Committee Summary for Health and Human Services Oversight Committee (11/21/2025)

Bill/Time	Type	Title	Sponsor
Unclear 00:06:29.280 - 9:05:10 AM	General Working Session	Unclear

Unclear: Lori Weaver, Commissioner HHS Information Only00:06:29.280 - 9:05:10 AM; Commissioner Weaver provided an update on the rural health transformation grant submission, noting it was submitted early on November 4th and reflects community input from across New Hampshire. She mentioned upcoming engagement with CMS for questions, edits, and budget negotiations, with formal approval expected by December 31st. The grant will be administered through 'Go North' in the governor's office, involving procurement and fiscal approvals starting in January. She confirmed the grant allows hiring positions within the 10% administrative cap and noted dual roles for some staff.
Unclear: Ian Watt, Director of Public Health Information Only00:12:54.639 - 9:11:35 AM; Ian Watt discussed the status of vaccines in New Hampshire amid federal changes, emphasizing commitment to safe vaccinations via the universal purchase program for children. He covered September guidance for flu, RSV, and COVID-19, focusing on vulnerable populations. He detailed CDC updates on MMR and varicella vaccines, noting the shift away from combined MMRV for first doses in children under four due to seizure risks, but retention for second doses. He affirmed New Hampshire's conservative approach with nine mandated vaccines for school children (ten for childcare), stable since the pandemic, with exemptions available. He addressed funding stability through federal programs and partnerships with insurers.
Unclear: Nathan White, Chief Financial Officer, DHHS Information Only00:20:34.559 - 9:19:15 AM; Nathan White presented the quarterly budget and staffing update, highlighting HHS's significant share of the state budget (44% all funds, 56% general funds). He projected a $20 million general fund lapse for FY26, noting challenges in projections due to utilization-driven spending. Only 33% of general funds can lapse due to statutory provisions. Vacancy rates have trended upward to about 12-13%, influenced by 400 unfunded positions and a hiring freeze prioritizing direct care. He discussed the impact of a 14% budget cut and its interaction with lapses.
Unclear: Jenny Han, Senior Public Policy Manager, Alzheimer's Association; Mory Merur, NH Board of Nursing Information Only00:31:35.120 - 9:30:16 AM; Jenny Han and Mory Merur presented the annual report of the Subcommittee on Alzheimer's Disease and Related Dementias. They noted over 26,500 individuals affected and 48,000 caregivers in NH. The subcommittee met six times, receiving presentations on services, Silver Alerts, brain health campaigns, and palliative care. They discussed challenges and began reviewing the 2015-2016 state plan. A needs assessment survey is being developed for next year to inform a new state plan. Recommendations include integrating Alzheimer's materials into public health programs, embedding brain health in aging and health plans, adding cognitive measures to BRFSS, and partnering with organizations for awareness and early detection. They highlighted recent research on prevention and treatments.
Unclear: Cynthia Pabonis, Chief Community Integration Officer, NH Hospital; Kathy Bizarro-Thumbberg, Executive VP, NH Hospital Association Information Only00:43:00.000 - 9:41:41 AM; Cynthia Pabonis and Kathy Bizarro-Thumbberg provided the SB 177 update on restraints in transports for involuntary emergency admissions (IEAs). From October 2024 to September 2025, there were 1,516 IEA transfers to NH Hospital and DRFs, mostly adults by law enforcement (61.5%) or ambulance (36%). 47% used no restraints, 51% had restraints before transport. Types included waist belts (46.5%), handcuffs (12%), and combinations (40%). Metrics have been stable over six years, with increases in transports due to more beds. They clarified IEA criteria (mental illness causing imminent danger, certified by practitioners) and processes involving emergency rooms, police, and alternatives like 988 calls.
Unclear: Unidentified Speaker (likely committee member or expert) Information Only00:50:49.440 - 9:49:30 AM; The speaker discusses the involuntary emergency admission (IEA) process, noting that individuals have probable cause hearings with potential legal representation and multiple points for review. They emphasize collaboration between law enforcement and mental health centers for de-escalation during crises, including on-site mental health professionals via rapid response.
Unclear: Senator Gray Information Only00:51:57.599 - 9:50:38 AM; Senator Gray inquires about restraint usage during sheriff transports, suggesting it would be useful to view it as a percentage given higher transport volumes. They propose considering additional training in de-escalation or alternative restraints beyond handcuffs for future improvements.
Unclear: Unidentified Speaker (likely expert on transport) Information Only00:52:44.079 - 9:51:25 AM; The speaker explains changes from Senate Bill 177 allowing clinicians in emergency departments to decide between ambulance or sheriff transport based on patient behavior and safety. They describe decision-making processes, including opting for less restrictive ambulance transport when possible, defaults to sheriff if needed, and factors like ambulance availability shortages in the state.
Unclear: Unidentified Speaker (likely Senator) Information Only00:53:48.079 - 9:52:29 AM; Drawing from experience as a former volunteer firefighter in Massachusetts, the speaker asks if New Hampshire allows direct transport to receiving facilities for repeat IEA cases without intermediate steps, based on observed police transmissions.
Unclear: Unidentified Speaker (likely expert) Information Only00:55:02.960 - 9:53:43 AM; The speaker clarifies that a new IEA petition is required every time, except in cases of conditional discharge revocation or replication of condition under probate commitment. Direct admission to a designated receiving facility (DRF) without proper petition is not permitted; options include IEA petition, revocation, or voluntary guardianship.
Unclear: Senator Gray Information Only00:56:13.280 - 9:54:54 AM; Senator Gray reminds the chair of a commitment at 11:00 and jokes about sneaking out, with light-hearted committee banter about fiscal matters.
Unclear: Lily Wellington, Executive Director, NH State Commission on Aging; Lori Duff, State Chair, NH State Commission on Aging Information Only00:56:32.079 - 9:55:13 AM; Lily Wellington and Lori Duff present the annual report and executive summary of a special project on community transportation needs. They outline the commission's purpose since 2019: advising on aging policy and planning. Priorities include advancing Age Well NH (multisector plan), strengthening care systems, and growing the direct care workforce. They detail demographics (NH as second-oldest state, 27% over 60), task forces, meetings, and emerging issues like rural aging, solo aging (25% over 65 living alone), and workforce contributions from older adults. They discuss Age Well NH phases, community engagement findings (assets: services, social connections, nature; challenges: transportation, housing, health needs), and pillars of independence, wellness, care. 90% of surveyed older adults want elected officials to prioritize aging planning. Legislative successes and recommendations include community programming and replicable models. On care systems, they highlight family caregivers (1 in 4 adults), new advisory council, DHS progress, and recommendations like caregiver respite, healthy aging plans to navigate services. For workforce growth, they address shortages, low pay ($16/hour), housing barriers, and demographic demands. Discussions with committee members cover immigration impacts, training incentives (e.g., community colleges, technical centers), retention strategies (flexibility, ownership), and model shifts like in-home care and community nursing, which face fewer hiring issues. They note rural health funding, mobile healthcare, and broader systemic issues like corporatization and healthcare as a privilege vs. right. The presentation ends with transportation assessment findings due in 2026 and offers the commission as a resource.