By GARRY RAYNO, InDepthNH.org

CONCORD — The Community Health Centers were given a financial boost by budget writers Friday with $6 million of federal relief money.

The Joint Legislative Fiscal Committee approved the request for one-time support for eight Federally Qualified Health Centers and one similar center to address the continuing impact from the COVID pandemic.

The $6 million is from the American Rescue Plan Act and will help with budgetary shortfalls and to develop plans for long term viability.

Rep. Jess Edwards, R-Auburn, questioned the use of the one-time federal money for on-going operations saying, in the future the money may not be available and the program would need general funds.

“Are we setting ourselves up for failure,” he asked, “and the money will not be available in future budget cycles.”
Associate Department of Health and Human Services Commissioner Patricia Tilley said the state has used some of the federal relief money to fill holes when programs have losses due to the pandemic.

She said the centers serve those without health insurance, those who are underinsured and anyone needing services and they have also been impacted by some changes in federal funding, which is being resolved.

Part of the funds are to develop sustainability plans, Tilley said.

“We want to be able to keep the doors open,” Tilley said, “or we will have a catastrophic effect on the entire health care system.”

She said the grants will be determined based on need as they were with additional money for the community mental health centers.

Edwards said he remains concerned about spending long time money on operations, and wondered how long you could blame the pandemic for financial problems.

Tilley said she was confident investing in the qualified health centers will save money in the long term by reducing uncompensated care in the system.

DSH Payments

The committee also approved using $12.4 million in federal Disproportionate Share Hospital Payments to pay for what the New Hampshire Hospital is owed over a three-year period in uncompensated care and coverage shortfalls.

The shortfall was discovered in audits done that were three years behind schedule, according to information the Department of Health and Human Services gave the committee.

The so-called DSH payments are to cover the cost of uncompensated care and the shortfall between what Medicaid pays and the actual cost of providing the services.

Currently hospitals receive 91 percent of what they are owed under an agreement between the state and the state’s hospitals that is about to end.

Lawmakers failed to agree on a change to the payouts at the end of the legislative session as Gov. Chris Sununu wanted to reduce the amount going to the hospitals and to use that money to help community health and mental health centers.

Without an agreement, Sununu ordered the department to begin drafting a program that would return 80 percent to hospitals, which was opposed by the hospitals.

State Sen. Lou D’Allesandro, D-Manchester, who is retiring at the end of this year, urged his fellow lawmakers to address the issue next session. 

“This 80 percent by fiat is in my opinion not the way to do business,” he said. “The legislature should have a say on that. We all have hospitals in our districts and we should have a say.”

Refugees

The panel approved accepting $2 million of federal money for the Refugee Cash and Medical Assistance program that reimburses states for cash and medical assistance and related costs.

Under the federal program, the federally approved refugees are eligible for the help for 12 months. Recently refugees were added to the program from Afghanistan and the Ukraine.

Rep. Keith Erf, R-Weare, wanted to know how many refugees were here due to executive order and if the state was following its policy of not paying for medical services for illegal immigrants.

HHS Associate Commissioner Ann Landry said the refugees that are under this program are approved through the federal government and did not know how many were from an executive order.

She also said she could not speak to how hospital emergency rooms deal with any populations of people using those services.

“These are legal refugees with lots of federal reporting,” she said. “We only serve those who come through that program.”

Federal funding has been increased and covers the costs currently, she said.

Solar Money

The panel approved accepting $43.1 million in federal money intended to help low-to-moderate-income people access solar arrays to save money on their electric bills.  

The program is a joint effort of the NH Department of Energy, the NH Housing Authority and the Community Loan Fund and will target resident-owned trailer parks and housing authority multi-family units.

Fiscal Committee chair Rep. Ken Weyler, R-Kingston, wanted to know if there is a list of low-to-moderate-income projects in the state.

Josh Elliot of the Department of Energy said the figure is determined by county and the individual can earn up to 80 percent of the county’s medium family income to qualify for the program.

Rye Harbor

The Fiscal Committee extended the end date of a federal ARPA grant for $1 million to construct a new retail building at Rye Harbor.

Currently the 10 individual buildings are privately owned at the pier and the new raised building would allow those businesses to move to more stable facilities if they desire or for new businesses to occupy.

The plan from the Pease Development Authority is controversial with many of the existing businesses opposed as are others from the community.

Several committee members asked about the transparency of the Pease Development Authority in moving forward with the proposal, and Myles Greenway, Interim Director of Ports and Harbors, said the transparency was addressed at the PDA’s last meeting.

He said the agency is working with the Rye Planning Board and keeping in contact with “everyone about the project.”
He said they plan to hold a couple more public meetings between now and the next board meeting in September.

The PDA wants to use $2 million in federal ARPA funds to do work on the Portsmouth fishing pier and the new building at Rye Harbor.

Weyler asked if the new building would impact parking for the commercial fishermen and Greenway said they currently park on the pier side of the area, but there would be some impact on parking for recreational fishing and others and they are continuing to work on that issue.

The committee voted to extend the end date from Sept. 30 to June 30, 2025.

Garry Rayno may be reached at garry.rayno@yahoo.com.