New Hampshire 2025 Regular Session

New Hampshire Senate Bill SB244 Compare Versions

The same version is selected twice. Please select two different versions to compare.

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	SB 244-FN-A - AS AMENDED BY THE SENATE
2	2
3	3
4	4
5	5	03/13/2025 0776s
6	6
7	7	2025 SESSION
8	8
9	9	25-0971
10	10
11	11	05/09
12	12
13	13
14	14
15	15	SENATE BILL244-FN-A
16	16
17	17
18	18
19	19	AN ACTrelative to expanding access to primary health care services, increasing the size of the health care workforce, and making appropriations therefor.
20	20
21	21
22	22
23	23	SPONSORS:Sen. Rosenwald, Dist 13; Sen. Watters, Dist 4; Sen. Reardon, Dist 15; Sen. Long, Dist 20; Sen. Perkins Kwoka, Dist 21; Sen. Fenton, Dist 10; Sen. Prentiss, Dist 5; Sen. Altschiller, Dist 24; Rep. Wallner, Merr. 19; Rep. Telerski, Hills. 11; Rep. Weber, Ches. 5
24	24
25	25
26	26
27	27	COMMITTEE:Health and Human Services
28	28
29	29
30	30
31	31	-----------------------------------------------------------------
32	32
33	33
34	34
35	35	AMENDED ANALYSIS
36	36
37	37
38	38
39	39	This bill expands access to primary health care services by directing the department of health and human services to amend its contract with the Bi-State Primary Care Association's Recruitment Center in order to expand health care workforce recruitment and retention efforts and increases funding for such programs. The bill also makes an appropriation to the department of health and human services to increase Medicaid reimbursement rates for opioid treatment providers.
40	40
41	41
42	42
43	43	- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
44	44
45	45
46	46
47	47	Explanation:Matter added to current law appears in bold italics.
48	48
49	49	Matter removed from current law appears [in brackets and struckthrough.]
50	50
51	51	Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
52	52
53	53	03/13/2025 0776s25-0971
54	54
55	55	05/09
56	56
57	57
58	58
59	59	STATE OF NEW HAMPSHIRE
60	60
61	61
62	62
63	63	In the Year of Our Lord Two Thousand Twenty Five
64	64
65	65
66	66
67	67	AN ACTrelative to expanding access to primary health care services, increasing the size of the health care workforce, and making appropriations therefor.
68	68
69	69
70	70
71	71	Be it Enacted by the Senate and House of Representatives in General Court convened:
72	72
73	73
74	74
75	75	1 Short Title. This act shall be known as The New Hampshire Needs Caregivers Act.
76	76
77	77	2 Statement of Purpose.
78	78
79	79	I. New Hampshire’s health care workforce is the foundation of our health care safety net, and the foundation is in crisis due to a lack of consistent investments. As a result, residents of New Hampshire will go without care. Recently, the state worked to stabilize the system using federal funds, including direct aid to hospitals, community providers, and long-term care facilities, and investments in our Medicaid program; however, there remains a strong need to invest in programs to foster a future health care workforce within the Granite State.
80	80
81	81	II. The state of New Hampshire shall address the health care workforce shortage by leveraging state funding through public and private partnerships, investing in programs designed to incentivize students to seek employment in health care and remain in New Hampshire upon graduation; and equipping health care organizations with the tools necessary to secure skilled clinicians.
82	82
83	83	3 Department of Health and Human Services; Division of Public Health Services; Public-Private Health Care Workforce Recruitment and Retention Hub; Infrastructure Contracts.
84	84
85	85	I. The department of health and human services, division of public health services, rural health and primary care section shall amend its current contract with Bi-State Primary Care Association’s Recruitment Center to require the Recruitment Center to strengthen the infrastructure needed to sustain and transform community-based primary care services through the creation of a Public-Private Health Care Workforce Recruitment and Retention Hub that promotes collaboration across the continuum of care. Bi-State Primary Care Association shall administer the Public-Private Health Care Workforce Recruitment and Retention Hub and manage the sub-recipient contracts, and leverage federal, state, and private funding, and seek new funding opportunities when appropriate.
86	86
87	87	II. Bi-State Primary Care Association shall design the sub-recipient contracts to facilitate health care workforce development, recruitment, retention, support nursing preceptor and mentoring programs, provide training and technical assistance, and loan repayment opportunities. Bi-State Primary Care Association shall:
88	88
89	89	(a) Expand and implement its national outreach and marketing campaign designed to recruit qualified clinicians to New Hampshire;
90	90
91	91	(b) Collaborate with an area health education center for the purpose of creating and expanding graduate level nursing mentoring and precepting programs. The area health education center shall provide the necessary support to graduate level nursing preceptors and the health care organizations that act as training sites;
92	92
93	93	(c) Collaborate with an area health education center for the purpose of supporting the New Hampshire Needs Caregivers Program. This program shall promote, recruit, and fund training of up to 500 individuals interested in a career in health care as a licensed nursing assistant. The New Hampshire Needs Caregivers Program shall create scholarship opportunities to cover the cost of tuition for licensed nursing assistant training up to $2,600; supportive services; and assist individuals in finding courses and employment;
94	94
95	95	(d) Expand student loan repayment opportunities for clinicians with bachelors’ degrees employed by non-profit health care organizations in exchange for the agreement to work for the non-profit health care organization for 24 months for part-time employees to 36 months for full-time employees; and
96	96
97	97	(e) Collaborate with a family medicine residency program in rural New Hampshire at a teaching health center program to support the training of family medicine residents in the north country. The teaching health center program shall be accredited or eligible for accreditation by a nationally recognized accreditation agency.
98	98
99	99	4 Department of Health and Human Services; Rural Health and Primary Care Section; Appropriations.
100	100
101	101	I. Appropriation; Public-Private Health Care Workforce Recruitment and Retention Hub. The sum of $580,000 for the fiscal year ending June 30, 2026 and the sum of $580,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph I of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
102	102
103	103	II. Appropriation; Workforce Recruitment, Advertising, and Marketing. The sum of $250,000 for the fiscal year ending June 30, 2026 and $250,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose described in paragraph II(a) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
104	104
105	105	III. Appropriation; Bi-State Primary Care Association Sub-Recipient Contract with an Area Health Education Center; Graduate Nursing Student Preceptors and Financial Support for Host Organizations. The sum of $300,000 for the fiscal year ending June 30, 2026 and the sum of $300,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(b) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
106	106
107	107	IV. Appropriation; Bi-State Primary Care Association sub-recipient contract with an area health education center; New Hampshire Needs Caregivers. The sum of $500,000 for the fiscal year ending June 30, 2026 and the sum of $750,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(c) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
108	108
109	109	V. Appropriation; Bi-State Primary Care Association sub-recipient contracts; Public-Private Health Care Workforce Recruitment and Retention Hub Loan Repayment Programs. The sum of $300,000 for the fiscal year ending June 30, 2026 and the sum of $300,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purpose set forth in paragraph II(d) of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
110	110
111	111	VI. Appropriation; Bi-State Primary Care Association sub-recipient contract with a rural residency training at a teaching health center program. The sum of $500,000 for the fiscal year ending June 30, 2026 and the sum of $500,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section for the purposes set forth in paragraph II(e) of section 3 of this act. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
112	112
113	113	VII. Appropriation; Early Childhood and Family Mental Health Credential. The sum of $203,500 for the fiscal year ending June 30, 2026 and the sum of $203,500 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, bureau of children's behavioral health for the purpose set forth in RSA 167:3-l, IV(a)(2). The bureau shall use the funding to support the training of up to 60 clinicians per year of the biennium. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
114	114
115	115	VIII. Appropriation; Primary Care Workforce Program. The sum of $115,000 for the fiscal year ending June 30, 2026 and the sum of $115,000 for the fiscal year ending June 30, 2027 are hereby appropriated to the department of health and human services, division of public health services, rural health and primary care section, for an administrator I position for the purpose of administering paragraph I of section 3 of this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
116	116
117	117	5 Department of Health and Human Services; Medicaid Rates Paid to Opioid Treatment Providers; Appropriation.
118	118
119	119	There is hereby appropriated to the department of health and human services the sum of $2,000,000 for the fiscal year ending June 30, 2026 and the sum of $2,000,000 for the fiscal year ending June 30, 2027, for the purpose of increasing rates paid to providers of opioid treatment programs. Said amounts are intended to cover the cost of rate increases for both the traditional Medicaid population and granite advantage program population. The department may accept and expend any federal funds available for the purposes of this section without the prior approval of the fiscal committee of the general court. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.
120	120
121	121	6 Effective Date. This act shall take effect July 1, 2025.
122	122
123	123
124	124
125	125	LBA
126	126
127	127	25-0971
128	128
129	129	Revised 2/25/25
130	130
131	131
132	132
133	133	SB 244-FN-A- FISCAL NOTE
134	134
135	135	AS INTRODUCED
136	136
137	137
138	138
139	139	AN ACTrelative to expanding access to primary health care services, increasing the number of direct health care providers, increasing Medicaid reimbursement rates, and making an appropriation therefor.
140	140
141	141
142	142
143	143	FISCAL IMPACT:
144	144
145	145
146	146	Estimated State Impact
147	147	FY 2025 FY 2026 FY 2027 FY 2028
148	148	Revenue $0 $0 $0 $0
149	149	Revenue Fund(s) None
150	150	Expenditures* $0 $29,620,500 $29,770,000 Indeterminable Increase
151	151	Funding Source(s)
152	152	Appropriations* $0 $29,620,500 $29,770,000 $0
153	153	Funding Source(s) General Fund
154	154	Expenditure = Cost of bill Appropriation = Authorized funding to cover cost of bill
155	155
156	156
157	157
158	158
159	159
160	160	Estimated State Impact
161	161
162	162
163	163
164	164	FY 2025
165	165
166	166	FY 2026
167	167
168	168	FY 2027
169	169
170	170	FY 2028
171	171
172	172	Revenue
173	173
174	174	$0
175	175
176	176	$0
177	177
178	178	$0
179	179
180	180	$0
181	181
182	182	Revenue Fund(s)
183	183
184	184	None
185	185
186	186	Expenditures*
187	187
188	188	$0
189	189
190	190	$29,620,500
191	191
192	192	$29,770,000
193	193
194	194	Indeterminable Increase
195	195
196	196	Funding Source(s)
197	197
198	198
199	199
200	200	Appropriations*
201	201
202	202	$0
203	203
204	204	$29,620,500
205	205
206	206	$29,770,000
207	207
208	208	$0
209	209
210	210	Funding Source(s)
211	211
212	212	General Fund
213	213
214	214	Expenditure = Cost of bill Appropriation = Authorized funding to cover cost of bill
215	215
216	216
217	217
218	218	METHODOLOGY:
219	219
220	220	This bill directs the Department of Health and Human Services to amend its current contract with the Bi-State Primary Care Association’s Recruitment Center for establishment of a “Public-Private Health Care Workforce Recruitment and Retention Hub.” The sum of $580,000 for FY 2026 and the sum of $580,000 for FY 2027 are appropriated from the general fund to the Department for this purpose. The Department anticipates these funds would directly pass through to the Bi-State Primary Care Association (BSPCA) to implement the terms and deliverables of the proposed contract amendment, and assumes a contract limit would be included to ensure that the terms of the contract would not exceed the funding appropriated for those activities.
221	221
222	222
223	223
224	224	The bill further directs the BSPCA recruitment center to enter into sub recipient contracts to facilitate a number of different workforce initiatives to strengthen the infrastructure needed to sustain and transform community-based primary healthcare services. The bill lists the activities that the sub recipients shall engage in and makes appropriations to fund them. The activities and appropriations include:
225	225
226	226
227	227
228	228
229	229
230	230
231	231
232	232
233	233
234	234
235	235
236	236
237	237
238	238	The bill makes nonlapsing general fund appropriations of $1,000,000 in FY 2026 and $1,000,000 in FY 2027 to the Department’s State Loan Repayment Program (SLRP), of which $300,000 in each year be expended by clinicians in the nursing profession.
239	239
240	240
241	241
242	242	The bill includes general fund appropriation of $287,000 in each year to fund an Administrator I, a Compliance Coordinator II, and an Administrative Assistant I position to administer the contracts above and increase the capacity of the Department to administer the additional State Loan Repayment Program contracts. The Department estimates the cost of these positions would be $279,000 in FY 2026, $287,000 in FY 2027, and $297,000 in FY 2028.
243	243
244	244
245	245
246	246	The bill provides general fund appropriations of $20,000,000 in FY 2026 and $20,000,000 in FY 2027 to the Department for the purpose of increasing Medicaid provider rates. The Department states the bill does not define “provider” and the legislation implies the rate increase would be applied to all Medicaid providers. However, the Department notes the language suggests the Department may prioritize rate increases for services deemed most critical within the appropriated amount.
247	247
248	248
249	249
250	250	The bill also provides general fund appropriations of $203,500 in each year of the biennium to the Department's Bureau of Children's Behavioral Health to support training of up to 60 clinicians in each year of the biennium, and $2,600,000 in each year of the biennium to increase rates paid to providers of opioid treatment programs. Where applicable, the bill provides that the Department may accept and expend any federal funds available without the prior approval of the fiscal committee of the general court.
251	251
252	252
253	253
254	254	AGENCIES CONTACTED:
255	255
256	256	Department of Health and Human Services