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State has paid home health agencies the same rate for 6 years

To The Daily Sun,
It is universally acknowledged that care at home is preferable and far less costly than care in a facility. In New Hampshire, the average cost of maintaining a Medicaid recipient in their own home is about $18,360 per year while the average cost of care in a nursing home is about $44,000 per year. So, keeping Medicaid-eligible people at home in New Hampshire makes economic sense. The formula works as long as there are willing home-health providers in the community. And that is where the problem arises.

Community-based home health agencies have been paid the same rate to provide service under the Medicaid "Choices for Independence" (CFI) program for the last six years — and even longer for some types of service. This has occurred in spite of the fact that the state was ordered to review and amend rates yearly following a legal settlement. Nevertheless, the rate revision has occurred only once — in 2009. Since then, agency costs to provide care have risen steadily. The increasing difference between agency cost to provide care and the state payment for care has caused a number of New Hampshire agencies to question whether or not they are financially able to serve CFI clients.

Some agencies have already elected to discontinue serving the CFI program altogether because they simply cannot afford to lose so much money and continue to service the broader needs of their communities. Many more are considering this option.

As the state budget debate commenced, home health agencies learned that the Bureau of Elderly and Adult Services reported significant unspent funds in the CFI line item that should have been used to fulfill the state's obligation to its Medicaid population. Instead, these unspent funds were planned to be used elsewhere. Ultimately, home health professionals worked with the budget committee to appropriate a portion of those funds — $1.8 million — back to the CFI budget line. This portion was earmarked for a retroactive supplemental payment. Additional funds were appropriated for a 5 percent prospective rate increase to service clients under CFI — consistent with state rules.

The current state budget impasse places these appropriations in limbo. While the budget debate continues and the state engages in its "continuing resolution", agencies are faced with the question of whether or not they can afford to continue staffing or accept new CFI clients at a financial loss.

The irony is that every case that does not get picked up by a home health agency ends up in a far more costly health-care facility at higher expense to the state. That is wildly inconsistent with our economic interests and our stated values concerning home-based care. The clock is ticking. But nothing in this debate is helpful to individuals in need of care. When the Legislature and the governor meet again to negotiate the budget, we want this issue to be in their minds.

Margaret Franckhauser, RN, MS, MPH
Executive Director

Central New Hampshire VNA & Hospice


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We are so grateful for support shown for college-bound students

To the Daily Sun,

The Lakes Region Scholarship Foundation has been working hard over the past few months preparing for the annual scholarships to be awarded. Each spring the board members review and rate hundreds of applications submitted. Then donors are invited to participate by making recommendations for their awards. Presentations are made to current graduates at local high school award ceremonies and others are notified by mail.

Who would have thought, back in 1956, that this idea, started by a small group of concerned citizens and supported by just eight local civic groups and businesses, would blossom into the remarkable organization we have today. From that small start in 1956, with awards totaling just $2,650 to 16 recipients, we have grown so that this year we awarded in excess of $311,400 to 305 local students from 232 donor funds. A total of $162,750 was awarded to 159 incoming freshman, and $148,650 to 146 upperclassmen.

Our official 60th anniversary will be Feb. 16, 2016. This year marks six decades of scholarships being awarded through the Lakes Region Scholarship Foundation, bringing the total awards given to more than $5.2 million, helping more than 4,600 students from 1956 through 2015.

All this help and money for our local students comes thanks to the generosity of about 525 donors over the years. We, however, are merely the conduit. It is the generosity of so many local people that makes all of this possible. Many of our scholarship funds are memorials set up by families when a loved one passes or by individuals in advance of their death. Each memorial tells the story of a special person. Someone who is no longer with us, but is still helping those they have left behind.

Other scholarship funds come from civic groups and area businesses, all investing in the youth of our local communities. And then there are the thousands who have contributed to specific memorial funds or special fundraisers.

We are so grateful to all our donors who deserve the credit for this proud record of supporting college-bound students and we congratulate this year's recipients. For a complete list of our 2015 recipients and a donor brochure, please contact us at 527-3533 or This email address is being protected from spambots. You need JavaScript enabled to view it. "

Paulette Loughlin, President

Lakes Region Scholarship Foundation

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