HB 1597-FN-LOCAL - AS AMENDED BY THE HOUSE
22Feb2006… 0921h
2006 SESSION
05/03
HOUSE BILL 1597-FN-LOCAL
AN ACT relative to municipal obligations for indigent medical expenses.
SPONSORS: Rep. Kurk, Hills 7; Rep. Patten, Carr 4; Rep. Wendelboe, Belk 1; Rep. N. Johnson, Straf 3; Sen. Martel, Dist 18
COMMITTEE: Municipal and County Government
This bill permits a municipality to exclude medical expenses, other than certain prescription medication, from the municipality’s local assistance program.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
22Feb2006… 0921h
06-2508
05/03
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Six
AN ACT relative to municipal obligations for indigent medical expenses.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Aid to Assisted Persons; Medical Expenses. Amend RSA 165:1 by inserting after paragraph III the following new paragraph:
IV. The local governing body of a town or city may adopt written guidelines to exclude from its general assistance program surgical and medical expenses, except for prescribed medication, when there is no other means to provide such medication.
2 Effective Date. This act shall take effect July 1, 2006.
LBAO
06-2508
Amended 3/24/06
HB 1597 FISCAL NOTE
AN ACT relative to municipal obligations for indigent medical expenses.
FISCAL IMPACT:
The Department of Health and Human Services and New Hampshire Municipal Association state this bill, as amended by the House (Amendment #2006-0921h), will have an indeterminable fiscal impact on state expenditures, and decrease local expenditures by an indeterminable amount in FY 2007 and each year thereafter. This bill will have no fiscal impact ton state, county, and local revenue or county expenditures.
METHODOLOGY:
The Department of Health and Human Services indicates this bill would relieve municipalities from any obligation to indigent individuals for medical assistance. The Department states to most municipalities “unable to support oneself” is interpreted to be as not eligible for any state or federal program for ongoing maintenance of health or finances. Medicaid provides such a large array of services that it is unusual for someone to have unpaid medical bills or unmet medical needs while on Medicaid.
The Department does not know how much municipalities pay for medical assistance for individuals, but assumes much of the medical assistance is for prescription medications. The Department maintains a fund to repay municipalities in the event that they have provided assistance to an individual who would have received their assistance from the Department instead of the town but did not because of unavoidable delays in determining eligibility within federally established timelines. The Department states traditionally few municipalities have availed themselves of this process, and the fund is set at $100,000. If the local obligation for medical assistance is limited to prescriptions, this fund could experience a decrease in utilization, and individuals not eligible for Medicaid or Medicare, and who lack health insurance would need to find assistance elsewhere to pay for their health care if they cannot pay for it themselves. The Department is not able to estimate the fiscal impact of this bill on state or local expenditures at this time.
The New Hampshire Municipal Association indicated that while municipalities currently pay drug prescription costs, they rarely pay other medical costs. The Association stated the local obligation under RSA 165 is broadly worded and could be interpreted to require municipalities to cover a wide range of physician and hospital charges. The Association assumed this bill would limit the municipal obligation to pay medical costs for local welfare recipients, and could decrease costs to the municipalities, but the amount cannot be determined.