Aging population could undermine projected job growth throughout N.H.

LACONIA — The New Hampshire Department of Employment Security (DES) has projected jobs to increase 10.5 percent throughout the state during the decade between 2012 and 2022, but Dennis Delay of the New Hampshire Center for Public Policy Studies suggests that an aging population and shrinking workforce could limit the growth of employment.

The DES projected job growth for each of the nine planning regions in the state. The Rockingham planning region set the pace with an increase of 14.7 percent, followed closely by the Southern planning region at 14.1 percent. Employment in the Upper Valley is projected to expand 10.2 percent, in the Nashua and Strafford planning regions by 9.5 percent and by 9.2 percent in the Central planning region. The agency projected employment in the Lakes Region to grow 6.3 percent , ahead of the 4.8 percent pace in the North Country and Southwest regions. The Lakes Region planning district includes the cities of Laconia and Franklin and 28 towns in Belknap, Carroll, Grafton and Merrimack counties.

However, Delay points out that between 2010 and 2025 the population of working age, between the ages 25 and 64, will decrease in all nine regions. The steepest decline of 12.9 percent is projected for the North County followed by a 9.2 percent drop projected for the Lakes Region. Without dismissing the projections of the DES, Delay described the aging demographic as "a limiting factor" on the growth of employment.

The city of Laconia and 10 towns of Belknap County all lie within the Lakes Region. Projections prepared for the New Hampshire Office of Energy and Planning by RLS Demographics of Rensselaerville, N.Y., indicate that the working age population of Belknap County will shrink from 33,543 in 2010 to 31,409 by 2025, a decline of 6.4 percent, and to slide another 2.6 percent to 30,577 by 2040.

Changing market presents challenges for LRGHealthcare

MEREDITH — The leadership and trustees of LRGHealthcare spoke of addressing the challenges of the changed marketplace for health care through partnerships with regional institutions and local agencies within the community of providers. "Collaboration," reads the annual report, "is now a basic requirement in healthcare to make needed resources and services available to patients."

The challenges of the changing environment were reflected in the financial report by Henry Lipman, senior vice president of financial strategy and external relations. Although operating expenses rose little more than $2 million, operating revenue fell by about the same amount, shrinking income from operations to $353,000, compared to $4.5 million a year ago. Meanwhile, non-operating gains jumped from $133,000 to $2.3 million, enabling the corporation to post a positive net margin of 1.2 percent.

Lipman said that the decline of operating revenue reflected changes in the insurance market, which find more individuals and families paying a greater share of the coverage provided by employers. When they cannot defray the cost, it is absorbed by the provider. At the same time, as the population ages, more are covered by Medicare, which fails to reimburse providers for their full costs. And with pressures on nursing homes, the hospital has been pressed to place older patients, particularly those with infirmities or dementias, requiring care after treatment, which has increased lengths of stay.

Lipman stressed that LRGH is in sound condition, paying its bills on time, servicing its debt, funding its pension obligations and holding sufficient cash reserves. But, he acknowledged that the operating results are "representative of a challenging trend," which LRGH is meeting by increasing productivity by offering value added services and pursuing partnerships."

The most significant of these partnerships, the Granite Health Network (GHN) was formed in April 2011 when five of the largest hospitals in the state — LRGHealthcare, Catholic Medical Center, Concord Hospital, Southern New Hampshire Health System and Wentworth-Douglass Hospital — joined to leverage their administrative and clinical resources to enhance the quality and improve the efficiency of medical care. Together the quintet employs 15,000 people, including 900 physicians, serves 500,000 individuals and counts operating revenue of $1.5 billion.

Chuck Van Sluyter, interim president and chief operating officer, said that the GHN has achieved clinical and operating efficiencies of $4.5 million, including trimming the costs of laboratory tests and blood products while the introduction of Cigna's accountable care model has spared LRGH $250,000 in the past two-an-a-half years.

In January, GHN announced the Tufts Freedom Plan, a provider-payer insurance company administered by the Tufts Health Plan. The employees of the member hospitals will be enrolled in the plan, which will compete in the New Hampshire marketplace.

Dr. Peter Doane, chief medical officer, said that the partners of GHN are sharing their expertise and experience to develop standardized care protocols ground in sound evidence and best practices. Among the protocols followed throughout the system are those for management and treatment of chronic asthma and acute low back pain. In addition, there is a protocol for identifying and treating patients suffering from depression, whose healthcare costs are 50 percent higher than those of other patients.

Maggie Pritchard, executive director of Genesis Behavioral Health, traced the agency's partnership with LRGH to 2005 and noted that it has grown closer ever since. In particular, she stressed that patients suffering from mental illness are more likely to seek help at the emergency department, an ineffective and expensive setting, in the Lakes Region than elsewhere in New Hampshire. Greater investment in the outpatient services Genesis provides, she said, will enable those with mental illness to live healthier, more productive lives while sparing the hospital the cost of housing patients while awaiting treatment in an appropriate setting.

LRGH recently partnered with Massachusetts General Hospital to diagnose and treat patients with strokes using video conferencing and image sharing technology. Dr. Fred Jones, chief of emergency medicine, and Kendra Peaslee, director of emergency services, explained that specialists in Boston can examine patients and sitting in the emergency room of both Lakes Region General Hospital and Franklin Regional Hospital in less than 25 minutes.

Bill Grimm of Franklin, who joined the board of trustees of Franklin Regional Hospital in 2000 and has been a trustee of LRGH since the merger in 2002, was honored with the Sally Proctor Award. In presenting the award Scott Clarenbach, chairman of the board of trustees, emphasized his contribution to the safety of patients. A member of the Quality Improvement Committee, Grimm worked closely with Gloria Thorington, director of medical safety and health management, to fashion a scorecard to measure the strengths and weaknesses of the organization. He considers everyone — patients, employees and members of the community — stakeholders and when the board tackles an issue is the first to ask "what about the stakeholder?"

Pritchard received the Rhoda C. Ladd Award. Clarenbach described her as "passionate and instrumental" and called her "an incredible advocate" who has been "a great support to LRGHeathcare." Despite the challenges of constant change and decreasing financial resources, Pritchard, he said, has recruited a strong team to meet the mental health needs of the community. She championed the opening of the psychiatric unit at Franklin Regional Hospital and helped to bring telepsychology to the emergency department of LRGH.

Job fair draws diversity of employers, seekers

LACONIA — A job fair, featuring a diverse array of nearly three dozen local employers and four employment agencies, drew more than 300 people, a significant number of high school students among them, to the ballroom of the Margate Resort yesterday.

The fair was presented by the Lakes Region Chamber of Commerce, whose executive director Karmen Gifford said she was very pleased to have such a healthy mix of employers and so many students from Belmont, Franklin, Gilford and Laconia come searching summer jobs and eying future careers.

Many of the businesses, including landscapers, restaurants, retailers and resorts, were primarily seeking seasonal employees, but not exclusively from the ranks of students.

Josh Lemire of T-Bones & Cactus Jacks said he expects to add between 35 and 40 employees to the normal complement of about 50 to handle the heavier customer volume during the summer. He anticipated many of his hires would not be looking past the summer, but said that the company was always looking for good employees and willing to offer the most promising permanent positions. Lemire, who has been with the company for 16 years, said those wishing to work in the hospitality industry would find the compensation and benefits attractive and competitive.

Abby Young of Centerplate Inc., the food and beverage concessionaire seeking 100 people to staff its operation at the Bank of New Hampshire Pavilion at Meadowbrook, said jobs waiting tables, tending bar, preparing food and washing dishes are seasonal which pay an inexperienced employee $8 or $9 an hour. But, she added that Centerplate operates across the country, and for good workers "there is room to grow within the company." She said she had taken many applications, including some from former employees.

Amanda Ouellet, assistant manager of the Taco Bell restaurant set to open on in place of Kentucky Fried Chicken on Union Avenue next month, said that she needs 40 or 50 employees, about half of them full-time, adding: "We're right where we want to be." Noting that there is "lots of turnover" in fast food franchises, she welcomed the applications submitted at the fair.

Several retailers from Tanger Outlets seeking to gird up for the summer season were offering part-time jobs starting at minimum wage. One representative of a major brand said that most of the stores at the mall have only two full-time employees, the manager and an assistant, and staff the sales floor with part-timers.

Kathy Nelson, assistant vice president of Bank of New Hampshire, said the bank is seeking to fill 15 positions throughout its organization, most requiring experience, but also some entry-level jobs.

"We're seeing qualified applicants," she said, explaining many are seeking full-time work in place of part-time jobs. She said that the bank is expanding and anticipates there will be new positions to fill.

Hannaford was also seeking additional employees for the summer, 30 for its store in Gilford, and 50 or 60 for its store in Meredith. Kim Sansoucie said, "There is a lot of competition for employees, but so far we've been very lucky."

"We're always hiring," said Nicole Lemelin of the Lakes Region Community Services, who was seeking "direct support professionals" to work closely with the disabled. She said that the agency provides the necessary training and pays between $10.68 and $14,72 an hour plus travel expenses. "It's been a good day," she said, pointing to a stack of applications. 

Aavid Thermalloy, New Hampshire Ball Bearing, EFI, three of the premier manufacturers in the region, had a presence at the fair. Representatives of all three said they were competing for employees in a shrinking pool of talent. Chris Currier of EFI said that the firm is seeking to expand and requires software, mechanical and electrical engineers, which are in short supply. He said that the company employs 350 people, eight out ten of whom are skilled employees.

Arthur Karageorges of Aavid Thermalloy explained that the Laconia facility designs and develops products, which are subsequently manufactured in plants with lower operating costs. Consequently, the local workforce is highly skilled. "It's difficult to get qualified people," he confessed. "we never have enough CNC (computer numerical control) operators." Karageorges said the company offers two internships each year and has partnered with the manufacturing programs at the Huot Technical Center and Lakes Region Community College. "And we've had a couple people stop by today," he said. "I try to bring them her between June and September," he laughed, "so they miss the winter."

Nicole Murray, human resources administrator at New Hampshire Ball Bearing, echoed her counterparts at EFI and Aavid. "There's a huge knowledge gap," she remarked, explaining that experienced employees are retiring in growing numbers, taking 40 or 50 years of exceptional skill and institutional memory with them. "We're trying to bring in experienced help," she said. "When we find experienced machinists, we're throwing cookies at 'em. And we found one today."

Like Jeremy Hiltz of Hiltz Excavating Inc. of Ashland, said finding capable employees is "the biggest challenge in our industry." He said that someone who starts at $12 an hour "gets paid to learn," but the work offers opportunities to earn a six-figure income. He suggested that too few have "the patience to start at the bottom and work their way through the ranks." He said he found one potential employee at the fair.

With unemployment dropping below 5 percent in the Lakes Region as the summer tourist season approaches, several innkeepers, restaurateurs, landscapers and retailers said that the fair provided a good opportunity to reach young people seeking seasonal and part-time work. Those businesses appeared to draw the most applications, leaving the manufacturers fishing the same small pool and the excavator eager to pay someone to learn.