Press Hears Our Plea for Funding

The Union Leader, New Hampshire’s largest newspaper, used it’s platform to highlight the plight of lower income Granite State seniors in Garry Rayno’s column the State House Dome.  In it Rayno draws attention to the CFI funding issue and alerted the public to a Press Conference on the issue spearheaded  by the state’s senior, disabled and  home health advocates which is scheduled for Tuesday, May 19.

See the article by Garry Rayno at


Senior advocates to sound off Tuesday

TWO WEEKS ago at the public hearing on the proposed $11.2 million biennial budget, Senate budget writers announced an agreement had been reached to restore about $4 million earmarked to cover rate increases for nursing homes.

Administration officials had set aside $7 million to help the Health and Human Service Department offset a more than $50 million budget shortfall, but a larger than expected budget surplus put aside that concern.

That meant nursing homes could receive the rate increases they anticipated this year.That is half the story. Lawmakers and administrators are going to hear the other half at a press conference scheduled for Tuesday, when senior advocacy and home health groups lay out what they say is a terrible situation.

Without changes, advocates are expected to say, many providers will go out of business, and there will be no one to provide the care services many at-home elderly need to survive.At issue is the Choices for Independence program, which provides Medicaid services to low-income elderly and adults.

Surplus money in the CFI program allowed House budget writers and Gov. Maggie Hassan‘s office to reach an agreement that allows nursing homes to receive their anticipated rate increase.While the nursing homes are taken care of in Senate Bill 8, the health and home care providers in the CFI program said they are not.

The House plan would give the agencies a one-time 2 percent rate increase.

“While Senate Bill 8 is good news for nursing homes that are woefully under-reimbursed by the state of New Hampshire,” said Gina Balkus, CEO of Granite State Home Health Association, “it’s yet another step in the deconstruction of home and community services that help keep our elderly loved ones out of nursing homes.”

Balkus’ organization represents 39 home care agencies licensed in the state that serve many of the people in the CFI program.

Under the program, those who qualify financially can receive personal and medical care services at home. Those served are eligible for nursing home services, but instead opt to remain at home, at about half the cost of care in a nursing home.

The department decides what services the people may receive at home and how often, according to Backus. The program will not spend about $5 million of the $14 million appropriated for this fiscal year.

“Ask any case manager who helps arrange services, or a home care agency that provides nursing care – the level and amount of services that the state approves for CFI clients have diminished to the point where one really wonders if we are truly meeting the needs of our elders,” Balkus said.

Reduction in services authorized is not the only problem, the home health agencies have not received a rate increase since 2010 and went without an increase from 1999 to 2005 until they sued the state, although state law required an annual review and adjustment for costs.

Some of the providers have reduced the number of CFI clients they serve or dropped out of the program.

“Low CFI reimbursement has shredded the community safety net,” Balkus said. “Who will serve our seniors if community agencies cannot?”

Case managers who oversee the services clients receive and “keep the state honest” are in a similar boat with no bumps in reimbursements and growing client lists.  Bob Clegg, who represents Heritage Case Management and Granite State Independent Living, said case managers have not had a rate increase since 1988 and many companies are just getting by.

“I was trying to explain to the Senate if you don’t pay up, a lot of these companies are going to go out of business,” Clegg said. “(The state) is not providing the same level of care and covering the needs of folks, and they call that cost savings.”

The Senate is in the final stretch of crafting its budget plan and on Thursday decided not to agree to the House version of SB 8 and instead wants to negotiate.

The press conference on Tuesday might provide some more ammunition for the home care providers.

A former House Speaker used to say every budget year is a balancing act between the very young and the old. How the scales tip this year remains to be seen.