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Committee backs bill to require child‑abuse training for health care providers, reduces hour requirement and makes it CME credit
Summary
After a lengthy hearing with medical experts and provider groups, the House Children and Family Law Committee voted to recommend House Bill 493 as amended. The measure would require education on child abuse and neglect for certain health care providers as part of continuing medical education, reduced to one hour in the final amendment.
The House Children and Family Law Committee on March 4 voted to recommend House Bill 493, which would require education on child abuse and neglect for certain health care providers as a condition of licensure, amended to make the training one hour and to count it toward providers’ continuing medical education (CME) requirements.
The committee’s vote came after multiple hours of testimony from medical practitioners, the Office of Child Advocate and professional associations, with proponents citing missed cases of abuse and opponents warning against a statutory mandate. The committee approved the bill as amended by voice/roll call and then by roll call 13–0 in favor of the recommendation to pass with amendment (OTPA).
The bill’s proponents said mandatory training is needed because voluntary courses have not reached enough clinicians. Cassandra Sanchez, child advocate for the state of New Hampshire, told the committee that her office identified nine non‑ambulatory infants who presented to emergency departments with multiple broken bones and that, in a five‑month period after the OCA released a voluntary course, 59 physicians and physician assistants and 87 registered nurses had completed the online course. "We do not want to continue to move in that direction," Sanchez said, describing the course and the office’s concern that gaps in recognition had led to children being returned to unsafe homes.
Pediatricians and child‑abuse specialists who testified said a focused hour of training can improve recognition and appropriate referral. Dr. Michael Matos, a general pediatrician at Wolfeboro Pediatrics, said training gives clinicians tools to act: "You don't rise to the occasion, you fall back on your training," he said, arguing that a one‑hour module aimed at recognition and triage would reduce missed cases. Retired child‑abuse pediatrician Dr. Gwendolyn Gladstone, representing the New Hampshire chapter of the American Academy of Pediatrics, said the two‑hour course the OCA developed covers recognition, reporting and working with the child‑protection system but that a one‑hour option would still be useful for clinicians who see children only occasionally.
Opponents urged caution about legislating a training mandate. Ben Bradley of the New Hampshire Hospital Association said hospitals and providers take reporting seriously and provide training, and he argued the legislature should not single out one training requirement in statute: "We do not believe the education requirements proposed in HB 493 should be legislated," Bradley told the committee, citing concerns about statutory micromanagement of professional education. Kathy Stratton, CEO of the New Hampshire Medical Society, said the society is working to increase awareness and that many physicians already meet CME requirements through other channels; she said a non‑legislative approach would be more flexible.
State licensing staff and counsel also raised operational questions. Attorney Nicholas Fry, representing the Office of Professional Licensure and Certification, said OPLC licenses physicians, physician assistants and nurse practitioners without capturing specialty or patient‑age information on the license, so the agency would lack a reliable way to determine which licensees treat minors and when the requirement should apply unless the statute is written to apply to all licensees or otherwise provides a workable mechanism.
Committee members and staff amended the bill during the hearing. The committee reduced the mandatory training from two hours to one hour, and a later amendment placed the requirement within continuing medical education (so the hour would be counted as part of existing CME requirements) and clarified how the requirement would be administered. Representative Greg (committee member) spoke for the final amendment that broadened the scope for administrative clarity.
The committee recommended HB 493 OTPA as amended. The committee record shows the formal recommendation passed by roll call 13–0.
Next steps: the committee recommendation (OTPA as amended) will be reported to the full House for further consideration during the legislative process.
