SB 244-FN-A - AS AMENDED BY THE SENATE
03/13/2025 0776s
2025 SESSION
25-0971
05/09
SENATE BILL 244-FN-A
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
COMMITTEE: Health and Human Services
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AMENDED ANALYSIS
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.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.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 0776s 25-0971
05/09
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 Short Title. This act shall be known as The New Hampshire Needs Caregivers Act.
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.
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.
3 Department of Health and Human Services; Division of Public Health Services; Public-Private Health Care Workforce Recruitment and Retention Hub; Infrastructure Contracts.
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.
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:
(a) Expand and implement its national outreach and marketing campaign designed to recruit qualified clinicians to New Hampshire;
(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;
(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;
(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
(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.
4 Department of Health and Human Services; Rural Health and Primary Care Section; Appropriations.
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.
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.
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.
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.
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.
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.
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.
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.
5 Department of Health and Human Services; Medicaid Rates Paid to Opioid Treatment Providers; Appropriation.
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.
6 Effective Date. This act shall take effect July 1, 2025.
25-0971
Revised 2/25/25
SB 244-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 | $29,620,500 | $29,770,000 | Indeterminable Increase | ||
Funding Source(s) |
| |||||
Appropriations* | $0 | $29,620,500 | $29,770,000 | $0 | ||
Funding Source(s) | General Fund | |||||
*Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill | ||||||
METHODOLOGY:
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.
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:
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.
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.
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.
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.
AGENCIES CONTACTED:
Department of Health and Human Services
| Date | Amendment |
|---|---|
| March 5, 2025 | 2025-0776s |
| Date | Body | Type |
|---|---|---|
| Feb. 5, 2025 | Senate | Hearing |
| March 13, 2025 | Senate | Floor Vote |
March 13, 2025: Ought to Pass with Amendment #2025-0776s, MA, VV; Refer to Finance Rule 4-5; 03/13/2025; SJ 7
March 13, 2025: Committee Amendment # 2025-0776s, AA, VV; 03/13/2025; SJ 7
March 7, 2025: Committee Report: Ought to Pass with Amendment # 2025-0776s, 03/13/2025; Vote 5-0; CC; SC 12
Jan. 29, 2025: Hearing: 02/05/2025, Room 101, LOB, 09:30 am; SC 8
Jan. 23, 2025: Introduced 01/09/2025 and Referred to Health and Human Services; SJ 3