. She highlighted the challenges she faced in securing child care, mentioning being on waiting lists for over a year and a half, which impacted her ability to work. She emphasized the importance of the DHHS scholarship program in helping her find reliable child care, and strongly supported SB243, stating it is essential for young families like hers.
SB243: Coralin Hoppy, Executive Director, Rochester Child Care Support02:32:17.319 - 10:32:08 AM; Coralin Hoppy, representing Rochester Child Care, discussed the operational challenges faced by her center, including serving a significant number of children on scholarships and dealing with financial losses. She described the difficulties in applying for scholarships and the subsequent impact on her business, including increased insurance costs and operating at a loss. Hoppy emphasized the need for timely funding to cover overhead costs to maintain the center's operations, which are crucial for the local economy and community services in Rochester. She strongly supported SB243, highlighting its necessity for the sustainability of child care centers like hers.
SB253: Tera Reen, Senate District 15, Concord, Bow, and Hopkinton Support02:36:49.000 - 10:36:40 AM; Tera Reen introduced Senate Bill 253, which aims to protect participation in the federal 340b drug pricing program. She explained that the program allows eligible entities to purchase drugs at reduced prices, benefiting rural hospitals that rely on contract pharmacies. Reen highlighted the need for the bill due to tactics by pharmaceutical manufacturers that restrict the program, and she proposed making it an unfair trade practice for manufacturers to discriminate against contract pharmacies. She expressed strong support for the bill and deferred detailed questions to experts following her.
SB253: Matthew Hood, Vice President of Government Relations, Dartmouth Health Information Only02:39:47.080 - 10:39:38 AM; Matthew Hood introduced himself as the vice president of government relations at Dartmouth Health and handed off the discussion to his colleagues, Keith Thomassetti and Kristen Chupka, to provide substantive details about Senate Bill 253. He did not express a direct stance on the bill but facilitated the transition to expert testimony.
SB253: Corn Hoppy, Executive Director, Rochester Child Care Information Only02:32:17.319 - 10:32:08 AM; Corn Hoppy, from Rochester Child Care, discussed the challenges faced by their center, which serves children from six months to 14 years. They mentioned serving 130 children in their center and about 250 school-aged children, with 168 on scholarships. Last year was particularly hard due to market failure, resulting in a $600,000 loss, necessitating a business model change. The scholarship application process was described as cumbersome, taking about 20 hours over two weeks. The center faced issues with insurance, being dropped from workers' compensation and forced into a high-risk pool, increasing rates by 25%. Despite keeping rates at the state minimum, the center is still at a loss of $144,000 after six months. Hoppy emphasized the need for timely payments to cover overhead costs and stressed the importance of their center to the local economy, serving essential workers like teachers, firemen, and police.
SB253: Tera Reen, Senator, District 15 (Concord, Bow, and Hopkinton) Support02:36:49.000 - 10:36:40 AM; Senator Tera Reen introduced Senate Bill 253, which focuses on participation in the federal 340b drug pricing program. She explained that the program allows eligible entities like hospitals and federally qualified health centers to purchase drugs at reduced prices, extending federal resources to more patients. The bill addresses issues with contract pharmacies, which are crucial for rural hospitals without in-house pharmacies. It aims to prevent pharmaceutical manufacturers from restricting the 340b program through tactics like limiting contract pharmacy utilization. The bill proposes to make it an unfair trade practice for manufacturers to discriminate against contract pharmacies. Senator Reen deferred detailed questions to experts following her.
SB253: Keith Thomet, Chief Pharmacy Officer, Dartmouth Health Support02:40:09.479 - 10:40:00 AM; Keith Thomet, Chief Pharmacy Officer at Dartmouth Health, was introduced to speak on Senate Bill 253. His testimony was not detailed in the transcript provided, but he was brought up to discuss the bill substantively.
SB253: Tera Reen, Senate District 15, Concord, Bow, and Hopkinton Support02:36:49.000 - 10:36:40 AM; Senator Tera Reen introduced Senate Bill 253, which addresses participation in the federal 340b drug program. This program allows eligible entities like hospitals and health centers to purchase drugs at reduced prices to extend federal resources and serve more patients. The bill focuses on the role of contract pharmacies within the 340b program, which are crucial for rural hospitals without in-house pharmacies. These pharmacies help in procuring and dispensing drugs for patients of the hospital, thereby ensuring access to necessary medications. The bill aims to prevent pharmaceutical manufacturers from restricting the use of contract pharmacies, classifying such restrictions as an unfair trade practice. Senator Reen deferred detailed questions to subsequent expert witnesses.
SB253: Matthew Hood, Dartmouth Health Support02:39:10.160 - 10:39:01 AM; Matthew Hood, Vice President of Government Relations at Dartmouth Health, introduced his colleagues Keith Thomet and Kristen Chupka to provide further testimony on Senate Bill 253. He did not provide substantive comments himself but facilitated the transition to his colleagues for detailed discussion on the bill.
SB253: Keith Thomet, Chief Pharmacy Officer, Dartmouth Health Support02:40:14.319 - 10:40:05 AM; Keith Thomet expressed support for Senate Bill 253, emphasizing the importance of the 340b program for Dartmouth Health, a seven-hospital system spanning New Hampshire and Vermont. He highlighted how the savings from the 340b program enable the system to care for patients across a wide geography and support specialty clinics. Thomet stressed that patients should have the freedom to choose their pharmacy, and the bill would help maintain this choice despite pressures from pharmacy benefit managers and manufacturers. He detailed the benefits Dartmouth Health provides with the 340b savings, including support for hemophilia and HIV patients, as well as a discount medication program to prevent hospital readmissions due to medication affordability issues.
SB253: Matthew Hood, Dartmouth Health Information Only02:39:47.080 - 10:39:38 AM; Matthew Hood introduced his colleagues, Keith Thomet and Kristen Chupka, to provide substantive testimony on the bill. He did not provide a personal stance on the bill but facilitated the continuation of the hearing.
SB253: Keith Thomet, Chief Pharmacy Officer, Dartmouth Health Support02:40:09.479 - 10:40:00 AM; Keith Thomet expressed support for Senate Bill 253, highlighting the importance of the 340b program for Dartmouth Health, which operates across seven hospitals in New Hampshire and Vermont. He emphasized that the savings from the 340b program are crucial for providing care across a wide geography, supporting specialty clinics, and aiding patients with various conditions such as hemophilia, bleeding disorders, and HIV. Thomet also noted the program's role in providing discounted medications to prevent hospital readmissions due to medication affordability issues.
SB253: Kristen Chupka, System Director for 340b, Dartmouth Health Support02:42:34.399 - 10:42:25 AM; Kristen Chupka supported Senate Bill 253, discussing the impact of the 340b program on Dartmouth Health's seven hospitals. She shared her experience in the 340b space and stressed the program's importance for smaller hospitals in rural areas, like New London Hospital, which relies on 340b benefits to offer services such as urgent care and ambulance services. Chupka also addressed questions about transparency and the use of 340b savings to support various community benefits, including uncompensated care and services for low-income and uninsured patients.
SB253: Matthew Hood, Vice President of Government Relations, Dartmouth Health Information Only02:39:47.080 - 10:39:38 AM; Matthew Hood introduced the next speakers, Keith Thomasset and Kristen Chupka, to discuss the bill substantively, indicating a handoff due to time constraints.
SB253: Keith Thomasset, Chief Pharmacy Officer, Dartmouth Health Support02:40:09.479 - 10:40:00 AM; Keith Thomasset expressed support for Senate Bill 253, highlighting Dartmouth Health's reliance on the 340b program. He explained that Dartmouth Health operates across New Hampshire and Vermont, serving rural areas and supporting specialty clinics. He emphasized the importance of the 340b program in enabling patient care across wide geographies and mentioned that patients should have the right to choose their pharmacies. He detailed the benefits of the program, including support for hemophilia and HIV patients, and a discount medication program to prevent readmissions due to medication affordability issues.
SB253: Kristen Chupka, System Director for 340b, Dartmouth Health Support02:42:34.399 - 10:42:25 AM; Kristen Chupka supported Senate Bill 253, discussing the impact of the 340b program on Dartmouth Health's seven hospitals. She shared her experience working with 340b and emphasized its importance in providing services like urgent care and ambulance services at New London Hospital. She raised concerns about potential service cuts if the 340b benefit were restricted. Chupka responded to questions about transparency and the allocation of 340b savings, stating that while specific reports are not required, Dartmouth Health would be willing to work with the state on reporting. She also clarified that the 340b program's original intent was to benefit the community broadly, not just through medication access.
SB253: Keith Thomet, Chief Pharmacy Officer, Dartmouth Health Support02:40:14.319 - 10:40:05 AM; Keith Thomet expressed support for Senate Bill 253, emphasizing the importance of the 340b program for Dartmouth Health, a seven-hospital system spanning New Hampshire and Vermont. He highlighted the program's role in supporting specialty clinics across a wide geography, which enables care for needy patients, including those traveling into New Hampshire. Thomet stressed that the 340b program's intent is to support patients, and it does not control where patients fill their prescriptions. He noted the influence of pharmacy benefits managers and manufacturers on patient choice of pharmacies. Thomet detailed the use of 340b savings for critical therapies for over 200 hemophilia and bleeding disorder patients, HIV treatment, and a discount medication program to prevent hospital readmissions due to unaffordable medications.
SB253: Kristen Chupka, System Director for 340b, Dartmouth Health Support02:42:34.399 - 10:42:25 AM; Kristen Chupka, following Keith Thomet, reiterated support for Senate Bill 253, underscoring the significance of the 340b program for Dartmouth Health's seven hospitals. With over 20 years of experience in pharmacy, Chupka emphasized the rewarding aspect of her work with the 340b program. She specifically mentioned New London Hospital in New London, NH, and its urgent care and ambulance services, which rely on the 340b benefit. Chupka argued that without the program, rural hospitals would face difficult decisions on service cuts. She responded to questions regarding transparency and the use of 340b funds, explaining that impact statements detail the program's benefits and that Dartmouth Health supports a wide range of community services with these savings.
SB253: Morgan Hower, Director of State Policy, Pharmaceutical Research and Manufacturers of America (PhRMA) Oppose02:56:19.680 - 10:56:10 AM; Morgan Hower, representing PhRMA, opposed Senate Bill 253, arguing that it would lock in the issues with the 340b program. She criticized the program's exploitation by large hospital systems, pharmacy benefit managers (PBMs), and chain pharmacies for profit. Hower supported the original intent of the 340b program to help low-income patients but stated it has grown excessively due to regulatory guidance allowing unlimited contract pharmacy arrangements. She highlighted the financial benefits reaped by PBMs and the negative impact on safety net providers and employers, including higher health insurance premiums and reduced tax revenues. Hower urged caution against enshrining federal guidance into state law without understanding the full impact.
SB253: Ken Gordon Support03:04:03.760 - 11:03:54 AM; Ken Gordon began to testify in support of Senate Bill 253, emphasizing its importance to rural communities. However, the provided text snippet ends abruptly and does not contain enough information to fully summarize his testimony.
SB253: Keith, Chief Pharmacy Officer at Dartmouth Health Support02:40:14.319 - 10:40:05 AM; Keith, representing Dartmouth Health, a seven-hospital system spanning New Hampshire and Vermont, expressed strong support for Senate Bill 253. He highlighted the critical role of the 340b program in enabling care across a wide geography, supporting specialty clinics for needy patients. The program's savings are vital for patient care, including treatments for hemophilia, bleeding disorders, and HIV. Additionally, it supports a discount medication program to prevent hospital readmissions due to medication affordability issues.
SB253: Kristen Chupka, System Director for 340b at Dartmouth Health Support02:42:34.399 - 10:42:25 AM; Kristen Chupka, with over 20 years of pharmacy experience, emphasized the importance of the 340b program for Dartmouth Health's seven hospitals. She detailed the program's impact on New London Hospital, which relies on 340b to fund urgent care and ambulance services. Without these funds, critical services would be at risk. She also discussed the broader support provided to underserved populations across New Hampshire.
SB253: Morgan Hower, Director of State Policy with the Pharmaceutical Research and Manufacturers of America Oppose02:56:19.680 - 10:56:10 AM; Morgan Hower, representing Pharma, opposed Senate Bill 253, arguing it would enshrine issues with the 340b program into state law, benefiting large hospital systems and pharmacy benefit managers at the expense of the program's original intent. He noted the program's significant growth and the shift away from its initial purpose of helping low-income patients. Hower also highlighted the financial impact on employers and the state due to the program's current structure.
SB253: Ken Gordon, CEO of Coos County Family Health Services Support03:04:06.800 - 11:03:57 AM; Ken Gordon, CEO of Coos County Family Health Services, supported Senate Bill 253, emphasizing its importance for rural communities like Coos County. He explained how the 340b program has been crucial for providing affordable medications and supporting expanded services such as dental care and transportation. Recent restrictions have significantly reduced their savings, threatening primary care services in the region.
SB253: Kristen Chup, System Director for 340b at Dartmouth Health Support02:42:34.399 - 10:42:25 AM; Kristen Chup, a pharmacist with over 20 years of experience and a system director for 340b at Dartmouth Health, emphasized the importance of the 340b program for supporting rural hospitals in New Hampshire. She highlighted the case of New London Hospital, which relies on 340b benefits to offer urgent care and ambulance services. Without these benefits, the hospital might have to cut these critical services or primary care, providers, and care management. Chup stressed that the program is vital for providing affordable medications and expanded services to patients, particularly in rural areas.
SB253: Morgan Hower, Director of State Policy with the Pharmaceutical Research and Manufacturers of America Oppose02:56:19.680 - 10:56:10 AM; Morgan Hower expressed opposition to Senate Bill 253, arguing that it would perpetuate the issues with the 340b program. He stated that the program, originally intended to help low-income patients, has been exploited for profit by large hospital systems, pharmacy benefit managers, and chain pharmacies. Hower highlighted the significant growth in the program and criticized the sub-regulatory guidance that allowed for numerous contract pharmacy arrangements, leading to a profit-focused system rather than patient-centric. He noted the negative impact on employers and the lack of direct benefit to patients at the counter, urging lawmakers not to lock in federal guidance into state law without understanding its consequences.
SB253: Ken Gordon, CEO of Coos County Family Health Services Support03:04:06.800 - 11:03:57 AM; Ken Gordon, CEO of Coos County Family Health Services, supported Senate Bill 253, emphasizing the critical role of the 340b program for rural communities in New Hampshire. He explained that the program allows his organization to provide affordable medications and expand services like dental care, transportation, and specialized diabetes care. Gordon noted a significant drop in savings due to restrictions by drug manufacturers, which resulted in a revenue loss of over $600,000, threatening the sustainability of primary care services in the North Country. He stressed the necessity of the legislation to counteract these restrictions and ensure continued access to care.
SB253: Greg White, Co-CEO of Lamprey Health Care Support03:08:47.880 - 11:08:38 AM; Greg White, Co-CEO of Lamprey Health Care, supported the 340b program, detailing its benefits for uninsured patients through discount card programs at pharmacies like Walgreens and Rite Aid. He explained that the savings from the program are reinvested into their mission to support operations, particularly important given their recent operating deficits. White highlighted the challenges posed by manufacturer restrictions on medication distribution, which limit patient access due to geographical constraints, and stressed the importance of maintaining broad pharmacy availability to serve their patient base across a wide area.
SB253: Greg White, Co-CEO of Lamprey Health Care Support03:08:47.880 - 11:08:38 AM; Greg White, Co-CEO of Lamprey Health Care, expressed support for the bill. He explained that Lamprey Health Care, serving Nashua, Newmarket, Raymond, Nashua, Derry, and other areas with a mobile health unit, participates in the 340b program as a covered entity. They have contracts with numerous pharmacies across their service area from Wilton to the Seacoast due to not operating their own pharmacy. The savings from the program are used to support an uninsured program, allowing patients to benefit from discounted drug prices, and to fund their mission, especially important given their operating deficits over the last two years. He highlighted challenges with certain manufacturers restricting distribution to one store, which is inconvenient given the geographical spread of their patient base.
SB253: Unidentified Speaker Information Only02:50:51.359 - 10:50:42 AM; The unidentified speaker asked Greg White about the percentage of 340b savings allocated toward patient assist programs versus administrative costs. Greg White responded that specific details would be provided in the impact statements, but generally, the program's savings are used to support uncompensated care and community health benefits. He mentioned being open to further inquiries and offered to provide detailed breakdowns if needed.
SB253: Unidentified Speaker Information Only02:51:38.439 - 10:51:29 AM; The speaker inquired about whether patients can fill prescriptions at any pharmacy and the cost differences if not using a contract pharmacy. Greg White explained that technically, patients should be able to fill prescriptions anywhere, but sometimes restrictions by payers or manufacturers limit this, potentially affecting the medication's price but not necessarily the price to the patient. He also mentioned that 12% of the savings is used for patient assistance programs as seen in the impact statement.
SB253: Unidentified Speaker Information Only02:52:27.680 - 10:52:18 AM; The speaker asked about the community benefits report and whether Lamprey Health Care would be opposed to it. Greg White stated they would not be opposed and are willing to collaborate with the state on a reporting system that works for all covered entities.
SB253: Unidentified Speaker Information Only02:53:13.040 - 10:53:04 AM; The speaker expressed concerns about the use of 340b rebates for services beyond medications, such as ambulance services, diapers, and food banks, which they believed was contrary to the original intent of the program. Greg White clarified that the original intent of the 340b program was to stretch scarce funds to provide overall health care benefits across the community, not just for medications.
SB253: Unidentified Speaker Information Only02:54:00.000 - 10:53:51 AM; The speaker recalled a program where patients paid a nominal amount for medications based on a sliding scale at a local pharmacy connected to a Federal Community Health Center. They asked how the sliding scale works now with multiple participating pharmacies. Greg White explained that the intent of the program is to benefit the community, whether directly at the pharmacy or through hospital services.
SB253: Unidentified Speaker Information Only02:54:46.760 - 10:54:37 AM; The speaker questioned if a patient going to a non-contract pharmacy like Rite Aid would experience the benefits of the 340b program. Greg White clarified that while the patient at Rite Aid might not directly benefit, the community as a whole would, possibly including that same patient later when needing hospital assistance.
SB253: Morgan Hower, Director of State Policy with the Pharmaceutical Research and Manufacturers of America Oppose02:56:19.680 - 10:56:10 AM; Morgan Hower, representing the Pharmaceutical Research and Manufacturers of America, opposed Senate Bill 253. He argued that the bill would lock in the issues with the 340b program, benefiting large hospital systems, pharmacy benefit managers, and chain pharmacies. He supported the original intent of the 340b program but noted its growth and exploitation by third parties. He cited statistics on the increase in contract pharmacy arrangements and their financial implications, including the negative impact on safety net clinics and employers due to higher insurance premiums and lost rebates.
SB253: Ken Gordon, CEO of Coos County Family Health Services Support03:04:03.760 - 11:03:54 AM; Ken Gordon, CEO of Coos County Family Health Services, supported Senate Bill 253. He highlighted the importance of the 340b program for rural communities like Coos County, operating clinics in Colebrook, Berlin, and Gorham. He explained that the program allows them to provide affordable medications and use savings to expand services like dental care, transportation, and diabetes care. He noted a significant drop in savings due to restrictions by drug manufacturers, threatening their financial sustainability and the provision of primary care in the North Country.
SB253: Unidentified Speaker Information Only03:07:13.120 - 11:07:04 AM; The speaker asked Ken Gordon about the state's role in the 340b program, given it's an agreement between the federal government and drug manufacturers. Ken Gordon mentioned that a dozen states have passed similar legislation, which has generally been upheld in court. The speaker also questioned the need for the legislation, given the revenue the program generates. Ken Gordon explained that the revenue had dropped significantly, threatening the services they provide.
SB253: Unidentified Speaker Information Only03:11:27.000 - 11:11:18 AM; The speaker asked Greg White if the federal government is aware of the declining 340b savings and if they are addressing it. Greg White mentioned that the federal government, specifically HRSA and the Office of Pharmacy Affairs, is aware but that the issue has been tied up in court.
SB253: Morgan Hower, Pharmaceutical Research and Manufacturers of America Oppose02:56:19.680 - 10:56:10 AM; Morgan Hower, representing the Pharmaceutical Research and Manufacturers of America, expressed opposition to Senate Bill 253, arguing that it would entrench the existing issues with the 340b program. They criticized the program for benefiting large hospital systems, pharmacy benefit managers (PBMs), and chain pharmacies rather than fulfilling its original intent of helping safety-net hospitals and clinics. Hower highlighted the rapid growth of the program, mentioning the increase in contract pharmacy arrangements from 2,300 in 2010 to over 205,000 currently, with 69% of these arrangements linked to the three largest PBMs. They also noted that the program's growth has led to significant financial benefits for PBMs and their affiliates, while not improving patient access to medications. Hower emphasized the adverse impact on employers due to lost manufacturer rebates and increased health insurance premiums, and urged the committee not to lock federal guidance into state law without understanding the full impact.
SB253: Ken Gordon, CEO of Coos County Family Health Services Support03:04:06.800 - 11:03:57 AM; Ken Gordon, CEO of Coos County Family Health Services, supported Senate Bill 253, emphasizing its importance for rural communities. He detailed how the 340b program, established in 1992, has been crucial for providing affordable medications and expanding services such as dental care, transportation, and specialty diabetes care in Coos County. Gordon expressed concerns about recent restrictions by drug manufacturers that have significantly reduced the savings from the program, threatening the sustainability of primary care in the North Country. He stressed the need for the legislation to counteract these restrictions and ensure the continuation of essential health services.
SB253: Greg White, Co-CEO of Lamprey Health Care Support03:08:47.880 - 11:08:38 AM; Greg White, Co-CEO of Lamprey Health Care, supported Senate Bill 253, highlighting its significance for communities served by their federally qualified health center, including Nashua, New Market, Raymond, Derry, and Wilton. He explained how the 340b program enables them to offer discounted medications to uninsured patients and use savings to support their mission, despite facing operating deficits. White pointed out the challenges posed by manufacturer restrictions on medication distribution, which affect patient access, particularly given the geographical spread of their patient base. He stressed the importance of having access to multiple pharmacies to serve their community effectively.
SB253: Christine Stoddard, Bi-State Primary Care Association Support03:12:34.479 - 11:12:25 AM; Christine Stoddard, representing the Bi-State Primary Care Association, supported Senate Bill 253, noting its critical role for New Hampshire and Vermont's community health centers serving over 100,000 patients in medically underserved areas. She stressed the necessity of the bill to counteract drug manufacturer restrictions that limit patient access to medications and reduce savings used for essential services like mobile clinics and medication-assisted treatment. Stoddard argued that while the program is federal, states have successfully implemented similar legislation, and emphasized the importance of the bill for ensuring patient care, particularly in areas like Berlin and Gorham where community health centers are the primary care providers.
SB253: Ken Gordon, CEO of Coos County Family Health Services Support03:04:06.800 - 11:03:57 AM; Ken Gordon, representing Coos County Family Health Services, spoke in support of SB253, emphasizing the importance of the 340b drug program for rural health care in New Hampshire. He detailed how the program has been vital for providing affordable medications and expanding services such as dental care, transportation, and specialty care for diabetes in Coos County. He highlighted the financial impact of recent restrictions by drug manufacturers, which have led to a significant decrease in savings, threatening the sustainability of primary care in the region. Gordon stressed the necessity of the legislation to counteract these restrictions and preserve access to care.
SB253: Greg White, Co-CEO of Lamprey Health Care Support03:08:47.880 - 11:08:38 AM; Greg White, from Lamprey Health Care, supported SB253 by discussing how the 340b program benefits their operations across Nashua, Newmarket, Raymond, Derry, and Wilton. He explained that the program enables them to offer an uninsured program and to use the savings to support their mission despite operating at a deficit. White expressed concerns about manufacturer restrictions on drug distribution, which complicate access for patients across a wide geographic area, emphasizing the need for the legislation to ensure continued access to necessary medications.
SB253: Christine Stoddard, Bi-State Primary Care Association Support03:12:34.479 - 11:12:25 AM; Christine Stoddard, representing the Bi-State Primary Care Association, testified in support of SB253, focusing on the role of the 340b program in supporting community health centers in medically underserved areas of New Hampshire. She highlighted the program's necessity for funding mobile clinics and other essential services for vulnerable populations, such as the homeless. Stoddard addressed concerns about federal versus state jurisdiction, asserting that the bill represents a necessary state solution to ensure patients can access medications at the nearest pharmacy, despite manufacturer restrictions.
SB253: Greg White, LPRE Healthcare Support03:08:47.880 - 11:08:38 AM; Greg White, co-CEO of LPRE Healthcare, a federally qualified health center, supports SB253. LPRE Healthcare serves Nashua, Newmarket, Raymond, Derry, and Wilton, extending to the Seacoast with a mobile health unit. They participate in the 340b program, which is crucial for their operations, allowing them to offer an uninsured program that benefits patients with significant savings on prescriptions. White emphasized that the savings from the 340b program are reinvested to support their mission, particularly important given their recent operating deficits. He highlighted the challenges posed by manufacturer restrictions on drug distribution, which complicate access for patients over a wide geographic area, reinforcing the need for the bill to ensure continued access to necessary medications.
SB253: Christine Stoddard, Bi-State Primary Care Association Support03:12:34.479 - 11:12:25 AM; Christine Stoddard from the Bi-State Primary Care Association, representing community health centers in New Hampshire and Vermont, supports SB253. She explained that these centers serve over 100,000 patients in medically underserved areas and populations, including the homeless. Stoddard stressed the importance of the 340b program savings, which fund mobile clinics and other critical services. She addressed concerns about the program's effectiveness, noting that New Hampshire health centers heavily rely on 340b savings, with these funds constituting a significant portion of their revenue. Stoddard argued that the bill is essential to prevent restrictions by drug manufacturers that limit where patients can access their medications, which could otherwise severely impact patient care and health center operations.
SB253: Megan Tishi and Tanya Carlton, New Hampshire Society of Health System Pharmacists Support03:24:47.399 - 11:24:38 AM; Megan Tishi and Tanya Carlton, representing the New Hampshire Society of Health System Pharmacists, support SB253. They emphasized the importance of the 340b program for the 16 hospitals in New Hampshire that participate, stating that the savings are essential for expanding programs and services, especially for the underinsured and uninsured. They highlighted the critical role of contract pharmacy arrangements in maintaining patient access, particularly for smaller and rural hospitals. Tishi and Carlton warned that any reduction in the benefits of the 340b program would be disastrous for New Hampshire hospitals, urging the committee to protect this program that has benefited citizens for over 30 years.
SB253: Senator Long Information Only03:11:27.000 - 11:11:18 AM; Senator Long inquired about the awareness and actions of the federal government regarding the 340b program. He questioned if the federal government is aware of the reduced savings from the program and what actions are being taken. The response indicated that the federal government, specifically HRSA, is aware but the issue has been tied up in court regarding their authority to intervene.
SB253: Christine Stoddard, New Hampshire and Vermont's Primary Care Association Support03:12:34.479 - 11:12:25 AM; Christine Stoddard, representing the Primary Care Association for New Hampshire and Vermont's community health centers, testified in support of the bill. She highlighted the importance of the 340b program for serving over 100,000 patients in medically underserved areas and populations. Stoddard emphasized the necessity of the bill to prevent drug manufacturers from imposing restrictions that reduce 340b savings, which are crucial for funding programs like mobile clinics for homeless patients and medication-assisted treatment. She stressed that without these savings, many patients would not be able to access necessary care, particularly in rural areas like the North Country.
SB253: Megan Tishi and Tanya Carlton, New Hampshire Society of Health System Pharmacists Support03:24:47.399 - 11:24:38 AM; Megan Tishi and Tanya Carlton, representing the New Hampshire Society of Health System Pharmacists, supported Senate Bill 253. They explained the importance of the 340b program for New Hampshire's 16 participating hospitals to provide critical access to care. The program allows hospitals to reinvest savings into patient assistance, chronic disease management, and access to specialty medications. They emphasized the need to protect contract pharmacy arrangements, especially for smaller and rural hospitals, to maintain patient access to medications. They urged the committee to protect the program, which has been beneficial for over 30 years.
SB253: Ben Bradley, New Hampshire Hospital Association Support03:28:01.359 - 11:27:52 AM; Ben Bradley, representing the New Hampshire Hospital Association, supported SB253. He detailed the necessity of the bill to close a loophole exploited by drug manufacturers, which denies 340b benefits when hospitals use contract pharmacies. Bradley highlighted the increasing drug prices and the importance of the 340b program to help hospitals manage these costs and provide care to underserved populations. He mentioned that other states have already taken action to ensure the full benefit of the 340b program and urged New Hampshire to follow suit to protect local providers and patients. Bradley also addressed concerns about the disparity in savings distribution and offered to provide impact statements from participating members.
SB253: Christine Stoddard, Bi-State Primary Care Association Support03:12:34.479 - 11:12:25 AM; Christine Stoddard from the Bi-State Primary Care Association, representing New Hampshire and Vermont's community health centers, spoke in support of SB253. She explained that these centers serve over 100,000 patients in medically underserved areas and populations, such as homeless individuals. Stoddard highlighted that the 340b savings from the program are used to fund mobile clinics, which are essential for reaching patients where they are, especially those who are hard to reach. She emphasized that the savings are also used to fund programs like medication-assisted treatment (MAT). Stoddard argued that despite being a federal program, states can still make changes to address local needs, and she cited successful legal precedents from other states. She urged the committee to consider the impact on patients, emphasizing that without 340b savings, many patients would not be able to access necessary care.
SB253: Megan Tishi and Tanya Carlton, New Hampshire Society of Health System Pharmacists Support03:24:47.399 - 11:24:38 AM; Megan Tishi and Tanya Carlton, representing the New Hampshire Society of Health System Pharmacists, testified in support of SB253. They explained that the discounts provided under the bill are essential for New Hampshire citizens to access high-quality healthcare. They noted that 16 hospitals in New Hampshire rely on 340b savings to provide critical services not just within hospital walls but also in the broader community. These savings are reinvested into patient assistance programs, chronic disease management, and access to specialty medications for underinsured or uninsured patients. They stressed the importance of protecting contract pharmacy arrangements to maintain patient access, particularly for smaller hospitals that may not have their own pharmacies. They urged the committee to act to protect this well-established program, which has been beneficial for New Hampshire citizens for over 30 years.
SB253: Ben Bradley, New Hampshire Hospital Association Support03:28:01.359 - 11:27:52 AM; Ben Bradley from the New Hampshire Hospital Association testified in support of SB253, representing the state's 26 acute care and all specialty hospitals. He highlighted that the bill aims to prevent drug manufacturers from exploiting a loophole in the 340b program, which was instituted in 1992 to help shield hospitals from rising drug prices. Bradley noted that drug prices are the fastest-growing expense for hospitals and that manufacturers are withholding 340b benefits when qualified providers use contracted pharmacies. He cited examples from other states that have taken action to ensure their providers receive the full benefits of the program. Bradley emphasized the importance of the program for low-income individuals and the need for accountability, offering impact statements from member hospitals to demonstrate their community investments. He urged the committee to support the bill and not wait for federal action.
SB253: Edan Sha, CEO of Ammonoosuc Community Health Services Support03:37:53.279 - 11:37:44 AM; Edan Sha, CEO of Ammonoosuc Community Health Services, spoke in support of SB253. He detailed the services his organization provides across 26 towns in New Hampshire, including Littleton, Warren, Woodsville, Franconia, and Whitefield. Sha explained that they are a federally qualified health center that participates in the 340b program, taking program integrity seriously by adhering to compliance standards and reinvesting savings into patient care, such as sliding fee scales, vouchers for dental care, and support for patient navigators and community health workers. He argued against restrictions on contract pharmacies, likening it to limiting where one can buy gasoline. Sha emphasized the importance of free trade and accountability, urging the committee to support the bill to ensure patient access and program integrity.
SB253: Committee Members Information Only05:39:31.638 - 1:39:22 PM; During the executive session on SB253, the committee discussed the bill and its implications. The discussion included concerns about the transparency of the 340b program's use by various entities, the potential for litigation if the state intervenes in a federal program, and the impact on critical access hospitals and underserved populations. Some members expressed support for the bill, citing the importance of the program for community health centers and hospitals, while others were hesitant due to the risk of legal action and questioned whether the program's funds were being used as intended. The committee ultimately voted 3-2 to recommend that the bill be deemed inexpedient to legislate (ITL).
SB253: Megan Tishi, Practicing Health System Pharmacist, New Hampshire Support03:24:47.399 - 11:24:38 AM; Megan Tishi, a practicing health system pharmacist in New Hampshire, spoke in support of Senate Bill 253. She emphasized the importance of hospitals and clinics having access to the discounts provided under the 340b program, which are crucial for ensuring that New Hampshire citizens have continued access to high-quality healthcare. The savings from the 340b program are used to expand programs and services, benefiting patients across the state, including those in the broader community. Tishi highlighted the necessity of protecting contract pharmacy arrangements to maintain patient access, especially for smaller hospitals that may not have their own retail pharmacies.
SB253: Tanya Carlton, Practicing Pharmacist, New Hampshire Society of Health System Pharmacists Support03:24:53.160 - 11:24:44 AM; Tanya Carlton, a practicing pharmacist and immediate past president of the New Hampshire Society of Health System Pharmacists, testified in support of Senate Bill 253. She stated that the bill is essential for ensuring that hospitals can access 340b discounts, which are critical for providing care to New Hampshire citizens. Carlton explained that the 340b program allows hospitals to reinvest savings into patient assistance programs, chronic disease management, and access to specialty medications. She emphasized the importance of protecting contract pharmacy arrangements, especially for smaller and rural hospitals, to maintain patient access to necessary medications.
SB253: Ben Bradley, New Hampshire Hospital Association Support03:27:57.120 - 11:27:48 AM; Ben Bradley, representing the New Hampshire Hospital Association, supported Senate Bill 253. He explained that the bill aims to prevent drug manufacturers from exploiting a loophole in the 340b program, which was instituted in 1992 to help shield hospitals from rising drug prices. Bradley highlighted that drug prices are a rapidly growing expense for hospitals and emphasized the need to close the loophole where manufacturers withhold 340b benefits when a qualified provider uses a contracted pharmacy. He noted that several states have already taken action to ensure that their providers receive the full benefits of the 340b program.
SB253: Edan Sha, CEO of AMC Community Health Services Support03:37:53.279 - 11:37:44 AM; Edan Sha, CEO of AMC Community Health Services, testified in support of Senate Bill 253. He explained that his organization, a federally qualified health center participating in the 340b program, takes program integrity seriously and ensures compliance with audits. Sha emphasized the importance of the 340b program for providing affordable medications to sliding fee scale eligible patients and reinvesting savings into patient assistance programs, such as dental vouchers and community health workers. He argued for the need to maintain contract pharmacy arrangements to ensure patient access to medications, especially in rural areas without local pharmacies.
SB253: Committee Members Information Only05:39:31.638 - 1:39:22 PM; In the executive session on Senate Bill 253, the committee discussed and voted on the bill. The motion to recommend the bill as 'inexpedient to legislate' (ITL) was moved and seconded. Discussions centered around the potential litigation risks associated with the bill, as well as the effectiveness of the 340b program for federally qualified health centers versus hospitals. Concerns were raised about transparency and the use of 340b savings for purposes other than intended. The vote resulted in a 3-2 decision in favor of the ITL recommendation, with Senator Aard taking it out.
SB253: Tanya Carlton, New Hampshire Society of Health System Pharmacists Support03:24:53.160 - 11:24:44 AM; Tanya Carlton, a practicing pharmacist and the immediate past president of the New Hampshire Society of Health System Pharmacists, testified in support of Senate Bill 253. She emphasized the importance of ensuring hospitals and clinics have access to discounts under the 340b program, which is crucial for providing high-quality healthcare to New Hampshire citizens. The program enables hospitals to use savings to expand services, support patient assistance, manage chronic diseases, and provide access to specialty medications for the underinsured and uninsured. Protecting contract pharmacy arrangements is vital for patient access, especially for smaller hospitals that may not have their own pharmacies. Carlton warned that reducing the benefits of the 340b program would be disastrous, particularly for rural and critical access hospitals, and urged the committee to protect the program that has benefited New Hampshire for over 30 years.
SB253: Ben Bradley, New Hampshire Hospital Association Support03:27:57.120 - 11:27:48 AM; Ben Bradley, representing the New Hampshire Hospital Association, supported Senate Bill 253. He highlighted the bill's aim to prevent drug manufacturers from exploiting a loophole in the 340b program, established to help hospitals cope with rising drug prices. Bradley noted the significant cost of new drugs and the necessity of the 340b program to stretch federal resources for providers serving qualified communities. He explained that manufacturers are withholding 340b benefits when providers use contracted pharmacies, which many hospitals rely on for patient access to medications. He referenced actions taken by other states to close this loophole and ensure providers receive the full benefits of the 340b program. Bradley urged New Hampshire to join these states in protecting the program and emphasized the need for action due to federal inaction.
SB253: Edan Sha, CEO of AMC Community Health Services Support03:37:53.279 - 11:37:44 AM; Edan Sha, CEO of AMC Community Health Services, supported Senate Bill 253. He described his organization's participation in the 340b program as a federally qualified health center, emphasizing their commitment to program integrity and compliance. Sha outlined how the program's savings are reinvested into services like sliding fee scales, dentistry vouchers, and patient navigators for addressing social determinants of health. He argued against restrictions on contract pharmacy arrangements, stating they are crucial for patient access and that the program should not be limited based on the actions of a few bad actors. Sha also discussed the changes in the program over the past decade, including issues with pharmacy benefit managers, and supported free trade in contract pharmacy arrangements while stressing accountability.
SB253: Committee Members Information Only05:39:31.638 - 1:39:22 PM; The committee members discussed Senate Bill 253, expressing concerns about the potential for litigation if the state were to intervene in the federal 340b program. There was a division in opinion, with some members highlighting the importance of the program for critical access hospitals and underserved populations, while others were cautious about engaging in a legal battle that other states have faced. The discussion included considerations of transparency and the proper use of program savings. Ultimately, the committee voted to recommend that the bill be found inexpedient to legislate (ITL), with a vote of 3 to 2.
SB118: Regina Burzell, State Senator for District 19 Support05:46:04.400 - 1:45:55 PM; Senator Regina Burzell introduced Senate Bill 118, which seeks to adjust the personal needs allowance for residents in nursing homes to reflect Social Security increases annually instead of every five years as per current law. She mentioned that the bill was requested by the Department of Health and Human Services and that she also has a non-germane amendment related to the bill.
SB118: John Williams, Director of Legislative Affairs, Department of Health and Human Services Support05:47:54.920 - 1:47:45 PM; John Williams, representing the Department of Health and Human Services, supported Senate Bill 118. He explained that the bill aims to adjust the personal needs allowance for nursing home residents annually based on Social Security Administration adjustments. Williams praised Senator Burzell's support for the initiative and highlighted its straightforward nature, aimed at improving the financial situation of residents in long-term care facilities.
SB118: Regina Burzill, State Senator for District 19 (Derry, Hampstead, Windham) Support05:46:04.400 - 1:45:55 PM; Senator Burzill, the prime sponsor of SB118, explained that the bill aims to adjust the personal needs allowance for residents in nursing homes to reflect Social Security increases annually instead of the current five-year adjustment. She mentioned that this amendment was requested by the Department of Health and Human Services. She also noted the existence of a non-germane amendment but deferred its discussion to a separate hearing.
SB118: John Williams, Director of Legislative Affairs, Department of Health and Human Services Support05:47:54.920 - 1:47:45 PM; John Williams, representing the Department of Health and Human Services, supported the bill, stating that it would adjust the personal needs allowances for residents in long-term care facilities annually based on Social Security Administration adjustments. He praised Senator Burzill for her support and had no further comments unless there were questions from the committee.
SB118: Regina Burzell, State Senator for District 19 (Derry, Hampstead, Windham) Support05:46:04.400 - 1:45:55 PM; Senator Burzell introduced Senate Bill 118 as its prime sponsor, explaining that the bill seeks to amend RSA 167:27-a to adjust the personal needs allowance for residents in nursing homes to reflect Social Security increases annually instead of every five years. She emphasized that this amendment was requested by the Department of Health and Human Services and mentioned a non-germane amendment related to Hamstead Hospital, also requested by the Department, which would provide a one-time appropriation and establish a capped fund for capital investments at the facility. She explained the need for the non-germane amendment to allow for prorated sign-on bonuses for staff transitioning from state employees to Dartmouth Hitchcock providers at Hamstead Hospital.
SB118: John Williams, Director of Legislative Affairs, Department of Health and Human Services Support05:47:54.920 - 1:47:45 PM; John Williams testified in support of Senate Bill 118, affirming that the bill aims to adjust the personal needs allowance for nursing home residents annually based on Social Security adjustments, rather than the current five-year basis. He highlighted the simplicity and importance of the bill and thanked Senator Burzell for her support. Williams also mentioned the presence of Wendy Alman and Brian Clark from the department, although he noted that Brian Clark was not scheduled to speak.
SB118 2025-0295s: Committee Information Only05:53:03.080 - 1:52:54 PM; The committee moved to adopt Senate Bill 118 as amended by Amendment 2025-0295s. The amendment was discussed and adopted unanimously, followed by a unanimous decision to pass the bill as amended. The bill was then moved to consent, and Senator Burzell agreed to take the bill out of the executive session.
SB118 2025-0295s: Regina Burzell, State Senator for District 19 (Derry, Hampstead, Windham) Support05:46:04.400 - 1:45:55 PM; Senator Burzell, the prime sponsor of Senate Bill 118, introduced the bill at the request of the Department of Health and Human Services. The bill aims to amend RSA 167:27-a, II to adjust the personal needs allowance for residents in long-term care facilities to reflect annual Social Security increases rather than the current five-year adjustment. She briefly mentioned a non-germane amendment related to the bill but indicated it would be discussed in a separate hearing.
SB118 2025-0295s: John Williams, Director of Legislative Affairs, Department of Health and Human Services Support05:47:54.920 - 1:47:45 PM; John Williams, representing the Department of Health and Human Services, supported Senate Bill 118. He explained that the bill would allow personal needs allowances for long-term care residents to be adjusted annually based on Social Security increases, rather than every five years as per current law. He acknowledged Senator Burzell's comprehensive introduction of the bill and offered to answer any questions.
SB118 2025-0295s: Regina Burzell, State Senator for District 19 (Derry, Hampstead, Windham) Support05:49:46.440 - 1:49:37 PM; Senator Burzell introduced Amendment 2025-0295s to Senate Bill 118, which was requested by the New Hampshire Department of Health and Human Services. The amendment includes a one-time appropriation of $160,000 for leave accrual payments and potential bonuses for temporary classified positions transitioning at Hampstead Hospital and Residential Treatment Facility. It also establishes a fund for capital investments at the facility. She explained that the amendment aims to allow employees who transitioned from state to Dartmouth Hitchcock to receive prorated sign-on bonuses.
SB118 2025-0295s: Marissa Hen, Deputy Commissioner, Department of Health and Human Services Support05:52:16.080 - 1:52:07 PM; Deputy Commissioner Marissa Hen was prepared to provide context for the amendment but stated that Senator Burzell had already given a comprehensive overview. She offered to answer any questions from the committee.
SB118 2025-0295s: Committee Information Only05:53:03.080 - 1:52:54 PM; The committee moved to close the public hearing on Senate Bill 118 and its amendment, and proceeded into an executive session. They voted to recommend Senate Bill 118 as amended by amendment 2025-0295s to be passed, with motions and seconds recorded.
SB118 2025-0295s: John Williams, Director of Legislative Affairs, Department of Health and Human Services Support05:47:54.920 - 1:47:45 PM; John Williams expressed support for SB118, which aims to adjust the personal needs allowances for residents of long-term care facilities annually based on Social Security Administration adjustments, rather than every five years as currently mandated. He mentioned that the bill's prime sponsor, Senator Birdell, had already covered the substance of the bill comprehensively, and he had nothing further to add unless there were questions.
SB118 2025-0295s: Regina Burdel, State Senator for District 19 (Derry, Hampstead, Windham) Support05:49:46.440 - 1:49:37 PM; Senator Regina Burdel introduced Amendment 2025-0295s to SB118, which provides a one-time $160,000 appropriation to the Department of Health and Human Services for leave accrual and bonus payments related to staff transitions at Hampstead Hospital and Residential Treatment Facility. The amendment also establishes a capped fund for supporting contractually required capital investments at the same facility. She explained that the amendment was necessary to ensure that employees transitioning from state employment to Dartmouth Hitchcock at Hampstead Hospital could receive prorated sign-on bonuses.
SB118 2025-0295s: Marissa Hen, Deputy Commissioner, Department of Health and Human Services Support05:52:16.080 - 1:52:07 PM; Marissa Hen, Deputy Commissioner, supported the amendment to SB118, stating that Senator Burdel had already provided a comprehensive overview of the amendment. She offered to answer any questions from the committee but did not provide additional testimony beyond that.
SB118 2025-0295s: Committee Information Only05:53:03.080 - 1:52:54 PM; The committee closed the hearing on SB118 and moved to consider the non-germane amendment 2025-0295s. After discussion, the committee voted to pass SB118 as amended by the non-germane amendment.
SB249: Regina Burdel, State Senator for District 19 (Derry, Hampstead, Windham) Support05:54:28.600 - 1:54:19 PM; Senator Regina Burdel introduced SB249, which deals with the Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. She explained that MET is a 5.4% assessment on certain hospitals' net patient services revenue, and DSH payments are for hospitals' uncompensated care. She noted that MET revenue is used to generate federal matches for hospital payments. She mentioned that the bill mirrors the governor's budget regarding the percentage of funds returned to hospitals and is intended as a starting point for further negotiations.
SB249: Regina Burdel, State Senator for District 19 (Derry, Hampstead, Windham) Support05:54:28.600 - 1:54:19 PM; Senator Burdel introduced Senate Bill 249, discussing its relation to uncompensated care and the Medicaid and Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. She provided historical context, explaining how MET and DSH work together, with hospitals paying a 5.4% tax on net patient services revenue, which is then matched by federal funds. The bill mirrors the governor's budget, setting the return rate at 80% instead of the previous 91%. She expressed hope that discussions between hospitals and the governor's office in the coming weeks would lead to a resolution.
SB249: Steve Aanen, President of the New Hampshire Hospital Association Information Only05:59:24.440 - 1:59:15 PM; Steve Aanen provided detailed testimony on the complexities of the Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. He highlighted the historical context of MET and DSH, which began in the early 1990s to help fund the Medicaid program through federal matching funds. Aanen discussed the current financial challenges hospitals face and the impact of the proposed 80% return rate, which would result in a $70 million reduction for hospitals. He proposed an alternative model where hospitals would pay up to 6% of net patient services revenue, with the aim of generating more federal funds and ensuring a fair return for hospitals. He stressed the urgency of resolving the issue before the April 15th payment deadline and expressed willingness to work with the committee to find a solution.
SB249: Senator for District 19, representing Derry, Hampstead, and Windham Information Only05:49:51.000 - 1:49:42 PM; The senator presented Amendment 2025- to the committee, which includes a one-time appropriation of $160,000 to the New Hampshire Department of Health and Human Services. This appropriation is intended for leave accrual payments and any applicable bonus or retention payments for staff transitioning at Hampstead Hospital and Residential Treatment Facility. The amendment also establishes a capped fund to support contractually required capital investments at the same facility. The senator noted the importance of ensuring that temporary state employees transitioning to Dartmouth Hitchcock providers at Hampstead Hospital receive a portion of their sign-on bonuses.
SB249: John Williams and Deputy Commissioner Marissa Henn Information Only05:51:30.600 - 1:51:21 PM; John Williams and Deputy Commissioner Marissa Henn were present to speak on the amendment. Marissa Henn was prepared to provide context for the bill, but the senator's presentation was considered comprehensive. They offered to answer any questions from the committee, indicating their willingness to provide further information if needed.
SB249: Senator Regina Berzel, State Senator for District 19, representing Derry, Hampstead, and Windham Information Only05:54:28.600 - 1:54:19 PM; Senator Regina Berzel introduced Senate Bill 249, focusing on uncompensated care and the Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. She provided historical context, explaining that MET is a 5.4% assessment on hospitals' net patient services revenue, used to generate federal matching funds. DSH payments are for hospitals' uncompensated care, not applicable to critical access hospitals. She mentioned the current agreement's reduction from 91% to 80% and emphasized the need for a resolution before the April 15th MET payment deadline.
SB249: Steve Aanen, President of the New Hampshire Hospital Association Oppose05:59:24.440 - 1:59:15 PM; Steve Aanen expressed the New Hampshire Hospital Association's opposition to Senate Bill 249 as currently written, highlighting its significant implications for hospitals and the state's Medicaid Program. He explained the MET and DSH mechanisms, emphasizing that hospitals lose money serving Medicaid patients. Aanen proposed increasing the MET assessment rate to 6% to generate more federal funds, which could be used to support essential Medicaid services and hospitals. He stressed the need for a collaborative solution to ensure fair and reasonable returns for hospitals, which are critical for maintaining patient care services.
SB249: John Jerik, President of St. Joseph Hospital in Nashua and Secretary Treasurer for the New Hampshire Hospital Association Oppose06:17:02.440 - 2:16:53 PM; John Jerik spoke against Senate Bill 249 as written, stating it would jeopardize the financial health of hospitals like St. Joseph Hospital. He highlighted the impact of the bill, which allocates only 80% of funds to hospitals starting in 2026, a decrease from the previous year. Jerik mentioned that this reduction would create a $6 million loss for St. Joseph Hospital, affecting services like inpatient psychiatry, maternity care, and outpatient pediatrics. He urged the committee to amend the bill to maximize federal matching funds and safeguard hospital services.
SB249: Regina Birdsell, State Senator for District 19, representing Derry, Hampstead, and Windham Information Only05:54:35.798 - 1:54:26 PM; Senator Regina Birdsell provided a historical overview of the Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. She explained that MET is a 5.4% assessment on hospitals' net patient services revenue, and the revenue is used to fund an uncompensated care and Medicaid fund. DSH payments are made to hospitals for uncompensated care, with a federal match rate ranging from 50% to 90%. She highlighted that the MET-DSH agreement had expired and that the current proposal in the governor's budget reduces the hospital reimbursement rate from 91% to 80%. Senator Birdsell's bill, SB249, mirrors the governor's budget, but she views it as a starting point for further negotiations.
SB249: Steve Ahnen, President of the New Hampshire Hospital Association, representing 26 community hospitals Information Only05:59:24.440 - 1:59:15 PM; Steve Ahnen detailed the complexities of the MET and DSH system, emphasizing its importance for funding New Hampshire's Medicaid program. He noted that the current 80% model results in a significant loss for hospitals, approximately $70 million less than under the prior agreement. He proposed increasing the assessment rate to 6% and using the existing framework to distribute funds more equitably, which would generate additional federal funds and minimize hospital losses. Ahnen stressed the need for a solution that benefits the state, hospitals, and Medicaid patients.
SB249: John Jerik, President of St. Joseph Hospital in Nashua, Secretary Treasurer for the New Hampshire Hospital Association Oppose06:17:02.440 - 2:16:53 PM; John Jerik expressed opposition to SB249 as it stands, stating it would negatively impact hospitals like St. Joseph's. He highlighted that the bill's allocation of 80% of funds to hospitals starting in 2026 represents an 11% decrease from the previous year, which could jeopardize the financial health of hospitals and interrupt access to services. He noted that St. Joseph Hospital would face a $6 million loss, affecting critical services like geriatric psychiatry, maternity care, and pediatrics. Jerik urged the committee to modify the bill to safeguard hospital services and maximize federal matching funds.
SB249: Holly McCormack, Registered Nurse and President and CEO of Cottage Hospital in Woodsville Oppose06:23:50.040 - 2:23:41 PM; Holly McCormack, representing Cottage Hospital, a critical access hospital in Woodsville, opposed the current amendment to the state's Medicaid Enhancement Tax. She highlighted the financial strain on hospitals, including increased costs for staff wages, travel nurses, and supplies, which have led to negative operating margins. She stressed the interconnectedness of New Hampshire's hospitals and the potential harm to patients and communities if any hospital were to close. McCormack urged the committee to oppose the current MET-DSH directive and work collaboratively to find a solution beneficial to the state, hospitals, and citizens.
SB249: Regina Birdsell, State Senator for District 19, representing Derry, Hampstead, and Windham Information Only05:54:35.798 - 1:54:26 PM; Senator Birdsell provided a historical context for the Medicaid Enhancement Tax (MET) and Disproportionate Share Hospital (DSH) payments. She explained that MET is a 5.4% assessment on the net patient services revenue of certain hospitals, and the revenues are used to generate a federal match on hospital payments. DSH payments are intended for hospitals' uncompensated care. She highlighted the current state of the MET-DSH agreement, which had expired and was renegotiated to an 80% return to hospitals from the previously higher percentage. She noted that her bill, SB249, mirrors the governor's budget and serves as a starting point for further discussions.
SB249: Steve Ahnen, President of the New Hampshire Hospital Association, representing all 26 community hospitals Oppose05:59:24.440 - 1:59:15 PM; Steve Ahnen expressed opposition to the current amendment in SB249, arguing that it would result in significant financial losses for hospitals across the state. He explained the history and mechanics of the MET and DSH, emphasizing that hospitals have been paying more in MET than they receive in benefits. Ahnen proposed an alternative model where hospitals would agree to a higher assessment rate of 6% if the returns were fair and reasonable, which would benefit the state by generating more federal matching funds. He stressed the need for a solution that supports hospitals, the state, and Medicaid patients, warning of the potential negative impacts on hospital services and patient care if the current amendment is passed.
SB249: John Jerik, President of St. Joseph Hospital in Nashua, and Secretary-Treasurer of the New Hampshire Hospital Association Oppose06:17:02.440 - 2:16:53 PM; John Jerik opposed the current amendment in SB249, stating it would jeopardize the financial health of hospitals like St. Joseph Hospital, which provides critical care to vulnerable patients in Nashua. He detailed the potential loss of $6 million for St. Joseph Hospital under the current bill, which would impact key service lines such as inpatient psychiatry, maternity care, and outpatient pediatrics. Jerik urged the committee to modify the bill to maximize federal matching funds and protect hospital services and access to care.
SB249: Holly McCormack, Registered Nurse and President and CEO of Cottage Hospital in Woodsville Oppose06:23:50.040 - 2:23:41 PM; Holly McCormack opposed the current amendment to the Medicaid Enhancement Tax in SB249, stating it would harm hospitals and the already stressed healthcare system in New Hampshire. She highlighted the financial struggles of Cottage Hospital, a critical access hospital, and the potential detrimental impact on access to care if the amendment were passed. McCormack emphasized the collaborative nature of the state's hospital system and the community benefits provided by Cottage Hospital, urging a collaborative solution to benefit the state, hospitals, and citizens.
SB249: Matthew Hood, Vice President of Government Relations at Dartmouth Health Oppose06:31:28.840 - 2:31:19 PM; Matthew Hood opposed the current amendment in SB249, noting the significant financial impact on Dartmouth Health's hospitals, particularly Mary Hitchcock Memorial Hospital. He highlighted the potential reduction in services, including telehealth and remote clinical sites, which would affect rural populations. Hood stressed the need to maintain current access levels and warned of the challenges in absorbing the proposed financial cuts, emphasizing the importance of finding a solution that supports the healthcare system's mission.
SB249: Steve Ahnen, President of the New Hampshire Hospital Association Oppose05:59:24.440 - 1:59:15 PM; Steve Ahnen, representing all 26 community hospitals in New Hampshire, opposes Senate Bill 249 due to its significant implications for hospitals and the state's Medicaid program. He explains the complexity of the issue and the historical context of the Medicaid enhancement tax (MET) and disproportionate share hospital (DSH) payments. Ahnen emphasizes the shared commitment to ensuring access to high-quality care for vulnerable citizens and the financial challenges hospitals face, including losses on Medicaid patients. He notes that hospitals opted out of previous rate increases to benefit other providers. Ahnen criticizes the 80% model proposed in the bill, which would result in a $70 million loss for hospitals compared to a $67 million gain for the state. He suggests an alternative proposal with a 6% assessment rate, which would be more beneficial for both hospitals and the state, generating an additional $14 million annually for Medicaid services. He urges the committee to consider an amendment to the bill to reflect this proposal.
SB249: John Jerik, President of St. Joseph Hospital in Nashua, Secretary/Treasurer of the New Hampshire Hospital Association Oppose06:17:02.440 - 2:16:53 PM; John Jerik from St. Joseph Hospital in Nashua opposes Senate Bill 249 as it stands, stating it would jeopardize the financial health of hospitals like his, which provide critical care to vulnerable patients. He highlights the impact of the bill on St. Joseph Hospital, which would face a $6 million loss under the proposed 80% allocation, affecting key service lines like inpatient psychiatry, maternity care, and outpatient pediatrics. Jerik emphasizes that these services are crucial for over 12,600 unique patients in the greater Nashua area. He advocates for a modification of the bill to maximize federal matching funds and safeguard hospital services and access to care for all New Hampshire residents.
SB249: Holly McCormack, President and CEO of Cottage Hospital in Woodsville Oppose06:23:50.040 - 2:23:41 PM; Holly McCormack from Cottage Hospital in Woodsville opposes the current amendment to the state's Medicaid enhancement tax, arguing it would harm hospitals and stress the already fragile healthcare system in New Hampshire. She describes Cottage Hospital's services, including emergency care, primary care, and a unique geriatric psychiatric unit, which serve a wide area. McCormack details the financial challenges faced by the hospital, such as increased expenses and negative operating margins. She warns that the proposed changes could lead to the closure of hospitals, resulting in decreased access to care and harm to citizens. She urges the committee to oppose the current directive and work collaboratively with hospitals for a solution that benefits all stakeholders.
SB249: Matthew Hood, Vice President of Government Relations at Dartmouth Health Oppose06:31:28.840 - 2:31:19 PM; Matthew Hood from Dartmouth Health opposes Senate Bill 249, highlighting the significant financial implications for Mary Hitchcock Memorial Hospital and other hospitals within the Dartmouth Health system. He explains that the proposed 80% model would result in a $25 million loss for Mary Hitchcock compared to the previous agreement. Hood discusses the potential impact on services, including substance use disorder and mental health services, and the necessity to scale back investments in rural areas and telehealth if the bill passes. He emphasizes the challenges of maintaining access levels and urges the committee to consider the threats to rural healthcare access.
SB249: John JK, President of St. Joseph Hospital in Nashua, Secretary Treasurer for the New Hampshire Hospital Association Oppose06:17:02.440 - 2:16:53 PM; John JK testified against Senate Bill 249, emphasizing its potential negative impact on St. Joseph Hospital in Nashua. He highlighted that the bill, if unamended, would jeopardize the financial health of hospitals like St. Joseph's, which provide critical care to vulnerable patients. He mentioned that the bill's allocation of 80% of funds collected under RSA 84A to hospitals starting in 2026 represents an 11 percentage point drop in funding, which could lead to struggles in funding key programs. JK pointed out the hospital's service lines, including geriatric psychiatry, maternity care, and outpatient pediatrics, generate significant losses annually. He argued that the bill would result in a $6 million loss for St. Joseph Hospital, affecting over 12,600 patients. He urged the committee to modify the bill to safeguard hospital services and maximize federal matching funds.
SB249: Holly McCormack, Registered Nurse and President and CEO of Cottage Hospital in Woodsville Oppose06:23:50.040 - 2:23:41 PM; Holly McCormack testified in opposition to the amendment to the state's Medicaid Enhancement Tax, stating it would harm hospitals like Cottage Hospital in Woodsville. She detailed the hospital's services to the community, including emergency, primary, and specialty care, and its unique 10-bed geriatric psychiatric unit. McCormack discussed the financial challenges faced by the hospital, including rising expenses and negative operating margins despite increased revenue. She emphasized the hospital's role in the community and the potential detrimental effects on patient care if funding is reduced. She also highlighted the interdependence of New Hampshire's hospitals and the potential impact of losing any hospital on the state's health care system. McCormack urged the committee to work with hospitals to find a solution that benefits the state and its citizens.
SB249: Matthew Hood, Vice President of Government Relations at Dartmouth Health Oppose06:31:28.840 - 2:31:19 PM; Matthew Hood opposed Senate Bill 249, stating it would have significant financial implications for Dartmouth Health and its hospitals. He highlighted the difference between the Medicaid Enhancement Tax payments and the disproportionate share hospital payments under the bill, which could not be easily absorbed. Hood discussed the potential retrenchment of services, including telehealth and rural care, due to the financial strain. He emphasized the importance of maintaining access levels for rural populations and the partnerships Dartmouth Health has established to support the community. Hood urged the committee to consider the challenges hospitals face in maintaining current service levels.
SB249: Holly McCormack, President and CEO of Cottage Hospital, Woodsville, NH Oppose06:23:50.040 - 2:23:41 PM; Holly McCormack, representing Cottage Hospital in Woodsville, NH, expressed strong opposition to the amendment to the state's Medicaid enhancement tax. She highlighted the hospital's history and its role as a critical access hospital serving over 25 towns in the North Country. She detailed the range of services offered, including emergency care, primary care, surgical services, and a unique 10-bed geriatric psychiatric care unit. McCormack discussed the financial challenges faced by the hospital, including a significant increase in staff wages and the costs of travel nurses, which have risen from an average of $800,000 per year in 2016-2019 to $4 million in 2024. She argued that the proposed changes to the Medicaid enhancement tax would negatively impact hospitals' operating margins and could lead to closures, severely affecting healthcare access in the state. She emphasized the collaborative nature of healthcare in New Hampshire and the potential harm to patients if any hospital were to close. Additionally, she mentioned the hospital's community benefits, including educational and training programs, and its significant employment within the community.
SB249: Matthew Hood, Vice President of Government Relations at Dartmouth Health Oppose06:31:28.840 - 2:31:19 PM; Matthew Hood, representing Dartmouth Health, opposed the amendment to the Medicaid enhancement tax, emphasizing its impact on the hospital system. He explained that Dartmouth Health includes seven hospitals, with varying classifications such as Medicare dependent and critical access hospitals. Hood pointed out the significant financial implications of the proposed 80% reduction in Medicaid enhancement tax, noting a potential $25,000 to nearly $26 million difference in payments for Mary Hitchcock Memorial Hospital. He discussed the essential services provided by Dartmouth Health, including substance use disorder services and mental health support, and highlighted the potential for service cuts in rural areas due to financial constraints. Hood stressed the importance of maintaining current access levels and the challenges of finding further efficiencies within the already strained financial margins of hospitals.
SB249: Matthew Hood, Vice President of Government Relations at Dartmouth Health Oppose06:31:28.840 - 2:31:19 PM; Matthew Hood, representing Dartmouth Health, expressed opposition to the implications of Senate Bill 249, particularly the financial impact on Mary Hitchcock Memorial Hospital. He highlighted the significant difference in payments under the new model versus the previous agreement, which could lead to substantial financial strain. Hood discussed the broader services provided by Dartmouth Health, including substance use disorder services, mental health services, and telehealth for rural populations. He warned that the proposed changes could force the hospital to retract investments in community partnerships and remote clinical sites, potentially increasing travel distances for rural patients. He emphasized the challenges of absorbing these costs, despite efforts to improve efficiency and manage finances, and stressed the potential threat to maintaining current access levels to healthcare services.

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