Committee Summary for Senate Health and Human Services (02/04/2026)

Bill/Time	Type	Title	Sponsor
SB545 00:07:49.840 - 8:07:31 AM	Executive Session	relative to financial eligibility for the Medicare savings program.	Rosenwald, Cindy(D)[F]2025
SB480 00:13:05.839 - 8:12:47 AM	Executive Session	limiting certain prior authorization requirements for physical therapy, occupational therapy, and similar rehabilitative services.	Prentiss, Suzanne(D)[F]2025
SB457 2026-0477s 00:13:56.480 - 8:13:38 AM	Executive Session	relative to the licensing of international physicians.	Reardon, Tara(D)[F]2025
SB441 00:18:46.799 - 8:18:28 AM	Executive Session	requiring a municipality that intends to transport a person needing substance use disorder treatment and other support services to have a memorandum of understanding with the receiving municipality prior to transport.	Sullivan, Victoria(R)[A-]2025
SB544 00:21:23.840 - 8:21:05 AM	Public Hearing	limiting changes to prescription drug formularies under health benefit plans.	Fenton, Donovan(D)[F]2025
SB549 01:06:23.920 - 9:06:05 AM	Public Hearing	prohibiting the state or local government from distributing or funding organizations that distribute drug paraphernalia.	Murphy, Keith(R)[A]2025
SB616 02:28:00.880 - 10:27:42 AM	Public Hearing	relative to reporting requirements under the right to try act.	Prentiss, Suzanne(D)[F]2025
SB616 2024-Committee Amendment 02:33:00.720 - 10:32:42 AM	Executive Session	relative to reporting requirements under the right to try act.	Prentiss, Suzanne(D)[F]2025
HB349 02:39:24.080 - 10:39:06 AM	Public Hearing	relative to the practice of optometry and authorization to perform ophthalmic laser procedures.	Kofalt, Jim(R)[A+]2025

SB545: Committee Chair Information Only00:07:49.840 - 8:07:31 AM; The chair introduces the discussion on SB 545, noting it removes the resource limit for the Medicare savings program. Emphasizes it's for discussion only, not ready to vote, and seeks committee thoughts and any questions to address before executive action.
SB545: Senator (Unnamed) Information Only00:08:56.480 - 8:08:38 AM; Provides background on the bill, referencing a hearing report. Notes a similar bill last year cost $14 million, but this version is reduced to $2.3-3.6 million. As policy committee, it would go to finance if advanced.
SB545: Senator Rushford Support00:09:42.160 - 8:09:24 AM; Supports the policy for allowing seniors to remain independent longer, potentially saving costs by avoiding nursing homes or county facilities funded by public dollars. Acknowledges fiscal note discussion needed and suggests involving Senator Rosenwald.
SB545: Senator (Unnamed) Information Only00:10:49.920 - 8:10:31 AM; Expresses policy support but concerns about cost. Worries about implementing if unaffordable later, leading to removal of benefits. Suggests advancing as good policy for finance committee review without funding commitment.
SB545: Senator Rushford (response) Information Only00:10:49.920 - 8:10:31 AM; Agrees on advancing to finance for funding consideration, which might allow solutions to evolve. Notes vote can happen later.
SB545: Committee Chair Information Only00:11:54.720 - 8:11:36 AM; Asks for other comments on SB 545 and decides to bring it up another time after initial discussion.
SB545: Senator Rosenwald Support00:16:57.920 - 8:16:39 AM; Thanks the committee for consideration. Explains the bill's two parts: removing resource limit for low-income seniors and clarifying statutory automatic enrollment in the low-income drug subsidy (federally funded). Notes confusion from prior legislation but department confirmation of ongoing practice. Mentions no good cost estimate yet for the resource limit part, which finance would review.
SB480: Senator Apprentice Information Only00:13:05.839 - 8:12:47 AM; Provides update: Connected with Paula Rogers from AHIP, planning a Zoom on Monday with AHIP, Sigma, Anthem, Harvard Pilgrim, OTS, and PTS to discuss solutions before next committee meeting.
SB480: Committee Chair Information Only00:13:56.480 - 8:13:38 AM; Acknowledges progress and suggests placeholder on calendars.
SB457 2026-0477s: Committee Chair Information Only00:13:56.480 - 8:13:38 AM; Introduces the bill and amendment, noting it addresses stakeholder concerns from the hearing about problematic wording in the original bill.
SB457 2026-0477s: Senator Rearen Support00:15:00.480 - 8:14:42 AM; Moves SB 457 to pass and the amendment 2026-0477s.
SB457 2026-0477s: Unnamed Senator Support00:15:00.480 - 8:14:42 AM; Seconds the motions and appreciates stakeholder work. Committee votes in favor of the amendment and bill as amended on consent docket.
SB441: Committee Chair Information Only00:18:46.799 - 8:18:28 AM; Brings up SB 441 for status check. Notes Senator Sullivan reached out to New Hampshire Legal Assistance, who submitted amendment recommendations now in front of the committee.
SB441: Committee Chair Information Only00:19:36.400 - 8:19:18 AM; The chair discusses an amendment setting up dispute resolution between municipalities, questions potential costs, plans to check with LBA on fiscal note impact, and considers intergovernmental agreements already allowing shared services. The chair also updates on speaking with Senator Rashardi on risk pools for child care under Senate Bill 614, expecting an amendment next week. The chair calls for a motion to exit executive session.
SB544: Senator Donovan Fenton, District 10 Support00:21:23.840 - 8:21:05 AM; Senator Fenton testifies in support of SB 544, emphasizing fairness, predictability, and continuity of care for patients relying on prescription medications. The bill prevents insurers from making significant mid-year formulary changes, such as removing drugs or shifting to higher cost tiers, requiring such changes at plan renewal. He shares a real-world example of a New Hampshire family affected by mid-year removal of their child's medication, noting lack of recourse as it's not a qualifying life event. Addressing the fiscal note, he acknowledges potential premium increases but highlights that states like Texas, Louisiana, Nevada, and New Mexico have similar laws for over a decade without market collapse. The bill allows cost management at renewal, uniform changes, removal of unsafe drugs, and promotion of generics. He stresses weighing marginal costs against real harms to patients from disrupted care, and urges support despite expected opposition.
SB544: John Stewart, Keene Support00:26:38.240 - 8:26:20 AM; John Stewart testifies in support of SB 544, sharing his personal experience contacting Senator Fenton after a loved one received a letter from their insurer discontinuing coverage for a critical medication mid-year, causing emotional distress and reliving trauma. He emphasizes continuity of care, patient safety, and fairness, noting the medication was already trialed and effective. Insurers can still decide on formularies but must implement changes at the next plan period, giving patients time to plan with doctors, especially given long wait times for specialists. He criticizes the 60-day notice as insufficient, the appeal process as burdensome (requiring full payment even if successful), and the inability to switch plans mid-year. Research shows insurers change formularies multiple times yearly without consumer input, and he calls for protections so patients and doctors, not insurers, decide on medical needs. He provided written testimony and answers questions on alternatives, appeal avoidance due to length, and the need for systemic fairness and stability.
SB544: Holly Stevens, Director of Public Policy, NAMI New Hampshire Support00:37:51.040 - 8:37:33 AM; Holly Stevens testifies in support of SB 544 on behalf of NAMI New Hampshire, a nonprofit improving lives affected by mental illness through support, education, and advocacy. Finding the right psychiatric medication is a long process (6 months to a year) involving trials and dosages, and medications are not interchangeable due to different brain mechanisms. Mid-year changes force restabilization, leading to risks like homelessness, ER visits, hospitalization, or incarceration, supported by studies in her written testimony. Patients and employers select plans based on formularies during open enrollment, so mid-year shifts disrupt access. She identifies a bill issue with 'modification' potentially blocking formulary additions (e.g., new drugs) and suggests changing to 'removal' while adding language to prohibit shifting drugs to higher cost tiers mid-year, as this makes them unaffordable. With these tweaks, NAMI supports the bill for continued access to effective medications.
SB544: Sabrina Dunlap, Senior Director of Government Relations, Anthem Blue Cross Blue Shield Oppose00:42:34.480 - 8:42:16 AM; Sabrina Dunlap testifies in opposition to SB 544, stating it limits formulary management and timely changes for member benefit. Insurers allow exceptions and often grandfather members to avoid disruption. Flexibility is needed for safety, efficacy, or superior drug availability, and mid-year changes promote lower-cost biosimilars, aligning with state cost-lowering policies. Prohibiting changes causes waste when equivalents emerge, benefiting drug companies by keeping high-cost drugs on formularies, driving up costs. She estimates a $10 per member per month increase ($100+ yearly, $15M for Anthem's fully insured market), pressuring employers. If passed, Anthem welcomes collaboration on language improvements, including effective date. She answers questions on premium adjustments (not mid-year, but longer-term), notifications in contracts (with 60-day notice, changes once mid-year), asynchronous contracting, appeal processes (details to follow, often granted for high-cost drugs), and clarifies insurers don't set plan change rules under ACA.
SB544: Apollo Rogers Information Only00:51:36.000 - 8:51:18 AM; Apollo Rogers provides information on the existing law amended by SB 544, focusing on the exception process for drugs used in the last 12 months that become unavailable. The provision requires 45-day notice, during which coverage continues if an exception is requested. He highlights paragraphs I, II, and III outlining the process, including an expeditious 48-hour reply. For mid-coverage changes (e.g., 6 months in), carriers must provide notice and handle exceptions promptly. He references Mr. Stewart's testimony and offers to discuss further, noting the law's details are in a lengthy section on electronic filing but address the bill's core issues.
SB544: Unidentified Speaker Information Only00:54:12.400 - 8:53:54 AM; The speaker discusses the exception process for medication coverage, noting potential gaps in patient understanding of appeal opportunities after denial. They express uncertainty about appeal mechanisms and suggest clarification in paragraph 2 to address issues. They highlight the value of mid-year formulary changes for patient care and cost efficiency, referencing the influx of new drugs due to advertising in the US and New Zealand.
SB544: Senator Burchill Information Only00:55:27.440 - 8:55:09 AM; The senator suggests solving issues with clarification in paragraph 2 and emphasizes the benefits of responsive formulary changes. They note the extraordinary number of new drugs advertised, complicating management for PBMs, plans, and providers.
SB544: Senator Birdsall Information Only00:56:36.960 - 8:56:18 AM; The senator asks about including a flowchart or directions in insurance denial letters to guide patients on requesting exceptions, including timelines.
SB544: Unidentified Speaker (continued) Information Only00:57:36.880 - 8:57:18 AM; The speaker references a handout on the provision's 21-year history, suggests clarifying notification of the exception process, and notes related managed care regulations.
SB544: Cam Lupine, Orr & Reno, representing Sigma Information Only01:00:02.960 - 8:59:44 AM; Defers to written testimony and answers Senator Burchill's question, explaining that annual enrollment and qualifying life events are ACA provisions.
SB544: Peter Bragden, Harvard Pilgrim Healthcare Oppose01:01:11.119 - 9:00:53 AM; Expresses concerns about operational challenges for small regional nonprofits without owned PBMs. Highlights the need to maintain multiple formularies due to varying plan years, potentially 36 versions, increasing costs passed to premiums. Discusses premium stability, reserves, and the balancing act in current statutes, suggesting clarifications rather than restrictions.
SB549: Senator Keith Murphy, District 16 Support01:06:23.920 - 9:06:05 AM; Introduces the bill citing dangers of discarded needles in Manchester (North Manchester, Goffstown, Raymond, Hooksett, Candia), sharing photos of needles found in playgrounds, homes, cars, and businesses. Criticizes nonprofit distribution of nearly 1 million syringes annually funded by taxes and donations, calling it enablement rather than treatment. Suggests redirecting $1.7 million to actual treatment and notes distribution of boofing kits.
SB549: Jenny O'Higgins and Dr. Jonathan Ballard, Department of Health and Human Services Oppose01:16:19.199 - 9:16:01 AM; O'Higgins notes current prohibitions on using funds for syringe purchases but the bill extends to defunding organizations entirely. Highlights technical conflicts in the bill conflicting with RSA 318B:43 authorizing SSPs, potential fiscal savings of $1.7M but indeterminable long-term costs from increased EMS, hospitalizations, infectious diseases. Ballard cites Kentucky data showing 50% Medicaid cost reduction in SSP counties for HIV, hepatitis, endocarditis; estimates $3.5M increase in NH Medicaid costs without SSPs. Emphasizes SSPs' role in overdose reduction via naloxone distribution and clarifies naloxone and testing implications.
SB549: Lauren Burn, HIV Resource Center, Lebanon Oppose01:34:32.159 - 9:34:14 AM; Strongly opposes, stating the bill would defund case management for 53 HIV clients, testing (300+ people last year), and naloxone distribution (4,000+ doses). Argues harm reduction prevents overdoses, reduces infectious diseases, connects to treatment, and lowers ER costs. Suggests kiosks and disposal boxes like in Vermont to address needle litter.
SB549: John Burns, Executive Director, SOS Recovery Community Organization Oppose01:38:34.800 - 9:38:16 AM; Opposes, noting the bill would force sunset of harm reduction or lose 60% funding ($1.2-2M), impacting recovery centers, juvenile diversion, re-entry programs. Emphasizes connections made via SSPs, distributed 3,476 naloxone doses reversing 417 overdoses in 2025. Cites research showing SSPs reduce improper discards; disputes sponsor's syringe numbers as inaccurate statewide data.
SB549: Cheryl Pacelli, Person in Long-term Recovery Oppose01:43:10.800 - 9:42:52 AM; Opposes based on 36+ years recovery experience, affirming SSPs reduce HIV/hepatitis transmission, overdoses, and engage disconnected individuals. Notes declining overdose rates and reduced infections in Laconia hospital. Agrees on needle concerns but suggests disposal sites like in Vermont/Connecticut instead of ending programs; stresses cost of red boxes vs. disease spread.
SB549: Eve Freeman Toth, Street Outreach and Stabilization Manager, Belknap-Merrimack Community Action Program Oppose01:48:06.560 - 9:47:48 AM; Eve Freeman Toth shares her field-based perspective on harm reduction policy as a former harm reduction program manager and current homeless street outreach lead for two counties. She emphasizes that harm reduction operates in unstable environments with people facing complex trauma, mental health issues, housing insecurity, and limited healthcare access. Key considerations include building trust through voluntary engagement, which can be eroded by policy changes increasing perceived surveillance or legal ambiguity, leading to disengagement, reduced healthcare contact, more diseases, fewer overdose preventions, increased isolation, and higher mortality risks. Service displacement relocates substance use to hidden, unsafe locations, increasing overdose mortality, straining emergency responders, and raising public health costs. Frontline programs face fixed staffing and funding challenges, leading to higher acuity crises, burnout, and turnover. She notes unintended consequences of killing funds, such as observed reductions in needles in Manchester's parks due to programs like Queen City Exchange. Personally, she lost 'Uncle Dad' to a preventable blood infection on December 26, highlighting the need for better access to these programs.
SB549: Todd Schillinger, Interim Director, Keene Serenity Center, New Hampshire Recovery Community Organization Oppose01:52:41.840 - 9:52:23 AM; Todd Schillinger, a person in long-term recovery since 2006, opposes SB 549. As interim director, he has managed relocation, licensing, and staff changes. At their center, they achieved over 100% syringe returns in the last three months of the previous year, meaning more needles collected than distributed. They collaborate with Keene Police Department by providing sharps containers, alert fire and police stations for pickups, and maintain containers at Keene Public Library bathrooms, playgrounds, and basketball courts. He acknowledges concerns about finding syringes but notes that harm reduction works alongside abstinence-based approaches, as he has learned through his own recovery journey.
SB549: Jessica Carter, Executive Director, Revive Recovery Resource Center Oppose01:56:37.679 - 9:56:19 AM; Jessica Carter strongly opposes SB 549, which would defund syringe service programs and all Revive's life-saving services, destabilizing the continuum of care in southern New Hampshire. Revive operates SA, a comprehensive harm reduction program since 2018, serving Nashua's public health region with centers in Nashua, Manchester, and Derry. They collaborate with city outreach, Nashua PD, fire department, and others for 100% syringe return rates. In 2025, they supported 1,154 unique individuals with recovery programming and 624 via SA, many unhoused or medically fragile, reaching 1,224 residents total. Outcomes include 434 overdoses reversed with Narcan in Nashua (excluding center distributions), over 260,000 syringes distributed but more removed from streets, over 1,700 Naloxone kits, over 1,000 xylazine test kits, over 1,500 wound care kits, and nearly 3,000 referrals to healthcare providers. Passing the bill would increase overdose deaths, HIV/Hepatitis rates, hospital costs for preventable infections, syringe litter, and burdens on law enforcement and EMS, while disconnecting people from care. Harm reduction does not encourage drug use but provides critical access.
SB549: Casey Larkcom, Employee, Revive Recovery Resource Center Oppose02:01:59.199 - 10:01:41 AM; Casey Larkcom, a Nashua local and woman in recovery, testifies personally about accessing SA harm reduction services, which provided safe supplies, non-judgmental support, resource referrals, and peer support while she was actively using. This pathway led her to recovery, volunteering, and now employment at Revive. She has seen firsthand the positive impact on community safety and vulnerable populations both personally and professionally.
SB549: Jody Newell, Representative, Cheshire 4 and Keene Oppose02:05:09.599 - 10:04:51 AM; Representative Jody Newell, an NCSL opioid policy fellow from 2024 focusing on opioid policy, supports increasing funding for harm reduction rather than defunding it. She highlights successful collaborations in Keene with local organizations to address needle disposal, significantly reducing issues in public spaces. These programs are evidence-based and essential for a holistic approach to reducing overdose deaths. Personally, she lost her children's father to a heroin overdose 17 years ago on Christmas Eve, noting that such tools were unavailable then, preventing her children and his mother from ever getting him back. Harm reduction keeps people alive long enough to seek recovery, and removing it risks exponential community impacts from preventable deaths.
SB549: Dr. Carrie Noli, Associate Professor of Nursing, University of New Hampshire; Family Nurse Practitioner, Greater Seacoast Community Health Oppose02:08:30.560 - 10:08:12 AM; Dr. Carrie Noli opposes SB 549, emphasizing well-documented benefits of syringe service programs (SSPs) including 50% reductions in new Hepatitis C and HIV cases, and fewer community-disposed needles. Her research focuses on reducing drug-related harms, collaborating with harm reduction teams. In a 2025 health needs assessment, they engaged nearly 300 users: 82% have health insurance, three-quarters are tested for HIV/HCV and have primary care; many (from 95% injecting in 2022 to 56% in recent data) transition away from injecting via supportive care, Naloxone, wound kits, and relationships. Barriers to care include stigma and transportation, which SSPs address. High rates of endocarditis and sepsis (10-20%) often lead people to these programs. Defunding would decimate services. In Dover, community needle disposal efforts reduced 911 calls for found syringes by 40%, freeing officers for policing. She addresses concerns about 'boofing kits' as a strategy to reduce injection frequency and needle use, not widely used but aimed at harm reduction.
SB549: Rachel Potter, Policy Associate, ACLU of New Hampshire Oppose02:14:44.880 - 10:14:26 AM; Rachel Potter expresses deep concerns about SB 549, particularly its restrictions on state and local funds for distributing drug paraphernalia and supporting related organizations, except during legislatively approved disease outbreaks. She argues that the bill limits government responses to public health crises, undermining individual dignity, bodily autonomy, and equal access to life-saving services. The broad definition of drug paraphernalia could capture harm reduction supplies, creating a chilling effect on evidence-based health services. This would disproportionately affect vulnerable populations like those with substance use disorders and low-income communities, exacerbating health inequities and stigma. Potter emphasizes that syringe service programs are cost-effective and life-saving, and restricting funding would increase disease, death, and public costs without eliminating substance use. She urges finding the bill inexpedient to legislate, stating that harm reduction aligns with community safety and New Hampshire values.
SB549: Kathy Stratton, New Hampshire Medical Society Oppose02:18:10.399 - 10:17:52 AM; Kathy Stratton speaks on behalf of the New Hampshire Medical Society and its 2,000 physicians in opposition to SB 549. She highlights concerns about public health resources as part of comprehensive efforts to reduce addiction and overdose deaths. Acknowledging issues with improperly disposed needles, she offers the society's help to mitigate risks. Stratton cites over 30 years of research from the National Institute on Drug Abuse showing that needle syringe exchange programs do not increase intravenous drug use. These programs serve as a critical bridge to addiction treatment within harm reduction strategies. Failing to support them leads to increased disease transmission, delayed healthcare, higher treatment costs, prolonged addiction, more overdoses, and strain on healthcare systems. She urges voting inexpedient to legislate (ITL) and focusing on syringe disposal instead.
SB549: Jake Barry, Senior Vice President, New Futures Oppose02:20:44.160 - 10:20:26 AM; Jake Barry, from the nonpartisan nonprofit New Futures, opposes SB 549, emphasizing needle exchange as an evidence-based practice backed by over 30 years of research that prevents infectious diseases and saves lives. He credits harm reduction programs, including needle exchanges, for distributing the most Narcan, providing overdose education to police and communities, and offering resources for those with substance use disorders. The bill would undermine the public health system built to address the addiction crisis, costing many lives. As a Manchester resident raising children there, Barry disputes negative characterizations of the city, noting needles are rare and he feels safer with these programs available, preferring occasional needles over body bags from increased overdoses.
SB549: Lauren McInley, Executive Director, New Hampshire Harm Reduction Coalition Oppose02:22:58.080 - 10:22:40 AM; Lauren McInley, executive director of the New Hampshire Harm Reduction Coalition, provides testimony opposing SB 549, summarizing 30 years of CDC-proven efficacy of syringe service programs in reducing fatal and non-fatal overdoses, syringe litter, HIV, hepatitis C, and other infections, while lowering hospital costs from injection-related wounds. She notes syringes are legally sold without prescription in pharmacies and online, so they will persist regardless of programs. Her organization is the only one offering free biohazard disposal for syringes from various sources, including medical uses like insulin or GLP-1 drugs, addressing syringe litter. Ceasing programs would not improve litter issues, and she offers her submitted testimony, annual report, and answers questions on funding.
SB616: Senator Suprentice, State Senator for District 5 Information Only02:28:00.880 - 10:27:42 AM; Senator Suprentice introduces SB 616, which addresses reporting requirements under the Right to Try Act. She represents District 5, covering 15 communities, and is presenting the bill on behalf of its purpose to enhance or modify reporting in this context.
SB616: Senator Bzel Support02:28:40.399 - 10:28:22 AM; Senator Bzel explains the purpose of SB 616, which adds reporting requirements to the Right to Try statute to track usage of experimental treatments for terminally ill patients who have exhausted FDA-approved options. She highlights the expansion from last year's HB 701, emphasizing the need for data on patient origins, therapies used, administration settings, and providers to align with other healthcare reporting like ambulatory care and EMS data. She notes the bill's simplicity, potential for patients traveling to NH for treatment, and suggests pushing the effective date to 2027 to integrate with other data systems, reducing costs as per the fiscal note.
SB616 2024-Committee Amendment: Committee Discussion Vote02:33:00.720 - 10:32:42 AM; The committee discusses the fiscal note, questioning the need for a full-time hire and confirming cost savings by delaying to 2027 to align with abortion statistics reporting. They propose and adopt a committee amendment changing the reporting start date from February 1, 2027, to February 1, 2028, and effective date to July 1, 2027, for efficiency. The motion for Ought to Pass with amendment passes unanimously, with consent calendar motion also passing. The session ends with assignment to Senator Apprentice.
HB349: Senator Jim Copalt, District 32 (Wilton, Temple, New Ipswich) Support02:39:24.080 - 10:39:06 AM; Senator Copalt introduces HB 349, which allows certified optometrists to perform three specific low-risk ophthalmic laser procedures: laser capsulotomy, trabeculoplasty, and peripheral iridotomy. He notes similarities to last session's SB 440, adds House amendments for live patient training and proctored supervision, and emphasizes board rulemaking for standards. He argues for improved access in rural NH, reducing wait times (3.5-4.5 months) and travel burdens, especially for non-drivers. Shares a story of a 77-year-old rural resident dependent on others due to delays. Cites safety in 14 states with only 2 adverse events in 146,000 procedures, no increase in malpractice rates, and potential cost savings. Urges support to attract trained optometrists.
HB349: Dr. Allison Langer, Advanced Eye Care (Hooksett) Support02:48:51.279 - 10:48:33 AM; Dr. Langer, a Goffstown optometrist with 15 years alongside ophthalmology, supports HB 349 to update NH's optometry scope unchanged in 20+ years, aligning with national training advances. Describes procedures as in-office, non-surgical (no scalpel, anesthesia, or OR), for front-of-eye issues only, not retinal or LASIK. Counters opposition from organized medicine's 'scope creep' campaign, noting past successful expansions like glaucoma treatment without harm. Addresses referrals, patient selection, and complications (inflammation, pressure, bleeding) managed routinely by optometrists; rare issues referred to specialists. Notes failed collaboration with ophthalmology and bill adjustments for concerns. Emphasizes access to safe care.
HB349: Kathy Stratton, CEO New Hampshire Medical Society Oppose02:55:42.640 - 10:55:24 AM; Stratton opposes HB 349, citing ophthalmologists' superior training: 4 years postgraduate + 3-5 years residency (12-16,000 hours) vs. optometrists' lack of required residency. Shares personal story of her 85-year-old mother's successful laser surgery restoring independence, underscoring expertise's importance. Argues against extending surgical privileges to those with limited training and oversight. Notes ophthalmologists' efforts to expand rural access, including new North Country services, addressing prior concerns. Urges Inexpedient to Legislate (ITL), prioritizing patient safety over scope expansion.
HB349: Dr. Larry Bich, OD PhD, MCPHS University School of Optometry Support03:04:22.319 - 11:04:04 AM; Dr. Bich, with 35 years in ophthalmology/optometry and 8 years as associate dean, details extensive optometry training: 176 hours in methods/lab on glaucoma, cataract, refractive surgery, including laser observation on simulated eyes. Post-graduation requires national board certification in laser/minor surgery, residencies, or proctoring by ophthalmologists/experienced optometrists. Clarifies ophthalmology residencies don't mandate 5/5/4 procedures for individuals, only availability. As a Lumenis laser trainer for MDs, notes physicians get similar didactic/simulated training before patients. Affirms NH students receive thorough preparation, not immediate surgery post-graduation.
HB349: Dr. Peter Ramlard, My Eye Doctor (Manchester) Support03:09:32.960 - 11:09:14 AM; Dr. Ramlard, 37-year optometrist licensed in CT, MA, NH, supports HB 349 for safety and protections: board certification beyond licensure, 4-year doctoral education + dedicated laser program, supervised live cases (minimums not guaranteeing certification), informed consent, and mandatory complication reporting. Cites 146,000+ safe procedures in other states, no increased complications or malpractice rates. Distinguishes NH's strict national exam requirements from Kentucky's autonomous board. Notes complications occur regardless of provider; bill's framework ensures proficiency, access, and patient safeguards.
HB349: Dr. Angelique Sawyer, Optometrist (North Conway and Berlin, NH) Support03:13:43.120 - 11:13:25 AM; Dr. Sawyer supports HB 349 to address access to timely eye care and patient choice in rural areas. She highlights the declining supply of ophthalmologists, predicted to worsen, while optometry grows. In northern NH, she notes severe shortages, with counties having few ophthalmologists, closures of referral centers, retirements without replacements, failed recruitments, and unsustainable traveling services. She praises a new ophthalmology outreach clinic at Androscoggin Valley Hospital for cataract surgery and retinal specialists but states it does not negate HB 349's need, as it offers broader services than the bill's limited laser procedures and involves rotating providers, leading to fragmented care. Patients are comfortable with optometrists performing these procedures after 13 years of experience.
HB349: Dedra Cullen, Optometrist (Belmont, NH) Support03:17:28.160 - 11:17:10 AM; Dr. Cullen supports HB 349, sharing her experience graduating trained in laser procedures from MCPHS University but unable to perform them in NH, hindering her practice and recruitment of top providers who leave for states allowing evidence-based care. She references the 2022 Light Trial concluding SLT as safe and effective first-line glaucoma treatment, which optometrists manage but cannot provide in NH. With declining ophthalmology workforce, increasing optometry, and growing patient population, she urges support for the bill.
HB349: Dr. Shaki Martin, Ophthalmologist (Dartmouth Hitchcock Medical Center, President of NH Society of Eye Surgeons and Physicians) Oppose03:19:21.920 - 11:19:03 AM; Dr. Martin opposes HB 349, emphasizing collaboration between optometrists and ophthalmologists but stressing optometry's non-surgical nature. Optometrists train 4 years post-college in primary eye care, while ophthalmologists undergo 8-10 years including medical school, internship, residency, and fellowship. He argues laser procedures are surgery involving irreversible tissue alteration. HB 349's minimum procedures mirror ACGME standards for physician programs, not individual competency, requiring prior surgical experience. Competency demands years of supervised live patient training, not didactic or model-based instruction in optometry schools, many in states prohibiting lasers. The professions complement each other through specialized training.
HB349: Dr. Amy Hennessy, Ophthalmologist (Medical Eye Center, Manchester/Bedford/Nashua/Peterborough/Concord, NH) Oppose03:24:46.479 - 11:24:28 AM; Dr. Hennessy opposes HB 349 for patient safety reasons. She describes the laser procedures as high-risk intraocular surgeries: laser capsulotomy (10-15% of cataract patients), SLT for glaucoma via delicate eye drain, and peripheral iridotomy for angle-closure risks, all involving inflammation and precision. Risks include blinding complications from inadequate training, as warned in some states allowing optometrists. No Northeast states permit this, and 72% of the US does not. As a glaucoma specialist, she sees delays from misdiagnoses; optometrists performing lasers could worsen this. Proper training requires residency for diagnosis, decision-making, and complication management, not brief courses. HB 349 removes safeguards; legislation should mandate rigorous hands-on training, oversight, and complication reporting.
HB349: Dr. Tim Peters, Ophthalmologist (Southern NH) Oppose03:28:49.200 - 11:28:31 AM; Dr. Peters opposes HB 349, drawing from his practice with six optometrists, a resident, and rotating students. He addresses North Country access via a $300,000 partnership with North Country Ophthalmology and AVH Hospital, involving eight physicians and 16 more committed, with a three-year succession plan. The program, opened January 9th, has treated patients for various conditions and invites visits. It ensures high-quality care without lowering standards. The bill's laser surgeries are rare (2% Medicare), not solving access; current setup covers 100% needs. Passing it would make NH the only New England state allowing non-MDs surgery, lowering standards. With quality addressed, question if NH wants the proposed standard. Suggests federal funding model for rural expansion.
HB349: Bruce Berkkey, She Infinity Capital Group (representing NH Society of Eye Physicians and Surgeons) Oppose03:33:02.399 - 11:32:44 AM; Mr. Berkkey opposes HB 349, following substantive testimony. He presents a statutory analysis showing confusion in current law, citing RSA 329:1 defining surgery broadly as procedures cutting, shaping, burning, vaporizing, or altering tissue, including lasers, which sounds invasive.
HB349: Bruce Berkley, She Infinity Capital Group (representing NH Society of Eye Physicians and Surgeons) Oppose03:34:18.399 - 11:34:00 AM; The speaker continues testimony opposing HB 349, noting the absence of the word 'surgery' in the bill despite it involving laser procedures, which are considered surgery under existing statutes. He argues that if the bill passes, guardrails are essential, referencing Amendment 3291A which emphasizes the medical community's responsibility to protect the public. He highlights the Board of Medicine's greater accountability compared to the Board of Optometry, due to its composition with only a minority of surgeons among 11 members, versus the Optometry Board's 5 members, 4 of whom are optometrists potentially lacking laser experience. Citing RSA 327, he defines optometry as excluding surgery and surgery as procedures cutting or altering tissue, including by laser. The bill's confusion on authority over surgery makes it unclear how the Optometry Board can regulate qualifying optometrists for these procedures.

Rochefort, David(Chairman)(R)[B-]2025	Avard, Kevin(V Chairman)(R)[B]2025	Birdsell, Regina(R)[B-]2025
Prentiss, Suzanne(D)[F]2025	Long, Pat(D)[F]2025