By ROGER AMSDEN, LACONIA DAILY SUN
LACONIA — Belknap County Commissioners, reacting to a looming crisis in licensed nursing home costs borne by county taxpayers, agreed Wednesday morning to form a committee to look into programs that will allow senior citizens to remain in their homes longer as they age.
Commissioner Hunter Taylor (R-Alton) pointed out that 44 percent of the $13,837,174 raised from Belknap County taxpayers in 2015, or $6,149,554, was paid to the New Hampshire Department of Health and Human Services as the county's share of a statutory requirement mandated by the legislature that the state's 10 counties pay the bulk of the 50 percent non-federal share of Medicaid costs for needy seniors who reside in a licensed nursing home or who receive in-home care. Those funds are separate from what the county pays for the Belknap County Nursing Home, which has 94 residents, and is funded in a different line in the county budget.
"Unless an unexpected change in financing elder care occurs, the non-federal Medicaid share will continue to be paid for through county taxes as a component of the local property tax. Thus a significant need exists to better control the cost of elder care," Taylor wrote in a letter to his fellow commissioners.
Taylor wrote that recent invoices paid by Belknap County show that the county is currently paying the non-federal Medicaid share on an average of 366 Belknap County seniors – 219 for nursing home care and 147 for in-home care," wrote Taylor. "The average monthly cost per person is $2,098.61 for nursing home care, $780.44 for in-home care. Based on these numbers a shift of 25 from nursing home care to in-home care would produce an annual savings of almost $400,000. A three-year delay in institutional care for our hypothetical 25 results in a $1.2 million savings."
The committee will include representatives from Community Action Program for Belknap-Merrimack Counties, Visiting Nurses, Genesis Behavioral Health, LRG Healthcare, Belknap County Nursing Home administrator in training Shelley Richardson, County Administrator Debra Shackett and Lori Shibinette, Merrimack County Nursing Home administrator, who has led a similar study for Merrimack County, as well as a representative from DHHS.
"It's vital that we be able to keep people in their homes longer," Taylor said, adding that programs like the Community Action Program provide the kind of services the elderly need such as meals on wheels, senior companion and transportation.
He said that supplementing current Medicaid services with non-Medicaid services should be considered. "The feasibility of such programs as house handyman service, grocery shopping and delivery, laundry service and adult day care should be considered. Clearly spending a little on the non-Medicaid side to save a lot on the Medicaid side would be worthwhile. Spending $100,000 to save $400,000 makes a lot of sense to me."
Commissioner Richard Burchell (R-Gilmanton) said that he liked the idea of doing a study and asked whether Taylor favored reducing the number of beds in the Belknap County Nursing Home, which currently is licensed for 94 residents and is funded in a separate line item in the county budget.
Taylor said that reducing the number of county nursing home beds in light of the projections of the elderly population more than doubling over the next 25 years didn't seem to be a good idea and observed that the county currently loses about a half million a year on the nursing home, which is much lower than the costs it bears for those in private nursing homes.
The committee is expected to come back to the county commission by early next summer with recommendations on programs and policies designed to keep elderly people living longer in their own homes.
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