relative to family caregiver support in certain programs and child care support for kinship caregivers.
Summary
SB 608 would direct the Department of Health and Human Services to seek federal approval to add family caregiver support services as an allowable service under two home- and community-based waiver programs: the Acquired Brain Disorder (ABD) waiver and the Choices for Independence (CFI) waiver. The bill defines these supports broadly to include services such as counseling, education and training, peer support, caregiver assessment, and other services intended to help caregivers continue providing care at home and in the community. It also requires the department to adopt rules governing eligibility, provider qualifications, service limits, and related program details.
The bill also makes several changes to child care scholarship eligibility and cost-sharing rules. It would eliminate the family cost share for child care scholarships when all enrolled children in a household are in kinship care, and it would allow retirement to count as a qualifying activity for child care scholarship work-requirement purposes, alongside approved mental health or substance use treatment. The child care-related provisions take effect only if the federal Office of Child Care approves the requested program modifications.
Impact
SB 608 would amend RSA 151-E and RSA 167:83 to expand the scope of services and eligibility rules within state-administered long-term care and child care programs. If approved by federal agencies, the bill would make family caregiver support an allowable service under the ABD and CFI waiver programs and would remove the child care scholarship family cost share for households in which all enrolled children are cared for by a caretaker relative. It would also broaden the list of activities that can satisfy the child care scholarship work requirement by adding retirement and certain treatment programs. The fiscal note anticipates new state costs, including systems changes and ongoing service costs, with some costs shared by federal funds.
Sentiment
The overall sentiment appears supportive of the bill’s goals, as it is framed around helping family caregivers, kinship caregivers, and households facing caregiving or treatment-related barriers to child care access. The bill’s sponsors and committee placement suggest a health-and-human-services policy focus rather than a partisan or ideological dispute. The fiscal note, however, indicates some caution because implementation depends on federal approvals and because the retirement provision could conflict with federal child care rules.
Contention
The main points of contention are likely to be fiscal and federal-compliance issues rather than the underlying policy objectives. The Department of Health and Human Services expects the bill to increase general fund and federal fund expenditures, and it notes that the retirement provision may run afoul of federal regulations governing child care scholarship eligibility. Another potential issue is that the child care cost-share elimination applies only to households where all enrolled children are in kinship care, which may raise questions about administrative complexity and fairness for mixed households. Because the child care provisions are contingent on federal approval, implementation uncertainty is also a notable concern.
Relative to the personal needs allowance of residents of nursing homes; making an appropriation to the department of health and human services for Hampstead hospital and residential treatment facility staff; establishing the Hampstead hospital and residential treatment facility capital investment fund; and permitting qualifying patients and designated caregivers to cultivate cannabis for therapeutic use.
Providing maternal depression screening for new mothers; increasing access to health care services for new mothers; enabling new parents to attend infant pediatric medical appointments; and developing a plan for perinatal peer support certification.
Relative to the department of health and human services management of social security payments, supplemental security income payments, and veterans benefits for children in foster care.