By GARRY RAYNO, InDepthNH.org
CONCORD — As a possible precursor to a vote to legalize recreational use of marijuana, the Senate Thursday approved allowing patients in the medical marijuana program to grow their own cannabis.
The House Thursday agreed to change work requirements approved last session for the Medicaid expansion program, as well as increase staffing at the Division for Children, Youth and Families and add money for emergency mental health services to address wait times in hospital emergency rooms.
The Senate approved allowing patients in the state’s medical marijuana program and their caregivers to grow their own marijuana on a bipartisan 14-10 vote.
Supporters of House Bill 364 said some people in the medical marijuana program are unable to find transportation to the state’s four dispensaries and others cannot afford to pay for the medication.
“We hear over and over again in hearings there is a problem with our state having so few dispensaries. It is not perfect for everyone to access,” said Sen. Tom Sherman, D-Rye.
Others said patients growing their own cannabis may better tailor the strain to their symptoms and can reduce the costs for the medication not covered by insurance.
The prime sponsor of the original bill establishing the medical marijuana program, Sen. John Reagan, R-Deerfield, said many of the people certified to participate have chronic pain and are on other medications as well so cost is important.
“With home-grown you can concentrate the cannabis to a greater degree so (the patient) can continue to stop the pain and continue to live,” he said. “At the dispensaries it costs about $400 a month but they can grow their own for $100.”
But opponents said the bill lacks regulation and will be difficult to enforce.
Sen. Sharon Carson, R-Londonderry, noted there is no means for testing in allowing someone to grow their own plants, and no penalties if someone steals a person’s plants.
“This bill needs real enforcement methods before it goes forward,” she said.
But Sherman said theft is theft and he noted there would be a state monitoring program to check compliance. A specific location has to be filed with the Department of Health and Human Services, he said.
Maine has had a similar provision since the state approved its medical marijuana program without problems, he said.
Under the bill, the caregiver or patient is limited to three mature plants, three immature plants and 12 seedlings, and eight ounces of usable cannabis. A designated caregiver may grow cannabis for up to two patients.
The bill would also allow an alternative treatment center registered with the department to cultivate their own marijuana.
Lawmakers have tried since approving the medical marijuana program to allow home cultivation in order to save patients money, but to date they have failed to approve a bill.
When the medical marijuana program was approved, the grow-your-own provision was removed after then Gov. Maggie Hassan threatened to veto the bill if it remained.
HB 364 goes back to the House due to Senate changes.
Medicaid expansion recipients will be less likely to lose their medical coverage if they fail to find employment, complete occupational training or community work under a bill given initial approval by the House Thursday.
Last year when the program was reauthorized, a work requirement was included, and the Trump administration approved the requirement imposing additional restrictions similar to Arkansas’s program which resulted in about one quarter of recipients losing their medical coverage.
Supporters of Senate Bill 290 said the changes would ensure the 52,000 people on the expanded Medicaid program would have more options to meet the community engagement requirement which includes work, training and community service.
“The majority of the committee is concerned about a significant loss of coverage for enrollees as happened in Arkansas where one quarter were eliminated,” said Rep. Jerry Knirk, D-Freedom. “The community engagement requirement should not result in loss of coverage.”
But opponents said the bill does away with a carefully crafted compromise with broad bipartisan support last year.
“It is with a heavy heart that we
are about to change the Medicaid expansion program,” said Rep. William Marsh,
R-Wolfeboro, “not because the data shows we need to, but because we can.”
SB 290 would make it easier to satisfy the work and training requirements and would establish triggers to bypass the requirements if hospitals experience increased uncompensated care costs due to loss of coverage or 500 or more patients lose their coverage.
The bill also would allow general funds to be used as a last resort to pay the state’s 10 percent share of the costs, while the federal government covers 90 percent. Currently, hospitals and insurance companies pay the state’s share.
SB 290 was approved on a 210-150 vote. The bill will go to the House Finance Committee for financial review before a final vote by the House.
DCYF Case Workers
The House approved Senate Bill 6 which increases case worker staffing levels at the Division of Children, Youth and Families.
The bill appropriates about $9 million over the next two fiscal years to hire 57 child protective case workers and nine supervisors.
The department has had a shortage of case workers resulting in large caseloads. The large caseloads are blamed for some children slipping through the cracks.
The national average was 12 cases for each caseworker two years ago. Vermont case workers handled an average of 16 cases, but in New Hampshire the average is 45 cases per worker.
“As we know from the report released by the Department of Health and Human Services last year, DCYF is in the midst of a growing challenge to meet high caseload demands in the state,” said House Majority Leader Doug Lay, D-Jaffrey. “This legislation is critical to helping caseworkers meet the needs of Granite State children efficiently by reducing the caseloads of those who provide first-rate care.”
The bill passed the House on a 272-87 vote. The bill goes to the governor.
The House approved a bill intended to address the continual problem of people needing emergency mental health treatment sitting in emergency rooms — some up to a month — until space is available at the New Hampshire Hospital, community mental health centers or other appropriate facilities.
Senate Bill 11 would add $10.6 million in surplus general fund money to address emergency room wait times for psychiatric services, double provider rates for those services, renovate up to three additional designated receiving facilities, increase funding for transitional housing, fund a new mobile crisis unit or second behavioral health crisis center and would require insurance companies to cover up to 30 days of emergency room boarding and treatment.
On average between 40 to 70 people wait in emergency rooms for mental health services.
“New Hampshire used to be a leader when it comes to mental health,” said the bill’s prime sponsor, Sen. Tom Sherman, D-Rye. The bill will go to the governor.
The Senate approved:
House Bill 224 to make emergency technical and rescue squad members eligible for a death benefit if killed in the line of duty. The bill goes back to the House because of Senate changes.
House Bill 692 to develop a program to provide dental care for Medicaid recipients. The bill goes to the governor.
House Bill 550 to extend the foster care program to youth up to 21 years old. The current limit is 18 years old. The bill goes to the governor.
And House Bill 334 to extend the time municipalities retain records for police for 20 years after an officer retires or has his or her employment terminated. The bill goes back to the House because of Senate changes.
The House approved:
Senate Bill 76 to prohibit the exploration for oil and natural gas off the New Hampshire coast. The bill goes to the governor.
Senate Bill 125 to no longer bill parents for the cost of voluntary services under the Children in Need of Services program that are not covered by insurance. The bill goes to the governor.
Senate Bill 139 to study options to lower student debt. New Hampshire college graduates have among the highest student debt in the country averaging about $32,000. The bill passed on a 217-142 vote. The bill goes to the governor.
Senate Bill 187 would raise the registration fees for Off-Highway Recreational Vehicles, rental agencies and snowmobiles to fund the trail maintenance program. The bill goes to the House Ways and Means Committee for review before a final vote.
Garry Rayno may be reached at email@example.com