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Sen. Jeanie Forrester - Protect state Medicaid appropriation for nursing homes

This past week the non-partisan Legislative Budget Assistant presented a "snapshot" of the state budget as of January 14th. Year-to-date, we are ahead of revenue estimates by $19.2 million which, if we didn't have some spending problems, would give us a projected surplus of just $44,000.00 to end Fiscal Year 2015 on June 30.

But, as I mentioned above, the state has a spending problem and though we've been asking for information from the governor since July of last year about department spending and lapses, the only hard data we've been able to get has been from the Department of Health & Human Services (DHHS) — and the data isn't good.

DHHS produces a "Dashboard", which is a monthly report meant to inform policy makers about the status of demand for services in entitlement programs. The department hasn't released any reports since September 2014 (http://www.dhhs.nh.gov/ocom/documents/dashboard-sept2014.pdf). In the September report, DHHS had a $48.8 million shortfall.

On January 23rd, DHHS will come to the Fiscal Committee to lay out its plan for cuts. (The governor issued an executive order asking departments to cut their budgets.) I am keenly interested in seeing what the department will be recommending, especially when it comes to our private and county nursing homes.

Apparently, DHHS advised the county and private nursing homes that they will not be paid about $5 million that was allocated for taking care of some of our oldest and frailest Medicaid recipients. What difference does any of this make to people who don't live or work in a nursing home? Ultimately, this cost will be downshifted to the taxpayers.

The majority of people in nursing homes are on Medicaid and ever since Medicaid was first created in the 1960s, the program has paid for nursing home care for people who are elderly or disabled and cannot pay for their own care. Every two years, the Legislature decides how much money should be paid to all nursing homes for Medicaid. In New Hampshire, the federal government pays half the amount, and the counties pay the other half.

DHHS, through a complicated rate determination process, decides how much each individual nursing home will actually get paid for providing Medicaid care. Right from the beginning, this process is designed so that nursing homes get paid less than their actual costs of providing the care. At the end of that process, after DHHS decides what rate a nursing home should get paid, DHHS then makes another cut, called the "budget neutrality factor." This is a flat percentage cut that applies to all nursing homes across the board. In the most recent rates set by DHHS, that cut amounted to over 29 percent.

All of this adds up to one thing: the nursing homes get paid substantially less than what it costs them to provide Medicaid services to the state. Now, there aren't many other places the nursing homes can turn to in order to make up what they aren't getting paid for Medicaid services, because the majority of the residents of nursing homes in this state are on Medicaid. And the costs of paying for the care of those residents do not go away just because there is no one to cover those costs.

Which brings us back to why this matters.

A big part of any nursing home's costs are payments to the many hard-working people who are at the bedside of the residents every day and every night, and reductions in rates can mean reductions in jobs. It would come as no surprise to anyone, then, that rate reductions can have a real impact at the bedside.

But there are also wider impacts. This Medicaid hole means that nursing homes need to find other sources of payment. In the county nursing homes, part of this hole is filled by county property taxes. In the private and the county homes alike, nursing home residents who are not on Medicaid subsidize the shortfall by paying substantially higher rates. So although you might feel the impacts most directly if you live or work in a nursing home, you don't need to be a resident or caregiver in order to be affected by this.

In the last state budget, we appropriated a sum of money for nursing homes that reflected what we in the Legislature thought we could reasonably designate for that purpose. The private and county nursing homes have planned their budgets accordingly and I believe we must stand by our funding commitment to them.

When DHHS comes to the Fiscal Committee on January 23rd, I am hopeful they will also stand by the commitment we made and not cut critical funds from the nursing homes.

(Meredith Republican Jeanie Forrester represents District 2 in the New Hampshire Senate.)

Last Updated on Tuesday, 20 January 2015 10:09

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Bob Meade - Think about it . . .

An old classmate of mine sent me an e-mail with the following six conundrums of socialism in the United States of America:
1. America is capitalist and greedy — yet half of the population is subsidized.
2. Half of the population is subsidized — yet they think they are victims.
3. They think they are victims — yet their representatives run the government.
4  Their representatives run the government — yet the poor keep getting poorer.
5. The poor keep getting poorer — yet they have things that people in other countries only dream about.
6. They have things that people in other countries only dream about — yet they want America to be more like those other countries.

While you ponder those for a few minutes, let's give them a closer look. We see some government officials working to divide our country in myriad ways, men against women, black against white, rich against poor, government against the private sector, and so on.

The government does not seem to want to look introspectively, but it/they provide us with information intended to convince us that all the problems are created by others. So, let's examine some of what they tell us.

We are told that the unemployment rate for December was at 5.6 percent, the lowest it has been since 2007. However, when we look into some other numbers, we can't help but wonder how that 5.6 percent was reached. We then look at the "labor participation rate" and find that it was 65.8 percent when President Obama took office but it is now down to 62.7 percent . . . Translating those percentages into real numbers, here is what we find:

— There are 10,000 people, "baby boomers", retiring every day; 3.65 million per year. Even with that number coming out of the labor force, while Obama has been in office, young people entering the labor force has resulted in the total force growing from 154.75 million in December of 2008 to 156.13 million in December of 2014 — a net increase of 1.38 million newly eligible workers. That's an average net growth in the available labor force of 230 thousand people per year.

— In December of 2008, 65.8 percent of the 154.75 million labor force were employed — 101.8 million people.

— In December of 2014, the available labor force totaled 156.13 million. However, the labor participation rate had dropped to 62.7 percent, resulting in only 97.9 million people who were working.

While the administration pats itself on the back for the "low unemployment numbers", we find that if we had the same labor participation rate now as we did in December of 2008, the number of people with employment would be 102,734 million, or 4.8 million more than are now employed. That raises the question, if we believe the "unemployment" number, was Professor Gruber right?

In looking at another issue, the loss of senior military officers, Investor's Business Daily reported that President Obama fired 197 senior officers in just five years, an unprecedented number. In one incident of note, the terrorist attack on Benghazi that resulted in the murder of our ambassador and three others cost both a general and an admiral their jobs. General Carter Ham, head of U. S. Africa Command, was immediately relieved of his duties when he said he intended to send support to our people in Benghazi who were under attack. Rear Admiral Chuck Gaouette, who headed up the John C. Stennis Carrier Strike Group, was also relieved of his command because he agreed to provide intelligence information to General Ham's people.

It is interesting to note, that a private in the Army or Marines, or a aeaman in the Navy, or an airman in the Air Force, can be court marshaled if they absent themselves from their assigned duties, whether in the front lines of battle or while on a state-side assignment. In the Benghazi case noted above, the general and the admiral who wanted to do everything within their power to try and save our ambassador and his aides, were fired . . . but their Commander in Chief's whereabouts at the time are still unknown. Go figure.

Another issue to consider is the War on Poverty. Back in 1965 when President Johnson initiated the plan, there were 34 million people, about 14.5 percent of the population, living in poverty. Since that time, the government has spent over $18 trillion citizen tax dollars in an effort to reduce that number. As of 2013, there were 45.3 million people living in poverty, about 14.5 percent of the current population. Eighteen trillion dollars didn't reduce the poverty levels but that number just about matches our current nation debt.

Businesses succeed by successfully filling a market need . . . giving the consumers what they want or need at a price they are willing to pay. Government, as it is now operating, grows bureaucratically, at great cost to the taxpayers, and in many cases is failing to meet the objectives for which they were established. Shouldn't we expect and demand better?

(Bob Meade is a Laconia resident.)

Last Updated on Monday, 19 January 2015 09:50

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Sanborn — The 2014 Year End Winni Sales Report

2014 ended with 14 residential waterfront transactions in December on Lake Winnipesaukee at an average sales price of $1,012,607. Seven of the sales exceeded the million dollar mark with the range being from a low of $237,000 for an island cottage up to $2.2 million for a property on Long Island in Moultonborough. That's a lot better than the four sales generated last December and helped close the gap in the total number of sales on the lake compared to last year.

For the year there were 128 transactions on the Winni (including island sales) at an average sales price of $1,082,119 and median sales price of $777,500. While we were just off the 134 sales number posted in 2013, the average sales price was up from $947,936 in 2013 which is pretty good news.

Of course, one should consider the fact that the highest sale ever on the lake, or in the region for that matter, occurred in April of this year at 212 Springfield Point in Wolfeboro. This extraordinary property sold for $8.975 million and tweaked the average sales average on the lake just a bit, but it was still a better year dollar wise. Total sales on the lake tallied up to a whopping $138,311,217 in 2014 compared to $127,023,459 in 2013.

Moultonborough posted the highest number of waterfront sales with 34 transactions at an average price of $1,164,703. This is a tribute to their low tax rate and the fact that it is a great place to live. It also does not hurt that they have a greater number of waterfront properties to begin with. Wolfeboro posted the highest sales price average at $2,280,445 with 11 transactions.

There were 19 non-bridged island sales among the waterfronts that changed hands in 2014. The average sales price came in at $320,700. Prices ranged from as little as $207,500 up to $400,000. This, my friend, is an affordable way to be on the lake!

Over on little sister, Winnisquam, sadly, there weren't any sales in December. But there were 14 transactions for the year at an average of $591,214 which is the highest average since 2008 when it came in at $602,700. There were also two sales over the million dollar mark on a lake not known for high price homes. That makes only eight properties that have sold on Winnisquam over a million dollars since 2004.

P​ease feel free to visit www.lakesregionhome.com to learn more about the Lakes Region real estate market and comment on this article and others.
​Data compiled using the NNEREN MLS system as of 1/14/15. ​Roy Sanborn is a realtor at Four Seasons Sotheby's International Realty and can be reached at 603-677-7012.

Last Updated on Friday, 16 January 2015 09:59

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Froma Harrop - License plates are not bumper stickers

A group called the Sons of Confederate Veterans has asked Texas to issue a license plate featuring the Confederate battle flag, which many consider an emblem of slavery. Texas said no, and the sons are suing because the state accepts other messages for specialty plates.

The sons have a point.

North Carolina issues a license reading, "Choose Life." When lawmakers there refused to allow a competing abortion-rights message, the American Civil Liberties Union sued. The ACLU has a point, as well.

States have jumped on the slippery slope of letting various business and social interests promote themselves on the specialty license plates. Now they have slid into the U.S. Supreme Court, which has taken the Sons of Confederate Veterans case.

The justices have examined license plates before. In the 1977 Wooley v. Maynard case, Jehovah's Witnesses held that the New Hampshire state motto stamped on all license plates, "Live Free or Die," offended their religious convictions. The court ruled that New Hampshire residents had a right to cover up those words on their plates.

How about no messages on state-issued license plates? Or perhaps limiting them to such neutral bragging as Wild, Wonderful (West Virginia), Evergreen State (Washington), Sweet Home (Alabama) or Garden State (New Jersey)?

I'll admit to a soft spot for environmental messages — such as calls on Florida plates to protect whales, dolphins, sea turtles, manatees and largemouth bass — but not for blatant advertising. Sports teams are big businesses, and they have specialty plates.

Rhode Island offers a plate featuring Mr. Potato Head, marketed by the local toymaker Hasbro. The fees car owners pay for such plates may go to a good cause (in Mr. Potato Head's case, a food bank), and states take their cut. Still, it's an ad.

But when license plates take on an obvious political tinge, sparks fly. And that's why a blanket "no" to specialty plates is the right way to go.
Corey Brettschneider, professor of political science at Brown University, doesn't agree. He sees license plate messages as "mixed speech." Because the United States allows a freedom of expression unmatched by any other country, the state has an obligation to defend its values, he writes in his book "When the State Speaks, What Should It Say?: How Democracies Can Protect Expression and Promote Equality."

Brettschneider believes that Texas was correct in turning down the plates displaying the confederate flag but that North Carolina was wrong in rejecting the abortion rights plates.

I asked him, what about the argument that many see the confederate flag more as a historical artifact than as an endorsement of slavery? Brettschneider responded that the flag's history, including its use in opposing civil rights legislation, suggests otherwise. And even if the intent of some of its backers is pure, the considerations are bigger than the views of a private person. Texas would be tied to the symbol, he said. "Texas has a deep duty to avoid an association between the state's message and a racist message."

But who speaks for the state? What happens when one set of officials is replaced by another with entirely different interpretations? "The Constitution requires deference to the democratic process," Brettschneider answered, "but it also sometimes requires limits on that process."

We do agree that bumper stickers are a great invention. They are a frugal way to advertise one's religion, preferred candidate, dog's breed, football team or sense of humor. State approval not required.

As for specialized messages on license plates, I persist in opposing them all. Professor Brettschneider's approach is well-constructed and certainly more nuanced, but managing its tensions would be a hard job.

(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)

Last Updated on Wednesday, 31 December 1969 07:00

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Michelle Malkin - This isn't about cartoons

I have never laughed so bitterly as I did while reading a recent lead editorial by the great pretender-defenders of free speech at The New York Times. Paying obligatory lip service to the 10 cartoonists and staffers of the Paris satirical weekly Charlie Hebdo who were slaughtered for offending Islam, the Times intoned: "It is absurd to suggest that the way to avoid terrorist attacks is to let the terrorists dictate standards in a democracy."

My GPS tracker of journalistic hypocrisy immediately identified the Times editorial board's high-altitude location — ensconced atop their own Mt. Everest of absurdity and self-unawareness.

The Fishwrap of Record priggishly refuses to print any of the Islam-provoking art that cost the brave French journalists their lives. In case you forgot (as its own editorialists have), the Times cowered in 2005-2006 when the Mohammed cartoons conflagration first ignited. And the publication is capitulating again.

Behold this groveling bow to terrorists dictating democracy's standards: "Under Times standards," a newspaper spokesman said in a statement this week, "we do not normally publish images or other material deliberately intended to offend religious sensibilities. After careful consideration, Times editors decided that describing the cartoons in question would give readers sufficient information to understand today's story."

So says the paper that blithely published a Catholic-bashing photo of the Virgin Mary covered in elephant dung and defended the taxpayer-funded "Piss Christ" exhibit thusly: "A museum is obliged to challenge the public as well as to placate it, or else the museum becomes a chamber of attractive ghosts, an institution completely disconnected from art in our time."

While they feign free-speech fortitude, what Times editorialists really don't want to see is their heads completely disconnected from their necks. Neither do editors at The Boston Globe, ABC News, NBC News, MSNBC and CNBC, who won't publish any possibly, remotely upsetting images of Mohammed, either.

But these quivering double-talkers aren't even the most laughable of Cartoon Jihad cowards. The Associated Press wins the pusillanimity prize after invoking the sensitivity card to explain why it refrained from publishing "deliberately provocative" Mo toons — even though the media conglomerate had been selling deliberately provocative "Piss Christ" photos on its website. After the Washington Examiner's Tim Carney pointed out the double standards, AP tried to cover its tracks by yanking the pic.

More absurdity? The New York Daily News pixelated a Mo toon carried by Charlie Hebdo as if it were pornography. CNN did the same in 2006, when it explained it was censoring the offending images "in respect for Islam" and "because the network believes its role is to cover the events surrounding the publication of the cartoons while not unnecessarily adding fuel to the controversy itself."

And therein lies the cartoon capitulationists' grand self-delusion. This isn't about cartoons.

Reminder: The First Mo Toons Wars were instigated in 2005 by demagogue imams who toured Egypt stoking hysteria with faked anti-Islam comic strips attributed to the Danish Jyllands-Posten newspaper (whose actual cartoons criticizing Islam were far more innocuous). The real agenda: Islamist thugs were attempting to pressure Denmark over the International Atomic Energy Agency's decision to report Iran to the U.N. Security Council for continuing with its nuclear research program. From Afghanistan to Egypt to Lebanon to Libya, Pakistan, Turkey and in between, hundreds died in insane riots under the pretext of protecting Mohammed from Western slight. Courageous journalists who stood up to the madness were silenced, jailed and threatened with beheading.

Cartoons did not start militant Islam's fire. Neither did the Bushes, Israel, the Satanic Verses, the Pope, beauty pageants, KFC restaurants in the Middle East, Mohammed teddy bears or a YouTube video.

The Religion of Perpetual Outrage hates all infidels for all reasons for all time. The targeting of Mohammed cartoonists is a convenient excuse to feed the eternal flame of radical Islamists' hatred of the West. If it isn't cartoons, it's something else. The grudge is everlasting.

Instead of acknowledging their gutlessness in the face of Koran-inspired Muslim vigilantes, press pontificators cloak their fear in the mumbo-jumbo of "tolerance." They demand that the rest of us pledge fealty to their selective multi-culti sensitivities lest we be branded "Islamophobes." And then they have the audacity to play "I am free-speech Spartacus" with those who risked life and limb to speak truth to Islamic supremacist power.

Sit down, fakers. You fakin'.

(Syndicated columnist Michelle Malkin is the daughter of Filipino Immigrants. She was born in Philadelphia, raised in southern New Jersey and now lives with her husband and daughter in Colorado. Her weekly column is carried by more than 100 newspapers.)

Last Updated on Thursday, 15 January 2015 11:38

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