Public Health warns against cuts to family planning, tobacco prevention and lab programs; raises concerns about vaccine schedule changes

Ian Watt, director of the Division of Public Health Services, and his bureau leaders told senators the division is highly dependent on federal and other funds (more than 80% of its budget), and that proposed House actions could eliminate or reduce several long-standing public-health services.

Watt and associate staff stressed three immediate concerns in the House budget and companion provisions: (1) elimination of state and federal funding for Title X family-planning contracts — the division currently funds four contractors at seven sites; officials said the total contract amount for the extension period (Jan 1, 2024 through June 30, 2025) is about $1.4 million and roughly one-third of that came from general funds (~$462,000), and officials warned cutting Title X contracts would reduce access to reproductive and preventive health care especially in northern counties; (2) the likely loss of federal tobacco-prevention grant funds this summer and the House’s proposed removal of general-fund support would effectively end the state tobacco-prevention program that supports youth prevention, cessation (quit line) and enforcement of the indoor-smoking act; and (3) a proposed 5% surcharge on many dedicated account revenues would impair programs where statute or federal rules require funds be reinvested in program services — Watt asked for exemptions for funds cited in testimony including WIC rebates, newborn-screening fee receipts, radiological health fees and the public-lab equipment replacement account (the presentation cited RSA references where program statutes require funds be used for program services).

Watt also flagged the statutory language in HB2 that would narrow the commissioner’s rulemaking authority for school and child-care vaccination schedules and potentially remove several vaccines (hepatitis B, varicella/chickenpox and Hib) from the required schedule after June 30, 2026. He said the process used to set school and childcare immunization requirements is deliberate, uses medical expertise, and already allows medical and religious exemptions; the proposed change would limit public-health rulemaking flexibility and could increase communicable-disease risk in childcare and school settings.

The public-health team recommended exemptions from the 5% dedicated-account surcharge for several funds suggested in the presentation, urged the committee to preserve Title X contracts to protect access in rural and northern areas, and asked for time and technical discussion before adopting rule-limiting changes to the vaccine schedule.

Ending: Watt said the department would provide statutory citations and technical detail for any accounts the committee wished to exempt from a surcharge and would follow up on timing and appeal status for recent federal-grant rescissions that reduced available CDC and SAMHSA funding.

Sections follow below.