no new beds

Since the mid-1990s, state law has restricted construction of new nursing home “beds” in New Hampshire, essentially preventing both private and county-run nursing homes from expanding their capacities. The moratorium was set to expire this year. House Bill 113 would extend the restriction until 2013, but also adds a provision that makes it easier for nursing homes to upgrade existing beds. 

The moratorium on nursing home beds has also been used in other parts of the country going back to the 1980s. The reason for limiting beds was, oddly enough, to keep prices down. 

Typically, limiting the supply of something drives up its price tag. But nursing home care is not a free market, according to Rep. Fran Wendelboe (R-New Hampton).  It’s a highly regulated industry where the standard laws of supply and demand don’t apply. She points to history to make her point.  

In the mid-1990s, she says, New Hampshire boasted a surplus of nursing home beds, yet paid one of the nation’s highest per capita costs per day for those beds. Limiting capacity at nursing homes, along with other measures to help people stay in their homes longer, has actually kept down the cost of elder care. “It’s better for the client and the budget,” Wendelboe says.

Nursing home beds in the state are now at about 90 percent occupancy, a figure that also reflects the growth of assisted living facilities, which many people prefer over nursing home care. As the baby boomer population continues to age, there will be a need for additional beds, Wendelboe concedes, “but we’re not there yet.” 

One regulation legislators apparently are ready to ease is permission to upgrade, which currently hinges on a dollar-limit threshold. Currently, if a nursing home wants to spend more than about $1.8 million on renovations, it must get permission from the Certificate of Need Board, which operates under the Dept. of Health & Human Services. The board must grant permission where the renovations are necessary to meet life safety code requirements. 

“It’s a shame to have to get that bad to get approval,” Wendelboe says. “So (the board) asked if a facility could spend whatever it wants, as long as they don’t add any beds or increase their rates.” Both private and county nursing homes, she says, supported the bill. 

So did the House Health, Human Services & Elderly Affairs Committee, which unanimously recommended its passage. The House Finance Committee was also in full support, and the bill passed the House with no opposition. Its public hearing in the Senate Health & Human Services Committee will be held on Tuesday, May 19. 

uniform child protection laws

There are not many child abduction cases in New Hampshire, according to Rep. Robert Foose (D-New London), “but there are more than just a couple going on at a time,” he says. House Bills 694 and 695, he believes, will reduce confusion and increase protection in the state laws that dictate how to handle—and prevent—abduction cases. 

House Bills 694 and 695 represent “an important improvement,” Foose says, “not a radical change.” Both bills, as their names suggest, stem from a move toward “uniformity” with the laws of other states.

HB 695, adopting the uniform child custody jurisdiction and prevention act, would repeal a similar law in favor of this updated one. It eliminates disputes over jurisdiction in the federal parental kidnapping law and contains new enforcement language, according to Rep. Edward Moran (R-Nashua). Moran wrote in favor of both bills on behalf of the House Children & Family Law Committee, which unanimously recommended them for passage. The full House chamber followed suit, and the bills go before the Senate Judiciary Committee for public hearing on Tuesday, May 19. 

HB 694, adopting the uniform child abduction prevention act, is written to complement its partner. It gives courts “clear guidelines for child abduction risk factors,” Moran writes, and “also provides effective preventive measures and gives protections to victims of domestic violence through confidentiality provisions.” 

Specifically, these bills were born within the Uniform Law Commission, a 117-year-old nonpartisan national conference of lawyers from all 50 states, Puerto Rico and the U.S. Virgin Islands. From New Hampshire, Attorney General Kelly Ayotte and attorneys Michael Dunn and Michael Ruedig serve as commissioners. 

“They meet on a regular basis and look at laws across the country,” explains Foose, who says he is a big advocate of the commission. “Where they think it’s appropriate to suggest uniformity (from state to state), they spend a lot of time working with individual legislators looking at particular laws and making recommendations,” he says. 

The work of the commission spans a wide range of subjects, from children of assisted conception to international wills to employment termination. Foose says that when it comes to matters of child abduction that cross state lines, uniform laws help both the parents and attorneys avoid having to relearn a new set of laws for every state that comes into play. 

Front Door Politics is a weekly legislative update for everyone affected by New Hampshire laws. An online learning center, additional reporting and a blog subscription are available at www.frontdoorpolitics.com.