SB 127-FN-A - AS AMENDED BY THE SENATE
03/13/2025 0772s
2025 SESSION
25-1002
09/11
SENATE BILL 127-FN-A
SPONSORS: Sen. Avard, Dist 12
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
This bill authorizes hospitals seeking to assist older adults or adults with a disability with discharge from a hospital setting to a less restrictive setting to seek to have a guardian or conservator appointed by the probate court, and makes appropriations to the department of health and human services to fund guardianship slots.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
03/13/2025 0772s 25-1002
09/11
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Long-Term Care; Guardianship Contracted Services. Amend RSA 151-E by inserting after section 27 the following new section:
151-E:28 Guardianship Contracted Services.
I. When all other resources are exhausted, hospitals seeking to assist older adults or adults with a disability as defined in RSA 151-E:24 with discharge from a hospital setting to a less restrictive setting may seek to have a guardian or conservator appointed by the probate court, pursuant to RSA 464-A, for any older adult or adult with a disability who:
(a) Requires an alternative decision maker to assist with discharge;
(b) Is deemed incapacitated by a court of competent jurisdiction; and
(c) Cannot secure guardianship services through any other alternative.
II. The department shall contract with office of the public guardian to provide publicly funded guardianship slots for individuals in need of guardianship pursuant to paragraph I.
III. Hospitals seeking to assist adults with discharge shall apply to the department for access to the publicly funded guardianship slots.
IV. Availability of publicly funded guardianship slots shall be subject to the availability of funding.
2 Appropriations; Department of Health and Human Services.
I. The sum of $550,000 for the biennium ending June 30, 2027 is hereby appropriated to the department of health and human services. Said appropriation shall be used for 50 slots to provide publicly funded guardianship for individuals as set forth in RSA 151-E:28. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
II. The sum of $3,884,000 for the biennium ending June 30, 2027 is hereby appropriated to the department of health and human services. Said appropriation shall be used by the department to create new contract guardian slots and adjusting rates for individuals served under RSA 171-A, RSA 161-F:52, and RSA 135-C. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
3 Effective Date. This act shall take effect September 30, 2025.
25-1002
Revised 2/25/25
SB 127-FN-A- FISCAL NOTE
AS INTRODUCED
FISCAL IMPACT:
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Estimated State Impact | ||||||
| FY 2025 | FY 2026 | FY 2027 | FY 2028 | ||
Revenue | $0 | $0 | $0 | $0 | ||
Revenue Fund(s) | None | |||||
Expenditures* | $0 | $3.6 million - $4.6 million | $3.6 million - $4.6 million | $3.6 million - $4.6 million | ||
Funding Source(s) | General Fund | |||||
Appropriations* | $0 | $1.9 million | $0 | $0 | ||
Funding Source(s) | General Fund | |||||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
METHODOLOGY:
This bill allows the Department of Health and Human Services to seek appointment of a public guardian for “adults in a post-acute hospital stay, clinically ready for discharge, who require the services of a guardian to assist with discharge planning and to ensure proper care and placement of the adult.” The bill further amends RSA 547-B:6 to require that rates for such services be sufficient to ensure that reimbursement covers the contractor's costs and that individuals in need of public guardianship services have access to those services.
The bill appropriates $252,200 to the Department in FY26 to pay for 50 new contract guardian slots. In addition, the bill appropriates $1,647,800 in FY26 to pay for 100 additional contract slots for individuals served under RSA 171-A and RSA 135-C. The Department assumes the intent of this appropriation is to amend its current contracts with the public guardianship and protection programs to add capacity for 100 additional individuals.
The Department notes that, in accordance with RSA 547-B, it currently contracts with two public guardianship and protection programs. The per diem rate per ward for whom the contractors provide guardianship services is $6.81 in one contract and $9.91 in the other contract. If the bill is adopted, the Department would need to amend the current contracts. The Department states that it does not have enough information to determine what any rate beyond FY26 may be, if one were to be established using the rate setting methodology included in the bill. Additionally, the Department is unable to determine any future expenditures that may be necessary due to the proposed assessment of the need for professional guardianship services. In order to increase the wards and adjust the rate in concurrently, the Department expects that it will need additional funds beyond the $1.9 million appropriated. While the amount is indeterminable, the Department expects it will need in the range of $3.6 million to $4.6 million per year.
AGENCIES CONTACTED:
Department of Health and Human Services
| Date | Amendment |
|---|---|
| March 5, 2025 | 2025-0772s |
| Date | Body | Type |
|---|---|---|
| Feb. 6, 2025 | Senate | Hearing |
| March 13, 2025 | Senate | Floor Vote |
March 13, 2025: Ought to Pass with Amendment #2025-0772s, MA, VV; Refer to Finance Rule 4-5; 03/13/2025; SJ 7
March 13, 2025: Committee Amendment # 2025-0772s, AA, VV; 03/13/2025; SJ 7
March 7, 2025: Committee Report: Ought to Pass with Amendment # 2025-0772s, 03/13/2025; Vote 5-0; CC; SC 12
Jan. 29, 2025: Hearing: 02/06/2025, Room 101, LOB, 10:15 am; SC 8
Jan. 22, 2025: Introduced 01/09/2025 and Referred to Health and Human Services; SJ 3