Bill Text: NH SB127 | 2023 | Regular Session | Amended

New Hampshire Senate Bill 127 (Prior Session Legislation)

Bill Title: Relative to certain programs administered by the department of health and human services.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Passed) 2023-07-11 - III. Remainder Effective 06/30/2023 [SB127 Detail]

Download: New_Hampshire-2023-SB127-Amended.html

SB 127-FN - AS AMENDED BY THE HOUSE

02/22/2023 0574s

18May2023... 1457h

2023 SESSION

23-0886

07/04

SENATE BILL 127-FN

AN ACT relative to certain programs administered by the department of health and human services.

SPONSORS: Sen. Bradley, Dist 3

COMMITTEE: Health and Human Services

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AMENDED ANALYSIS

This bill:

I. Clarifies and re-routes fees paid by methadone providers to the special fund for administration of opioid treatment programs.

II. Alters the definition of personal care services provider for the purposes of reimbursement by the department.

III. Alters the payment structure to residential care facilities for features outside of room and board.

IV. Eliminates the long term care facility reporting requirement to the department of health and human services regarding the Nursing Facility Quality Assessment (NFQA).

V. Removes the requirement for a beverage license if the facility is only offering bottled beverage direct to consumer and already holds a retail food license from the state health department or self-inspecting jurisdiction.

VI. Removes payment of premiums from the MEAD program.

VII. Aligns public assistance benefits within this state with federal regulations.

VIII. Alters the reporting requirements of the state office of rural health.

IX. Extends the commission to study the delivery of public health services through regional public health networks report date and prospective repeal to 2024.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

02/22/2023 0574s

18May2023... 1457h 23-0886

07/04

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Three

AN ACT relative to certain programs administered by the department of health and human services.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Controlled Drug Act; Professional Use of Narcotic Drugs. Amend RSA 318-B:10, VII(f) to read as follows:

(f) The department shall assess a fee to be paid by providers of methadone detoxification and maintenance programs for certification and administration by the department. [The fee shall be $8 per client based on the annual client census of the previous calendar year. If the provider had no clients in the previous calendar year, then the fee shall be $1,000.] The initial fee shall be $1,000. Annually thereafter, the fee shall be $8 per client based on the annual client census of the previous calendar year. All moneys collected by the department from fees authorized under this subparagraph shall be deposited into the [general fund] special fund for administration of opioid treatment programs established in RSA 172:8-c.

2 New Hampshire Substance Use Disorder Services System; Special Fund for Administration of Opioid Treatment Programs. Amend RSA 172:8-c to read as follows:

172:8-c Special Fund for Administration of Opioid Treatment Programs. There is hereby established a special fund for administration of opioid treatment programs. The fund shall be composed of fees collected by the commissioner in accordance with [RSA 172:14, II] RSA 318-B:10, VII(f), and shall be used to carry out the provisions of this chapter including, but limited to, acting upon the application for the certification, permit, or training of opioid treatment programs. The fund shall be nonlapsing and shall be continually appropriated to the commissioner for the purposes of this chapter to support program operations for certification and administration of the department of health and human services oversight of opioid treatment programs.

3 Personal Care Services; Definitions. Amend RSA 161-I:2, XII to read as follows:

XII. "Personal care services provider" means a person who:

(a) Is selected by:

(1) The eligible consumer;

(2) The eligible consumer's legal guardian;

(3) The eligible consumer's representative; or

(4) A person granted power of attorney by the eligible consumer; and

(b) Is employed by a home health agency or other qualified agency to provide personal care services; and

(1) The eligible consumer's legally responsible relative, except as authorized pursuant to RSA 161-I:3-a;

(2) The eligible consumer's legal guardian, except as authorized pursuant to RSA 161-I:3-a;

(3) The eligible consumer's representative; or

(4) A person granted power of attorney by the eligible consumer, except as authorized pursuant to RSA 161-I:3-a.

4 Personal Care Services; Authorization of Legally Responsible Relative, Guardian or Person Granted Power of Attorney. Amend RSA 161-I:3-a to read as follows:

161-I:3-a Authorization of Legally Responsible Relative, Guardian, or Person Granted Power of Attorney. The department may authorize reimbursement to a legally responsible relative, a guardian, or a person granted power of attorney by the eligible consumer who provides personal care to an eligible consumer with special health care needs residing at home. Such reimbursement shall occur only when the department determines that the needs of the eligible consumer, the unavailability of appropriate providers or suitable alternative care services, and cost efficiencies make utilization of a legally responsible relative, guardian, or person granted power of attorney by the eligible consumer for the provision of such services necessary and appropriate. Reimbursement shall be limited to care that is medically necessary due to specific health needs and shall not be made for care generally expected and provided by a legally responsible relative. The department shall not authorize reimbursement to a legally responsible relative until a plan and rules adopted pursuant to RSA 541-A, are reviewed and approved by the oversight committee on health and human services, established in RSA 126-A:13.

5 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children; Personal Needs Allowance of Residents in Residential Care Facilities and Community Residences. Amend RSA 167:27-b to read as follows:

167:27-b Personal Needs Allowance of Residents in Residential Care Facilities and Community Residences. Recipients of assistance who are approved by the department of health and human services for residential care facility or community residence payments shall be allowed to retain from their income an amount not less than the amount established by the commissioner of the department of health and human services as provided in RSA 167:27-a as the monthly allowance for their personal needs, in accordance with rules adopted by the commissioner of the department of health and human services pursuant to RSA 541-A. This amount shall not be used to reimburse facilities for the cost of care or room and board.

6 New Paragraph; Assisted Living Residences, Independent Living Retirement Communities and Housing for Older Persons. Amend RSA 161-J:4 by inserting after paragraph II the following new paragraph:

III. A residential services agreement shall not require payment from a third party for any services included in the base rate. Nothing in this section shall prohibit an assisted living residence, independent retirement community, or housing for older persons from seeking payment from a resident’s insurance. Nothing in this section shall prohibit a third party from agreeing to pay for additional items or services not included in the base rate, such as cable television. Nothing in this section shall prohibit a third party from agreeing to pay for upgrades to services included in the base rate, such as an additional fee for a private room instead of a shared room.

7 Nursing Facility Quality Assessment; Returns. Amend RSA 84-C:4 to read as follows:

84-C:4 Returns. Every nursing facility shall on or before the tenth day of the month following the expiration of the assessment period make a return to the commissioner [and to the commissioner of the department of health and human services]. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the form of such return and the date which it must contain for the correct computation of facility net patient services revenues and the assessment upon such amount. All returns shall be signed by the authorized representative of the nursing facility, subject to the pains and penalties of perjury. If such return shows an overpayment of the assessment due, the commissioner shall refund or credit the overpayment to the nursing facility.

8 Manufacture and Sale of Beverages; Beverages and Beverage Concentrates. Amend RSA 143:9 to read as follows:

143:9 Beverages and Beverage Concentrates. The term "beverage" as used in this subdivision shall include all still and carbonated drinks; fruit juices and all beverages compounded therefrom; all bottled waters, whether for medicinal or table use; and all packaged liquids intended for use in the manner of drink. Milk and unmixed products thereof, and [fruit juices and waters] 100 percent apple cider retailed exclusively by the producer or manufacturer direct, are not included. The term "beverage" as used in this subdivision, shall not apply to a beverage as defined in RSA 175:1, VIII. The term "beverage concentrate" as used in this subdivision shall include all concentrated fruit juices, fruit-flavored and other syrups, and compounds and mixtures in concentrated liquid form, put up in packages for retail sale and which are intended as a basis for the preparation of a beverage. Flavoring extracts for general culinary use are not included.

9 Manufacture and Sale of Beverages; License Required. Amend RSA 143:10 to read as follows:

143:10 License Required. No person, firm or corporation shall, within the state, put up for sale in package form any beverage without having obtained a license, to be issued by the department of health and human services. Any New Hampshire beverage manufacturers offering product direct to consumer that hold a valid food service license under RSA 143-A from the from the department or from a self-inspecting municipality shall not be required to obtain a separate license under this chapter.

10 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children; Rulemaking. Amend RSA 167:3-c, XII to read as follows:

XII. The MEAD work incentive program under RSA 167:6, IX and RSA 167:3-i as follows:

(a) Eligibility for the program, including medical need and asset and income limits.

(b) Participant employment requirements.

(d) Termination of participation for nonpayment of premium or other good cause.

(e)] Requirements that the participant disclose any employer-sponsored health insurance available to the participant.

11 Human Services; SNAP Program; Overpayment. Amend RSA 161:10 to read as follows:

161:10 [Food Stamp] Supplemental Nutrition Assistance Program; Overpayment. To the extent permitted by the Food Stamp Act of 1977, [as amended] under 7 C.F.R. section 273.18(e), and federal regulations adopted thereunder, the department of health and human services shall terminate or waive any claim to reimbursement for the overpayment of [food stamps] supplemental nutrition assistance program (SNAP) benefits if the overpayment was the result of department error and[:

I.] the amount of the overpayment is not more than $450[; or

II. The recipient's income is less than or equal to 2 times the federal poverty level].

12 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children; Discontinuation of [Food Stamps] Supplemental Nutrition Assistance Program (SNAP) Benefits. Amend RSA 167:17-d, I to read as follows:

I. Subject to the provisions of 7 C.F.R. section 273.16, or any subsequent amendments thereto, when a person receiving [food stamps assistance] supplemental nutrition assistance program (SNAP) benefits is convicted of a violation of RSA 167:17-b, the commissioner shall discontinue his or her assistance for a minimum period of [6] 12 months upon the first conviction, [one year] 24 months upon the second conviction, and permanently upon the third conviction, unless the court orders that assistance be discontinued for longer periods of time after the first or second convictions.

13 Commissioner of Health and Human Services; State Office of Rural Health; Commissioner's Report. Amend RSA 126-A:5, XVIII(c) to read as follows:

(c) The commissioner shall submit [an annual] a report beginning on November 1, [2009] 2025 and on every third year thereafter to the speaker of the house of representatives, the senate president, the governor, the oversight committee on health and human services established under RSA 126-A:13, the chairs of the house and senate executive departments and administration committees, the chairs of the house and senate committees having jurisdiction over health and human services, and the commission on primary care workforce issues established under RSA 126-T:1, on the health status of rural residents incorporating current data from the bureau of health statistics and data management and the SORH.

14 Commissioner of Health and Human Services; State Office of Rural Health; Office's Report. Amend RSA 126-A:5, XVIII-a(e) to read as follows:

(e) On or before December 1, 2019, and annually thereafter, the SORH shall make a written report to the speaker of the house of representatives, the senate president, the governor, the oversight committee on health and human services established under RSA 126-A:13, the chairs of the house and senate executive departments and administration committees, the chairs of the house and senate policy committee having jurisdiction over health and human services, and the commission on interdisciplinary primary care workforce established by RSA 126-T:1. The report shall include, but not be limited to, aggregate data and information on current and projected primary workforce needs and the participation rate on surveys completed pursuant to this paragraph. [This report shall be incorporated into the report required pursuant to RSA 126-A:5, XVIII(c).]

15 Commission to Study the Delivery of Public Health Services Through Regional Public Health Networks; Extension of Report Date. Amend RSA 127:12, VII to read as follows:

VII. The commission shall report its findings and any recommendations for proposed legislation to the president of the senate, the speaker of the house of representatives, the senate clerk, the house clerk, the governor, and the state library on or before November 1, [2023] 2024.

16 Prospective Repeal of the Commission to Study the Delivery of Public Health Services in New Hampshire Through Regional Public Health Networks; Extension. Amend 2022, 278:3, I to read as follows:

I. Section 2 of this act shall take effect November 1, [2023] 2024.

17 Effective Date.

I. Sections 1, 2, 5, 6, 11, and 12 of this act shall take effect July 1, 2023.

II. Sections 3, 4, 8, and 9 of this act shall take effect 60 days after its passage.

III. The remainder of this act shall take effect upon its passage.

LBA

23-0886

Amended 3/7/23

SB 127-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2023-0574s)

AN ACT relative to certain programs administered by the department of health and human services.

FISCAL IMPACT: [ X ] State [ ] County [ X ] Local [ ] None


	Estimated Increase / (Decrease)
STATE:	FY 2023	FY 2024	FY 2025	FY 2026
Appropriation	$0	$0	$0	$0
Revenue	$0	Indeterminable	Indeterminable	Indeterminable
Expenditures	$0	Indeterminable	Indeterminable	Indeterminable
Funding Source:	[ X ] General [ ] Education [ ] Highway [ ] Other

LOCAL:
Revenue	$0	Indeterminable	Indeterminable	Indeterminable
Expenditures	$0	$0	$0	$0

METHODOLOGY:

This bill makes a variety of changes to statutes covering the Department of Health and Human Services. In the aggregate, the fiscal impact of the changes are expected to be minimal. Individual impact will be as follows:

Sections 1 and 2 : These sections relate to the opioid treatment program fund established in Chapter 272:8 Laws of 2022 (HB 1661), and corrects the statutory citation for the funding source for the special fund for administration of opioid treatment programs. The Department states that currently, the cross-reference to RSA 172:14, II, is incorrect. These sections will have no fiscal impact.

Sections 3 and 4: These sections relate to reimbursement for guardians and powers of attorney for providing personal care services. The Department states that currently, it is prevented from reimbursing guardians and power of attorneys for providing personal care services to their wards or principals. These sections allow reimbursement for guardians and powers of attorney if they meet requirements that the Department will lay out in administrative rules similar to legally responsible relatives. The Department states this change will have no fiscal impact, because it does not affect the number of people eligible for services or the amount that will be paid for those services, only who may be paid to provide those services. Additionally, there is no change in eligibility requirements because of the proposed legislation.

Sections 5 and 6: These sections relate to room and board charges for choices for independence (CFI) participants residing in residential care facilities. The sections prohibit residential care facilities from (1) charging for room and board beyond a resident’s income less personal needs allowance; and (2) charging family members for services other than additional services. These sections are anticipated to result in no fiscal impact to the Department.

Section 7: This section relates to the Nursing Facility Quality Assessment (NFQA). The section amends RSA 84-C:4 to eliminate the requirement that nursing facilities file returns with the Department of Health and Human Services. The return referenced in this statute relates to the NFQA, and is an assessment paid to the Department of Revenue Administration (DRA) by nursing facilities utilized as part of the rate setting process. DHHS states that it already receives the returns in conjunction with DRA because DRA provides the relevant information to the DHHS separately. DHHS does not expect a fiscal impact as a result of this provision.

Sections 8 and 9: These sections relate to food protection services. The Department states that the sections are intended to provide clarity around when a beverage/bottled water manufacturer license is required. Specifically, the bill removes the requirement for a license if the facility is only offering bottled beverage direct to consumer and already holds a retail food license from the state health department or self-inspecting jurisdiction. The Department anticipates that these sections may result in a minimal reduction in state or local revenues due to the elimination of an additional fees to certain beverage/bottled water manufacturers holding a retail food license from the state health department or self-inspecting jurisdiction.

Section 10: This section relates to the Medicaid for Employed Adults with Disabilities (MEAD) and Medicaid for Employed Older Adults with Disabilities (MOAD) programs. The Department states that the changes contained in this section are remedial follow-ups to HB 1661 from 2022, which eliminated the requirements for clients to pay premiums in the MEAD and MOAD programs. The current change provides further clean up by omitting references to the MEAD and MOAD premiums in another section of the state law. No fiscal impact is anticipated.

Section 11: This section relates to Supplemental Nutrition Assistance Program (SNAP) disqualification penalties. The Department states that this amendment to RSA 167:17(d) is for the purpose of aligning the disqualification penalties with the federal law. The section will result in minimal, if any, fiscal impacts to the Department.

Section 12: This section relate to SNAP overpayment. The Department states that this amendment to RSA 167:10 aligns state overpayment remedies with federal law. The section will result in minimal, if any, fiscal impacts to the Department.

Sections 13 and 14: These sections modify the annual report prepared by the Department's State Office of Rural Health by changing it to a three-year cycle. No fiscal impact is expected.

Sections 15 and 16: These section extends the sunset for the Commission to Study the Delivery of Public Health Services through Regional Public Health Networks by one year to November 1, 2024. No fiscal impact is anticipated.

AGENCIES CONTACTED:

Department of Health and Human Services