Committee weighs licensure for outpatient substance‑use clinics; sponsors and providers say oversight would protect vulnerable patients

Representative Mark McLean told the House Health and Human Services and Elderly Affairs Committee HB 751 would create a licensure requirement for outpatient substance‑use treatment programs and an ombudsman to receive and investigate complaints. McLean said the measure grew from requests from municipal officials and providers who flagged predatory behavior in some treatment programs and the state’s limited visibility over many outpatient providers.

The Department of Health and Human Services told the committee it already licenses residential substance‑use facilities and that integrating outpatient program licensure into existing healthcare facility licensure would be more efficient than creating a parallel certification program. Doreen Shockley, manager of DHHS’s Bureau of Licensing and Certification, said the department worked with sponsors to reduce fiscal impacts: an earlier draft required four new positions and IT infrastructure; the updated amendment asked for one position by rolling outpatient oversight into the existing licensing framework.

Treatment providers, recovery‑court coordinators and addiction‑service directors strongly supported the bill. Kate Peters, an emergency‑medicine physician, and Jamie Powers and Annette Escalante, both providers with billing and program experience, told the committee patients seeking treatment are ‘‘vulnerable’’ and that licensure and an ombudsman would close gaps that let some programs operate without basic safety and quality checks. Amanda Vashon, Merrimack County recovery‑court coordinator, said courts typically refer the highest‑risk patients into treatment and ‘‘we have an obligation to provide oversight’’ for programs that courts require clients to attend.

Advocates described complaints documented in media reporting and local testimony of sexual exploitation and other abuse at some treatment locations and said the state lacks a central list of outpatient providers. New Futures and other advocacy groups told the committee licensure would let DHHS monitor quality and follow up on complaints and ensure taxpayer‑funded treatment dollars go to appropriate services.

Several providers acknowledged concerns that overly burdensome rules could reduce access; sponsors said the amendment removed residential licensing and narrowed the requirement to outpatient programs, exempted nonclinical programs and 12‑step groups and preserved a role for independent practitioners.

Following testimony the committee did not take immediate action on HB 751; sponsors said they would work with DHHS on final rule language and fiscal impacts.