Committee advances non-germane patient Bill of Rights amendment to HB71, flags possible $12–18M federal funding risk

Division III took up a revised non-germane amendment to HB71 that would insert the patient Bill of Rights into standard HHS contract terms and conditions and include a sunset clause. Chairman Edwards described the amendment as inserting ‘‘the requirement to also comply with the patient bill of rights’’ into vendor contracts and said the change would carry an effective repeal date to avoid orphaning compliance obligations.

Matthew Hood, government-relations representative for Dartmouth Health, told the committee Dartmouth ‘‘is totally supportive of that addition’’ but said he could not speak to the underlying bill. John Williams, legislative director for the department, said the department likewise is ‘‘fine with this amendment.’’ The Department of Education attorney Diana Fenton provided technical assistance and explained that the Department of Education did not expect a fiscal impact to its agency; Department of Health and Human Services (DHHS) staff, however, reported a potential risk to federal funds.

Committee staff and DHHS fiscal analysts explained that the fiscal note uses language emphasizing a potential or "may" loss of federal revenue. The fiscal note referenced prior grant awards from the Office of Refugee Resettlement and the Department of Housing and Urban Development and estimated a potential worst-case loss of federal revenue ranging from $12 million to $18,000,000. Staff described that figure as a worst-case scenario and said additional backup documentation and specific budget-line locations will be provided to the committee.

Because the non-germane amendment is being attached to a different bill than it previously was considered on, staff advised the committee it likely requires another non-germane public hearing in full finance before a vote. The chair asked staff to attempt to schedule that hearing at the next full finance meeting and to add a Division 3 work session if needed. Members asked the department for more detail about which federal grants and accounting units would be affected; staff agreed to follow up.

Representative Edwards (chair) publicly modified his earlier, stronger description of an incident at Dartmouth, saying he had ‘‘spoken more strongly than I ought to have’’ and that the episode appeared to have been a one-off that Dartmouth leadership resolved. The chair apologized for overstating the situation while noting he wants patient Bill of Rights language to be effectively implemented.

Next steps: The committee agreed to take the amendment to full finance as a non-germane amendment, seek a public hearing, request DHHS to provide backup for the fiscal estimate and identify the specific accounting units the estimate would affect, and schedule a follow-up Division 3 session with expert witnesses.

Ending: The committee adjourned after scheduling follow-up and asking staff to add the item to upcoming calendars.