LACONIA — A majority of the Belknap County Commission yesterday turned thumbs down on a proposal that the county look at managed care organizations to take over the operation of the Belknap County Nursing Home.
Commissioner Richard Burchell (R-Gilmanton), who last week met with members of the state Department of Health and Human Services about Medicaid rate setting, said that he knew of two private companies who have submitted ideas about managing the nursing home.
At the commission's last meeting Burchell, said that managing the nursing home "doesn't have to be a county function," and suggested that nonprofit entities should be encouraged to look at taking over the nursing home.
But Commissioner Hunter Taylor (R-Alton) said the nursing home "plays a unique role which cannot be filled by a private company. It's a home of last resort for Medicaid patients and no private company can make money from it. The county needs to take care of its elderly."
Burchell maintained that Texas has lower reimbursement rates than New Hampshire and still has five private companies that manage nursing homes there. He also said that when New Hampshire counties started taking care of the elderly, it was an entirely different situation.
"200 years ago, you didn't have a convoluted system," said Burchell.
But County Commission Chairman David DeVoy (R-Sanbornton) said that his goal is to make sure that the nursing home is run efficiently. "I'm not interested in privatizing the nursing home at this time."
Burchell said that at the meeting he had attended last week, he had learned the chief factor in setting Medicaid reimbursement rates for counties is the percentage of Medicaid residents at the county home and that the state uses two "snapshot dates" of Feb. 28 and Aug. 1 to set those rates.
He said that there was a 10 percent drop in the number of Medicaid patients registered in the nursing home in 2015 compared to 2014, which resulted in a large drop of payments for the county.
Taylor said responsibility for Medicaid nursing home patients were at one time split equally between the state and the county, but the state has been passing on a greater share of costs to the counties in recent years.
"Each year, a greater percentage is passed back to the counties," said Taylor, who said that 70 percent of the burden now falls on counties.
He said he would like to discuss the funding with members of the Belknap County Convention and make sure they are aware of the impact on county taxpayers.
Taylor said he thinks the county should take a good look at legislation which is currently being proposed in the New Hampshire House which would allow counties to establish heroin use prevention and treatment programs.
He also said he would like to get some feedback from the County Convention as well as the Belknap County Sheriff and Belknap County Attorney on establishing a program in the county in which the Sheriff's Department add a position similar to what Laconia police currently have for handling drug problems.
DeVoy said he thought that was a good idea and would like to explore it further.
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