STATEWIDE INDEPENDENT LIVING COUNCIL
November 26, 2025
2:30pm
Advocacy Committee Meeting
ZOOM

Members Attending: Committee Chair Andrew Harmon, Herb Carpenter, Ryan Donnelly, Jennifer Cook, Isadora Rodriguez-Legendre, and Joshua Gehling

Staff: Jennifer Beaulieu (SILC Assistant)

Guests: Mo Baxley (GSIL) and Danielle Murphy (Member of the Public)

Committee Chair Andrew Harmon called the meeting to order at 2:32pm. 

Benefits Counseling Presentations
Andrew Harmon noted that the presenter who was going to be here today was unable to make it. He has her tentatively scheduled for their December meeting.  This is regarding Objective 4.3. Joshua Gehling mentioned that each of the area agencies has a benefits specialist. Since we had presentations from a variety of benefits specialists, he thought it would be good to have a presentation from a benefits specialist at an area agency. He offered to reach out to an area agency benefits specialist and helped create a list of all the benefits specialists at each of the area agencies. Dee Johnson offered to provide a presentation. He mentioned that if he needed additional contacts, to let him know. Andrew Harmon mentioned that unless someone thinks we really want to change it, he is going to keep Dee Johnson as the presenter. Jennifer Cook mentioned using AI to compare the different presentations we’ve had. 

Review of Minutes from October 22 Meeting
* Isadora Rodriguez-Legendre made a motion to accept the minutes. 
Second: Jennifer Cook
Discussion: None
All in Favor: Yes	Abstaining: None
Motion Carried

Discussion of Medicaid Work Requirements from Federal and State Legislation in 2025
Andrew Harmon mentioned that he briefly discussed this item at the last Full SILC meeting, but he wanted to bring it up here as well. He wants to make sure everyone here is aware of the changes that are coming in the new year to Medicaid and how our state is going further than what is required by the federal government by passing SB 134. Ryan Donnelly reported that these community engagement requirements are for individuals who receive their Medicaid through the Granite Advantage program. The Granite Advantage program is NH’s expanded Medicaid program; it’s not standard Medicaid. It requires individuals to work, volunteer, engage in educational opportunities, or a combination of these for 80 hours per month to receive Medicaid. Proof of meeting these requirements would need to be provided on a regular basis. The federal government requires states to check that these requirements are being met at least twice a year or every 6 months. What has been proposed by SB 134 is that it would be checked quarterly instead, going further than what the federal government requires. If someone fails to submit their proof they are meeting those requirements, they will be given a month to provide DHHS that proof or risk losing their coverage. SB 134 also requires individuals newly signing up for the Granite Advantage program to prove they have been working for a month prior to applying for the program. It was originally 3 months but was reduced to 1 month. 

There are a few populations that are exempt from the community engagement requirement. The exemptions are the following: (1) Foster youth or former foster youth under the age of 26; (2) American Indians or Alaska Natives who are eligible for health services through the Indian Health Service; (3) Caregivers, which are defined as a parent, guardian, caretaker relative, or family caregiver of a dependent child 12 years of age and under or a disabled individual; (4) Disabled veterans; (5) People who are blind or disabled; (6) People who have a substance use disorder; (7) People who have a serious or complex medical condition; (8) People who are already meeting a work requirement for another program such as with TANF or SNAP; (9) People who are participating in a substance use disorder treatment program; (10) Incarcerated individuals or individuals who have been recently incarcerated for 3 months; and (11) People who are pregnant or are up to 12 months postpartum. These individuals still need to provide proof that they are exempt. 

These changes will be implemented by December 31, 2026. We don’t have all the details and answers yet. The federal government has until June 1st to issue final guidance to the states. The state would need to get started on all this before they get the final guidance because 6 months isn’t enough time for the department to roll everything out. Andrew Harmon mentioned that it’s hard to differentiate between what has been removed and what’s been included in the bill. He mentioned how it looks like the exemptions for people with disabilities would be changing to include only the most severe disabilities, like needing nursing home level support. He hopes that part was removed but it’s hard to tell. Herb Carpenter asked if mental health disabilities would be included in the exemptions. Andrew Harmon mentioned that it would, but it would need to be severe. There were questions on if the federal requirements would trump the state requirements. If so, would the state have to change the timeline for submission of proof of community engagement from quarterly to 6 months. Ryan Donnelly mentioned that the federal government  have indicated there are some areas where the states would have a bit of wiggle room with its implementation of these requirements. The 6-month submission of proof is a minimum requirement, a state could decide to check more frequently. Currently, the state plans to pursue this as a state amendment rather than a demonstration 1115 waiver. With a state plan amendment, we would need to make sure we are closely aligned with what the federal government would allow. If the state wanted to go further, they would need to submit a waiver. There is hesitation to do this as a waiver because that is how we did it last time we tried work requirements here in NH and it was a disaster. The courts shut it down. The legislation doesn’t want that happening again. The other thing he knows is when it comes time for CMS to look at how the states are going to be implementing these requirements; they will be looking at the states that are filing as a state plan amendment. He thinks the state is hoping to get this to the front of the line and get the ok from the federal government that they are implementing the requirements how they would like it so everything will be set for the December 31st deadline. 

Danielle Murphy asked if there is any language or consideration for individuals who are unable to meet those requirements because of the lack of transportation or other transportation barriers. Andrew Harmon mentioned that he doesn’t know if there’s anything that we can do as a group, but he at least wanted to bring it to our attention because he wasn’t sure how extensively this would be hurting people, but he knows this is going to hurt people. Jennifer Cook asked if this information  was going to be sent out to everyone. Andrew Harmon noted that he has mentioned it at the meeting, but he can send something out, maybe the email that Ryan Donnelly has sent out. 

Ryan Donnelly noted that there is a bill in this coming session that addresses the community engagement requirements for the Granite Advantage program. The bill is SB 506 and is sponsored by Senator Pearl. It’s not a very long bill and it doesn’t go into any of the exemptions. What is interesting is that according to the bill analysis, the bill came as the request of the Department of Health and Human Services. Discussion ensued. Mo Baxley and Ryan Donnelly will investigate it further. Jennifer Beaulieu mentioned that the bill does include some language about the MCOs. Michelle Cutting mentioned that she is here as a member of the public but works at WellSense, which is one of the state’s MCOs. Her expertise is in the transportation industry. She was thinking ahead on how this would impact members that would not have an exemption but not have transportation available to engage in things to meet the community engagement requirement. She thinks there might be potential here for the MCOs to assist. She mentioned how some MCOs have what is called value-added benefits where they assume the cost for transportation that doesn’t meet the Medicaid requirements. She mentioned that it is something that we should consider here and something she could certainly discuss with her peers if that has not already come up, but she thinks this is a huge barrier. 

Discussion ensued on the complications of people losing coverage. One is that when people lose their coverage and something happens to them, we have to pay for it in uncompensated care. The other complication is that right now we have 3 MCOs operating in NH. If the number of enrollees falls below a certain number, it may not be financially viable for three MCOs to operate here and if we lose one of those three MCOs, it will make it harder for the state to negotiate favorably when it comes time to negotiate contracts. 

Review of SPIL Objectives
Jennifer Cook mentioned that she would like to renew her request from last time that every time we discuss a topic, we discuss how it relates to one of our SPIL objectives. That way we know what work has been done on a specific objective. Danielle Murphy asked if it would be beneficial as a group to look at the goals and reprioritize based on new things that have come up. Jennifer Beaulieu mentioned that you need to be careful with the SPIL because the SPIL’s goals and objectives need to be approved by the federal government. 

Goal 1 Objectives
Andrew Harmon mentioned one of the things we got behind on with the SPIL, is the Goal 1 objectives. He is not sure how to best approach these objectives at this point. His desire has been to try and find a list of the main agencies or organizations that serve the disability community. It has been suggested to reach out to 211 as a starting point. He is wondering if that is still the best approach or if someone has any other suggestions. Discussion ensued. He mentioned how a lot of the other objectives under this goal are informed by our ability to figure out the gaps in terms of independent living in our state. Jennifer Cook noted the importance of knowing what we want to know from them. The main focus of this objective is to identify service gaps. Discussion ensued. Joshua Gehling mentioned how sometimes the service gaps are knowledge based like it’s hard to navigate our system and there ends up being a lot of services that are underutilized because people don’t necessarily know who to call or where to turn to. There were questions on where we are regarding 211. Andrew Harmon mentioned that a script was created that was going to be used to reach out to 211. Jennifer Beaulieu mentioned that Sarah Sweeney reached out to someone named Erica Madden. She mentioned that Sarah Sweeney took notes, but she hasn’t shared them yet. Andrew Harmon will touch base with Sarah Sweeney to see where she is with 211. 

Discussion regarding Outreach and/or Future Panel Discussion
Andrew Harmon asked if the committee thinks we will have enough subject matter experts by the time we finish our discussion with Dee Johnson to start planning for the panel. Jennifer Cook mentioned the idea of doing a deeper dive into what information the presenters provided to see if anything is missing. 

Jennifer Beaulieu mentioned that we can look at the recordings from past presentations. Joshua Gehling mentioned that we also have PowerPoints  from the presenters that can be looked at as well. 
Andrew Harmon asked everyone to look through those materials by February’s meeting at the latest, or by January’s meeting to try to get a general sense of what we are missing. Jennifer Beaulieu will send out a one-liner by email, letting them know to review the materials from all the presentations we had regarding benefits counseling. 

Goal 5 Objectives
Andrew Harmon mentioned that he is going to table the discussion on the Goal 5 objectives for now. They will be discussed at the next meeting. 

Other Business 
Danielle Murphy was thanked for her attendance at the meeting. 

Adjournment
*Joshua Gehling moved to adjourn. 
Second: Ryan Donnelly
Discussion: None
All in Favor: Yes	 Abstaining: None
Motion Carried
Meeting adjourned at 3:33pm.

Minutes Recorded by Jennifer Beaulieu.