Conferees clear most of nursing-home funding bill but reject cannabis carve-in; debate prompts caucus and delay

Conferees for the House and Senate met to discuss Senate Bill 118, a bill that would make several changes affecting nursing homes and Hampstead Hospital, including updating personal-needs-allowance timing to reflect annual Social Security increases and creating a maintenance fund funded by rent from Dartmouth-Hitchcock. The session broke into caucus after a dispute over newly attached language permitting limited cannabis cultivation for therapeutic use.

Why it matters: supporters said the bill's core purpose is to provide nursing-home residents annual adjustments to personal-needs allowances and to secure a maintenance fund for Hampstead Hospital after Dartmouth-Hitchcock begins paying rent. Opponents objected to attaching cannabis cultivation language to the measure, saying the addition could imperil passage and was not germane to the bill's health-care focus.

Details and discussion: "What 1 18 did, It was a request from DHHS in order to give personal needs allowance for our nursing home residents to reflect their Social Security increases," Senator Bridal said, explaining the bill's three main components: the personal-needs-allowance adjustment, prorated sign-on bonuses for state employees who left for Dartmouth-Hitchcock, and a maintenance fund to accept up to about $3,000,000 a year in rent.

Department of Health and Human Services staff described amendments the House offered that preserve the bill's fiscal implications while providing the department greater flexibility in handling certain federal and ARPA funding restrictions. "It did not change the fiscal implications regarding the bill," a DHHS representative said, urging conferees to adopt the House amendment because it reflected work with the House Health Policy Committee.

Members from both sides said they supported the base bill; the dispute centered on an amendment—originating in a separate cannabis bill (HB 53)—that would allow qualified patients to cultivate limited cannabis. Some senators said the Senate had given the cannabis measure an 'ITL' recommendation in a separate committee and were unwilling to carry that policy in SB 118. One conferee said they feared the governor would veto any bill carrying cannabis language and that inclusion could become a "poison pill." Other conferees urged preserving the nursing-home provisions and asked whether certain cannabis language could be removed so the base bill could move forward.

Outcome: conferees agreed to caucus and asked to reconvene later in the week (the parties discussed meeting Wednesday or the 18th). No final vote was taken in the conference and no change to the bill was adopted on the record. The conferees said they were willing to "seat to the House position" on SB 118 but without the cannabis provision, subject to final caucus agreement.

Next steps: conferees planned additional meetings to resolve whether the House amendment sans cannabis could serve as the conference position, and to confirm whether the budget will ultimately carry the nursing-home provisions if the broader budget passes.