LACONIA — Although LRGHealthcare is participating in all three medical plans now being offered to New Hampshire residents who use Medicaid to pay for health care, adults in the area will still have to use a non-LRGHealthcare physician for their primary care. Medicaid users must enroll in one of the plans before November 1 as part of a switch to a managed care program.
According to Andrew Patterson, executive director of the hospital company-owned Laconia Clinic, "wrap-around health care networks" like Health First Family Care Center in Laconia and Franklin are better designed to assist adult Medicaid patients with services that are an addition to just primary care.
Some of those "wrap-around" services, said Patterson, are nutritionists, social workers, and other non-physician services not typically provided by a primary care physician. In addition, patients can access clinical psychologists, visiting nurses for the home-bound, and nurse midwives at Health First and other similar networks.
At least one local man, who asked not to be identified, said he was confused when he saw the name of his former LRGHealthcare primary care physician listed under the new Well Sense, New Hampshire Healthy Families, and Meridian managed care plans.
One of the 3,500 area residents who were removed from patient rolls in late 2011 when LRGHealthcare stopped accepting primary care Medicaid users because of what were seen as inadequate government reimbursement rates, this man saw the name of his former primary care doctor at the Laconia Clinic listed when he went to the new exchanges and wanted to reestablish his relationship there.
"I was told they were accepting Medicaid patients," he said, accusing LRGHeathcare of misrepresenting themselves as participating in the exchanges.
Patterson said there was no misrepresentation but allowed there could be some confusion because New Hampshire chose to roll out its managed care networks for Medicaid at the same time as joining the Anthem network for general health insurance access under the Affordable Care Act (Obamacare).
He said all LRGHealthcare physicians who are specialists continue to see Medicaid patients who are referred to them by the rural health centers like Health First and that is why all of their physicians are listed on the three new exchanges created by state's managed care system.
In November of 2011, due to an operating loss of $4-million, LRGHealthcare stopped seeing adult primary care physicians at its 12 primary care offices. The 12 were Andover Family Practice; Belknap Family Practice in Belmont and Meredith; Caring for Women in Laconia, Franklin, and Moultonborough; Franklin Internal Medicine; Hillside Family Medicine in Gilford; Laconia Clinic in Laconia, Tilton and Franklin; Lakes Region Family Practice in Laconia; Moultonborough Family Practice; and New Hampton Family Practice.
Patterson said the 12 above offices still provide pediatric care to children on Medicaid and the emergency rooms at Lakes Region General Hospital and Franklin Regional Hospital accept Medicaid payments.
In addition to not accepting adult primary care patients who are on Medicaid, to cope with decline revenues LRGHealthcare trimmed staff and cut some overhead costs that saved $14-million in 2011.
Triggering the declining revenues were reductions in Medicaid reimbursements from the state government that began when the state Legislature stopped returning the Medical Enhancement Tax to hospitals and kept the federal match in the state's operating budget.
Patterson said the "wrap around" agencies like Health First get higher federal Medicaid reimbursements than LRGHealthcare does for primary care services and until that changes, he said it's not likely his company will serve adult Medicaid recipients for their primary care services.
Last Updated on Thursday, 24 October 2013 02:31
CONCORD — Representative Jane Cormier (R-Alton) has introduced legislation that would do away with the state's nine regional planning commissions by 2015. The intent of the bill, she said, is not only to repeal but also to replace the commissions by authorizing cities and towns to enter cooperative and collaborative arrangements at their discretion.
The regional planning commissions have been a frequent target of Cormier's weekly column in "The Weirs Times" since the advent of the Granite State Future initiative, a three-year project aimed at developing regional master plans that would be melded into a statewide plan. The project is funded by a $3.37-million grant from the United States Department of Housing and Urban Development.
Cormier is among those who believe that the regional planning commissions are the stalking horses of a federal effort, pursued under the aegis of Granite State Future, to promote "Smart Growth" and "sustainable living" at the expense of local control of land use decisions and private property rights. "I'm all for good stewardship," she declared, "but this is about private property rights guaranteed by our Constitution."
Cormier points to the budget of the Lakes Region Planning Commission, which includes $123,521 in revenue from the 30 member communities in a $572,500 budget. Noting that salaries represent $369,548, excluding an estimated $100,000 for benefits, she asks "what money is actually left to 'improve' our communities?" More importantly, since the employees of the planning commissions are paid with federal funds, she asks "where does their loyalty lie, with the federal government or the taxpayers of our communities" and concludes "the answer is, of course, "with the federal government. The facts are the facts."
"NH Regional Planning Commissions," Cormier recently wrote, "are a scam, fueled by the feds, to reach the goals of sustainable 'smart growth' in our Live Free or Die state."
Cormier said that her bill would provide that once the regional planning commissions are shuttered, any remaining fund balances would distributed among the member municipalities according to an equitable formula.
Cormier said that she has been traveling around the state to warn against the threat to local control and property rights posed by federal government agencies and regional planning commissions. "I'll drive and I'll talk until I can't drive or talk anymore," she said.
Last Updated on Thursday, 24 October 2013 02:13
CENTER HARBOR — At an Inter-Lakes School District forum Tuesday, some parents called for implementing full-day kindergarten in the district's schools, citing education and childcare benefits, while others questioned if such a move was the best way to improve early childhood education and development.
About 25 people showed up to offer opinions and ask questions at an open forum on the idea of all-day kindergarten. The session took place away from the board's regular Meredith meeting place in what board Chairman Richard Hanson said is an ongoing effort to encourage input from residents of the district's three towns.
Superintendent Mary Ellen Ormond said all-day kindergarten was a way to enhance education for children at an age when they are naturally curious and therefore benefit from the opportunity to explore subjects in greater depth. But she added that any changes to the kindergarten program had to be flexible enough to meet the needs of individual families. She said that taking a one-size-fits-all approach would be wrong.
Resident Dick Hughes of Center Harbor agreed, saying: "All-day kindergarten is great, but you need to have flexibility."
Currently Inter-Lakes offers half-day kindergarten sessions lasting 2 3/4 hours at Inter-Lakes Elementary School in Meredith, while Sandwich Central School has an extended four-hour program.
Wendy Mills of Meredith said she supports a longer kindergarten program. She noted that her son who is now in first grade has had difficulty adjusting to the longer school day at the same time he is facing more rigorous demands academically.
But Dan Kusch of Sandwich said he worries that all-day kindergarten was an indication of increasing pressure on academics at a younger age. Kusch, who is chairman of the Sandwich Child Center's Board of Directors, said the question of kindergarten education touches on three issues: childhood development, early intervention and child care.
"If we need to look at early intervention and child care then let's look at those issues and not just throw in all-day kindergarten in the hopes that that will correct early intervention and child care problems," he said.
Nancy Fredrickson of Sandwich said she felt the issue of all-day kindergarten was being rushed.
"I think it is premature to try to implement full-day kindergarten for the coming school year," she said.
Ormond said that the School Board has not made any decision one way or the other on kindergarten expansion, but she indicated that school administrators are developing the necessary information for the board to consider when the time comes to make a decision.
School Board member Lisa Merrill said more public input was required.
"I want to hear from parents before we move forward with anything," she said.
Ormond said that a survey would be posted on the School District website and printed in local newspapers. Hanson also urged that surveys be targeted to various groups in the district.
"If we do anything right away," Hanson added, "it will be to give people choices."
Inter-Lakes Curriculum Coordinator Kathleen Hill said that if parents are offered a choice between full- and half-day kindergarten it will be done in a way that parents who choose the half-day option will not be made to feel that they are short-changing their child's education.
The curriculum content for both programs would be the same. The difference would be the all-day program would offer more time for activities, such as art, physical education, and music.
Kusch told the board, "I want to hear ... a clear rationale for whatever options are being offered. 'Kindergarten is good, so more of it is better' is not a rationale," he added.
Last Updated on Wednesday, 23 October 2013 03:27
GILFORD — The N.H. Preservation Alliance has included Kimball Castle in its annual "seven to save" list, meaning the board has determined it is one of seven most endangered historical and architectural buildings in the state.
The castle, which is privately owned but is subject to the provisions of a trust managed by the Gilford Selectboard, lies in near ruins on Lockes Hill, overlooking Lake Winnipesaukee.
"It has become a cause celebre as the town considers a request for demolition of a privately held property that was supposed to have been rehabilitated long ago," read the media release sent out yesterday by the Preservation Alliance.
The castle has become one of the hot topics in Gilford after the town's code enforcement officer determined that it is unsafe and should either be demolished or enclosed by a fence.
Built in 1899 by railroad magnate Benjamin Kimball as his summer home, the castle had spectacular views of Lake Winnipesaukee and continues to be a landmark that can be seen from the "Broads" section of the lake.
Kimball's daughter-in-law Charlotte created a trust for the property on the grounds that it be used for wildlife observation and for hiking trails. According to legend, she also left about $400,000 for the management and upkeep of the castle and its environs.
The money disappeared and in the early 1980s the N.H. Attorney General Office offered the land to the town for its preservation. The town was never able to raise the money for the castle upkeep.
In 1999, the town carved out a 25-acre lot that included the decaying castle and sold the property to a company that wanted to renovate it an make it into an inn and restaurant.
One of the partners in the company, David Jodoin, ended up with the property after plans for the renovation failed.
In the interim, the castle continued to go downhill, portions of the roof collapsed, and vandals and trespassers wreaked their own havoc upon the now 100-year-old structure.
The town building inspector ordered Jodoin to address the situation, giving him a May deadline.
Jodoin drafted a petition for changes in the trust that would need allow him to rezone the property for single-family use that would allow him to demolish the castle and sell the 25-acre lot to another.
Because the selectmen are the trustees of the entire piece of property, they must be the ones that petition the Belknap County Superior Court for any changes to the trust.
After listening to residents at a public hearing speak overwhelmingly against the destruction of the castle and other provisions of the suggested petition, Selectmen voted not to recommend the petition as drafted and the petition will appear on the town ballot March as a warrant article.
Selectmen extended the demolition order until after the 2014 annual town meeting.
By naming Kimball Castle as one of the seven to save, it gives proposed demolition a bigger audience and can help with any fund-raising efforts to save it.
Last Updated on Saturday, 01 February 2014 12:38
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