Revision: Feb. 10, 2022, 8:53 a.m.
Health and Human Services
February 9, 2022
2022-0642s
05/10
Amendment to SB 430-FN-A
Amend the bill by replacing all after the enacting clause with the following:
1 New Subparagraph; State Treasurer and State Accounts; Application of Receipts; Special Fund for Administration of Opioid Treatment Programs. Amend RSA 6:12, I(b) by inserting after subparagraph (382) the following new subparagraph:
(383) Moneys deposited in the special fund for administration of opioid treatment programs established in RSA 172:8-c.
2 New Section; New Hampshire Substance Use Disorder Services System; Special Fund for Administration of Opioid Treatment Programs. Amend RSA 172 by inserting after section 8-b the following new section:
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, 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 Department of Health and Human Services; Developmental Services; Pilot Program.
I. For the fiscal year ending June 30, 2023, the department of health and human services, division of long term supports and services, shall implement a pilot program to provide services for individuals with developmental disabilities, between 18 and 21 years of age, who are enrolled in school and determined eligible for developmental services that are not the responsibility of the local education agency, another state agency, or another division of the department. Participation in the pilot program shall be limited to not more than 20 eligible individuals. The department may adopt rules under RSA 541-A relative to implementation and administration of the pilot program.
II. For purposes of the pilot program, the local education agency, all state agencies, and divisions of the department involved with an individual seeking services shall, with the consent of the individual or the individual’s guardian, provide information to the area agency and participate in the individual’s service planning. The area agency shall provide such information to the department.
III. In addition, the department shall use the information provided in accordance with paragraph II to make the final determination as to whether the services requested are the legal responsibility of the local education agency, another state agency, or another division of the department.
IV. For individuals deemed eligible pursuant to paragraph I, the time period between completion of the individual service agreement, pursuant to RSA 171-A:12, and the allocation by the department of the funds needed to perform the services required by the agreement shall not exceed 90 calendar days.
V. On or before February 1, 2023, the department shall provide a detailed report of the pilot program to the senate health and human services committee, the house children and family law committee, and the house health, human services and elderly affairs committee. The report shall include data on utilization, including the number of individuals seeking services in accordance with paragraph I, the number of individuals provided services as part of the pilot program, the types of specific services provided for each individual, the total cost of the services provided, and other relevant information necessary to assess the pilot program for statewide expansion as part of the state budget for the biennium ending June 30, 2025.
VI. There is hereby appropriated to the department of health and human services the sum of $2,800,000, for the fiscal year ending June 30, 2023, for the purpose of implementing the pilot program for developmental services established in this section. This appropriation shall be nonlapsing and continually appropriated to the department. Additionally, the department may accept and expend any applicable federal funds, and any gifts, grants, or donations that may be available for the purposes of the pilot program. In the event of any remaining funds not otherwise expended after reaching the cap of serving 20 eligible individuals under the pilot program, the department may allocate funding and provide services to additional eligible individuals. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
4 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children; Unauthorized Payments; Recovery by State. RSA 167:17-a is repealed and reenacted to read as follows:
167:17-a Unauthorized Payments; Recovery by State. Any sums paid to or on behalf of any person for any public assistance program under the provisions of RSA 167 as a result of any failure to report collateral resources pursuant to each program’s requirements, false statement, misrepresentation or concealment of or failure to disclose the receipt of property, wages, income, or resources by such person, or by any person legally liable for such person's support, or in the case of supplemental nutrition assistance program (SNAP) benefits overpaid in error, without regard to the reason for such SNAP benefit overpayment, if required by federal law, may be recovered through administrative or judicial process, in an action brought by the state or the commissioner of the department of health or human services, or his or her designee, against such individual. This recovery shall be limited by the provisions of RSA 161:10. The commissioner of the department of health and human services shall recover any unauthorized payments by reasonably adjusting current and future grant amounts received by the person violating the provisions of this section, or through the return of the overpayment through repayment to the department. A person who knowingly, and with malfeasance, assists a recipient or other person in obtaining an overpayment shall be jointly and severally liable for the overpayment.
5 Repeal. The following are repealed:
I. RSA 126-A:4-a, relative to the health care plan report.
II. 2019, 346:348, relative to quarterly reporting on Medicaid rate increases.
6 Department of Health and Human Services; Medicaid Family Planning Services Report. Amend RSA 126-A:5, XXII to read as follows:
XXII. The commissioner shall fully implement expanded coverage of Medicaid family planning services as required by RSA 126-A:4-c no later than July 1, 2013. At the time of implementation, the state's Medicaid plan shall be amended to enable the state to accept federal matching funds. As provided in RSA 126-A:4-c, the department shall ensure that the state realizes the 90 percent federal Medicaid match available for the family planning services. If the traditional claims payment systems are unavailable for implementation within the time frame indicated in this paragraph, the commissioner shall manually process the payment of claims or contract with a third party administrator to ensure timely provider payment capacity and uninterrupted access to eligible recipients. At least 30 days in advance of program implementation, the commissioner shall conduct an outreach effort to all participating Medicaid family planning providers to distribute guidance and technical assistance regarding patient enrollment procedures, eligibility criteria, and covered medical services and supplies. Within 60 days after program implementation as required under this paragraph [and annually thereafter], the commissioner shall make a report relative to the Medicaid family planning services program to the joint legislative fiscal committee.
7 New Paragraph; Child Protection Act; Issuance of Summons and Notice. Amend RSA 169-C:8 by inserting after paragraph II the following new paragraph:
II-a. If the location of the parent or parents is unknown and this fact is sworn to under oath by the petitioner, the court may take whatever steps it deems necessary, including service by publication or certified mail, to ensure due process is satisfied unless, for good cause shown, it determines that process is impracticable or would serve no purpose, in which case notice may be waived.
8 New Paragraph; Child Protection Act; Issuance of Summons and Notice. Amend RSA 169-C:8 by inserting after paragraph IV the following new paragraph:
V. The summons shall be considered notice for subsequent proceedings pursuant to RSA 170-C and shall include express notice that failure to appear and participate in a proceeding under this chapter may result in the termination of parental rights pursuant to RSA 170-C, without further notice. This shall be deemed adequate notice of a subsequent proceeding pursuant to RSA 170-C.
9 New Subparagraph; Residential Care and Child-Placing Agency Licensing; Definition. Amend RSA 170-E:25, II by inserting after subparagraph (f) the following new subparagraph:
(g)(1) “Kinship care home” means a type of foster home in which an individual or individuals are licensed to provide care exclusively to kin. There shall be a maximum of 6 children including the children living in the home and children received for child care who are related to the residents.
(2) Notwithstanding the limit of 6 children under subparagraph (g)(1), if the kinship care family is willing and able to take a sibling or a group of siblings of a child already in their care, and the department has concluded that the kinship care family is able to provide for the safety, permanency, and well-being of the child or children, the department may place the sibling or group of siblings in the kinship care home.
10 New Paragraph; Residential Care and Child-Placing Agency Licensing; Definition of Kin Added. Amend RSA 170-E:25 by inserting after paragraph X the following new paragraph:
X-a. “Kin” means a child or children who for which there is a connection or history between a child or their parents and another responsible adult, including but not limited to related adults.
11 New Paragraph; State Registry and Criminal Records Check for Foster Family Homes, Institutions, and Child-Placing Agencies. Amend RSA 170-E:29 by inserting after paragraph V the following new paragraph:
VI. A kinship care home shall be considered a foster family home for purposes of this section.
12 Residential Care and Child-Placing Agency Licensing; Issuance. Amend RSA 170-E:31, I to read as follows:
I. Licenses shall be issued in such form and manner as prescribed by rules adopted by the commissioner under RSA 541-A and, for foster family homes, kinship care homes, and specialized care, shall be valid for 2 years from the date issued, unless revoked by the department, or voluntarily surrendered by the licensee, or subject to conditions attached to the license which provide for a shorter license period than 2 years.
13 New Paragraph; Residential Care and Child-Placing Agency Licensing; Record of Licenses. Amend RSA 170-E:33 by inserting after paragraph II the following new paragraph:
III. For kinship family care licenses, the name of the children for which the license is issued shall be confidential and exempt from RSA 91-A.
14 Residential Care and Child-Placing Agency Licensing; Issuance. Amend RSA 170-E:45, II to read as follows:
II. Foster family homes and kinship care homes which have not been licensed but which have been asked to receive children by the department or another child-placing agency on an emergency basis shall not be subject to the penalty provided in subparagraph I(a). The exemption provided in this paragraph is valid for a period of [30] 180 days from the date of placement of the child in the home.
15 Child Protection Act; Jurisdiction, Continued Jurisdiction, Modification. Amend RSA 169-C:4, III to read as follows:
III. When a custody or supervision award has been made pursuant to this chapter, said order shall not be modified or changed, nor shall another order affecting the custody or legal status of the child, including a guardianship order pursuant to RSA 463, be issued without the consent of the court in this proceeding.
16 Adoption; Consequences of Surrender. Amend RSA 170-B:11, II to read as follows:
II. Except in cases where one parent will remain a parent, upon approval of a surrender of a minor executed by the parent, the court shall issue an order granting temporary care, custody, and control of the child to the prospective adoptive parents or where applicable, guardianship of the person to the department or agency. The temporary order shall impose upon the prospective adoptive parents or the department or agency, the responsibility for the support and medical and other care of the minor child. The temporary order shall not be valid for longer than 6 months, unless otherwise ordered by the court, and, with the exception of adoptions in which the department or an agency is involved, shall cease upon the granting of the interlocutory decree of adoption. In adoptions in which the department or an agency is involved, during the interlocutory period, the department or agency shall continue to have [a legal relationship] guardianship of the person, giving it responsibility for oversight of the support, medical, and other care of the minor child.
17 Department of Health and Human Services; Preventative Health Care Benefits; Medicaid Program. The commissioner of the department of health and human services shall, if necessary, submit a Title XIX Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to establish and provide preventative health care benefits under the state Medicaid program, including but limited to nicotine cessation, transitional care management, chronic care management, diabetes prevention program, and screening, brief intervention, and referral to treatment (SBIRT) services. In addition, the commissioner may adopt rules under RSA 541-A relative to the preventative health care benefits described in this section.
18 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children. Amend RSA 167:6, IX to read as follows:
IX. For purposes hereof, a person with a disability between 18 and 64 years of age who is eligible to participate in the work incentive program, known as Medicaid for employed adults with disabilities (MEAD), shall be eligible for medical assistance as medically needy or categorically needy. [The department of health and human services shall establish a sliding fee scale for participants to contribute to the cost of such medical assistance.] Participants in the MEAD program shall be employed at the time of enrollment, and may remain enrolled during temporary unemployment for medical reasons or other good cause.
19 Public Assistance to Blind, Aged, or Disabled Persons, and to Dependent Children. Amend RSA 167:6, IX-a to read as follows:
IX-a. A person with a disability age 65 and older who is eligible to participate in the work incentive program, known as Medicaid for employed older adults with disabilities (MOAD), shall be eligible for medical assistance as medically needy or categorically needy but not to exclude Medicare coverage. [The department of health and human services shall establish a sliding fee scale for participants to contribute to the cost of such medical assistance.] Participants in the MOAD program shall be employed at the time of enrollment, and may remain enrolled during temporary unemployment for medical reasons or other good cause.
20 Domestic Relations; Medical Assistance Recipient; Notice of Petition for Spousal Support. Amend RSA 458:19-c, II, to read as follows:
II. The department of health and human services shall have the opportunity to address the court in any proceeding under this section if the court, or the department, upon motion to the court, has concerns relative to:
(a) The impact on the recipient of any period of Medicaid ineligibility that would result from the allocation of income or assets;
(b) Whether the ward has been the victim of a crime or has been or is at risk of being abused, neglected, or exploited within the meaning of RSA 161-F:43; or
(c) The cost of the recipient's care to be paid by Medicaid as the result of the proposed allocation of income or assets.
21 New Paragraph; Domestic Relations; Medical Assistance Recipient; Notice of Petition for Spousal Support. Amend RSA 458:19-c to insert after paragraph II the following new paragraph:
III. No petition of spousal support shall be enforceable against the department as it relates to eligibility for medical assistance unless the petitioner provides a copy of the petition to the department at least 14 days prior to filing with the court.
22 Guardians and Conservators; Estate Planning by Guardian. Amend the introductory paragraph on RSA 464-A:26-a, VII, to read as follows:
VII. The department of health and human services, the county attorney, and the department of justice shall be notified and shall have the opportunity to address the court in any proceeding under this section if the court, or the department, upon motion to the court, has concerns relative to:
23 New Paragraph; Guardians and Conservators; Estate Planning by Guardian. Amend RSA 464-A:26-a, VII by inserting after paragraph VII the following new paragraph:
VIII. No petition of spousal support shall be enforceable against the department as it relates to eligibility for medical assistance unless the petitioner provides a copy of the petition to the department at least 14 days prior to filing with the court.
24 New Section; Uniform Civil Liability for Support; Medical Assistance Recipient; Notice of Petition for Spousal Support. Amend RSA 546-A by inserting after section 7 the following new section:
546-A:7-a Medical Assistance Recipient; Notice of Petition for Spousal Support.
I. The department of health and human services, the county attorney, and the department of justice shall be notified and shall have the opportunity to address the court in any proceeding under this chapter if the court or department of health and human services has concerns relative to:
(a) The impact on the ward of any period of Medicaid ineligibility that would result from the proposed gift;
(b) Whether the ward has been the victim of a crime or has been or is at risk of being abused, neglected, or exploited within the meaning of RSA 161-F:43; or
(c) The cost of the ward's care to be paid by Medicaid as the result of the proposed gift or income reallocation.
II. No petition of spousal support shall be enforceable against the department as it relates to eligibility for medical assistance unless the petitioner provides a copy of the petition to the department at least 14 days prior to filing with the court.
25 Department of Health and Human Services; Medicaid Program; Personal Care Attendants.
I. The commissioner of the department of health and human services shall, if necessary, submit a Title XIX Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to authorize family caregivers or legally responsible persons of Medicaid recipients to serve as personal care attendants under the state Medicaid program. In addition, the commissioner may adopt rules under RSA 541-A relative to the ability of family caregivers and others to serve as personal care attendants for Medicaid recipients.
II. There is hereby appropriated to the department of health and human services the sum of $700,000 for the fiscal year ending June 30, 2023, for the purpose of implementing this section. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
26 Department of Health and Human Services; Eligibility for Assistance. Amend RSA 167:4, I(b) to read as follows:
(b) To the extent permissible under federal law, in the case of an applicant for public assistance or medical assistance who has made an assignment or transfer of assets to an individual for less than fair market value within [60] 36 months, or for up to 60 months if deemed necessary by the department based upon case specific information or extenuating circumstances, or in the case of transfers of real estate, or transfers of assets to a trust or portions of a trust that are treated as assets disposed of by the individual within [60] 36 months, or for up to 60 months if deemed necessary by the department based upon case specific information or extenuating circumstances, immediately preceding the date of application or while the application is pending, or in the case of a recipient of public assistance or medical assistance who makes such an assignment or transfer while in receipt of the assistance, the assistance sought shall only be granted or continue to be granted in accordance with rules establishing restrictions and eligibility criteria for such cases as adopted by the commissioner of the department of health and human services under RSA 541-A, subject to applicable federal regulations and waiver approval, if any, and review by the oversight committee on health and human services, established in RSA 126-A:13. The oversight committee on health and human services shall make a report to the legislative fiscal committee which shall have final approval authority.
27 New Subparagraph; Departmental Administration; Registry Identification Cards. Amend RSA 126-X:4, II by inserting after subparagraph (g) the following new subparagraph:
(h) An attestation on a form issued by the department stating that the applicant has not been convicted of a felony offense. This attestation shall be subject to the penalties set forth in RSA 641:3 for unsworn falsification and this shall be noted on the form issued by the department. In addition, a designated caregiver shall promptly inform the department if convicted of a felony offense subsequent to being issued a registry identification card.
28 Repeal. RSA 126-X:4, II-a and II-b, relative to criminal background checks for caregivers, are repealed.
29 Departmental Administration; Registry Identification Cards. Amend RSA 126-X:4, III to read as follows:
III. The department shall verify the information contained in an application or renewal submitted pursuant to this section. The department shall approve or deny [an] a complete application or renewal for a qualifying patient within 15 days of receipt of the application. The department shall approve or deny [an] a complete application or renewal to serve as a designated caregiver within 15 days of receipt of the application [and the criminal history records check results]. The department may deny an application or renewal only if the applicant did not provide the information required pursuant to this section, or if the applicant previously had a registry identification card revoked for violating the provisions of this chapter or rules adopted by the department, or if the department determines that the information provided was falsified or did not meet the requirements of this chapter or rules adopted by the department. The department shall notify an applicant of the denial of an application. An applicant who is aggrieved by a department decision may request an administrative hearing at the department.
30 Alternative Treatment Centers; Requirements. Amend RSA 126-X:8, IV(a) to read as follows:
IV.(a) [An alternative treatment center shall conduct] A state and federal criminal records check shall be required for every person seeking to become a principal officer, board member, agent, volunteer, or employee of an alternative treatment center before the person begins working at the alternative treatment center pursuant to RSA [126-X:4, II-a] 126-X:8, IV-a. An alternative treatment center shall not allow any person to be an alternative treatment center agent who:
(1) Was convicted of a felony or felony drug-related offense; or
(2) Is under 21 years of age.
31 New Paragraph; Alternative Treatment Centers; Requirements; Criminal Background Check. Amend RSA 126-X:8 by inserting after paragraph IV the following new paragraph:
IV-a.(a) A person applying to be an alternative treatment center agent shall submit directly to the department of safety a criminal history records release form, as provided by the New Hampshire division of state police, authorizing the release of any felony convictions to the department. The applicant shall submit with the release form a complete set of electronic fingerprints taken by a qualified law enforcement agency or an authorized employee of the department of safety. In the event that the first set of fingerprints is invalid for whatever reason, a second set of fingerprints shall be necessary in order to complete the criminal history records check. If, after 2 attempts, a set of fingerprints is invalid due to insufficient pattern, the department may, in lieu of the criminal history records check, accept police clearances showing no felony convictions from every city, town, or county where the person has lived during the past 5 years. The division of state police shall conduct a criminal history records check through its records and through the Federal Bureau of Investigation. Upon completion of the records check, the division of state police shall report to the department whether or not there are any felony convictions. The department shall maintain the confidentiality of criminal history record information received pursuant to this section. The applicant shall bear the cost of a criminal history records check.
(b) Notwithstanding subparagraph IV(a), an alternative treatment center may make a conditional offer of employment and allow a person to begin working at or for the alternative treatment center while the results of the state and federal criminal history records check are pending, provided that:
(1) Prior to beginning employment, the person completes a statement stating that the person does not have any felony convictions in this or any other state, and such statement shall be subject to the penalties set forth in RSA 641:3 for unsworn falsification, which shall be noted on the form issued by the department; and
(2) The conditional employment granted shall be revoked immediately if the criminal history records check results show any felony convictions in this or any other state.
32 Lead Paint Poisoning Prevention and Control; Investigations. Amend the introductory paragraph of RSA 130-A:5, I to read as follows:
I. The commissioner shall investigate cases of lead poisoning in children reported under RSA 141-A whose blood lead level meets or exceeds 5 micrograms per deciliter of whole venous blood[, as reported on 2 separate tests except that a blood lead level may be designated as elevated by the health care provider when the level reported meets or exceeds 5 micrograms per deciliter on the first venous test. With such a declaration, a second test shall not be required]. The commissioner may also conduct investigations when there is reason to believe that a lead exposure hazard, as defined in RSA 130-A:1, XVI(b) and (d), for a child exists. Such investigations shall include, but not be limited to:
33 Public Health; Food Service Licensure; Exemptions. Amend RSA 143-A:5, IV to read as follows:
IV. Recreation camps inspected and licensed under RSA [149] 170-E, including recreation camps that offer food to camp families or alumni in the 45 days prior to or after the camp operating season.
34 Compensation of Certain State Officers; Health and Human Services Positions Amended. Amend the following position in RSA 94:1-a, I(b), grade DD to read as follows:
DD Department of health and human services [administrator, family strengthening and child well-being initiatives] business improvement administrator
35 Department of Health and Human Services; Shift Differential Payments; Recovery Forgiveness; Appropriation.
I. Any shift differential payments made on or before July 1, 2021, which were inadvertently paid due to administrative error to certain clinical staff at New Hampshire hospital and the Glencliff home, shall be forgiven in full. This section shall preclude any recovery action by the state against those individuals for such payments.
II. Any clinical staff at New Hampshire hospital and the Glencliff home who did not receive the shift differential payments described in paragraph I, shall receive such payments retroactively. The department of health and human services, in coordination with the department of administrative services, may provide the retroactive payments without the approval of governor and council or the fiscal committee of the general court.
III. The sum of $29,000 for the fiscal year ending June 30, 2023, is appropriated to the department of health and human services for the purpose of providing shift-differential payments to clinical staff at New Hampshire hospital and the Glencliff home, as described in paragraph II. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
36 Department of Health and Human Services; Inpatient Treatment of Children’s Behavioral Health; Positions Established. There are hereby established within the department of health and human services, 8 full-time, unclassified clinical positions to provide inpatient treatment of children’s behavioral health, in the division for behavioral health services.
37 New Paragraph; Compensation of Certain State Officers; Salary Adjustment for Recruitment or Retention. Amend RSA 94:3-b by inserting after paragraph I the following new paragraph:
I-a. Notwithstanding any other provisions of law to the contrary, for any expenditure more than $10,000 under this paragraph, upon the request of an appointing authority submitted to the commissioner of administrative services for review and evaluation and upon approval by the joint committee on employee classification, the governor and council is hereby authorized, upon a finding by them that it is in the best interests of the state and is necessary in order to recruit and retain or recruit or retain qualified personnel, to make recruitment or retention bonuses for classified clinical positions at New Hampshire hospital and the Glencliff home. The department of health and human services, in conjunction with the department of administrative services, is authorized to make any expenditure less than or equal to $10,000 under this paragraph.
38 Department of Health and Human Services; Office of Reimbursement; Duties. Amend RSA 126-A:34, I(a) to read as follows:
(a) Review and investigate all records of the New Hampshire hospital, [Laconia developmental services,] the secure psychiatric unit, the Glencliff home, and [the Anna Philbrook center] facilities that provide child inpatient psychiatric treatment within the state mental health system, relative to expenses incurred by patients, residents, or clients at such institutions, facilities, or programs or expenses incurred by patients, residents, or clients receiving care, treatment, services, or maintenance at the direction of the commissioner of health and human services, and make recommendations to the commissioner and to the respective superintendents or directors of such institutions, facilities, or programs as to the rates to be charged for the care, treatment, and maintenance of such patients, residents, or clients.
39 Department of Health and Human Services; Liability for Expenses and Hearing on Liability. Amend RSA 126-A:40, I(a) to read as follows:
(a) Whenever the court issues an order for evaluation, care, or treatment of a child at [the Philbrook center] a facility that provides child inpatient psychiatric treatment within the state mental health system pursuant to RSA 169-B, 169-C, or 169-D, the expenses of such evaluation, care, or treatment shall be borne by the department, except as otherwise provided in this section.
40 Department of Health and Human Services; Liability for Expenses and Hearing on Liability. Amend RSA 126-A:40, III to read as follows:
III. The office of reimbursements, acting on behalf of the [New Hampshire hospital] department of health and human services, is authorized to compromise or reduce any expense to be charged to the state.
41 Department of Health and Human Services; Limiting Use of Child Restraint Practices; Definitions. Amend RSA 126-U:1, III(d)(1) to read as follows:
(1) [The Anna Philbrook center.] Facilities providing inpatient psychiatric treatment within the state mental health system.
42 Department of Health and Human Services; New Hampshire Mental Health Services System; References to Anna Philbrook Center Removed. Amend the subdivision heading and the introductory paragraph of RSA 135-C:64 to read as follows:
[Anna Philbrook Center] Child Inpatient Psychiatric Treatment Facility
135-C:64 [Philbrook Center] Child Inpatient Psychiatric Treatment Facility; Purpose. The commissioner shall maintain behavioral health services for children and adolescents in one or more facilities [on the New Hampshire hospital campus, or other locations to be determined] as designated by the commissioner. All services for children and adolescents shall be appropriate for each child's developmental stage and shall address the educational, supervisory, and clinical needs of each child. The purposes of child and adolescent services shall include but not be limited to:
43 New Hampshire Mental Health Services System; Reference to Anna Philbrook Center Removed. Amend RSA 135-C:65 to read as follows:
135-C:65 Admission Limitation. Children subject to proceedings in juvenile court may be admitted to [the Philbrook center] a child inpatient psychiatric treatment facility within the state mental health system for evaluation, care, or treatment only upon prior approval of the commissioner or designee.
44 New Hampshire Mental Health Services System; Reference to Anna Philbrook Center Removed. Amend RSA 135-C:66 to read as follows:
135-C:66 Access of Records. Notwithstanding any other provisions of law, records regarding children [placed at Philbrook center] receiving child inpatient psychiatric treatment at a facility within the state mental health system, pursuant to RSA 169-B, 169-C, or 169-D shall be exchanged between employees of the department to facilitate coordinated care for those children and their families. The confidentiality of such information shall be maintained according to applicable law.
45 New Hampshire Mental Health Services System; Reference to Anna Philbrook Center Removed. Amend RSA 135-C:67 to read as follows:
135-C:67 Admission and Discharge. The commissioner shall adopt rules relative to eligibility criteria and procedures for admission to and discharge from [the Philbrook center] facilities within the state mental health system that provide inpatient psychiatric treatment to children.
46 Delinquent Children; Determination of Competence. Amend RSA 169-B:20, V to read as follows:
V. A competency evaluation may be conducted by an entity approved by the commissioner of health and human services, which may include an agency [other than the Philbrook center], a psychiatrist, or psychologist licensed in the state of New Hampshire. The commissioner shall adopt standards establishing the process for approval as an examiner as well as the qualifications required for approval, which shall be based on generally accepted standards for forensic psychiatrists and psychologists.
47 Delinquent Children; Liability for Expenses Incurred. Amend RSA 169-B:40, I(b) to read as follows:
(b) Subparagraph (a) shall not apply to expenses incurred for special education and related services, or to expenses incurred for evaluation, care, and treatment of the minor [at the Philbrook center] when receiving child inpatient psychiatric treatment within the state mental health system, or to expenses incurred for the cost of accompanied transportation.
48 Delinquent Children; Liability for Expenses Incurred. Amend RSA 169-B:40, III to read as follows:
III. The office of reimbursements acting on behalf of [Laconia developmental services and the New Hampshire hospital] the department of health and human services is authorized to compromise or reduce any expense to be charged to the state under this section.
49 Child Protection Act; Preliminary Disposition. Amend RSA 169-C:16, III to read as follows:
III. The court may at any time order the child, parents, guardian, custodian, or household member subject to the petition or ex parte order, to submit to a mental health evaluation, or undergo a physical examination or treatment, with a written assessment being provided to the court. The court may order that the child, who is the subject of the petition or the family or both be evaluated by a mental health center or any other psychiatrist, psychologist or psychiatric social worker or family therapist or undergo physical examination or treatment with a written assessment provided to the court. Evaluations performed at [the Philbrook center] a facility providing child inpatient psychiatric treatment within the state mental health system may occur only upon receiving prior approval for such evaluation from the commissioner of the department of health and human services, or designee.
50 Child Protection Act; Liability for Expenses. Amend RSA 169-C:27, I(b)(2) to read as follows:
(2) Expenses incurred for evaluation, care, and treatment of [the child at the New Hampshire hospital] a child receiving inpatient psychiatric treatment within the state mental health system; or
51 Child Protection Act; Liability for Expenses. Amend RSA 169-C:27, IV to read as follows:
IV. The office of reimbursements acting on behalf of [Laconia developmental services and the New Hampshire hospital] the department of health and human services is authorized to compromise or reduce any expense to be charged to the state under this section.
52 Children in Need of Services; Adjudicatory Hearing. Amend RSA 169-D:14, III to read as follows:
III. If the court finds the child is in need of services, it shall, unless a report done on the same child less than 3 months previously is on file, order the department of health and human services or other appropriate agency to make an investigation and written report consisting of, but not limited to, the home conditions, school record and the mental, physical and social history of the child including sibling relationships and residences for the purpose of preserving relationships between siblings who are separated as a result of court ordered placement. Evaluations performed at [the Philbrook center] a facility providing child inpatient psychiatric treatment within the state mental health system may occur only upon receiving prior approval for such evaluation from the commissioner of the department of health and human services or designee. When ordered by the court, such investigation shall include a physical and mental examination of the child, parents, guardian, or person having custody. The court may order a substance abuse evaluation of the child, parents, guardian, or person having custody. Any substance abuse evaluation of the parent, guardian, or person having custody of the child shall be conducted by a provider contracted with the bureau of substance abuse services, or a provider paid by the parent, guardian, or person having custody of the child. The cost of said evaluation shall be paid by private insurance, if available, or otherwise by the person undergoing the evaluation, to whom the evaluation shall be provided free or at a reduced cost if the person is of limited means. The court shall inform the parents, guardian, or person having custody and child of their right to object to the physical examination, mental health evaluation, or substance abuse evaluation. Objections shall be submitted in writing to the court having jurisdiction within 5 business days after notification of the time and place of the examination or evaluation. The court may excuse the child, parents, guardian, or person having custody upon good cause shown. No disposition order shall be made by the court without first reviewing the investigation report, if ordered.
53 Children in Need of Services; Determination of Competence. Amend RSA 169-D:18-a, I to read as follows:
I. At any point during the proceedings, the court may, either on its own motion or that of any of the parties, order the child to submit to a mental health evaluation for the purpose of determining whether the child is competent to have committed the offenses or acts alleged in the petition. The evaluation shall be completed within 60 days of the date of such order and shall be conducted by an agency [other than the Philbrook center] which is approved by the commissioner of health and human services, or conducted by a psychologist licensed in New Hampshire or a qualified psychiatrist, or by [the Philbrook center] a facility providing child inpatient psychiatric treatment within the state mental health system only upon receiving prior approval for admission of the child for such evaluation by the commissioner of the department of health and human services. The evaluation shall be submitted to the court in writing prior to the hearing on the merits.
54 Children in Need of Services; Liability for Expenses. Amend RSA 169-D:29, I(b) to read as follows:
(b) Subparagraph (a) shall not apply to expenses incurred for special education and related services, or to expenses incurred for evaluation, care, and treatment of [the child at the Philbrook center] a child receiving inpatient psychiatric treatment within the state mental health system or to expenses incurred for the cost of accompanied transportation.
55 Children in Need of Services; Liability for Expenses. Amend RSA 169-D:29, IV to read as follows:
IV. The office of reimbursements acting on behalf of [Laconia developmental services and the New Hampshire hospital] the department of health and human services is authorized to compromise or reduce any expense to be charged to the state under this section.
56 Youth Services Center; Records. Amend RSA 621-A:7, I to read as follows:
I. Full and complete records shall be kept by the commissioner of the care and study of each child admitted to the youth services center. The records shall not be open to the inspection of any persons not on the staff of the commissioner except that such records shall be available, by court order, to any court having competent jurisdiction of the child in any matter pending in this state or to such person or persons as may be authorized by the court. Notwithstanding any other provision of law, exchange of medical or psychiatric records between [the Philbrook center] a facility providing child inpatient psychiatric treatment within the state mental health system and the department shall be permitted.
57 Emergency Treatment; Reference Change. Amend the introductory paragraph of RSA 135:21-b to read as follows:
135:21-b Emergency Treatment. A physician licensed in the state, a psychiatrist-supervised physician assistant licensed in this state, a psychiatric mental health advanced practice registered nurse, or a person acting under such physician's, psychiatrist-supervised physician assistant's, or advanced practice registered nurse's direction may administer a recognized and approved form of medical or psychiatric treatment which the physician, psychiatrist-supervised physician assistant, or psychiatric mental health advanced practice registered nurse reasonably believes will tend to promote the physical and mental health of a patient of the New Hampshire hospital, [Laconia developmental services,] Glencliff home, any community mental health or developmental services program or treatment facility receiving state grants under RSA 171-A, or any other treatment facility designated as a receiving facility under RSA 135-C, when:
58 State Facilities Other Than New Hampshire Hospital; Reference Change. Amend RSA 135-C:4, I to read as follows:
I. The commissioner shall have charge of the property and concerns of any facility owned by the state which provides, or which may be established to provide, care and treatment to persons who have mental illness or developmental disabilities, including those subject to the exception set forth in paragraph I-a, with regard to the care and maintenance of the grounds and buildings located at the facility in Concord, known as New Hampshire hospital. Such facilities include, but are not limited to, facilities established at Glencliff known as Glencliff home [and Laconia, known as Laconia developmental services].
59 Child Protection Act; Institutional Abuse and Neglect; Reference Change. Amend RSA 169-C:37 to read as follows:
169-C:37 Institutional Abuse and Neglect. The department of justice shall be empowered to receive and investigate reports of institutional abuse or neglect at the youth development center, [Laconia developmental services, and New Hampshire hospital] and any facility that provides child inpatient psychiatric treatment within the state mental health system; and the department shall be empowered to receive and investigate reports of all other suspected instances of institutional abuse or neglect. Either the department of justice or the commissioner of the department or both may adopt rules consistent with this authority to investigate such reports and take appropriate action for the protection of children.
60 Guardians and Conservators; Conduct of Hearing; Reference Change. Amend RSA 464-A:8, III to read as follows:
III. The medical affidavit shall be evidence only of the proposed ward's inability to attend the hearing and shall not be considered in determining his or her incapacity. If the proposed ward is a patient at a county nursing home, or state hospital [or Laconia developmental services], the affidavit shall be by the medical director or medical superintendent of such county nursing home[,] or state hospital[, or developmental services].
61 Child Day Care Licensing; State Registry and Criminal Records Check; Revocation of Registration and Withholding of State Funds. Amend RSA 170-E:7, IV-d to read as follows:
IV-d. The fee for a child care employment eligibility card issued under paragraph IV-a shall be [$50] $25 and the card shall be valid for 5 years from the date of issuance, or a prorated amount of [$10] $5 per year from the most recently completed criminal background check. A replacement card may be requested for a [$15] $10 fee.
62 Residential Care and Child-Placing Agency Licensing; State Registry and Criminal Records Check for Child Care Institutions and Child Care Agencies. Amend RSA 170-E:29-a, VII(b) to read as follows:
(b) The fee for a residential child care employment eligibility card shall be [$50] $25, and the card shall be valid for 5 years from the date of issuance, or a prorated amount of [$10] $5 per year from the most recently completed criminal background check. The fee for a replacement card shall be [$15] $10.
63 Child Day Care Licensing; Definitions. Amend RSA 170-E:2, IV(d) to read as follows:
(d) ["Day care nursery"] "Infant and toddler program" means a child day care agency in which child day care is provided for any part of a day, for 5 or more children under the age of 3 years.
64 Child Day Care Licensing; Definitions. Amend RSA 170-E:2, XII to read as follows:
XII. "Regularly" or "on a regular basis" means supervision and care up to and including 7 days a week, whether paid or unpaid, for the following as defined in RSA 170-E:2, IV: (a) family day care home, (b) family group day care home, (c) group child day care center, (d) [day care nursery] infant and toddler program, (e) night care agency, (f) preschool program, and (g) school-age program.
65 Residential Care and Child-Placing Agency Licensing; Definition of Child Care Agency. RSA 170-E:25, II is repealed and reenacted to read as follows:
II. "Child care agency" means any person, corporation, partnership, voluntary association or other organization either established for profit or otherwise, who regularly receives for care one or more children, unrelated to the operator of the agency, apart from the parents, in any facility as defined in this subdivision and maintained for the care of children. The types of child care agencies are defined as follows:
(a) "Child care institution" means a child care agency where more than 12 children are received and maintained for 24-hour care for the purpose of providing them with care or training, or both. The term "child care institution" shall not include:
(1) Any state operated institution for child care or juvenile detention established by law.
(2) Any institution, home, place, or facility operating under a license pursuant to RSA 151:2.
(3) Any bona fide boarding school in which children are primarily taught branches of education corresponding to those taught in public elementary schools or high schools, or both, and which operates on a regular academic school year basis, and which is approved by the department of education.
(4) Any licensed recreation camp.
(b)(1) "Foster family home" means child care in a residence in which family care and training are provided on a regular basis for no more than 6 unrelated children, unless all the children are of common parentage. The maximum of 6 children includes the children living in the home and children received for child care who are related to the residents.
(2) If the limit of 6 children under subparagraph (a)(1) is reached, the foster family is willing and able to take a sibling or a group of siblings of a child already in their care, and the department has concluded that the foster family is able to provide for the safety, permanency, and well-being of the child or children, the department may, notwithstanding the limitations of subparagraph (a)(1), place the sibling or group of siblings in the foster family home.
(c) "Group home" means a child care agency which regularly provides specialized care for at least 5 but no more than 12 children who can benefit from residential living either on a short-term or long-term basis.
(d) “Independent living home” means a child care agency which regularly provides specialized services in adult living preparation in an experiential residential setting for persons 16 years of age or older who have a legal relationship with the department of health and human services and who can benefit from independent living training.
(e) "Specialized care" means a child care agency which regularly provides general care for children who are diagnosed as mentally ill, intellectually disabled, or physically disabled and who are determined to be in need of special mental treatment or nursing care, or both.
(f) "Homeless youth program" means a program, including any housing facilities utilized by such program, which receives any child for the purpose of providing services to facilitate independent living including all of the following program components: individual assessment, referral, housing, and case management. Such services may be provided directly by the agency or through one or more contracts for services.
66 Repeal. The following are repealed:
I. RSA 170-E:25, III, relative to the definition of child care institution.
II. RSA 170-E:25, VIII, relative to the definition of experiential/wilderness facility.
III. RSA 170-E:25, X, relative to the definition of independent living home.
67 Residential Care and Child-Placing Agency Licensing; Definitions. Amend RSA 170-E:25, VI to read as follows:
VI. "Corrective action plan" means a written proposal setting forth the procedures by which a child care agency[, child care institution,] or child-placing agency will come into compliance with the standards set by rule adopted by the commissioner under RSA 541-A and subject to the approval of the department. The proposal shall include the time needed to assure compliance and the steps proposed by the agency to reach compliance.
68 Residential Care and Child-Placing Agency Licensing; Definitions. Amend RSA 170-E:25, XI to read as follows:
XI. "License" means a complete license issued to an operator of a child care agency[, child care institution] or child-placing agency, authorizing the licensee to operate in accordance with the term and conditions of the license, this subdivision, and the rules of the department.
69 Recreation Camp Licensing; Definitions. Amend RSA 170-E:55, I to read as follows:
I. "Recreation camp" means any place set apart for recreational purposes for boys and girls. It shall not apply to preschool programs as defined in RSA 170-E:2, private camps owned or leased for individual or family use, or to any camp operated for a period of less than 10 days in a year.
70 New Section; Residential Care and Child-Placing Agency Licensing; Transfer or Discharge. Amend RSA 170-E by inserting after section 42 the following new section:
170-E:42-a Transfer or Discharge of Residents.
I. In this section:
(a) “Discharge” means movement of a resident from a child care agency to a non-institutional setting or the termination of services by a child care agency when the child care agency ceases to be legally responsible for the care of the resident.
(b) "Transfer" means movement of a resident from one child care agency to another child care agency when legal responsibility for the care of the resident changes from the transferring to the receiving child care agency.
II. A resident shall be transferred or discharged after appropriate discharge planning only for medical reasons, for the resident’s welfare or that of other residents, or if the child care agency ceases to operate.
III. Transfer or discharge of a resident from a child care agency shall in all instances be preceded by written notice which shall contain the following:
(a) The reason for the proposed transfer or discharge;
(b) The effective date of the proposed transfer or discharge;
(c) The location to which the resident is transferred or discharged; and
(d) The name, address, and telephone number of the office of the ombudsman, established under RSA 126-A:4, III, and the name, address, and telephone number of the federally-designated protection and advocacy agency for individuals with disabilities.
IV. Except as provided in paragraph V, written notice of transfer or discharge shall be given at least 30 days before the resident is transferred or discharged. A copy of the notice shall be placed in the resident’s file and a copy shall be transmitted to the resident’s parent or legal guardian and the agency responsible for the resident’s placement.
V. Written notice as provided in paragraph III shall be given as soon as practicable before transfer or discharge in the following circumstances:
(a) If an emergency transfer or discharge is mandated by the resident’s health care needs;
(b) If the transfer or discharge is mandated by the health or safety of other individual’s in the child care agency;
(c) If the transfer or discharge is appropriate because the resident’s needs cannot be met in the child care agency;
(d) If the transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the child care agency;
(e) If the transfer or discharge is mandated by court order;
(f) If the resident has reached the age of 21; or
(g) If the resident has resided in the child care agency for less than 30 days.
VI. For the purposes of this section, “transfer” or “discharge” shall not include transfers or discharges initiated at the request of the resident’s parent or legal guardian.
VII. If the resident’s parent or legal guardian wishes to have the resident relocate to another child care agency or place, the resident shall be relocated according to the resident’s parent’s or legal guardian’s wishes; provided that the resident’s parent or legal guardian gives written notice of such relocation to the child care agency.
VIII. For the purposes of this section, transfer shall not include the temporary movement of a resident from a facility to a hospital or other location for emergency medical treatment.
IX. The provisions of this section shall not apply to foster family homes, as defined in RSA 170-E:25.
71 New Sections; Recreation Camp Licensing; Confidentiality and Investigations. Amend RSA 170-E by inserting after 66 the following new sections:
170-E:67 Confidentiality and Investigations. The department may request and shall receive cooperation from other state agencies in connection with investigations and licensure. The department shall strictly observe the confidentiality requirements of the agency from which it receives information.
170-E:68 License Suspension, Revocation, or Denial. The department may suspend, revoke, or deny any license if the license holder:
I. Neglects or abuses children in his or her care;
II. Does not comply with this subdivision or the rules adopted under this subdivision relative to the health and safety of children;
III. Violates any provision of this subdivision, or is unable to meet and maintain standards adopted by the commissioner;
IV. Substantially or repeatedly violates any provisions of the license issued;
V. Furnishes or makes any misleading or any false statement or report to the department;
VI. Refuses or fails to submit any reports or to make available to the department any records required by it in making an investigation of the facility for licensing purposes;
VII. Refuses or fails to submit to an investigation or to the required visits by the department;
VIII. Refuses or fails to admit authorized representatives of the department at any time the camp is in operation for the purpose of investigation or visit;
IX. Fails to provide, maintain, equip, and keep in safe and sanitary condition premises established or used for recreation camps as required under standards prescribed by rules adopted by the commissioner under RSA 541-A or as otherwise required by any law, rule, ordinance, or term of the license applicable to the location of such facility; or
X. Retaliates against an employee who in good faith reports a suspected violation of the provisions of this subdivision and rules adopted under it.
72 New Paragraph; Out-of-State Physicians; Consultation and Follow-up Care via Telemedicine Permitted. Amend RSA 329:21 by inserting after paragraph II the following new paragraph:
II-a. To a physician licensed and in good standing in another state, when providing consultation services or follow-up care via telemedicine to a patient who previously received services from the physician in the state where the physician is licensed.
73 Department of Health and Human Services; Appropriation of Centene Settlement Funds. The sum of $2,420,203 from the first payment of the 2-part payment totaling $21,148,822.13 received by the state as a result of the settlement agreement with Centene Corporation and its affiliates (“Centene”) is hereby appropriated to the department of health and human services to meet the financial requirements of completing the Medicaid Care Management SFY 2020 Risk Corridor calculation.
I. Sections 1-3, 18, 19, 25, 37, 61, 62, and 71 of this act shall take effect July 1, 2022.
II. Section 17 of this act shall take effect June 30, 2023.
III. Sections 27-31 of this act shall take effect 30 days after its passage.
IV. Sections 20, 26, and 32 of this act shall take effect 60 days after its passage.
V. Sections 34-36 of this act shall take effect June 30, 2022.
VI. The remainder of this act shall take effect upon its passage.
2022-0642s
AMENDED ANALYSIS
This bill:
I. Establishes a special fund for administration of opioid treatment programs.
II. Establishes a pilot program for individuals with developmental disabilities.
III. Permits a physician licensed in another state to provide consultation services or follow up care via telemedicine to an existing patient.
IV. Revises the department’s authority to recover unauthorized payments by the state.
V. Repeals certain reporting requirements.
VI. Allows for alternative service of process under RSA 169-C when a child’s parent cannot be located.
VII. Creates a separate category of foster care license for kinship care homes.
VIII. Grants the department guardianship of a child following surrender of parental rights under RSA 170-B.
IX. Expands the state Medicaid plan to include preventative health care benefits.
X. Removes the requirement that the department charge premiums for medical assistance provided under MEAD and MOAD.
XI. Allows the department to address the court in guardianship and spousal support cases involving Medicaid recipients or suspected victims of abuse or exploitation.
XII. Directs the department to submit a Medicaid state plan amendment to allow certain family caregivers or legally responsible persons of Medicaid recipients to serve as personal care attendants and makes an appropriation for this purpose.
XIII. Revises the “look back” period for Medicaid eligibility for long term care.
XIV. Removes the criminal background check requirement for designated caregivers in the therapeutic cannabis program and modifies the criminal background check requirement for alternative treatment center agents.
XV. Modifies the blood test requirement for purposes of lead paint poisoning prevention and control.
XVI. Clarifies the food service licensure exemption for recreational camps.
XVII. Revises childcare license definitions.
XVIII. Revises certain department of health and human services employee position titles.
XIX. Provides shift differential payments to clinical staff at New Hampshire hospital and the Glencliff home and makes an appropriation for this purpose.
XX. Establishes new positions for inpatient treatment of children’s behavioral health.
XXI. Permits salary adjustments for recruitment or retention of classified clinical positions at New Hampshire hospital and the Glencliff home.
XXII. Removes references to the Anna Philbrook center, Laconia state school, and Laconia developmental services.
XXIII. Appropriates a portion of the funds received by the state from the Centene settlement to the department of health and human services for the purpose of completing the Medicaid Care Management SFY 2020 Risk Corridor calculation.