SB441

Harm reduction is critical to providing services to those who use substances and need access to services. Harm reduction saved my son's life. I am strongly opposed to this bill

People willing to get and receive help should not have addition layers of bureaucracy. Better communication among the agencies seem like a place to start.

Dear Esteemed Legislators, Thank you for taking the time to review my testimony. I am a Psychology PhD student at the University of New Hampshire and have extensively reviewed the research literature regarding substance use treatment and specifically harm reduction services. There is a lot of science to support the notion of "meeting people where they are," which harm reduction specifically executes. I have also had the distinct privilege of closely collaborating with a neuroscientist who specializes in substance use, and it is my understanding that substance use is a highly complex issue involving many treatment barriers. Additionally, many such individuals find themselves very alone. They are often ostracized from their friends, family, and other loved ones. Thus, harm reduction services not only meet people where they presently are (e.g., offer realistic treatment options for their individual situations) but also offer a supportive community that is much needed. Having such community membership stabilizes and grounds people. It also helps to keep them accountable. I would echo such sentiments for broader community-based substance use treatment services as well, as there is a tremendous amount of scientific literature that speaks to the strength of such programming. As such, I kindly request you consider opposing SB 441. Thank you for your time and consideration.

I am a nurse and it is crucial to include harm reduction services as a part of overall treatment for substance use disorders. The evidence shows unequivocally that harm reduction saves lives.

I definitely oppose!

To: House Health and Human Services Committee Re: Opposition to SB 441-FN From: Rep. David Preece, Hillsborough District 17 Dear Chairman and Members of the Committee, I write in strong opposition to SB 441-FN, a bill that, while perhaps well-intentioned, would create dangerous barriers to care for some of New Hampshire’s most vulnerable residents—those struggling with substance use disorder and homelessness. At its core, this bill requires municipalities to negotiate and execute a formal memorandum of understanding before transporting an individual to another community for treatment, shelter, or recovery services. In theory, this may sound like coordination. In practice, it is delay, bureaucracy, and risk—at the worst possible moment. Substance use disorder is not a condition that waits for paperwork. When someone is ready for treatment—when a window opens—that moment is often brief and fragile. SB 441 risks closing that window by inserting administrative hurdles between a person in crisis and the care they need. This bill prioritizes process over people. First responders, outreach workers, and local welfare officials must be able to act quickly and compassionately. Requiring a pre-negotiated MOU—complete with financial terms, service agreements, and municipal approvals—will slow down or even prevent life-saving interventions. Second, it creates a chilling effect on municipalities trying to do the right thing. The threat of a $5,000 fine per violation will not encourage coordination—it will encourage hesitation, inaction, and risk avoidance. When faced with legal uncertainty and financial penalties, municipalities may simply choose not to assist individuals in accessing out-of-town services at all. Third, this bill undermines existing treatment networks. New Hampshire’s behavioral health system already relies on regional providers, recovery centers, and specialized programs that are not available in every municipality. Access often requires transportation across town lines. This bill places artificial barriers between individuals and those services. Fourth, it expands government in ways that should concern fiscal conservatives. Despite no appropriation, the fiscal note makes clear that this bill will require new state employees, IT systems, and enforcement mechanisms—costing hundreds of thousands of dollars annually. This is a new layer of bureaucracy—funded by taxpayers—to regulate decisions that are currently handled locally and effectively. And finally, this bill raises serious concerns about local autonomy. Municipalities are best positioned to respond to the needs of individuals in their communities. SB 441 replaces that flexibility with a rigid, state-driven compliance framework. We all agree that coordination matters. But coordination should enable care—not obstruct it. If the concern is inappropriate or unilateral transfers, then we should address that issue directly with targeted solutions—not a sweeping mandate that risks unintended and harmful consequences. At a time when New Hampshire continues to battle the opioid crisis and rising homelessness, we should be removing barriers to treatment—not building new ones. Lives depend on timely access to care. SB 441 makes that harder, not easier. For these reasons, I respectfully urge the Committee to recommend Inexpedient to Legislate (ITL) on SB 441-FN. Respectfully submitted, Rep. David Preece Hillsborough District 17

Senate Bill 441 could make accessing treatment more difficult and place new restrictions on harm reduction programs. These essential services have played a pivotal role in decreasing our overdose rates across New Hampshire.

People need help sometime.

Thank you for your attention, time and representation in opposing this bill.

Harm reduction is just that-- reducing the harm that comes with use of illegal substances. Everyone deserves a chance to get to tomorrow, to a time and state of mind that is ready for recovery. Please don't put anything between a person and that person's chances of staying alive,

I am writing to express my strong opposition to Senate Bill 441. Now is not the time to take our foot off the gas pedal in addressing the overdose crisis. While we have seen a decrease in overdose numbers across our state, the crisis is far from over. Every life lost is a reminder that our work is not done. New Hampshire’s system of care is already difficult to navigate for many individuals seeking help. Adding additional barriers will only make it harder for people to access the support they need, ultimately leading to worse outcomes for our citizens. Senate Bill 441 has the potential to make accessing treatment more challenging and to place new restrictions on harm reduction programs. These programs are not optional—they are essential. Harm reduction services have played a critical role in reducing overdose deaths and connecting individuals to treatment and recovery supports across New Hampshire. We should be building on what is working, not limiting it. I urge you to oppose SB 441 and continue supporting policies that expand access to care, reduce harm, and save lives.

Honorable Chair MacDonald and Members of the Committee, New Hampshire's largest cities shouldn't be expected to shoulder a disproportionate share of the responsibility to ensure Granite Staters are able to access basic necessities like shelter and health care. I can understand the frustration of city leaders and think it may be worth exploring how smaller towns can better help their own residents when they are struggling. However, this bill would create additional barriers for New Hampshire residents, and I therefore cannot support it.

Please do not make it harder for those who need assistance to get the help they need. I have had all 3 boys suffering from substance use disorders at various times and 2 of them have had to seek housing and assistance out of state at various times. We are the lucky ones who have had all 3 survive and now thriving thanks to the assistance they received in those housing situations. While I agree, they probably should meet certain criteria to house these individuals, this bill will only set us back significantly if it. passes. Thank you, Charles Mancuso

People will suffer and/or die without access to harm reduction services. Please kill this bill immediately, it is so harmful and bad for NH.

This bill requires a municipality that intends to transport a person needing substance use disorder treatment and other support services to have a memorandum of understanding with the receiving municipality prior to transport. This bill should not pass. A bill such as this adds an unnecessary burden of bureaucracy that needs to be resolved before before any assistance is provided to someone who needs substance use treatment. The focus should be on assisting the person in need.

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