NH HHS subcommittee recommends against HB 621 after health officials warn of risks to newborn screening and federal funding

A subcommittee of the New Hampshire House Health, Human Services and Elderly Affairs Committee voted unanimously to recommend that HB 621 be reported Inexpedient to Legislate (ITL), after testimony that allowing mothers to opt out of providing personal identifiers on the live-birth worksheet would harm public-health programs and risk federal funding.

The issue, committee members were told, is not the collection of maternal and child-health statistics per se but the loss of personal identifiers — names, addresses, dates of birth and similar fields — that officials say are necessary to link records, run newborn screening and verify eligibility for programs such as Medicaid and child support.

"This was one of the few bills that we as a department actually took a position in opposing," John Williams, legislative director for the Department of Health and Human Services (DHHS), told the subcommittee. He said the department’s concerns were both fiscal and programmatic.

DHHS officials described several concrete harms they said could follow from the bill as written. A bureau chief in the division of public-health statistics said vital-record identifiers allow the department to link birth records to newborn-screening tests and other services, and to geocode addresses into small areas such as census tracts for rural-health work. "The personal identifiers are crucial for linking data across systems and ensuring that public-health efforts and social services can be effectively implemented," the bureau chief said.

Connie, a program representative for the state newborn-screening program, told the panel that some screening results require immediate follow-up. "Some of our conditions are time sensitive," she said, adding that missing or incomplete contact information can delay provider notification and the referral needed for timely care.

Representatives of the Bureau of Child Support Services said access to vital records is central to establishing parent‑child legal relationships and locating noncustodial parents. "The birth certificate is the key record that our program is most interested in," Lisa Nagatowski, bureau chief for child support, said. She told members the program is governed by federal Title IV‑D requirements and state confidentiality statutes and uses the vital record to open cases and pursue support when parents apply for services.

Deb Sorely, who identified herself as responsible for business and policy in the Bureau of Family Assistance, said DHHS uses birth-record identifiers to verify citizenship and residency for programs including Medicaid, SNAP and TANF. She told the subcommittee that, without those identifiers, applicants could be required to supply a certified birth certificate or other proof themselves and that, when records are incomplete, DHHS may be forced to deny applications.

Kristen Martino, the state registrar in the Department of State’s vital-records office, told members that implementing an opt-out function would carry its own costs and legal conflicts. "We would have to redo our birth worksheets, which is about $25,000," she said, and warned that the bill as drafted could conflict with existing statutes that require the secretary of state to provide continuous electronic access to vital records to DHHS (statutes referenced in testimony included RSA chapter 5‑C provisions and a statute designating DHHS's direct interest in vital records). Martino also said the current data-flow model has hospitals enter the worksheet into the state's system (identified in testimony as the vital-records software used by hospitals and town clerks), and the registrar's office disseminates data to DHHS.

Panel members also raised questions about legal protections and disclosure. DHHS staff described a review process for requests for confidential or limited-use data that involves an application, research protocol and review by a vital-records privacy board; they said routine HIPAA protections and state confidentiality rules apply to the department’s handling of identifiable data. When Representative Markel asked whether the bill would create a HIPAA violation, DHHS staff and the legislative director said HIPAA would continue to apply and that the department had not identified the bill itself as creating a HIPAA compliance issue; rather, they said, the problem was the reduction in data available to the department.

Witnesses also noted recent statutory and legislative context referenced in testimony: the committee received a side‑by‑side comparison of HB 621 and Senate Bill 92; staff said SB 92 (signed into law) narrowed certain data elements provided to federal partners and adjusted APGAR reporting timelines. Witnesses also referenced a prior change (testimony cited an SB 105 enacted in 2025) that removed a criminal penalty that had previously applied to maternal statistical information, and they discussed federal public‑health designations cited by the registrar and DHHS during testimony.

Fiscal impacts were a recurring concern. DHHS testimony cited a written fiscal analysis saying a portion of federal funding — described by presenters as "a little over $11,000,000" — could be at risk if key identifiers were removed from the statewide birth dataset. The registrar offered the $25,000 estimate for reprinting and software changes as a departmental cost; DHHS asked for a department‑wide fiscal estimate to be provided to the full committee ahead of executive session.

After testimony and a brief recess, Representative Markel moved that the subcommittee recommend ITL on HB 621; Representative Lamontagne seconded. The motion passed unanimously. Chairman McDonald asked DHHS staff to provide a department‑wide estimate of fiscal impact for the committee’s executive session and the full committee meeting.

The subcommittee’s ITL recommendation will be recorded as the panel’s recommendation to the full Health, Human Services and Elderly Affairs Committee at its next executive session.