Senate advances bill to create long-term care advisory council amid concerns of duplication with county commission

Senators on the Senate Health and Human Services Committee voted to recommend passage of Senate Bill 288, which would establish an advisory council on long-term care to gather data, engage stakeholders and make recommendations aimed at improving access to long-term care and speeding hospital discharges.

The bill’s sponsor, Sen. Ruth Ward, told the committee she and 13 colleagues brought the bill after constituents described long inpatient waits for non‑acute patients. “We know that one of the biggest challenges with access to inpatient bed capacity is that many beds are being taken up by non acute patients,” Ward said, citing a Foundation for Healthy Communities report that identified 46 patients statewide waiting for long‑term care and “hundred and 5 unnecessary extra days in a hospital.”

Supporters — including the New Hampshire Hospital Association, Dartmouth Health, the Commission on Aging and several provider groups — said the council would help untangle a multifaceted barriers-to-discharge problem that harms patients, ties up acute beds and creates unreimbursed costs for hospitals. Ben Bradley of the New Hampshire Hospital Association said the association’s analysis found a median of about 72 unnecessary inpatient days for patients awaiting long‑term placement and estimated more than $10 million in accumulated costs in a previously circulated report. Courtney Tanner of Dartmouth Health told the committee her flagship medical center had about 20% of its 400 beds occupied by patients ready for discharge and cited examples of individual patients sitting in hospital beds hundreds of days past clinical need (one patient cited at 692 days past clinical need).

County officials, represented by Craig Labore of the New Hampshire Association of Counties, opposed the bill as written. Labore said the County State Finance Commission (created under RSA 28‑B) already convenes many of the same discussions and that SB 288 would duplicate work and compete for attention and resources. He urged the committee to consider using existing commission structures or to fill current vacancies on the County State Finance Commission so the topic can be handled there.

Rebecca Skye, executive director of the New Hampshire State Commission on Aging, said the Commission on Aging has prioritized “systems of care for healthy aging” in annual reports and that the commission intends to partner with counties, DHHS and other stakeholders if the council is established. Skye said the commission is thinly staffed and that any sustained effort needs dedicated staff resources to produce measurable results.

Multiple advocacy groups asked for representation on the proposed council. Theresa Rosenberger of the New Hampshire Brain Injury Association and Adam Shrier (Brain Injury Association of New Hampshire) requested that the council or the Commission on Aging include a representative for people with acquired brain injury, noting such injuries affect all ages and can create long‑term care needs for children and younger adults. Representatives of home‑and‑community‑based case management and home health groups (Life Coping; Granite State Home Health & Hospice Association) also expressed general support and asked for a seat at the table.

After discussion, the committee voted (motion by Sen. Avard, second by Sen. Birtzel) to report the bill “ought to pass” out of committee. Committee debate acknowledged concerns about possible duplication with the County State Finance Commission but emphasized that the proposed council would bring a broader multisector group together and that county representatives already have seats in the broader stakeholder conversations.

The Commission on Aging and DHHS were identified repeatedly as key implementation partners; committee members noted that the council’s effectiveness will depend on sustained staffing and collaboration with existing bodies.

The committee directed that an amendment under development (to place the advisory council within the Commission on Aging and refine membership) be filed and considered in executive session.

Votes at the committee on SB 288: motion to report “ought to pass” carried; committee recorded an affirmative voice vote (committee tally recorded in committee discussion as 5–0 in favor). The bill will proceed with a committee amendment to refine membership and placement in the Commission on Aging.

The discussion highlighted three persistent issues for follow up: staffing and resourcing of any new council, clear roles to avoid duplicating the County State Finance Commission’s statutory work, and ensuring representation for brain injury, home‑care case management, and direct care workers.