State House Dome: HHS gets consultant's to-do change list

Feb. 21—A HIGH-POWERED national consulting firm has completed a $1.5 million assessment of how to make New Hampshire's largest state agency more efficient and take the most advantage of federal grants to support its operations.

Health and Human Services Commissioner Lori Shibinette gave House budget writers a peek at the report, from Alvarez and Marsal Public Sector Services of Washington, which she said will soon be public.

By the end of 2022, Shibinette said the state will seek a so-called IMD Waiver to get Medicaid reimbursement for in-patient adults at New Hampshire Hospital with mental health challenges. This would cover 50% of the cost of care for these residents.

Another change to reduce recidivism in mental health would be an evidence-based program known as Critical Time Intervention. The effort will follow the resident at the time of discharge from the state hospital for nine months to ensure a "warm handoff" into the community, Shibinette said.

A third reform would end the practice of sending mental health clients needing the highest level of care for treatment out of state by creating in-state services.

The consultant also urged the state upgrade the infrastructure of the Managed Medicaid Information System supporting the largest single contract in state government. The change, which would take 8 to 10 years, must be made to avoid federal penalties, Shibinette said.

Vouchers a COVID casualty

There was shock through the mostly empty State House last week when the House Education Committee failed to move a GOP priority bill (HB 20), the Dick Hinch Freedom Savings Account.

In reality, the panel's 20-0 decision to hold onto this bill until 2020 was COVID-driven.

The House got a late start hosting public hearings on bills as they worked out the best way to hold them during the pandemic.

Then voucher supporters ran up against a Feb. 25 deadline for all House committees to make recommendations on bills that have to go to a second panel.

The voucher bill would have gone to the House Finance Committee for review if the House education committee and the full House had initially endorsed it.

With two House sessions in Bedford this week, the education panel had to pull the trigger last week and ran out of time.

Gov. Chris Sununu kept social distance from this issue despite his philosophical support for it.

"That was not my bill per se," Sununu said. "I think it's a good idea, but obviously you have to do it the right way. We weren't really driving on it."

The issue won't go away for 2021.

The Senate has its own similar bill (SB 130), which has the co-sponsorship of eight GOP senators and is likely to leave that upper chamber.

However, it will be difficult to convince House membership to act on a topic its own committee is still working on.

The Senate debate will allow supporters to iron out the many kinks in this policy to make the voucher cause ready for prime time when the House takes it up.

NH says no to CDC

Sununu has cited guidance from the Centers for Disease Control in defense of his order last week that all New Hampshire schools must offer in-person classes two days a week.

But at the same time, New Hampshire is ignoring a new CDC advisory that offers specifics on how reopenings should be handled.

The federal package discourages middle and high schools in areas of high rates of community transmission from opening.

It recommends testing teaching students and staff weekly for the virus, while Sununu's public health team calls for testing those who have COVID-19 symptoms.

The CDC already had a six-foot social distancing recommendation. NH's rules say a three-foot separation is permissible in tighter spaces.

School funding preserved

The Senate voted unanimously to give communities a one-year "hold harmless" to ensure declining enrollments from COVID-19 don't cost school districts $45 million in lower state aid.

The bill (SB 135) now heads to the House.

But Senate Democrats tried to go further. Keene Democratic Sen. Jay Kahn offered a $36 million boost (SB 145) in fiscal disparity aid, which also is at risk of decline.

Senate Majority Leader Jeb Bradley, R-Wolfeboro, said that item should be taken up during discussion of the state budget. The Senate agreed, killing Kahn's proposal on a partisan 14-10 vote.

"I'm disappointed that this kind of win-win proposal was rejected by Senate Republicans, who voted today to deny essential aid to their own districts," Kahn said.

The original bill can help assure local school officials they can count on the $45 million as they build their school budgets at local meetings next month, Bradley said.

"If we want to help property taxpayers today, then let's vote for something that is certain," Bradley said.

Conservative slams Dem tactics

State Rep. Terry Roy, R-Deerfield, took to Gab, an anti-Twitter social media site for conservatives, to sound off about how liberals were packing Zoom hearings on bills with virtual supporters.

"The lefties are taking advantage of it by getting their basement dwelling, parent living, hot pocket eating, multi genders having followers to go online and sign up for or against bills and claiming it represents public support for them," Roy posted.

He created a link and urged his 12,000 followers to beat liberals at their own game.

"Let's fight back and show your support for Live Free or Die Republicans in NH," Roy concluded. "I want these liberal commies to not know what hit them!"

VAMS' number is up

Sununu has been eager to replace the problem-plagued federal Vaccine Administration Management System (VAMS) that caused tens of thousands of Granite Staters to have their second dose appointments erased or not refiled a few weeks back.

In response, state officials took over the second-dose scheduling but kept VAMS as a backstop. The system contains all records on COVID-19 vaccinations so far.

Sununu said the state plans to put up its own online appointment system, which he said will leave VAMS in the dust, but it won't be available until the next phase, 2-A, which covers educators and school staff. Officials hope to start those vaccines in early April.

"This makes sense. Otherwise we would have to move over a few hundred thousand records from Phases 1-A and B and that could cause other issues," Sununu said. "We want to start fresh in the next phase with a new and better system."

Sununu said the April start to teacher vaccinations is "not a promise," as it's reliant on the Biden administration ramping up even bigger deliveries of vaccine.

House special election set

The Executive Council approved a second special election following the resignation of Bow Democrat Samantha Fox, who was elected to the House on Nov. 3.

Dunbarton and Bow voters will pick her replacement June 8, with a primary election April 20 if necessary. The filing period for the seat runs through Friday.

According to House records, Fox never cast a vote in the House. She was absent when the House had its only session this year, on Jan. 6 at UNH.

The first special election will be April 13 in Merrimack to pick a replacement for the late House Speaker Dick Hinch, who died in December after contracting COVID.

Child boarding crisis

The state hit an alarming milestone in recent weeks — a record 50 children with mental health issues waiting in hospital emergency rooms for a treatment.

At the end of last week, Shibinette acted. She directed New Hampshire Hospital to restart a 10-bed unit for children that she said should "quickly reduce" this waiting list.

The HHS boss stressed this doesn't reflect an "inpatient bed crisis," but rather a shortage of community resources.

"We have 40 adults wanting a bed in New Hampshire, but we have 60 there ready for discharge that can't get the services in the community that they need," Shibinette said.

Hampstead Hospital should be opening up additional beds by this May, she said.

Meanwhile, a bipartisan group of senators pushed legislation (SB 157) at a hearing last Wednesday to make good on a $20 million investment in child mental health services with provider contract awards that had been delayed, due in part to the pandemic.

Sen. Becky Whitley, D-Hopkinton, co-wrote the 2019 law with ex-Senate Majority Leader Dan Feltes and is sponsoring this follow-up bill, which includes the creation of eight new state jobs to carry out the plan.

Windham audit historic

When was the last time the state ordered a post-recount audit of an election in New Hampshire?

David Scanlan has been Deputy Secretary of State since 2002 and was a House GOP leader for nearly 20 years before that.

Secretary of State Bill Gardner started in his post in December 1976, a month after Jimmy Carter was elected president.

Neither one can recall it happening before.

Scanlan endorsed the idea of the amended bill (SB 43) the Senate fast-tracked over to the House last Thursday.

"The Legislature calling for an audit of the ballot counting devices specific to Windham is the appropriate way to help address the disparity in the results from election night and the recount in the state representative race," Scanlan said.

Young Dems push education

College and high school young Democratic leaders urged the Legislature to kick up education spending above what Sununu proposed in his budget.

Michael Roderick, co-president of the University of New Hampshire College Democrats, criticized Sununu's budget for cutting endowment spending and reducing higher ed aid by $17.6 million, which he said could cause tuition to increase.

Sarah West, a Concord High School student, said the money in Sununu's one-time $30 million infrastructure grant plan would be better used in providing more aid for schools dealing with pandemic costs

Sununu responded during a House budget writers briefing. He said the UNH endowment fund can't be spent for operations, and public school district administrators are sitting on more than $175 million in federal COVID-19 relief they haven't spent.

House gets spiritual assist

House Speaker Sherman Packard, R-Londonderry, announced last week that the Rev. Bob Stewart will serve as House chaplain for this two-year term. Stewart is pastor of St. Paul's United Methodist Church in Manchester and is known as a leader in the interfaith services program with other area clergy.

The Rev. Kate Atkinson, of St. Paul's Episcopal Church in Concord, has served in this role for the past six years.

Kevin Landrigan is the State House bureau chief for the New Hampshire Union Leader and Sunday News. Reach him at klandrigan@unionleader.com.