No one there to greet you - Belknap County Nursing Home hasn’t had receptionist for seven years

LACONIA — One of the top priorities for the Belknap County Nursing Home this year is hiring a receptionist for the home, which has not had a receptionist for the last seven years.
Interim nursing home Administrator Bob Hemenway told members of the County Convention's Nursing Home Subcommittee Friday morning that he was surprised to discover that the receptionist position had been funded in the last two budgets but that none had ever been hired.
The $46,000 position is not a part of this year's budget, which was originally proposed by the commissioners, but Hemenway said that it is crucial to the operation of the home.
"The people working in the front office have other responsibilities which are important. What a mistake that was, not to fill it," said Hemenway, who later noted that the lack of a receptionist contributes to lower morale in that office.
Rep. Don Flanders (R-Laconia), chairman of the subcommittee, said that he has many times walked through the front door into the nursing home and found that no one was there to greet visitors.
County Administrator Debra Shackett said she has been with the county for seven years and that during that time the nursing home has never had a receptionist. She said that although the position was funded the last two years, the previous administrator did not believe the nursing home needed a receptionist and had not filled the position.
"It's a real hardship not to have a receptionist," said Shackett, who said that Commission Chairman David DeVoy (R-Sanbornton) has expressed support for hiring one and is looking to fund the position by finding savings in other areas.

Record-keeping

Another major priority is implementing an electronic medical record-keeping program. Hemenway told subcommittee members that the current record keeping system is inefficient and doesn't accurately capture all of the activity for which the county should be reimbursed.
The county currently uses PointClickCare software for the nursing home, but licensed nursing assistants do not have access to it, so they enter information on what they have done into another system at the end of the day.
Hemenway said that it will be 18 months to two years before the benefits of electronic record-keeping can be realized because reimbursement rates won't reflect the new information for about two years.
But he urged immediate action, saying "the longer you wait, the longer it will take for it to have an impact."
County commissioners have already approved encumbering $20,000 in funds from the 2015 budget in order to purchase 12 wall-mounted kiosks this year, which will allow the nursing home to begin to implement an electronic medical record-keeping program as soon as possible.
The change is designed to stem an estimated $185,420 yearly loss in Medicaid income due to lack of adequate documentation of services provided for residents.

Chris Christie promises to disrupt the status quo while in Meredith

MEREDITH — "We need to turn the status quo upside down and build it over again," Chris Christie, the governor of New Jersey who is seeking the Republican presidential nomination, told more than 200 voters crammed into the cafeteria at Inter-Lakes High School on Thursday evening. "I know how to disrupt and I know how to build," he added.
Christie recalled that when he was elected governor in 2010 New Jersey faced a projected budget deficit of $2.2 billion. Resisting rising pressure from the Democratic legislature to raise taxes, instead he declared a fiscal emergency and, without consulting the legislature, reduced spending to balance the budget. He said he has balanced budgets throughout his six years as governor without increasing income, sales or corporate taxes and while vetoing more proposed tax hikes than any governor in the country. After upsetting the apple cart, Christie said that he "brought people together" to reform the tenure system for school teachers and the pension system for public employees.
Referring to his rivals in the GOP field, Christie said "we have governors, senators, business types and a character" then quipped "we're not electing an entertainer-in-chief. We're electing a commander-in-chief. He dismissed first-term senators — Ted Cruz and Marco Rubio — whom he said "have no idea how to run the most complex government the world has ever known. We did that eight years ago," he said, and stressed "We need need someone who's done this before."
Apart from his experience as governor, Christie also touted his seven years as United States Attorney, which included investigations and prosecutions of both corrupt public officials and plotters of terrorism.
"I'm the only candidate who has pursued and prosecuted terrorists," he said, noting that more than 14 years after the attack on the Twin Towers "We are questioning whether the government can keep us safe."
He called for strengthening intelligence agencies and restoring their authority to collect data.
"This is a much more dangerous world," Christie said. "American leadership is a burden and an opportunity, but it's not a choice," he continued. "But, American cannot carry the burden by itself."
He said that during the first 100 days of his presidency he would meet with the leaders of America's allies and, after "giving them an hour to vent about how they've been treated by the Obama administration," set about repairing relationships.
Christie said that a coalition of a coalition of European and Middle Eastern allies Imust be formed to destroy ISIS. Calling the nuclear accord with Iran "the worst thing the president has done," he said that he would tell the Iranians that the United States will never permit Iran to have a nuclear weapon, will have no relationship with Iran until it recognizes the right of Israel to exist and encourage Iranians to overthrow their government.
"To be part of the civilized world, you have to be civilized," he said, "and they are not."
Noting that 71 cents of every dollar in the federal budget is spent on entitlement programs and debt service, Christie said that the swollen national debt can only be shrunk by restructuring Social Security and Medicare and accelerating the pace of economic growth. He has proposed raising the retirement age from 67 to 69 over the next 25 years and means testing Social Security, which he said would save $1 trillion in a decade, while raising the eligibility for Medicare and reducing its subsidies for the well-to-do.
Health care, Christie said, should be the responsibility of the states. He said he would repeal Obamacare within a year then give states a year to develop a health care plan tailored to their own circumstances. He explained that each state differs and "the same plan can't work for all states."
At the same time, he would increase funding for the National Institute of Health for medical research, especially to address cancer, heart disease, diabetes and Alzheimer's disease, which account for the major share of healthcare costs, especially at the end of life.
Rejecting calls to bar Muslims from entering the United Sates as "ridiculous," Christie said there should be no religious test for citizenship. Likewise, he dismissed the notion of building a wall on the southern border, but instead proposed additional fencing, electronic fencing and additional personnel to secure the border. Above all, Christie emphasized that existing immigration laws must be enforced.
With two-thirds of Republican voters still undecided, Christie is among a handful of candidates polling in the single digits. The recent CNN/WMUR poll of New Hampshire voters, conducted by the Survey Center of the University of Hampshire, indicates that his support has slipped from near 10 percent in December to 6 percent in January.

PBIS program shows students are better behaved (626)

LACONIA — Since its introduction throughout the Laconia School District in 2014, the Positive Behavioral Interventions and Supports, or PBIS, program appears to be achieving its intended result by reducing the number of incidents requiring referrals for disciplinary action according to data presented to the School Board this week.

PBIS rests on the notion that appropriate behavior can be taught just like core subjects of the academic curriculum by setting positive expectations for students rather than telling them what not to do. Presented on matrices prominently displayed in all five schools, the expectations signal the appropriate behavior in the classroom, hallways, cafeteria, restroom and school bus as well as on school grounds and at school events. Expectations are tailored to specific locations and activities within the schools, but at the same time are consistent. For example, if cell phones are restricted in one classoom, they are restricted in all classrooms.

Maureen Tracey, the district coordinator of the program, explained that the program aims to maximize the time students spend learning by reducing the number referrals to the office for inappropriate behavior, which take both the student and the teacher out of the classroom. She said that PBIS includes a software program that gathers and arranges behavioral data, which identifies the student and transgression, along with the date, time and place of the incident leading to a referral.

McKenzie Harrington-Bacote, the Safe Schools and Healthy Students Administrator, told the board that while all students benefit by meeting consistent expectations, some require extra support and others more intensive. individual direction.

Tracey and Harrington-Bacote presented two measures of progress, the number of "office discipline referrals" and the number students referred more than once. At Em Street School from September to December the average referrals per day per month decreased from between four and eight to between two and four this year compared to last. During the same period average referrals per day per month at Pleasant Street School decreased from eight to less than four every month. At the same time, the number of students who were referred more than once declined at both schools. At Woodland Heights School, where average referrals per day per month topped eight in 2014, the decline was less dramatic and more uneven, but there as well the number of students referred more than once shrank.

At Laconia Middle School, referrals averaged between 12 and 16 per day per month in 2014, but this year have decreased to eight or less while the number of students referred has also declined.

At Laconia High School, the number of referrals during the first semester dropped from 1,606 in 2014 to 548 in 2015. During the first semester for the past three years there has been a marked decline in "problem behaviors." Incidents involving cell phones has decreased from 132 to 95 to 31. Use of abusive language has fallen from 78 incidents to 47, While there were 178 cases of disruption in 2013 and 2014, there were only 57 in 2015. Truancy has fallen from 238 cases in 2013 and 204 in 2014 to 49 in 2015. And the number of incidents of insubordination, which rose from 227 in 2013 to 332 in 2014, dropped to 146 in 2015.

Harrington-Bacote said that surveys of parents of students at Elm Street School found that majorities of between two-thirds and three-quarters believe that PBIS has improved both the academic performance and routine behavior of their children.

PBIS is funded by two federal grants, one of $2.2 million that will expire in September 2017 and another of $1.01 million that will expire in September 2019. Harrington-Bacote stressed that building the capacity to sustain the program beyond its initial funding is among her highest priorities. She noted $1.6 billion in federal funding to address the mental and behavioral needs of students will become available in August 2016, with school districts serving the greatest numbers of students living in poverty eligible for the largest share of the money.