Parental Consent for Medicaid to Schools Services

SB34 makes three substantive changes to New Hampshire law governing the Medicaid to Schools program, and the American Council urges its passage.

First, the bill adds a new paragraph VIII to RSA 186-C:25 requiring that written parental consent be obtained for each new service provided to a Medicaid-enrolled child pursuant to RSA 200:27-a. The bill defines what triggers that consent obligation precisely: "each new service shall mean each new Medicaid International Classification of Diseases (ICD) diagnostic code." Parents are therefore entitled to give or withhold consent each time their child is assessed or treated under a previously unused diagnostic code, not merely once at program enrollment. This is a service-by-service, code-by-code consent standard.

Second, the bill amends RSA 200:27-a, which already requires explicit written parental or guardian consent for a child's participation in any program that provides medical or dental treatment in any school setting. SB34 adds to that existing requirement the phrase "for each new service as defined by a new diagnostic billing code," bringing the school health statute into alignment with the new Medicaid-specific paragraph. One note on the relationship between the two provisions: RSA 186-C:25 VIII defines "each new service" as each new ICD diagnostic code, while RSA 200:27-a uses the phrase "new diagnostic billing code." These phrases appear to describe the same concept, and the definition in paragraph VIII states it applies "for the purpose of this paragraph and RSA 200:27-a," which is the most natural reading that the ICD-code definition governs both provisions. However, the two sections use slightly different language, and a reader should be aware that the text does not expressly resolve this on the face of RSA 200:27-a itself.

Third, the bill amends the existing annual reporting requirement in RSA 186-C:25, VII. That provision already directs the DHHS commissioner to submit an annual report to the senate president, the speaker of the house, the chairpersons of the house and senate policy committees with jurisdiction over education, and the chairpersons of the house and senate finance committees, covering the total cost of the Medicaid to Schools program and the number of students who received services through the program during the prior school year. SB34 adds the chairpersons of the house and senate policy committees with jurisdiction over health and human services to that list of report recipients. The reporting obligation itself and its content are otherwise unchanged.

The bill's as-introduced text sets an effective date of January 1, 2026. That date has already passed relative to the bill's current procedural posture, described below.

The American Council supports SB34 because parental consent is not a bureaucratic formality; it is the practical expression of a parent's irreplaceable role in decisions about their child's medical care. When a school setting introduces a new diagnostic category for a child, parents deserve to be asked, informed, and heard before that step is taken. SB34 establishes that standard clearly and should become law.

Procedural posture: The bill drew a minority committee report of Inexpedient to Legislate on November 19, 2025. The House adopted Amendment 2025-3056h by voice vote on January 7, 2026, then passed the amended bill 186 to 155. On February 5, 2026, the Senate voted, on motion by Sen. Ward, to nonconcur with the House amendment. The two chambers are now in disagreement over the amended text. The bill's path forward depends on whether a committee of conference is convened or further action is taken before the session closes. Because the analysis above is based on the as-introduced text, constituents should be aware that the House amendment may have altered one or more provisions, and the final shape of the bill remains unresolved.