Commissioners will slow growth of money-making program until supplemental appropriation issue resolved

LACONIA — County officials are planning to slow the admissions of Medicare patients into a rehabilitative services program at the Belknap County Nursing Home until they know the fate of a proposed supplemental appropriation of $200,000 the County Commissioners have asked the County Convention to approve.
A public hearing on the request and a convention meeting to vote on the appropriation which had been scheduled for late Wednesday afternoon was cancelled earlier this week by County Convention Chairman Rep. Colette Worsman (R-Meredith), who claimed that County Administrator Debra Shackett had failed to provide the convention with the information it requested in sufficient time to prepare for the meeting.
''Our only control is through admissions. It's too much of a risk. We'll have to stop taking any new patients until we have more money'' Shackett told County Commissioners John Thomas and Steven Nedeau at Wednesday morning's meeting. adding that $82,000 has already been spent out of the $180,000 budgeted for the program.
Last month the commissioners requested the $200,000 supplemental appropriation, which Mat Logue, director of the nursing home, says is projected to generate $400,000 in annual revenue. Logue says that Medicare reimburses occupational, speech and physical therapy as well as pharmaceutical, testing and X-rays at 14-percent above costs.
The convention voted to schedule a public hearing and asked Logue to prepare a formal written proposal. Worsman, along with Rep. Mike Sylvia (R-Belmont), posed a series of questions to the county administrator. Shackett said that she sent Worsman a spread sheet listing the accounts affected by the program along with a PowerPoint presentation addressing some, but not all, the questions. She said that she did not include answers to all the questions in the PowerPoint because Logue was not available last week, but assured Worsman that "all of the questions will be addressed at the meeting," adding "that way the public will also be informed.''
Worsman replied that the convention would require more information and needed it in time to be able to review it before the meeting.
Commissioner John Thomas said that he was frustrated that the hearing wasn't held and said that it was essential that the PowerPoint presentation be done at the public hearing.
He said that he was concerned that the information which was provided would be used to ''let a few people on the county convention make a decision and then hold a public hearing after they've made a decision.''
Shackett said that part of the motivation for the PowerPoint presentation is ''that it's hard to get a word in edgewise at county convention meetings since we're not often allowed to answer questions.'' She also said that the additional information sought by Worsman and Sylvia, which has since been provided, ''was not relevant to the questions they have asked.''
She said that she was hopeful that the convention would eventually approve the supplemental appropriation but Thomas said that he had ''no confidence that anything is going to happen.''
Thomas has charged that the county convention has been making decisions in closed door meetings, an assertion Worsman denies. She has said that the convention has held only one secret session, a Republican only caucus which was held at the Laconia Public Library in December.
On another of the many issues which have divided the convention and the county commissioners, Thomas questioned the form that the convention submitted to the Department of Revenue Administration, which was returned to the county as unacceptable.
The form, called an MS-42, has been at the center of the controversy between the convention and Belknap County Commission over the 2013 county budget. The Republican majority of the convention has insisted that the convention possesses the authority to rewrite the budget proposed by the commission by adding or deleting, raising or lowering appropriations for particular line items. In the course of managing the budget, the commission may only move funds between lines with the approval of the executive committee of the convention.
The commissioners, backed by a legal opinion, claim that the authority of the convention is limited to itemizing appropriations in keeping with the MS-42 signed by the chair and clerk of the convention and submitted to the DRA.
Following the adoption of the 2013 county budget in March, Worsman hand delivered the MS-42 to DRA, attaching a copy of line item budget voted by convention along with a copy of the draft minutes of the March 4 meeting where the vote was taken. For good measure, she typed on the form a note advising the DRA that by majority vote the convention adopted a line-item budget and required the commission to secure the written permission of the executive committee of the convention to transfer funds from one line to another.
Worsman has said that she has been advised by the DRA that the differences which led to the form being not accepted are only cosmetic.
But Thomas says that the form has ''alterations and erasures'' and asked ''who at the DRA told them was OK to write all over the form?''
The commission deferred action on another item which has them at odds with the delegation, a $1,500 bill from the Mitchell Municipal Group for legal services. The firm was hired by the county convention to represent the delegation in a legal action it wanted to take against the commission, which had already hired an attorney.
Shackett said the bill doesn't qualify for payment as it was incurred after the commission had already provided legal counsel for the convention.
Commissioners voted to postpone action until it had all three members present. Commissioner Ed Philpot was not at Wednesday's meeting.