In this Issue:
Nonprofit Org.
How Did It Happen? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Slamming the Brakes on Managed LTS and Services . . . . . . . . . 3
NH Commissioner of Health and HS, Jeffery Meyers . . . . . . . . . 4
Classroom Behavior Management Presents New Challenges . . . 4
Opinion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Important Quotes from the LBA Audit of NH DHHS . . . . . . . . 16
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The New Hampshire Challenge
disability issues from a family perspective
published quarterly by: The New Hampshire Challenge, Inc. P.O. Box 579, Dover, NH 03821-0579
Volume 28, Issue 1
© 2016 All rights reserved
Winter 2016
NH Audit Finds BDS Underspend
T
By: John M. Krumm (Jack), Editor, The New Hampshire Challenge
Developmental Disability Money FY15
Source Data: LBA Audit
Lost Money; $14.30M
Returned; $16.90M
Lost Money; $18.10M
Authorized; $216.90M
Authorized; $232.70M
Black
Sent to FY 15; $11.20M Returned; $3.50M
Continued on page 10
Yellow
Developmental Disability Money FY14
Source Data: LBA Audit
to underutilizing the appropriated funds, including DHHS
problems with tracking expenditures, constraints imposed by
DHHS on future budgets, delays
in hiring people to provide client
services, newly imposed “adhoc” DHHS restrictions on Area
Agencies reallocating unspent
funds, inadequate DHHS rules
regulating timely service provisions, and forces external to the
service delivery system.
The Bureau of Developmental Services, until the retirement of its leader Matthew
Ertas, contracted in a spirit of
partnership with New Hampshire’s ten regional non-profit
organizations, known as area
agencies (AAs). Area Agencies
Magenta
legislature during this period money was available. The audit
amounting to a combined $65.0 discovered that during this pemillion (15 percent) increase riod $38.5 million in Medicaid
over SFYs 2012-2013. The au- appropriations in the two waiver
dit found that BDS’s oversight programs went unspent because
of the financial delivery system BDS never forwarded the legwas ill prepared to take full islatively authorized funding to
advantage of this increase in Area Agencies.
legislative funding. BDS had
However during this same
experienced a 100% turnover period and without the authoof personnel and the experience rized funding being forwarded
it had within BDS in this area. by BDS to the Area Agencies,
The audit further found that the audit objectively documents
eight Acquired Brain Disorder that 674 clients were removed
(ABD) and 101 developmen- from the DD waitlist during fistally disabled (DD) clients, cal years 2014-2015. This numAuthorized
$232.70M
who would require aboutLost
$4.9Money
ber in fact exceeded
the planned
$14.30M
million in services, remained
number
to be removed
Sent to new
FY of people
$0.00M
$16.90Mpromised to
on waitlists at the end ofReturned
SFY from the waitlist
2015 because existing funding the legislature. The Area Agenwas not forwarded to the Area cies simply found other ways to
Agencies. BDS had no visibil- exceed legislative expectations.
ity of it, and did not know the
Several factors contributed
Cyan
he Legislative Budget Meyer’s tenure. Commissioner
Assistance (LBA) group Meyers will oversee the placein Concord has accom- ment of any new mechanisms
plished an internal audit of or improvements to correct the
NH Department of Health and deficiencies documented.
Human Services (DHHS) and
The period these shortthe effectiveness and account- comings began was under the
ability concerning the flow of tenure of Commissioner Toumplegislatively authorized funding as, during State fiscal years
to the Area Agencies (AAs). The (SFY) 2014 and 2015. The New
main findings of this audit is Hampshire Challenge reported
that DHHS Bureau of Develop- throughout this timeframe of
mental Services (BDS) did not the dismantling of the Bureau of
effectively manage Medicaid Developmental Services (BDS).
appropriations to ensure adults The last vestige of experience in
with acquired brain disorders effectively delivering legislative
(ABD) and developmental dis- authorized resource to manage
abilities (DD) receive timely Medicaid appropriations to the
services.
Area Agency system left BDS
Authorized
$216.90M
This Lost
auditMoney
is being delivered
with the retirement of Matthew
$18.10M
at the very
beginning
Ertas in 2014.
Sent
to FY 15 of our new
$11.20M
Returnedof Health and
$3.50M Additional appropriations
Commissioner
Human Services, Mr. Jeffery A were authorized from the NH
1
2
The New Hampshire Challenge — Winter 2016
How Did It Happen?
Audit reveals how authorized funding never reached our people
By John M. Krumm (Jack), Editor, The New Hampshire Challenge
Some Background:
T
2
Black
he New Hampshire Legislative Budget Assistant
(LBA) accomplished an
audit of the legislatively authorized funding allocated to the
Developmental Disability (DD)
community and the Acquired
Brain Disorder (ABD). This
audit accounted for funding
as spent under former Commissioner Toumpas and an
extremely cut back Bureau of
Developmental Services (BDS).
The LBA audit was released
during the first week of February, 2016. This article seeks to
place in laymen’s terms how the
legislatively authorized funding
never was released to clients
who needed it in the DD and
ABD communities.
Budgeting for the DD program has always been based on
DD clients known to the BDS
early in the budgeting process.
However, individuals who are
later added to the waitlist after
the start of the budget process
and any estimates for other clients who might request services
during the next biennium are not
projected and are excluded from
the newly submitted budget. The
very process of budget planning
for a new two year fiscal cycle
is inefficient.
Other inefficiencies are
documented in the LBA audit.
These can be traced to NH Department of Health and Human
Services (DHHS) statutes, rules,
and guidelines, which lacked
clarity and did not provide overall timeliness requirements and
the flexibility needed for timely
service delivery. The audit outlines how ABD client service
delivery was incompletely incorporated into statutes, and
new rules imposed after 2014
were imposed arbitrarily and
were unnecessarily complex.
These rules left gaps in the
regulatory framework, which
were attempted to be addressed
by BDS. This was attempted
by starting to impose “ad hoc”
(arbitrary) rulemaking.
BDS guidelines imposed
after 2014 placed new burdens
on our Area Agencies (AAs).
They made substantive and
new requirements for waitlist
and fund creation and management, contained discretionary
decision-making provisions—
without objective criteria—and
comingled maintenance and
waitlist funds for certain uses.
All this was done according to
the audit, without clear basis
of authority to do so in statute
or rule.
Since 2014, The BDS inconsistently enforced compliance
with rule timeliness requirements, and the client budget
and prior service authorization
processes contained imbedded
inefficiencies. Further, the BDS
did not complete re-designation
processes for the AAs as required by state statute and rule.
BDS and DHHS further
lacked management controls
over information technology
systems upon which the service delivery system relied.
The New Hampshire Medicaid
Management Information System (MMIS) in previous issues.
MMIS has been a long term
headache for NH DHHS. Its cost
overruns and failure to deliver
have been biting at NH DHHS
since the tenure of former Commissioner John Stephens. This
system was originally contracted for by the Executive
Council, under the assurance of
former Commissioner Stephens
that it would save the state tens
of millions of dollars annually.
Consider advertising in The New Hampshire Challenge
The system never has delivered
on Stephen’s promise to the Executive Council. Former Commissioner Toumpas had to go
before the Executive Council to
request even more NH Taxpayer
resource to finish and receive
some value from the MMIS
job. The audit just concluded
this system does not provide
adequate management control.
Over $54M of NH Tax revenue has been spent on NH’s
MMIS. The system just failed to
make visible and forward authorized resource to our people with
DD and ABD and because of
the lack of visibility it provided
to NH Tax Resource allocated
added new members to “the
waitlist” needlessly.
The BDS was also challenged by a wide span of control
for the administrator and several
Continued on page 10
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3
The New Hampshire Challenge — Winter 2016
Slamming the Brakes on Managed
Long Term Supports and Services
By: Alison Cohen, Special to The New Hampshire Challenge
B
do not have the necessary experience and expertise but the
numbers are required to make
managed care work. That’s
not enough to upend a system
that works as far as Forrester is
concerned.
Forrester’s bill, SB 553,
states that Step 2 shall not be
implemented prior to July 1,
2017 and only if it receives approval by the joint legislative
fiscal committee
Forrester said the bill is
being reviewed by the Senate’s
Health and Human Services
Committee, but she expects it
to be reported out the first or
second week in March. She is
optimistic about the chances for
a favorable committee decision
and ultimate passage as it has
bi-partisan support in both the
Senate and House. Forrester has
received lots of feedback from
stakeholders and feels her bill
will have bi-partisan support,
but hopes people will show up
and testify when hearings are
scheduled to convince legislators who may not be sold on the
bill. Judging by past hearings,
Forrester may have no problem
drawing a crowd.
The Area Agency system
that currently provides case
management and provides or
coordinates services such as
housing, respite care, supported
employment and training in
personal care and other activities of daily living has made no
secret that they believe that the
managed care organizations are
ill equipped to take over. Community Network Support, Inc.
(CSNI), a backup center for the
Area Agencies,
Families already struggling
with the MCOs’ poor grasp of
the difference between acute
medical care (you get sick, you
get better; you get hurt, you
heal) and the chronic and complex care needs of persons with
disabilities fear the companies
will apply the same misunderstanding to long term supports
and understandings. Families
complain that the two managed
care companies currently operating in New Hampshire—a
third company left the state
abruptly less than a year into
its contract and no replacement
has been found as yet—put
them through repeated rounds
of prior authorizations for long
established and effective medications, demand justification
for the use of critically needed
physical therapy to maintain
essential functions and chokes
off access to specialists outside
their network. Unsurprisingly,
they don’t want to see their nonmedical care turned over to the
managed care organizations.
A spokesperson for Community Support Network, Inc.
(CSNI), a backup center for
the Area Agencies, says CSNI
has no position on this issue at
this time. “We take positions
on pieces of legislation once
they are in available to the general public. Until a bill becomes
public, there is really no way to
know what it will contain,” she
said, adding, “We have never believed that commercial managed
care is the answer to long term
services in New Hampshire.”
The sort of oversight Forrester wants in place is considered an essential element by the
federal agency in charge of the
Medicaid programs. In its guide
for states implementing LTSS
programs, it says that states
“should monitor to ensure that
identified participant needs and
preferences are incorporated
into service plans, and must
provide enhanced monitoring of
any service reductions (should
there be any) during the transition to managed care.”
Similarly, a 2012 AARPfunded study stated emphatically that strong state oversight
and monitoring is one of five
key issues, but worried that
states were ill prepared to do
so given the cutbacks in funding and reduction in staffing
and hiring freezes implemented
in the past few years, noting,
“Although contracts between
states and MCOs establish standards and requirements, such
contracts are empty promises
if states are unable to monitor
and enforce plan compliance
and performance.”
Most experts believe that
the significant savings other
states have found in managed
care results from moving people
from costly state institutions
into community-based settings.
Because New Hampshire already has a community-based
system of care in place, there
are relatively few places to go
for savings that won’t cut into
the level and quality of services
currently being provided.
Forrester just may find sup-
port from newly appointed
DHHS Commissioner Jeffrey
Meyers as well if the recent
interview he gave NH Challenge editor Jack Krumm is
any indication. During the interview, Meyers told Krumm,
“I want a plan made; process
flows depicted before the next
phase of implementation. We
have a lot of work to do to reach
that point.” He made a point of
telling Krumm that the waiver
work is not yet accomplished
to implement the next phase,
and the next phase cannot move
forward unless the implementation plan is complete.
Forrester hopes to capitalize
on a newfound sense of urgency
on the part of both DHHS and
stakeholders as the implementation of managed long term supports and services inches closer
to becoming a reality. For Forrester, holding the Department’s
feet to the fire is one of the most
important things the Legislature
can do on behalf of the state’s
most vulnerable citizens.
“I want them to provide
answers to the questions before
they move forward. Better communication is needed. I need to
feel sure that they are not going
to create turmoil,” she said. “I
want to make sure when Step 2
is rolled out that they are ready
and have the ability to meet the
needs. n
Do you know someone
who could use
The Challenge?
Send name, address, phone and email to:
Mary Ellen Horan-Krumm
173 Mason Road, Milton, NH 03851
or email at: [email protected]
3
Black
ased on her advocacy for
frail elders, the nursing
homes on which many
rely for support and services,
and the developmental disability
community, NH Sen. Jeanie Forrester, R-Meredith, held serious
reservations about turning over
responsibility for their long term
supports and services (LTSS) to
private health care management
organizations like Well Sense
and NH Healthy Families when
first proposed.
Forrester wondered how
companies whose sole expertise
is in delivering acute medical
care services at a savings has
the knowledge and experience
to deliver non-medical care to
elderly people and those with
developmental disabilities or acquired brain injuries could take
on those responsibilities simply
because some believe the state
could save money by handing
them over. She said she suspects
they need the numbers to make
managed care work.
If anything, her reservations
grew deep enough to spur Forrester to introduce legislation to
put Medicaid Care Management
for LTSS on ice. Asked why she
introduced the bill, Forrester
replied, “First of all, where do
I begin?”
Forrester went on to explain
that she has received a great deal
of feedback from consumers,
their family members, advocates and providers. She heard
the unanswered questions and
deep fears and concluded “I
have concerns about the MCOs
and their ability and readiness
to implement Step 2. I haven’t
gotten any answers.”
Her unease wasn’t helped
by the fact that that DHHS had
yet to develop a plan to oversee the delivery of long term
supports and services despite
three years of meetings with
the Governor’s Commission on
Medicaid Care Management to
discuss the need for a plan and
oversight system by the state.
It is her opinion that the MCOs
4
The New Hampshire Challenge — Winter 2016
Interview with NH Commissioner of Health
and Human Services, Jeffery Meyers
A New Hampshire Challenge Exclusive
By John M. Krumm (Jack), Editor, The New Hampshire Challenge
The New Hampshire Challenge
and the vision of our founder
Janet Krumm, Commissioner
Meyers launched into two areas
I had sent him earlier in the week
as background concerns of our
Challenge readership.
The Commissioner men-
tioned how he had met just the
day before, with the Area Agencies (AAs) and Community
Services Network Incorporated
(CSNI). This in itself was a
ground shift because the former
Commissioner flatly refused to
meet or take input concerns or
offers of help from our statewide
network of AAs and CSNI. “I
realize more communication
is needed”, the Commissioner
outlined. He went on to observe
that “a dialogue” is critical if we
are going to successfully address
the issues and challenges that
lay before us. It seems to this
reporter, our new Commissioner
will end the practice of silence
and stonewalling. He seemed
intent to garner the knowledge
of the network that rose to proContinued on page 10
Classroom Behavior Management
Presents New Challenges
4
Black
O
n Friday the 19 th of
February, I had the
honor and privilege to
interview New Hampshire’s
new Commissioner of Health
and Human Services, Jeffrey
Meyers. Commissioner Meyers
received his appointment from
Governor Hassan, and was confirmed by the Executive Council
in December.
Commissioner Meyers
takes over Health and Human
Services after a critical audit
report by the Legislative Budget
Assistant (LBA) of NH. This
audit outlined an under-spend
of authorized funding in the Bureau of Developmental Services
(BDS). Our new Commissioner
knows full well the impact of
such negative findings, as he
himself was a legislator representing Milton New Hampshire
earlier in his professional career.
During his tenure representing Milton, Meyers helped his
town deal with hazardous waste
management left by a bankrupt
tannery businesses. Thousands
of hides were left to rot in the
open in Milton; he opened
communication to his town and
fixed it. The Commissioner is no
stranger to walking into a mess,
and cleaning it up.
After some introductory
remarks, and listening intently
to my explanation of the role of
By Alison Cohen, Special to The New Hampshire Challenge
Fear. Anger. Pain.
Frustration.
We all experience these
emotions. The extent to which
we act upon them and the form
our action takes depends on our
level of self-awareness, selfcontrol, maturity and our ability
to both express and get our needs
met. A sense of powerlessness
can magnify the response. If we
are fortunate, we can choose the
environment in which we work,
learn, live and recreate that best
meets our needs. No one has
fewer choices than a child, and
a child with a disability that
leaves them unable to clearly
communicate what they feel and
need—and to have those needs
respected—is the most vulnerable person in any room.
It also goes without saying
that there are people who are
simply cruel, boorish or indifferent to the needs and desires
of others.
At one time or another,
every teacher will talk about
the need for classroom management and the frustrations
they experience dealing with a
child with behavior problems
who disrupts the classroom and
negatively impacts the learning environment of his or her
peers. It’s understandable; we
would not welcome a coworker
or customer who yells, throws
things about and threatens us.
The challenge in a school setting
is to find effective ways to deal
with negative behaviors.
One of the primary roles of
parents and teachers is to help
children learn to recognize their
needs and emotions and to express them appropriately. Sometimes those in authority resort to
coercion and control to satisfy
their need for an orderly and
compliant environment. This
dynamic can result in an escalating power struggle or increased
frustration on both sides as any
parent who has experienced a
child in full blown tantrum or an
angry teenager can attest.
Too often the response to
bad behavior is to punish, isolate, exclude or overpower the
child who misbehaves or acts
out. Once upon a time, the punishment of choice for all but the
most egregious of offenses was
after-school detention. Students
so sanctioned would report to a
supervised, silent study hall or
the principal’s office to reflect
on the errors of their ways.
Unlike today’s in-school or
out-of-school suspension, no
instructional time was lost. With
the rise of the Zero Tolerance approach, more and more students
were removed from their classroom for even the most minor of
offenses. Some were subjected
to in-school suspensions, but
more and more schools resorted
to out-of-school suspensions
and expulsions.
In the 2007–2008 school
year, New Hampshire schools
suspended or expelled students
at every grade level although
most occurred at the high school
level. New Hampshire schools
had a higher rate of out-ofschool suspensions than the
national rate and almost one-half
of the suspensions reported in
elementary schools were outof-school suspensions. According to a Carsey Institute report
on school discipline done on
that year’s record, almost 60%
of the suspensions and expulsions reported were for “other”
reasons rather drug or weapon
use or another serious offense.
A not insignificant number of
students are also suspended for
truancy or skipping class, a situation Irwin Hyman, Professor of
School Psychology at Temple
University, called “patently absurd” as it requires children to
do the very thing they are being
punished for already doing.
The Carsey study found the
actual breakdown for that school
year was 31% of the suspensions
were for “verbal behavior and
violence,” 7% were related to
the possession or use of tobacco,
alcohol or drugs and a whopping 59% for the unspecified
“other” offenses. Their report
states that there is no way to
determine from the data the
nature and seriousness of these
“other” offenses, however state
law permits schools to suspend
or expel students for “gross misconduct or for neglect or refusal
to conform to the reasonable
rules of the school.” Refusal
to conform to the rules gives
school officials a great deal of
latitude and superintendents
and school boards tend to defer
to the judgement of classroom
teachers and principals.
The problem with suspension is that it is a moderate to
strong predictor that the student
will drop out of school. Students
who are suspended or expelled
often receive a grade of zero
for every day they miss and fall
hopelessly behind as a result
of loss instructional time. They
may feel that there is no way
they recover academically and
give up. A 2000 report by The
Advancement Project and The
Civil Rights Project found that
more than 30% of sophomores
who drop out had been suspended prior to the decision to
quit school. Adults who dismiss
this as a “they get what they
deserve” scenario might want to
consider the amount of mischief
unsupervised teenagers can get
into and the long term conseContinued on page 5
The New Hampshire Challenge — Winter 2016
Behavior Mgmt.
Continued from page 4
before the end of the school
day and a written report must
be sent to them within 7 days.
If the child has an IEP or 504
plan, the plan must be reviewed
at least the first time restraint or
seclusion is used, and if there are
multiple instances of restraint or
seclusion since the last review.
The rules for suspending
a child with a disability and
the circumstances under which
services must be provided are
quite specific.
Schools can suspend students with disabilities for up to
10 days under the same criteria
as a non-disabled student with
the exception that they must be
provided with homework and
sufficient time to complete assignments and take tests. In the
case of suspensions for the use
or possession of drugs, weapons
or serious bodily injury, the
child can be placed in an interim
alternative setting for up to 45
days without regard to whether
the misconduct is a manifestation of their disability. That can
be extended for an additional
45 days if it is determined that
the child is a risk to himself or
others. In these cases, the child
must be provided with the educational supports and services
required by his or her IEP.
During any suspension that
totals more than 10 days, whether consecutive or when all shortterm suspensions are added up,
the school district must provide
services. Additionally, the IEP
team must hold a manifestation
determination meeting within 10
days of the first day the child is
suspended. During that meeting,
they must determine whether the
misconduct can be attributed to
the child’s disability.
If it is decided that the
behavior is attributable to the
child’s disability, the child must
be returned to school immediately. The IEP team must also
conduct or update a functional
behavioral assessment and develop or modify a behavior
intervention plan and implement
it. Finally, the team must review
the child’s IEP and modify it if
necessary to enable the child to
participate in the general curriculum and progress toward
achievement of their IEP goals.
If the team determines that
the misconduct is not the result
of his or her disability, the child
may be subjected to the same
disciplinary sanction as any nondisabled child, including suspension or expulsion. However, even
in this situation, a student with a
disability remains entitled to an
interim alternative that provides
the services and supports needed
to make effective progress.
Given these protections,
why do things go off the rail as
often as the statistics show?
According to Barbara D.
Cohen, Ed.D., a professor for
teacher preparation programs
at several New Hampshire colleges and a consultant for several schools, sometimes teachers
simply react without thinking.
“Teachers need to know
how to react and know what
strategies will be the most effective?” Cohen explains. “Do
they remove the child? Do they
remove others? Do they do
neither and give the child a few
minutes to vent?”
Cohen trains her teacher
candidates to consider whether
the behavior or misconduct
came of the blue or is there already a behavior plan in place
that should have been implemented. She finds the majority
of public school teachers have
had no training in behavior
management techniques. While
restraint training isn’t necessary
for all teachers, all teachers and
classroom paraprofessionals
should be trained in preventive
and de-escalation techniques.
One of the basic elements of
an IEP for a child with behavior
issues is the development of a
behavior plan based on a Functional Behavior Assessment
(FBA). The purpose of an FBA
is to determine what triggers
the behaviors, what “needs”
the behavior satisfies and what
helps the child comport his or
her behaviors with expectations.
Too often, schools fail to
conduct an FBA and establish
a behavior plan until the situation reaches a crisis level and
the child is unmanageable. And,
unfortunately, there are also
teachers who refuse to follow
guidelines and plans.
“Consistency what makes
things work,” Cohen says. “It’s
not about punishment. It is about
being clear in one’s expectations
and holding students to it. Also,
one needs to have a well-structured school day with interesting
activities throughout—this is a
great preventative for problem
behaviors.”
What if you found a better
way? What if it was a school
that motivated and encouraged
all students, a school that was
welcoming and created an ideal
learning environment? What if
the school believed that a child
who is not behaving has a need
that is not being met?
That’s the theory behind the
Positive Behavior Interventions
and Supports (PBIS) movement, a multi-tiered approach
designed to create a school
environment that promotes the
“strategic systems and practices
that promote the behavioral,
social-emotional and academic
growth of all children. Tier One
focuses on creating a culture and
climate that includes students,
their families, school staff and
the wider community in a collaborative relationship of mutual
respect and support.
Tier Two identifies and develops teams of specialists and
administrators specially trained
to work with students at risk for
school failure due to academic,
social or behavioral issues. Here
the implementation of functionbased interventions and the creation of small communities of
students with shared issues who
can support each other has been
effective in reducing problem
behaviors.
Tier Three focuses on students who need a more intensive, individualized approach
to help students struggling with
significant emotional or behavior challenges to be successful
in school and in the wider community. It also helps connect the
student with sources of support
to whom they can turn.
PBIS programs have been
instituted in all 50 states and are
present in at least 19,000 schools,
according to a recent report by
the US Department of Education.
The results are heartening. According to a 2008 study, students
attending schools where PBIS is
implement “with fidelity” were
33% less likely to be referred for
discipline. In a follow-up study in
2009, it was found that “[y]outh
with a ‘high risk’ and ‘at-risk’
profile at baseline did better in
PBIS than control schools with
regard to discipline problems and
service utilization.” n
5
Black
quences on employability for
a student who does not receive
a high school diploma. Some
experts consider suspension and
expulsion the first steps in the
school-to-jail pipeline.
Students with disabilities are
far more likely to be subjected to
these measures. Statistics on both
the federal and state level bear
this out despite the protections
that students with disabilities
have under state and federal
education rules and regulations.
Nationally, students with disabilities are more than twice as likely
to receive an out-of-school suspension than their non-disabled
peers. Shockingly, that begins at
the earliest grades. Fully six percent of schools with pre-school
programs reported at least one
out-of-school suspension of a
preschooler. In a 2015 article,
Atlantic Magazine found that
one-third of all K–12 students
with an emotional disability had
been suspended at least once.
These statistics are even
more shocking when you consider that state and federal regulations contain provisions aimed
at limiting or reducing suspension and expulsion for students
when their misconduct is caused
by their disability or by the
school’s failure to provide appropriate services and supports.
Logic would lead one to believe
the incidence of suspension and
expulsion for students with disabilities should mirror that of
their non-disabled peers if those
rules were applied faithfully.
Students with disabilities
are even more likely to be subjected to the use of restraints
and/or seclusion to compel
compliance. In 2014, the Office for Civil Rights in the US
Department of Education found
that students with disabilities
represented only 15 percent of
the New Hampshire’s school
population, but 82 percent of
those who were physically
restrained. Nationally, those
statistics are 12 percent and
75 percent. In the 2009–2010
school year, there were 111,417
instances where students were
placed in a seclusion room. Of
that number, 61.7% were students with disabilities despite
being only 12 percent of the total
student population.
Writing in the Winter 2014
edition of The Rap Sheet, a semiannual electronic newsletter
covering the latest information
in disability research, advocacy,
policy, and practice, the mother
of a 12-year-old, non-verbal
student with autism wrote of
three instances when her daughter was restrained by school
personnel. Although she knows
their intention was to keep her
daughter safe, she faults them
for failing to determine why
the behavior was occurring and
to find less traumatizing ways
to deal with it. The first time,
the child repeatedly attempted
to remove her sock. No effort
was made to determine whether
there was a pebble or splinter in
the sock before restraining her
child. Increasingly frustrated in
her efforts to remove the sock,
she began to bang her head. The
last incident saw her physically
immobilized in an awkward and
uncomfortable position by two
staff members while she cried.
“We can only imagine the
level of desperation, fear and
panic she experienced,” the
mother wrote.
Sadly, then US Secretary of
Education Arne Duncan wrote,
“…there continues to be no
evidence that using restraint or
seclusion is effective in reducing the occurrence of problem
behavior.”
The good news is that New
Hampshire has some protections in place for students with
disabilities.
The use of restraint can only
be applied by trained personnel,
only when all other means have
been tried and failed and only
in emergency situations where
there is a “substantial and imminent risk of serious bodily
harm.” Dangerous forms of
restraint are expressly forbidden
and can never be used to punish
or subject the child to unnecessary ridicule, humiliation or
emotional trauma.
Similarly, seclusion cannot
be used for punishment or discipline and only as a last resort.
There are very specific rules for
the type of room that can be used
and for supervision of the child
while being secluded.
Parents must be notified
as soon as possible and always
5
6
The New Hampshire Challenge — Winter 2016
The Doctor Will See You Now
“18 million U.S. adolescents,
ages 18-21, are moving into
adulthood and will need to
transition from pediatric to
adult centered health care.” –
U.S. Census Bureau, 2013.
The Issue
6
Black
Health care transition is
the process of getting ready for
health care as an adult. When we
think of transition for youth who
have disabilities, we generally
think of high school to college
or high school to work. But
there are many other aspects to
adult life. Transitioning to the
adult medical system is a whole
different set of challenges. This
involves activities like being
able to describe health issues,
schedule doctor appointments,
ask questions, follow medical
advice, and generally participate
in self-care.
I met Dr. Carl Cooley when
he presented at a LEND seminar.
He is the Chief Medical Officer
at Crotched Mountain Foundation and a Clinical Professor of
Pediatrics at Geisel School of
Medicine at Dartmouth. He explained to us that some Doctors
are reluctant to accept young
adults with intellectual disabilities into their Adult Healthcare
Practices. The main concern being that people who experience
intellectual disabilities would
not be able to fully participate in
their own healthcare. Dr. Cooley
has written many articles on the
subject which can be found at
www.gottransition.org.
Some of you might be thinking my son or daughter won’t
ever be able to independently
manage his or her healthcare
needs. Well, you may be right.
But everyone deserves the
chance to become as independent as possible especially when
it comes to understanding one’s
own disability or special healthcare needs. Privacy is a valuable
commodity when you have to
rely on assistance from parents
or others for your personal care
needs.
Most teens would have to
practice some essential selfhelp skills in order to participate in the adult healthcare
system. The website www.disability.gov has lots of resources
and publications to help young
adults and their families with
this issue. Transition to Adult
Healthcare developed by the
Waisman Center at the University of Wisconsin-Madison is a
great example of the resources
that can be found on the website. There are worksheets that
help teens or young adults learn
what questions to ask while
making an appointment. Another worksheet has important
questions that you could ask
your doctor.
An important skill that
teens should be developing
is the ability to describe their
own disabilities and individual
needs in simple terms. This
will make it a lot easier when
they are asked questions about
their disability. It should give
a medical provider an idea of
the teens knowledge base about
their condition. Asking for help
when you need it, is also very
important. Some young people
have a really hard time doing
this because they may not really want to focus on all the
things that are hard for them
to do. When I was about 7 or 8
years old, other little kids would
ask me why my voice sounded
so funny? or why I couldn’t
walk? I would always just say
“I have Cerebral Palsy, I was
born too early, and my brain
did not get enough oxygen. So
the messages my brain sends
my body get messed up, and I
can’t walk”. I don’t know if they
understood all that, but then we
could go back to playing. My
openness put them at ease and
helped me make friends. There
are however, other practical
reasons why teens and young
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adults should be able to describe
their disabilities.
If they ever want to participate in self-directed care
and hire their own direct support professionals, it would be
important to be able to answer
questions about their disability
for potential employees. In a
college setting, the student has
the responsibility of self-disclosure in order to receive supports
he/she may need. For example,
a scribe for a written exam. The
same is true for supports needed
for employment.
Letting go, or giving your
child the gift of independence, is
not an event, it’s a process which
takes practice almost daily. It is
important to resist the tempta-
tion to speak for your child.
This is especially important the
older they get. They have to find
their own voice, even if speech
is difficult. Communication is
necessary for everyone. That
said, transitioning to the adult
healthcare system does not have
to be as scary as it may seem.
Some skills such as learning to
take care of one’s body, exercising, and eating right can be practiced beginning in childhood.
These skills are important for
everyone, regardless of whether
or not they have a disability. You
can also set up scenarios and do
some role playing to practice for
different situations e.g. introducing yourself. It is also important
to meet with the new doctors
before you are sick so that you
have some time to get comfortable with each other.
Learning these skills in order to navigate the adult healthcare system is very important,
but that is not to say that an extra
set of ears in the doctor’s office isn’t important sometimes.
Parents may need to seek out
the help and advice of other
parents in order to support each
other as their children become
more independent. All young
adults, disability or not, need
help learning how to manage
their healthcare. Transitions are
a natural part of everyone’s life.
It’s inevitable, everyone grows
up, or at least they should have
the right to. n
New Beginnings
By Robin Carlson
“P
EOPLE WITH DISABILITIES Want
Real Lives”—a slogan button my great friend
Kathy Bates gave to me from
the Disability Is Natural website
she purchased them from. As a
direct support worker this is everything I need to know. This is
how I am going to proceed with
my work in supporting people.
This is what I am going to teach
and mentor to all my colleagues
who are in this human service
world.
We have worked long and
hard at creating programs and
services for people who experience disabilities to overcome
the long history of oppression
by being institutionalized, discarded, disrespected and even
killed. We have so many laws,
rules, regulations and policies in
place to ensure people’s rights
but we have yet to achieve creating a mindset and universal
belief system that all means
all. All people need intimate,
close relationships to thrive, all
people need a purpose to get up
in the morning (employment,
volunteerism, striving for a good
education), all people need to
make important choices about
their lives, and all people need
to belong to their communities
in order to contribute to the
greater good.
Special services aren’t so
special. Special has just become
another word for being different.
And being seen as different only
offers people limited options. I
am going to be so bold as to say
that anything that has the word
special in front of it screams
out segregation and congregation. It might have intended to
mean special circumstances
of which people would need
accommodations or unique
supports to achieve an outcome
but I think we have created an
industry around “special” which
is keeping people locked in and
not liberating them to their full
potential.
I believe we all experience
support in some form or another
every day of our lives. None
of us go to the grocery store
independently to buy groceries
to feed ourselves. We depend
on the truck driver to bring the
food to the store, the workers to
stock the shelves and the farmers to produce the food. It is a
great myth that says we should
strive for independence because
we all must cooperate and collaborate with each other to get
our needs met. And I think this
is the message that people with
disabilities are helping us come
to realize.
What I have discovered by
working directly with people
with disabilities for 32 years
is that it is mostly attitudes
that determine their level of
disability. I have supported
people with the most complex
disabilities become members
of a church, regulars at a restaurant, employees of a local
business, good neighbors, voters and loving family members.
I have learned to see the people
I serve for all their gifts and
capacities and beyond all their
diagnosis’s.
Developing welcoming
communities is our new frontier in human services. We
must begin to see people with
disabilities just like any other
human being who wants to
live a vibrant life full of hopes,
dreams and make contributions
to society in meaningful ways.
Citizenship is our common
identity where we can all launch
from to create the world we all
want to belong to. n
7
The New Hampshire Challenge — Winter 2016
Opinion
Keeping the Founders’ Mission
A NH Challenge Editorial, by: Jack Krumm, Editor
I
the need to keep NH families
informed. The New Hampshire
Challenge was born. The ladies
who formed it were Janet M.
Krumm and Jamie Stephenson.
During their tenure and
period of leadership of this
newspaper, both were firm in
the conviction that our readership’s interests would never—
ever—be sacrificed for the fiscal
comfort of the Incorporation
that puts this newspaper out. We
would not care if we drew the ire
of the powerful if they attempted
to exploit our readership’s interests. We have been praised,
cursed, challenged, threatened
and trusted. The praise and the
trust came from our readers, for
which we are grateful.
Since 1987, we have called
out the good and the bad as wave
after wave of Governors, Commissioners, and House Speakers
looked to save a dime or two at
our readership and family members with DD expense. We are
particularly proud that we stood
strong in resisting Commis-
7
Janet Krumm proudly showing her son
Joseph’s costume. Janet was the founder of
The Challenge.
sioner Toumpas’s blind march to
privatize our Community Based
service system and hand it over
to insurance companies. The DD
community fought armed with
our information, and we are the
last standing as we go to print.
We published the truth as Janet
Jamie Stephenson and her daughter Sally.
Jamie was foundational to the mission of
The Challenge.
and Jamie would want, without
them. They were taken by horrible disease but other’s picked
up their march.
We were proven right to
have resisted by NH’s own
Legislative Budget Assistant
(LBA) audit. No one else in
Thank you Governor Hassan
T
his editorial page has been hard on
Governor Hassan during her tenure.
We put the interests of our readership, composed of families and family
members with disabilities above any partisan interest. We perceived the Governor
from day one of her tenure to move too
slowly in controlling the destruction threatened to our best of breed community based
service delivery system, the Area Agency
system. Our Commissioner of Health and
Human Services seemed out of control and
to want change for change’s sake.
The Governor seemed to slow down
the rush to drive our system of community-based care for people with developmental disabilities over the cliff. Because
of the LBA audit, we now realize we can
see all the competing egos and interests
that the last administration of NH DHHS
gave safe haven to during her tenure as
Governor.
Governor Hassan was dealt a very
bad set of cards at the beginning of her
administration, but at her sunset she leaves
the DD and ABD communities intact and
able to deal with a new Commissioner of
Health and Human Services who has table
manners, and who has gone on record
saying he will re-open dialogue DD and
ABD stakeholders.
The Governor also had to withstand a
few elected state house representatives and
state senators who demanded the former
Commissioner develop policy and release
services according to what they dictated.
The former Commissioner listened to them.
He thought they were his clients. Both the
DD and ABD communities were spoken
at, and told to sit back and take what was
coming. We had to rise up and defend
ourselves the best we could. The Governor
and the Commissioner now have a chance
to set it to right.
The Challenge will continue to
cover this, accountability and setting to
right must happen. After all, release of
authorized funding appears to have been
purposely throttled back to Area Agencies and ABD clients under the former
Commissioner. Funding which could
have removed both wait lists was hidden
by (in the LBA audit’s words) “ad-hoc”
imposition of confusing rules, new policies and guidelines not supported by state
or federal statute.
We sincerely thank you Governor, for
the appointment of Commissioner Jeffrey
Meyers. He is reported to us by former
colleagues in the town of Milton, and in
Concord as a good man who will at least
give us our day in court, and a chance to
explain our concerns. We are told we may
disagree with him at the end of the day,
but we can deal with him in dialogue and
mutual respect. n
this state could pull together
the behind the scenes efforts to
remove gifted leadership from
the Bureau of Developmental
Service (BDS), attempt to destroy our strong DD identity
and slowly strangle community
based services by imposing “adhoc” restrictive regulations upon
the Area Agencies. These efforts
were covered issue after issue by
The Challenge. It led to a massive underspend of Legislatively
Authorized funding during the
years 2014 and 2015 to our
people. Money, was simply cut
off and skillfully strangled out
of the system.
There is a bigger story here
and perhaps someday NH’s
mainstream press may want our
notes, articles and timeframes to
cover it more in-depth for NH’s
citizens. We will see.
What we do know is we held
true to Janet and Jamie’s original
mission. We remembered we are
not here to grow, become bigger,
stable or accepted. We are here
to cover “disability issues from a
family perspective” and we will
go down fighting doing just that.
We hope Janet and Jamie are
proud of the mission they started.
That is reward enough. n
Black
n 1986, two women who
had children with disabilities teamed up and made a
timely presentation to the NH
Department of Developmental
Services (DDS at the time).
The ladies observed that with
the recent closure of Laconia
State School, and the movement
of people with Developmental
Disabilities (DD) from state
institutions to the community,
it would be a very good thing to
have a newspaper watching out
for their interests. Times change
and our most needy citizens may
need help keeping their interests
from harm.
The vision developed that it
would not run under censorship
nor be a “voice of the state”,
but be a frugal and independent
news venue covering disability
issues from a family perspective. The proposal was put
before a very conservative Executive Council, and approved.
We remember with pride Executive Counselor Ruth Griffin and
former Governor Sununu seeing
8
The New Hampshire Challenge — Winter 2016
5 Websites You
Should Know About
L
et’s face it; we’ve become a digital world. But that’s
not a bad thing when it comes to getting information,
digital means you can find what you need—quickly.
Here’s a list of 5 websites with great information that is only
a click away.
Independent Living Centers
Want to find out more information about independent living
or assisted living options? Check these websites out.
Granite State Independent Living –
gsil.org
8
Today, as a statewide non-profit and New Hampshire’s
only Center for Independent Living, stays close to its roots
with a focus on their 5 core services of education, information, advocacy, support and transition services for seniors
and people with disabilities.
Cyan
New Hampshire Association of
Residential Care Homes – nharch.org
Magenta
Yellow
The New Hampshire Association of Residential Care
Homes (NHARCH) is a dynamic and professional association of assisted living communities within the state providing
residents with assistance in daily living and activities. The
Association and its members work closely with regulators
and facility owners/administrators to assure the quality of
life and care for residents in various members’ homes. It is
the statewide affiliate of the Assisted Living Federation of
America and represents more residential care/assisted living
providers than any other group in the state.
Black
Sports and Recreation
The Real Me as a Self Advocate
Hi, I am Sarah Cooley, and I am thirty
one years old and I have disability. I am a
Self-Advocate in Concord, NH and I am also
a Book Author.
I want to start out on a journey. What I
learn though Self Advocacy helps me to know
who I really am by letting me to be my own
person. This is important, along with my family
who has always inspired me and encouraged
me to live out my dreams.
I want to be more than a leader and more
than a public speaker I want to continue to live
out my dreams by stepping up to get to know
more about myself. I thought I was going to
be the first person in my family to conquer the
world but that’s not going to happen. I wanted
to be the one to go to college and make something of myself then I realized that dream also
disappeared on me. Now I’m afraid that that
dream might never come true.
I always told myself that I want to know
my inner self. I am more than a Book Author
and more than a writer and more than a poet I
see myself as my own person and going after
the things that I want to be and being someone
who I want to be. What I have noticed about
myself is that I want to discover something in
my life by following my heart and my family’s
footsteps into a dream that I always wanted my
whole life, to be something that I want to be
for myself not just for everyone.
There is something out there in the world
for me—could it be my dream or could it be
my first true love? I see myself as the person I
want to be and I follow that history of mine to
find out where I belong in the world. I want to
see what the future holds for me by discovering
who I really want to be and knowing myself
by following my heart to the one thing that I
love the most in the world which is the dream
of going to college. I need to be following my
dream, following my heart, and following my
career to that dream.
If something happens to my family, my
parents, my cousins or me, I need to carry on
their history by continuing to be a Book Author
and a poet. That is what I want to do for the
rest of my life. I will never give up on what I
want to do for myself—following my heart to
what I need to be for myself.
I sometimes I feel like I would like to have
a boyfriend who can see the real me to see
what it’s like to feel frightened of something
or to know that if something happened to my
family, if they were gone, that I would be left
all alone in this world. I am trying my hardest
to make my life look easy, but it is sometimes
really hard trying to be the best person that I
can be. n
How important is
The Challenge to you?
Looking for a way to get involved in sports or participate
on a team? These websites will start you on your path.
You can help us by sending in a tax-deductible donation today. Please be generous.
New England Handicapped Sports
Association – nehsa.org
Name ______________________________________________________________
NEHSA is a volunteer, non-profit organization operated
by and for individuals with disabilities. Their goal is to integrate individuals with disabilities into society through social
and recreational activities.
Northeast Passage – nepassage.org
Northeast Passage empowers individuals with disabilities
to define, pursue, and achieve their Therapeutic Recreation
and Adaptive Sports goals.
Special Olympics New Hampshire –
sonh.org
SONH provides year-round sports training and athletic
competition in a variety of Olympic-type sports for children
and adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate
courage, experience joy and participate in a sharing of gifts,
skills and friendship with their families, other Special Olympics athletes and the community. n
Street ______________________________________________________________
City________________________________________________________________
State/Zip ____________________________________________________________
Phone Number _______________________________________________________
E-mail ______________________________________________________________
I will support The Challenge with my donation:
_____ My check is enclosed.
Send your donation to:
The New Hampshire Challenge, P.O. Box 579, Dover, NH 03821-0579
Or donate online at: https://sites.google.com/site/newhampshirechallenge/
All gifts to The New Hampshire Challenge are tax-deductible to the fullest
extent of the law.
9
The New Hampshire Challenge — Winter 2016
The Loving Push:
How Parents and Professionals
Can Help Spectrum Kids Become
Successful Adults
by Deborah Moore Ph.D and Temple Grandin Ph.D.
Wendy E.N. Thomas
T
(and let’s face it, much needed) discussion on the topic
of “Compulsive Gaming and
Media Recluses” with regard to
autistic individuals The authors
do a thorough job of explaining
why this particular community
is so vulnerable to compulsive
gaming (predictability, rules,
limited social interaction.)
While gaming on a limited
basis is fine, the problem arises
when that gaming becomes
compulsive or obsessive and
it is all the individual does. By
constantly gaming you lose the
opportunity to contribute to society and miss out on valuable
chances to socially interact with
others. This is one of the few
books that confronts this relatively new danger head-on and
addresses specific steps parents
can take when combatting this
behavior.
In summary The Loving
Push is a great resource for parents and educators and provides
practical steps to take in order to
ensure those with autism can use
their gifts, gain independence,
and become valuable contributors to society. n
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Yellow
Our Support Services include:
• Respite
• Career Development
• Transition Support
• Children’s Services
• Community Connections
• Shared Living
Conscientious care
while you’re away
Making the move from
school to adulthood
17
Support to obtain
and keep a job
In-home after
school care
Finding a perfect fit
with a host family
Ask about our Participant/Family Directed Option,
available on all services
Serving New Hampshire, Maine & Rhode Island
New Hampshire Offices:
Portsmouth, NH: 603-430-5430
Windham, NH: 603-893-7286
Find us online at LivingInnovations.com
Black
Providing support to people of all ages and abilities
to have a good life at home and in the community
Social & Recreational
Opportunities
Magenta
Beside the inspiring case
studies, this book also provides
concrete steps parents can take
to correct typical negative behavior. Topics include: How
to Break Your Child’s Bad
Habits—A Necessary Step So
Your Child Keeps Moving Forward, and What to Do When
Your Child Doesn’t Seem to
Care or Is Chronically Anxious.
By breaking each of these subjects into actionable items, the
authors take something that can
be overwhelming and provide
a stap-by-step path for both the
parents and the youth to follow.
What’s also appreciated
in the Loving Push is a frank
Cyan
he Loving Push is an
important reference
for parents of autistic
young adults as well as other
youths with disabilities who
are ready to leave the house.
After years and years of advocating for your child and
protecting him from a sometimes antagonistic school and
social setting, it’s often difficult
to think about releasing him
into the real world. What can
he do? Who will stand up for
him? How will he be protected?
Oftentimes that fear of how do
I go forward leads to inertia on
everyone’s part.
It doesn’t have to be this
way say the authors. By using
sound research and plenty of
case examples Loving Push
raises important issues that parents and educators alike should
consider when planning for the
future of youths with autism.
Throughout the book there is
an emphasis on promoting independence and having the young
adult step out of his comfort
zone. In its essence the book’s
message is “you don’t know
unless you try, but you’ll never
know if you never try.” And with
some autistic kids, they’ll never
try unless they are pushed by
their parents.
This, of course, does not
mean you abandon your child.
It means that you set up independence in such a way that
there is little chance of failing
(but if failure happens, that’s
okay because it’s something
from which to learn.) Setting up
independence will mean teaching social skills, identifying
passions, and then helping the
kids to find a job in that area.
The book even has advice on
teaching sleeping habits and
eating junk food.
9
10
Funds Audit
Continued from page 1
10
Black
either provide services directly
or subcontract with other service
providers throughout the state.
Practices vary statewide and require varied coordinating layers
for successful service delivery.
BDS typically approved
individual client budgets before
AAs provided services. AAs
charged the Medicaid program
directly after providing the
services. Some families opted
to self-manage their own budgets and hire service providers
directly. Delays or conflicting
decisions in any of these tiers of
management can affect timely
service provision, leading to
unspent funds. Under Eras’s
leadership, this was kept to a
minimum.
Starting in 2014, client illnesses, vacations, individual
preferences, inclement weather,
and difficulty hiring or retaining service staff contributed to
delays or gaps in service delivery. This is because AAs client
services are billed to BDS by the
Jeffery Meyers
Continued from page 4
vide community-based service
to our citizens with Acquired
Brain Damage (ABD) and Developmental Disabilities (DD)
these past 33 years. “We may
not agree on everything, but
we will communicate and hear
each other.” For the first time
in over 8 years, I felt hope and
encouragement originating from
the office of the Commissioner
of Health and Human Services.
“We need to work closely
now,” the Commissioner stated
especially in light of the struc-
The New Hampshire Challenge — Winter 2016
AAs based on a daily charge per
client. If normal “life” circumstances occur which preclude
the clients to participate in AA
programs, the AA’s may not bill
for the time the client is not in
attendance. Sickness, or clients
not attending day service programs because they need to attend family events such as marriages, funerals or vacations will
remove days charged by AAs
per client. This will result in cut
backs to the AAs and unspent
funds in client individual budgets. Until the Ertas retirement
in 2014, the funds that were not
spent due to vacations, sickness
or snow day closures were allowed to be re-allocated within
the Area Agency with BDS approval. This was to benefit the
DD population as a whole. This
allowed the Area Agency the
ability to maximize the impact
of legislatively authorized fund-
ing on the local level to others
who may not have been served
at all.
The new restrictions imposed by the former commissioner’s staff—after BDS was
dismantled—since 2014 have
stopped this practice and resulted in cut back of services to
people already within the DD
service delivery system.
As previously reported by
The Challenge, other motiva-
tions to squeeze savings out of
the legislative budget seemed to
take hold around the year 2014
and the former commissioner’s
rush to turn over service delivery of DD and ABD clients
to insurance companies. There
are many competing agendas
that appear at that time. Among
these pressures was that insurance companies who might
How?
vacant mid-level management
positions. Again, The New
Hampshire Challenge has covered in past issues the almost
systematic dismantling of BDS
under former Commissioner
Toumpas. This removal of experienced personnel such as
Ertas and many others in BDS
had a clear and negative cause
and effect.
The Area Agencies were
also challenged by increased
tightening and restricting of
their ability to move funding to
cover shortfalls. As outlined in
the audit, the daily charge rate
for DD and ABD clients was
deducted from AAs if the client
took a vacation to visit far-away
family, was sick, or if hazardous
conditions on the road caused a
snow day to be taken for client
safety. Previously, this funding was allowed to be made
visible at the AA level, and
could be used to provide other
services to include transport of
clients to and from the service
they receive each day, physical improvements to homes to
assist people with accessibility
issues, respite, speech or other
augmentative therapy, or even
provide the resource necessary
to remove people from wait-list
status and start to provide them
services.
This funding remained hidden, and at the end of the twoyear fiscal reporting period New
Hampshire follows, became
visible as “unspent” funds.
The unspent funds appear in
an unfavorable light to families
who have members with disabilities, people with DD and
ABD. It means service was not
delivered.
Unspent funding appears at-
tractive to insurance companies
who can turn it into profit for
their corporate stockholders.
Also removed in 2014, was
the permission Ertas extended
to Area Agencies to start service
once a client reaches eligibility,
and back bill BDS to reclaim
expenses spent on these new
clients. Without this ability,
even more funding backed up
and became unspent. This again,
was cited by the audit as not
supported by statute and resulted
once again in the “inflexible”
method of moving money to
where it is needed. n
tural flaws outlined in the Legislative Budget Assistant (LBA)
audit. The Commissioner stated
that it would take all parties
involved to correct these shortcomings, and make sure that
all the legislatively authorized
funding reaches the DD and
ABD population. “This department always wanted that.” The
Commissioner realizes he needs
to look at how the money should
flow, wants the blockages quantified and measured so they may
be quickly corrected.
The Commissioner also
mentioned how he realizes reimbursement rates have not kept
pace, so high quality care can be
delivered to the people he is entrusted to serve. He mentioned
how he just studied Pediatric
Nursing rates and found he had
to raise them to assure quality
service to NH’s children. He
voiced that to keep these rates
so low, it would have the effect
of driving quality care givers
away from our children who
need them.
Concerning medical “managed care” the Commissioner
observed how “duel eligible”
clients now are mandatory to
be enrolled. In order to protect
complex situations that already
exist in this pool of clients, the
Commissioner made sure a 60day timeframe for protection
was built into the implementation plan. During this time, all
complex medical cases and
prescriptions will be looked at
to assure continuity of care.
Concerning “managed care”
and long term services to the
DD-ABD communities, the
Commissioner said, “This has
to work with the involvement
of all.” The Commissioner observed that success was not possible if he failed to listen to the
families involved, clients, AAs
and others who provide such service today. “I want a plan made,
process flows depicted before
the next phase of implementation. We have a lot of work to
do to reach that point. We have
no chance of reaching it without
input and communication from
the families.” The Commissioner observed that the waiver
work is not yet accomplished to
implement the next phase, and
the next phase can not move
forward unless the implementation plan is complete.
Once the developing plan
reaches a point the Commissioner is comfortable sharing
it, he realizes it has to go out
for public input and feedback.
“We are not there yet.” He mentioned. When the plan takes suitable shape it will be publically
shared and input/feedback will
be solicited. “The community
has to support this, it can not be
successful if families resist it.”
We had spoken for over
double the amount of time the
demanding schedule of Commissioner Meyers had allocated,
and he was being called away.
Before we ended our discussion
the Commissioner asked for ten
copies of The Challenge to be
delivered to his office from this
point on. “I realize the value of
the 4th estate,” he observed. He
let release from deep within him
a healthy laugh when I observed
that I thought The Challenge
was burnt over the last 8 years in
his office. I told Commissioner
Meyers I welcomed the change,
and would make sure he is put
on our mailing list.
The sun is shining a bit
brighter in NH again. n
Continued from page 2
Continued on page 16
11
The New Hampshire Challenge — Winter 2016
Area Agencies
Region 1 — North Country
Northern Human Services
www.northernhs.org
87 Washington Street
Conway, NH 03818
(603) 447-3347
Chief Executive Officer:
Eric M. Johnson, 447-3347
[email protected]
Family Support Council Chair:
Jennifer Pineo, 616-7170,
[email protected]
Family Support Coordinators:
Stacy Bilodeau,752-1005 or 636-2555
(Coos), [email protected]
Shannon Smith, 837-9547 (Upper Grafton),
[email protected]
Karen Nelson, 356-6921 (Carroll County),
[email protected]
Family Centered Early Supports and
Services:
Karen Willet, 447-4356,
[email protected]
Path Ways of the River Valley
www.pathwaysnh.org
Administrative Office
654 Main Street
Claremont, NH 03743
542-8706 or 448-2077
Executive Director:
Mark Mills, 504-1517,
[email protected]
Family Support Council Chair:
Dianne Milliken, 826-4361,
[email protected]
Family Support Coordinator:
Cory Shomphe, 443-4107,
[email protected]
Family Centered Early Supports and
Services:
Heather Murphy Hicks, 504-1520,
[email protected]
Respite Coordinator:
Kristin LaRocque, 504-1538,
[email protected]
Region 3 — Lakes Region
Lakes Region Community Services
www.lrcs.org
719 North Main Street
Laconia, NH 03247
(603) 524-8811
Executive Director:
Christine Santaniello, 524-8811,
[email protected]
Family Support Council Chair:
Lynn Hilbrunner,
[email protected]
Director of Individual and Family
Services:
Shannon Kelly, 581-1502,
[email protected]
Family-to-Family Coordinator:
Karen McDowell, 581-1544;
[email protected]
Benefits Technician:
Lisa Richardson, 581-1513,
[email protected]
Respite Coordinator:
Lyn Carlson, 581-1539,
[email protected]
Legislative Liaison:
Denise Colby, 657-4449;
[email protected]
Region 4 — Capitol District
Community Bridges
www.communitybridgesnh.org
70 Pembroke Road
Concord, NH 03301
(603) 225-4153
Executive Director:
Roy Gerstenberger, 225-4153 ext. 239,
[email protected]
Family Support Council Chair:
Vicki Therrien, [email protected]
Director of Family Support:
Barb Drotos, 225-4153 ext. 226,
[email protected]
Family Centered Early Supports and
Services:
Ellyn Schriber, 225-4153
Region 5 — Monadnock
Region
Monadnock Developmental Services
www.mds-nh.org
121 Railroad Street
Keene, NH 03431
(603) 352-1304
Executive Director:
Alan Greene, 352-1304, [email protected]
Family Support Council Co-Chairs:
Linda Phelps, [email protected]
Steven Nelson, [email protected]
Family Support Coordinator:
Lynn Yeiter, 352-1304, [email protected]
Benefits Technician:
Piper Reason, 352-1304,
[email protected]
Respite Coordinator:
Katie Sickles, [email protected]
Region 6 — Nashua
Gateways Community Services
www.gatewayscs.org
144 Canal St
Nashua, NH 03064
(603) 882-6333
President/CEO:
Sandra Pelletier, 882-6333,
[email protected]
Family Support Council Chair:
Mike Poulin, 402-2703,
[email protected]
Director of Family Support and In-home
Supports:
Mindy Pond, 459-2745,
[email protected]
Region 9 — Strafford
County
Family Centered Early Supports and
Services:
Nancy Lucci, 459-2773
Community Partners
www.communitypartnersnh.org
Forum Court
113 Crosby Road, Suite 1
Dover, NH 03820
(603) 516-9300
Gateways Therapy Services Intake
Admin: 459-2765
Executive Director:
Brian Collins, 516-9300,
[email protected]
Region 7 — Manchester
Family Advisory Council Chair:
Karen Salter, 692-2088,
[email protected]
[email protected]
Moore Center Services
www.moorecenter.org
195 McGregor Street, Unit 400
Manchester, NH 03102
President and CEO:
Paul Boynton, 668-5423,
[email protected]
Vice President for Individual & Family
Support:
Maureen Rose-Julian, 206-2726,
[email protected]
Early Supports and Services
Coordinator:
Paula Roberts, 206-2782,
[email protected]
Family Centered Early Supports and
Services:
Elizabeth Warner (Intake Coordinator),
206-2732,
[email protected]
Respite and Intake Coordinator:
Vicki Pepper, 206-2879,
[email protected]
Partners in Health Council Chair:
Loretta McGrail, 335-1832
Family Centered Early Supports and
Services:
Suzanne Iverson, 516-9300,
[email protected]
Director of Family Support:
Deirdre Watson, 516-9300,
[email protected]
Parent to Parent:
Julie Oakley, 516-9300,
[email protected]
Transition Coordinator:
Marcia Flinkstrom, 516-9300,
[email protected]
In Home Supports:
Kristina Elliott, 516-9300,
[email protected]
Region 10 — Atkinson/
Salem
Family Support Council Chair:
Pam McDonald, 471-0052,
[email protected]
Community Crossroads
www.communitycrossroadsnh.org
(603) 893-1299, Fax (603) 893-5401
8 Commerce Drive, Suite 801
Atkinson, NH 03811
Region 8 — Seacoast
President/CEO:
Dennis Powers, 893-1299, ext. 315
[email protected]
One Sky Community Services
www.oneskyservices.org
755 Banfield Road Suite #3
Portsmouth, NH 03801
(603) 436-6111
Executive Director:
Bob James, ext. 103
Director of Service Coordination:
Karen McLaughlin, ext. 135
Director of Family Support:
Lenore Sciuto, ext. 107
Respite Coordinator:
Riah Forbes, ext. 142
Director of One Sky Futures:
Martha Bonneau, ext. 125
Area Agency Director:
Cynthia Mahar, 893-1299,ext.341
[email protected]
Director of Community Services
(including FS and Adult services):
Kelly Judson, 893-1299, ext. 331
[email protected]
Legislative Liaison:
Jennifer Bertrand, 930-1235,
[email protected]
Respite Coordinator:
Anita Trudel, 893-1299, ext 334
[email protected]
Family Centered Early Supports and
Services:
Tammy Dudal 893-1299, ext 326
[email protected]
Intake Coordinator, Over Age Three:
Eliza Hobson, ext. 115
Benefits Coordinator:
Deanna Johnson, 893-1299, ext. 323
[email protected]
Intake Coordinator, Under Age Three:
Mallorie Patterson, ext. 147
Family Support Council Chair:
Laurie Giguere, 893-1299
11
Black
Region 2 — Lower Grafton
and Sullivan County
for Developmental Services
12
The New Hampshire Challenge — Winter 2016
Where to Find Help
Readers: If you know of resources
that are not listed here, please
email me so I can add them to
the list. To agencies: If your
information has changed,
please email the corrections
to: [email protected].
Information is Power is more than
our motto, it is our mission to
provide this to our readers.
12
Black
Ability Jobs
www.abilityjobs.com
Ability Jobs is the Leading
Website dedicated to employment
of people with disabilities. Ability
Jobs is the largest resume bank
with tens of thousands of job
seekers with disabilities, from
entry level candidates to PhD’s.
The goal of Ability Jobs and
Job Access is to enable people
with disabilities to enhance their
professional lives by providing
a dedicated system for finding
employment. By posting job
opportunities, or searching
resumes, employers can find
qualified persons with disabilities
as well as demonstrate their
affirmative action and open door
policies.
ABLE-NH- Advocates Building
Lasting Equality in New
Hampshire
www.ablenh.org
ABLE NH is a grass roots
organization dedicated to working
toward equality and advocating for
the civil rights of individuals and
families with disabilities. Local
Chapters throughout the State.
APSE
www.apse.org
Association of Persons in
Supported Employment (APSE):
Advancing Employment,
Connecting People. APSE is
the only national organization
with an exclusive focus on
integrated employment and career
advancement opportunities. See
also www.nhddc.org.
NAMI-NH—Alliance for the
Mental Illness of NH
85 North State Street
Concord, NH 03301
603-225-5359
[email protected]
www.naminh.org
Statewide organization and
affiliates offer information and
support to people with serious
mental illnesses and their parents,
children, spouses, siblings and
friends.
The Arc National Office
1825 K Street NW, Suite 1200
Washington, DC 20006
Phone: 202-534-3700 /
800-433-5255
Fax: 202-534-3731
Email: [email protected]
Facebook: facebook.com/thearcus
Twitter: twitter.com/thearcus
YouTube: youtube.com/user/
thearcoftheus
The Arc’s Public Policy Office
Phone: 202-783-2229
Fax: 202-783-8250
Medicaid Reference Desk: The
Arc of The United States now
has a new Medicaid Reference
Desk which is intended to help
individuals with Intellectual and
Developmental Disabilities (I/
DD) and their families as they
navigate the complexities of
Medicaid benefits, services and
supports.
Currently, there is no state
chapter of The Arc in New
Hampshire.
Concord Regional Arc, Inc.
228-8279
PO Box 1173
Concord, 03302-1173
The Arc of Greater Manchester
Chris Marchand, President
627-3179
arcmanchester.org
Membership $20 a year. Provides
a newsletter to members, offers
6 dances a year, participates
in Special Olympics activities
and provides information &
advocacy. Open to anyone in the
State.
Salem Arc- SARC located at the
Voter Center
893-9889
8 Centerville Drive
Salem, NH 03079
Elaine Lavin , Executive Director
Provides programs for
Developmentally Disabled
persons, conducts a public
education campaign, assists with
volunteer services, and provides
counseling and information and
referral services. Provides Classes
in cooking, computers, etc.
Autism Society of NH
P.O. Box 68
Concord, NH 03302
603-679-2424
[email protected]
www.geocities.com/SV2833
Statewide organization
provides information, advocacy
and support to individuals
with Autism and Pervasive
Developmental Disorders (PDD),
and their families.
Autism Support @ Easter Seals
Autism Clinic
555 Auburn St,
Manchester, NH 03103
603.621.3481
[email protected]
Elizabeth Webster
603.621.3444
[email protected]
Diagnostic clinic & support
groups & resources for families
with children on the Autism
spectrum.
Brain Injury Association of New
Hampshire
109 N. State Street, Suite 2
Concord, NH 03301
225-8400 or 1-800-773-8400
[email protected]
www.bianh.org
Statewide organization provides
resource information to survivors
of brain injury and their families.
Bureau of Special Medical
Services
271-4488
1-800-852-3345 x4488
Division of Public Health;
broad range of health programs
for diagnosis and treatment of
children (0-20) who have physical
disabilities, chronic illnesses or
developmental delays.
Bureau of Vocational
Rehabilitation
271-3471 or 1-800-299-1647
Fax: 271-7095
www.ed.state.nh.us
Provides individualized guidance,
counseling and placement
services to eligible consumers;
also provides family services
around needs of individual.
Child Development Center
653-6060
Assessment, diagnosis, follow-up;
information and education.
Council for Children and
Adolescents with Chronic
Health Conditions and their
Families
105 Pleasant Street
Concord, NH 03301
Denise Brewitt
225-6400
1-800-852-3345 x4991
Fax: 271-5166
[email protected]
www.ccachc.org
Crotched Mountain ATECH
Services
57 Regional Drive, Suite 7
Concord, NH 03301
603.226.2900
www.cm-atech.org
As the largest and most
comprehensive provider of
assistive technology services in
NH, Crotched Mountain ATECH
Services offers creative options
and professional expertise to
Statewide Resources
address mobility, communication
and accessibility needs.
Crotched Mountain REM
(Refurbished Equipment
Marketplace)
57 Regional Drive, Suite 7
Concord, NH 03301
603.226.2900
[email protected]
www.shopREM.com
Sale of quality refurbished
equipment at affordable prices.
Inventory on website and at our
showroom in Concord.
Crotched Mountain Ready, Set,
Connect!
57 Regional Drive, Suite 7
Concord, NH 03301
340 Granite Street, Unit 3
Manchester, NH 03102
603.226.2900
www.cmf.org/aba
Young children with autism can
improve social, communication,
daily living and motor skills
through Crotched Mountain’s
Ready, Set, Connect! — an
intensive site-based Applied
Behavior Analysis treatment
program led by Board Certified
Behavior Analysts.
Crotched Mountain Accessible
Recreation and Sports
1 Verney Drive
Greenfield, NH 03047
603.547.3311
[email protected]
www.cm-cmars.org
CMARS brings people of all
abilities together with family and
friends to enjoy sporting activities.
Certified recreational therapists
and volunteers provide needed
support, equipment modification
and expert instruction.
Department of Education
Bureau of Special Education
101 Pleasant Street
Concord, NH 03301
603-271-3494
Fax: 271-1953
www.ed.state.nh.us
Information and advocacy.
Responsible for ensuring that
school districts provide a free
and appropriate education to
all educationally handicapped
students.
NH Department of Education
Public Information Office
Lori Temple
(603) 271-6646
Email: [email protected]
“If children cannot learn the way
we teach, maybe we should teach
the way they learn.”
Department of Health &
Human Services
dhhs.state.nh.us
This website is for the entire array
of services that are provided by
State government. One program is
SMS, Special Medical Services,
the NH Title V Program for
Children with Special Health
Care Needs is just one of the
programs offered by the Bureau
of Developmental Services. SMS
offers a broad array of diagnostic,
treatment and coordination
services for children birth to 21
with chronic illness, physical
disabilities or developmental
delays. Programs are Nutrition,
Feeding and Swallowing, Care
Coordination, Child Development
evaluation and Neuromotor
Disabilities clinics and access to
Family Support and Resource
programs. Call Nurse on Call to
get more information.
Direct Connect
DDhttps://directconnect.unh.edu
A grant from the Department
of Labor to provide training
opportunities for Direct Support
Professionals to anyone who
would need someone to assist
them, especially anyone with a
disability and/or elderly.
DirectConnect will address
the growing direct care workforce
shortage in New Hampshire by
providing recruitment, training and retention opportunities
aimed at creating a sustainable
workforce.
Disability is Natural
www.disabilityisnatural.com
Kathie Snow’s email kathie@
disabilityisnatural.ccsend.com
Kathie Snow is best known for
her website and eNewsletter,
Disability is Natural. She is a
marvelous resource for parents
and professionals as well as
policy makers.
Disability Rights Center – NH
64 N Main Street, Suite 2, 3rd Flr
Concord, NH 03301-4913
603-228-0432
1-800-834-1721
Fax: 225-2077
[email protected]
Provides legal services and other
advocacy assistance to persons
with disabilities; information/
referral and publishes the Rap
Sheet @www.drcnh.org/rapsheet.
htm.
Early Education and
Intervention Network of NH
10 Ferry St. #416
Concord, NH 03301
603-228-2040
[email protected]
www.eeinnh.org
Information/referral; early
intervention and pre-school
programs for children with
Developmental Disabilities or at
risk for developmental delay.
The New Hampshire Challenge — Winter 2016
www .family-friendly-fun .com/
disabilities/coping-stress .htm
This website offers parents
information on coping strategies
and parent groups along with
interactive sections where parents
can ask questions and get the
thoughts & support of other
parents. It also has several Guides
that can be down loaded.
Enable Mart
www.enablemart.com
Assistive technology devices
can help make the lives of all
individuals easier. EnableMart is
the worldwide leader in assistive
technology distribution.
Governor’s Commission on
Disability
121 S. Fruit St., Suite 101A
Concord, NH 03301
271-2773 (Voice),
271-2774 (TTY)
1-800-852-3405 (Voice)
Fax: 271-2837
Granite State Independent
Living (GSIL)
603-228-9680 (V/TTY)
1-800-826-3700 (V/TTY)
www.gsil.org
Information and referral, peer
support and counseling, skills
training, advocacy, interpreter
and personal care attendant
services, transportation, social
and recreational programs and
accessibility services.
The Homemakers Health
Services
www.thehomemakers.org
603-335-1770
1-800-660-1770
A full service, charitable health
care agency which provides
compassionate, professional,
comprehensive and visiting
nursing service.
Institute on Disability/UCED
(Concord office)
Phone: 603-228-2084
Fax: 603-228-3270
(Durham office)
Phone: 603-862-4320
Fax: 603-862-0555
www.iod.unh.edu
Training, technical assistance
and resources with the goal of
improving the quality of life and
level of participation of people
with disabilities in schools, the
community and the workplace.
Medical Genetics
Dartmouth-Hitchcock Medical
Center
603-653-6044
Genetic testing and counseling,
information and referral.
The National Clearinghouse on
the Direct Care Workforce
www.directcareclearinghouse.org/
i_workerassoclist.jsp
The National Clearinghouse
on the Direct Care Workforce
collects, analyzes, and
disseminates information
concerning the health care
paraprofessional workforce. In
New Hampshire you can find
more information at www.nhddc.
org. See also www.nadsp.org.
NH Association for the Blind
603-224-4039
(800) 464-3075
[email protected]
www.nhbvi.com
Provides information and gives
direct services to visually impaired
people of all ages to enable them
to maintain their independence.
New Hampshire Council on
Developmental Disabilities
2.5 Beacon Street
Concord NH 03301
Phone: 603-271-3236
1-800-852-3345, x3236
www.NHCDD.org
Monitors services; promotes
policy; advocacy.
NH Family Ties
Ashlee Fye, M.Ed
NH Family Ties Statewide
Coordinator
P2PUSA Alliance Member of NH
Community Bridges
70 Pembroke Road
Concord NH 03301
(603) 226-3212 x241
1-800-499-4153 x241
[email protected]
www.nhfamilyties.org
Specializes in networking families
of children who have a special
health care need, disability or
mental health issue; support and
information
NH Family Voices, a Family to
Family Health Information and
Resource Project
271-4525
(800) 852-3345 x4525
[email protected]
www.nhfv.org
Assists families in finding
their way through the maze
of services by providing
information and emotional
support, identifying resources
available within the community,
and making available a lending
library of books, videos and
audio tapes; distributes free
newsletter, Pass It On.
Northeast Passage
UNH/Recreation
862-0070
[email protected]
www.nepassage.org
Provides (for a fee) equipment
and expertise to individuals,
schools and companies to ensure
access to educational outings and
recreational activities.
Office of Public Guardian
603-224-8041
Provides legal guardianship
services for people with
Developmental Disabilities and
mental illnesses.
Parent Information Center
54 Old Suncook Road
Concord, NH 03301
224-7005
www.nhspecialed.org
Information, support and training
around educational issues and
advocacy.
People First of NH
Janet Hunt
4 Park Street, Suite 304B
Concord, NH 03301
603-568-2128
www.peoplefirstofnh.org
www.institutionsclosethem.org
www.linkedin.com/in/janetehunt
Self-advocacy group of people
“working together to help each
other take charge ofour lives”;
help team available for new
or existing groups; 24-hour
answering service.
Seacoast Child Development
Clinic at UNH
603-862-0561 (Voice/TDD)
603-862-0034 (fax)
www.seacoastclinic.unh.edu
An interdisciplinary clinical
consultation service, assisting
families of children with
Developmental Disabilities by
using a team approach. Evaluation
may include home and/or school
visit, depending on needs of
child and family. The program
is affiliated with Dartmouth
Center for Genetics and Child
Development and the Institute on
Disability, UNH.
seriweb .com
This site offers Internet accessible
information resources of interest
to those involved in the fields
related to Special Education.
This collection exists in order to
make on-line Special Education
resources more easily and readily
available in one location. This site
will continually modify, update,
and add additional informative
links.
Service Link
1-866-634-9412
ServiceLink Resource Centers are
the places in your community to
get answers about healthcare and
other services for older adults,
persons with disabilities and
family caregivers.
Special Olympics NH
603-624-1250
1-800-639-2608
Fax: 624-4911
www.sonh.org
Provides sports opportunities
for athletes with Developmental
Disabilities.
“Talking Books”
(NH Bureau of Services to
Persons with Disabilities)
271-3429 or 1-800-491-4200
www.nh.gov/nhsl/talking_books
FREE service for people with
visual, physical, and reading
disabilities. Supplies (by mail)
cassette books and records and
equipment needed to use them.
Fiction, non-fiction and popular
magazines available.
TECH-LAB
117 Pleasant Street
Dolloff Bldg.
Concord, NH 03301
603-226-2900
[email protected]
Hands-on technology exploration;
loans of assistive technology;
training; technical support.
Tri-County CAP, Inc ./
Guardianship Services
www.gsgs.org
Whitefield Office:
34 Jefferson Road
Whitefield, NH 03598-1221
Phone: (603) 837-9561
Fax: (603) 837-2613
Concord Office:
18 Low Avenue
Concord, NH 03301-4902
Phone: (603) 224-0805
Fax: (603) 229-1758
A private, non-profit agency
providing guardianship,
protective and fiduciary services
to persons with disabilities
in New Hampshire. Provides
legal conservatorship services,
court appointed Special Needs
Trustee, Representative Payee,
Federal Fiduciary, and we provide
consulting services to family
guardians, etc. Our scope of clients
also include individuals with TBI,
PTSD, and elderly dementia.
UNH Institute on Disability
10 West Edge Drive
Suite 101
Durham, NH 03824
phone: 603.862.4320
relay: 711
fax: 603.862.0555
iod.unh.edu
Vision and Hearing Support
Services at PIC
224-7005 ext. 112
VSA arts of New Hampshire
228-4330
[email protected]
www.vsarts.org
Provides opportunities in the
arts for people with disabilities
and technical assistance for
programmatic and cultural access.
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Family Resource Connection
New Hampshire State Library
Nancy Cristiano Coordinator
Email: [email protected]
20 Park Street
Concord, NH 03301
NH 1-800-298-4321
V: (603) 271-7931
F: (603) 271-2205
Toll-Free (NH) 1-800-298-4321
www.nh.gov/nhsl/frc
[email protected]
Located in the NH State Library,
Family Resource Connection
(FRC) provides information and
resources free of charge (upon
request) to residents of NH
including families, caregivers,
educators and other professionals
seeking information, referrals
or resources on topics relating
to children of all ages. FRC
maintains a user-friendly website
with access to 1) FRC’s Online
Lending Library Collection
containing over 5,000 books,
videos, dvds, etc. Patrons can
easily request items using FRC’s
convenient Online Request Form.
Requested materials are then
delivered to the individual’s Local
Public Library via State Library
Van Service. In addition, 2) FRC
maintains a Statewide Directory
of NH specific programs and
services connecting families,
caregivers and professionals; as
well as a 3) Statewide Listing
of workshops and events for
families and professionals. the
UNH Cooperative Extension
4H Youth Development & FRC
participates in “operation: military
kids” project. The project,
Operation: Military Kids (OMK)
is designed to support “suddenly
military” youth and families of
the National Guard and Reserves.
The NH State Library and Family
Resource Connection are open to
the public on weekdays (Mon-Fri)
from 8:00 am – 4:30 pm.
www.state.nh.us/disability
email: [email protected].
The New Hampshire Governor’s
Commission on Disability (GCD)
is proud to be the New Hampshire
State Affiliate for the DBTAC
New England ADA Center. The
Center is the leader in providing
information, guidance and training
on the Americans with Disabilities
Act, tailored to meet the needs
of business, government and
individuals at local, regional and
national levels. Contact us or call
1-800-949-4232 about your rights
and responsibilities under the ADA.
The Commission’s goal is
to remove the barriers, architectural, attitudinal or programmatic,
which bar persons with disabilities from participating in the
mainstream of society.
GCD is committed to ensuring
that our web site is accessible to
everyone and provides information
about the many services, laws, and
regulations that affect citizens with
disabilities, Implementing and
operating the federally funded Client Assistant Program designed to
work out problems that may arise
between persons with disabilities
and the Division of Vocational
Rehabilitation.
13
14
The New Hampshire Challenge — Winter 2016
Additional Resources
aapd .com
American Association of
People with Disabilities is the
country’s largest cross-disability
membership organization,
organizes the disability
community to be a powerful
voice for change—politically,
economically, and socially.
www .ablenh .org
Advocates Building Lasting
Equality in New Hampshire
is a new grassroots advocacy
organization for families &
professionals concerned with
achieving inclusive natural
supports for children and
adults with disabilities in New
Hampshire.
www .access-able .com
Access-Able Travel Resource
providing access information
and resources to the mature and
travelers with disabilities.
14
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www .ada .gov
American Disability Association
provides access to Americans
with Disabilities Act regulations
for businesses and State and
local governments, and technical
assistance.
www .albinism .org
The National Organization for
Albinism and Hypopigmentation
is an organization where people
with albinism, their families and
those that work with them can get
information, ask questions and
share their experiences.
www .autismnow .org
The Autism NOW Center is the
nation’s source for resources and
information on community-based
solutions for individuals with
autism, other Developmental
Disabilities.
www .autism-society .org
asanet@autism-society .org
The Autism Society, the nation’s
leading grassroots autism
organization, exists to improve
the lives of all affected by autism.
Founded in 1965 by Dr. Bernard
Rimland, Dr. Ruth Sullivan and
many other parents of children
with autism, the Autism Society is
the leading source of trusted and
reliable information about autism.
www.benefitscheckup.org
A nonprofit initiative led by the
National Council on Aging which
features a database of roughly
1,000 federal and state programs
for the elderly and people with
disabilities.
citizens of benefits they may be
eligible for Provides information
on how to apply for assistance.
www .csni .org
Community Support Network,
Inc. is a not for profit organization
that works in support of the 10
Area Agencies throughout the
state of New Hampshire that
provide services to individuals
with Developmental Disabilities
and acquired brain injury and
their families disabilities.
www .disabilityscoop .com
The national Developmental
Disability news site covering
Autism, Cerebral Palsy, Down
syndrome, Intellectual Disability
and more.
congress .org
Information on daily happening in
Washington D.C.
www .dhhs .nh .gov/dcbcs/bds/
qualitycouncil/index .htm
The Developmental Services
Quality Council was established
to NH Department of Health and
Human Services
www .dot .gov/accessibility
The US Department of
Transportation’s site for
information about air travel for
people with disabilities
www.Benefits.Gov
The official benefits website of
the U.S. government Informs
Publications of Interest
Ability Magazine
FREE
Provides information on New Technologies,
the “Americans with Disability Act”, Travel
and Leisure, Employment Opportunities for
People with Disabilities, Human Interest
Stories, National and Local Resource
Centers and more.
www.abilitymagazine.com
Dialogue Magazine
FREE
Blindskills, Inc. is a non profit corporation,
based in Salem, Oregon, that publishes
Dialogue, a magazine written specifically
for persons who are blind or are
experiencing sight loss.
www.blindskills.com
Disabled Peoples’
International
FREE
Disability magazine supported by Disabled
Peoples’ International.
www.dpi.org
Disability Solutions
FREE
A resource for families and others interested
in Down syndrome and related disabilities.
Published six times a year. For information
on subscriptions, call 503-244-7662.
www.disabilitysolutions.org
[email protected]
Exceptional Parent
Magazine
Paid subscription, $39.95 a year
(201) 489-4111 or 1-877-372-7368
Feature articles; extensive listing of national
organizations for specific disabilities/
conditions. www.EParent.com
Headway
A quarterly newsletter provided by the Brain
Injury Association of New Hampshire,
giving out up-to-date information on brain
injury, services and programs, and survivor
stories. You may find current issues and
information on our website at BIANH.org.
New Developments
FREE
(301) 652-2263
While membership is free, we encourage
a donation. Published quarterly by
Developmental Delay Resources, resource
network integrating conventional and
holistic approaches for parents and
professionals.
[email protected]
www.devdelay.org
Parents Make the
Difference
FREE
For Parents of Children Age 3–26 A
publication of the Parent Information Center
© 2010 The Parent Information Center of
NH Parent Involvement is the “hidden in
plain sight solution.”
www.nhparentsmakethedifference.org
www .dredf .org
Disability Rights Education
and Defense Fund, founded in
1979 by people with disabilities
and parents of children with
disabilities, is a national law and
policy center
www .emerginghorizons .com
Consumer oriented magazine
about accessible travel. Available
in print and on-line.
www .eseals .org
Easter Seals NH
www .cms .hhs .gov
Information from the US. Centers
on Medicare and Medicaid
(formerly the U.S. Health Care
Financing Administration)
www .crotchetmountain .org
Crotched Mountain is a charitable
organization employing more than
900 people, whose mission is to
serve individuals with disabilities
and their families, embracing
personal choice and development,
and building communities of
mutual support. More information
& resources on the website.
www .dhhs .state .nh .us
NH Department of Health
and Human Services web site.
Information on benefits programs.
www .hhs .gov/newfreedom/
US Department of Health and
Human Services’ New Freedom
Initiative
www .nh .gov/disability
The Governor’s Commission’s
goal is to remove the barriers,
architectural or attitudinal, which
bar persons with disabilities from
participating in the mainstream of
society.
www .inclusionresearch .org
Inclusion Research Institute—a
nonprofit organization whose
activities include education,
research and dissemination of
information promoting inclusion
www .nhhelpline .org
New Hampshire Help Line
Pass It On
FREE
New Hampshire Family Voices
800-852-3345 x4525
Family to Family Health Information &
Education Center. Supporting families
having children with special healthcare
needs and disabilities. Resources and
information for families with special health
care needs; quarterly
[email protected]
www.nhfv.org
Ragged Edge
FREE
Fax: (502) 899-9562
Magazine written by and for people with
disabilities with information on issues
pertinent to the disability movement;
bi-monthly
[email protected]
www.raggededgemagazine.com
NH Rap Sheet
A collaborative newsletter of the NH
Council on Developmental Disabilities, the
Disabilities Rights Center of NH, and UNH
the Institute on Disability
www.nhddc.org/publications.html
Stepping Stones NH
FREE
www.steppingstonesnh.com
A guidebook for people with disabilities,
their families and the professionals who
support them. A specialty publication of
Parenting New Hampshire sponsored by the
NH Council on Developmental Disabilities.
www .nhspinal .org
NH Chapter of the National
Spinal Cord Injury Association
www .nod .org
National Organization on
Disability
www .nhspecialed .org
Parent Information Center (PIC),
is a statewide parent center
for families of children with
disabilities.
www .sath .org
Society for Accessible Travel &
Hospitality
www .silcnh .org
Information and Resource
Newsletter New Hampshire
Statewide Independent Living
Council (SILC) is updated
monthly with a host of resources
from A to V under resources
that can be sent by email,
just hit subscribe or send to:
NH Statewide Independent
Living Council c/o Governor’s
Commission on Disability
www .skimhs .org
Maine Handicapped Skiing—
offers year-round recreation for
people with physical disabilities
free of charge
www .socialsecurity .gov
Information on Supplemental
Security Income (SSI), disability
and related benefits
www .yourtickettowork .com
Information on the Social Security
Ticket to Work program
15
The New Hampshire Challenge — Winter 2016
NH SMS Partners in Health
NH Special Medicial Services,
Partners in Health (PIH) is a
community-based program to
address the social service needs
of children with chronic health
conditions and their families.
Partners in Health may be the
difference!
Child and Family Services
25 Main Street
Lancaster, NH 03584
Ph: 603/788-4172 and
1-800-640-6486 ext 4243
Coordinator: Joyce Bernier,
[email protected]
Eligibility Criteria for
Enrollment:
Acworth, Charlestown,
Claremont, Cornish, Croydon,
Goshen, Grantham, Langdon,
Lempster, Newport, Plainfield,
Springfield, Sunapee, Unity,
Washington, Canaan, Dorchester,
Enfield, Grafton, Hanover,
Lebanon, Lyme, New London,
Orange, Orford, Lebanon,
Canaan, Dorchester, Enfield,
Grafton, Hanover, Lebanon,
Lyme, Orange, Orford, Wentworth
• Chronic illness lasting 12
months or more with a verification form from MD, DO,
or ARNP
• Illness impacts activities of
daily living
• Family resides in New
Hampshire
• Family does not receive services from a developmental
services Area Agency
Administering Agency:
SMS Services Include:
• Health Care Coordination—
Support for managing healthcare and related services
• Neuromotor Clinic Coordination—Clinical team support
& services for neuromotor
conditions
• Child Development Clinic—
Specialty consultation in
home and community settings
• Nutrition, Feeding, &
Swallowing—Team based
developmental diagnostic
evaluations
• Psychology & Psychiatry
Services—Consultations for
children enrolled in SMS
Partners in Health:
Family Support - Recreation,
advocacy, and support to address
needs within homes, schools, and
communities
Ph:1-800-656-3333
Manager: Alicia M. L’Esperance,
aml’[email protected]
Region 1
Berlin, Carroll, Clarksville,
Colebrook, Columbia, Dalton,
Dixville, Dummer, Errol, Gorham,
Groveton, Jefferson, Lancaster,
Milan, Northumberland,
Pittsburg, Randolph, Shelburne,
Stark, Stewartstown, Stratford,
Wentworth, Whitefield
Region 3
Alexandria, Alton, Ashland,
Barnstead, Belmont, Bridgewater,
Bristol, Campton, Center Harbor,
Ellsworth, Gilford, Gilmanton,
Groton, Hebron, Holderness,
Laconia, Meredith, New
Hampton, Plymouth, Rumney,
Sanbornton, Thornton, Tilton,
Wentworth
Central New Hampshire VNA
& Hospice
780 N Main St
Laconia, NH 03246
Ph: 603/524-8444 Fax: 527-1821
Coordinator: Mary Mirkin,
[email protected]
www.centralvna.org
Region 4
Allenstown, Andover, Boscawen,
Bow, Bradford, Canterbury,
Region 5
Alstead, Antrim, Bennington,
Chesterfield, Dublin, Fitzwilliam,
Francestown, Gilsum, Greenfield,
Greenville, Hancock, Harrisville,
Hinsdale, Jaffrey, Keene,
Lyndeborough, Marlborough,
Marlow, Nelson, New Ipswich,
Peterborough, Richmond, Rindge,
Roxbury, Sharon, Stoddard,
Sullivan, Surry, Swanzey, Temple,
Troy, Walpole, Westmoreland,
Winchester
Monadnock Developmental
Services
121 Railroad Avenue
Keene, NH 03431
Ph 603/352-1304 Fax 352-1637
Coordinator: Janet O’Brien,
[email protected]
Region 6
Amherst, Brookline, Hollis,
Hudson, Litchfield, Mason,
Merrimack, Milford, Mont
Vernon, Nashua, Wilton
Gateways Community Services
144 Canal Street
Nashua, NH 03064
Ph: 603/459-2744 Fax: 889-5460
Coordinator: Lindsey Cozzens,
[email protected]
Coordinator: Pamela Thyng,
pthyng@communitypartnersnh.
org
Auburn, Bedford, Candia,
Goffstown, Hooksett,
Londonderry, Manchester, New
Boston
Region 10
VNA of Manchester and
Southern New Hampshire
1070 Holt Ave, Suite 1400
Manchester, NH 03109
Ph: 603/622-3781 Fax: 641-4074
Coordinators: Sandra Katsikas,
[email protected],
Carmen Polo,
[email protected]
Region 8
Brentwood, Deerfield, East
Kingston, Epping, Exeter,
Fremont, Greenland, Hampton,
Hampton Falls, Kensington,
Kingston, New Castle, Newfields,
Newington, Newmarket,
North Hampton, Northwood,
Nottingham, Portsmouth,
Raymond, Rye, Seabrook, South
Hampton, Stratham
Families First Health and
Support
100 Campus Dr. Suite 12
Portsmouth, NH 03801
Ph: 422-8208 Fax: 422-8219
Coordinator: Anna Shultz,
ashultz@familiesfirstseacoast.
org
www.familiesfirstseacoast.org
Region 9
Barrington, Dover, Durham,
Farmington, Lee, Madbury,
Middleton, Milton, New
Durham, Rochester, Rollinsford,
Somersworth, Strafford
Community Partners,
Behavioral Health and
Developmental Services of
Strafford County, Inc .
Forum Court, 113 Crosby Rd. #1
Dover, NH 03820
Ph: 603/516-9636 Fax: 743-3244
Atkinson, Chester, Danville,
Derry, Hampstead, Newton,
Pelham, Plaistow, Salem,
Sandown, Windham
Gateways Community Center
144 Canal Street
Nashua, NH 03064
Ph: 603/459-2763 Fax: 889-5460
Coordinator: Maura Pennisi,
[email protected]
Region 11
Albany, Bartlett, Brookfield,
Chatham, Conway, Eaton,
Effingham, Freedom, Hart’s
Location, Jackson, Madison,
Moultonboro, Ossipee, Sandwich,
Tamworth, Tuftonboro,
Wakefield, Wolfeboro
White Mountain Community
Health Center
298 White Mountain Highway
PO Box 2800
Conway, NH 03818
Ph: 603/447-4240 Fax: 447-4846
Coordinator: Leslie
Stanicki, lstanicki@
whitemountainhealth.org
Region 13
Bath, Benton, Bethlehem, Easton,
Franconia, Haverhill, Landaff,
Lincoln, Lisbon, Littleton,
Livermore, Lyman, Monroe,
Piermont, Sugar Hill, Warren,
Waterville, Woodstock
Child and Family Services
28 Lafayette Ave
Littleton, NH 03561
Ph: 603-518-4339/Fax: 444-4459
Coordinator: Stephanie Eastman,
[email protected]
NH Community Mental Health Centers
Region I
Northern NH Mental Health
and Developmental Services
Main Office: 447-3347
Berlin: 752-7404
Conway: 447-2111
Colebrook: 237-4955
Littleton: 444-5358
Wolfeboro: 569-1882
Region II
West Central Community
Mental Health Services
Main Office: 448-0126
Claremont: 542-2578, 542-5449
Region III
Genesis Behavioral Health
Main Office: 524-1100
Plymouth: 536-1128
Region IV
Riverbend Community
Mental Health Center
Main Office: 228-1600
Franklin: 934-3400
Region V
Monadnock Family Services
Main Office: 357-4400
Jaffrey: 532-4291
Keene: 357-6870
Peterborough: 924-7236
Walpole: 756-4735
Winchester: 239-4376
Region X
Center for Life Management
Main Office (Derry): 434-1577
Salem: 893-3548
Windham: 434-9937
Region VI
Greater Nashua Mental
Health Center at
Community Council
Main Office: 889-6147
Region VII
Mental Health Center of
Greater Manchester
Main Office: 668-4111
Region VIII
Seacoast Mental Health Center
Main Office: 431-6703
Exeter: 772-2710
Region IX
Community Partners
Dover: 516-9300
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NH Department of Health and
Human Services
Division of Community Based
Care Services
Bureau of Developmental
Services
Special Medical Services
129 Pleasant St – Thayer Building
Concord, NH 03301
Ph: 603/271-4488 Fax: 271-4902
www.dhhs.nh.gov/dcbcs/bds/sms
Administrator: Elizabeth Collins,
[email protected]
Child and Family Services
3 Atwood Avenue, PO Box 5223
W. Lebanon, NH 03784
Ph: 603/518-4358 Fax: 668-6260
Coordinator: Adam Dalpra,
[email protected]
Community Bridges
70 Pembroke Road
Concord, NH 03304
Ph: 603/225-4153 Fax: 225-0376
Coordinator: Janice
Boudreau, jboudreau@
communitybridgesnh.org
Region 7
co Ou
r
Pl nst re
ea a so
se ntl ur
ca r y u ce
re ea pd s a
fu d a re
lly th te
. em d.
• Birth to 21
Region 2/12
Chichester, Concord, Danbury,
Deering, Dunbarton, Epsom,
Franklin, Henniker, Hill,
Hillsboro, Hopkinton, Loudon,
Newbury, Northfield, Pembroke,
Pittsfield, Salisbury, Sutton,
Warner, Weare, Webster, Wilmot,
Windsor
Returned
-$0.90M
16
The New Hampshire Challenge — Winter 2016
ABD Money FY14
Source Data: LBA Audit
ABD Money FY15
Source Data: LBA Audit
Sent to FY15; $0.90M Returned; $0.90M
Lost Money; $2.30M
Lost Money; $3.80M
Returned; $2.80M
Authorized; $25.50M
Money Spent; $20.90M
Funds Audit
Continued from page 10
16
Cyan
Magenta
Yellow
Black
wish to bid to provide service
delivery to people with DD and
ABD needed to see profits were
possible to be made for their
stockholders.
If the State was able to
squeeze tens of millions of
dollars out of legislatively authorized budgets, insurance
companies could see and envision a way to profit. The concern
The New Hampshire Challenge
consistently reported was that
these profits could come at the
expense of services denied to
NH citizens with DD and ABD.
Better policy to increase
service was not put forward as
“the agenda” of DHHS’s former
leadership. During the push to
involve insurance companies
into DD service delivery, “better service” was never cited as
a reason to take the insurance
company approach. Creating
financial incentives to attract
insurance companies into the
new area of providing community based service delivery
to people with DD and ABD,
and resulting savings to the state
budget was the agenda. It all
revolved around promises that
insurance companies could at
once, save the state money and
provide service to people with
DD and ABD.
The audit outlined how
DHHS lacked sufficient management controls to separately
track spending on waitlist and
maintenance clients. Both the
ABD and DD programs had
separate budget lines for continuing maintenance services for
existing clients and new services
for waitlisted clients. DHHS
practice was to assign most of
the expenditures in a biennium’s
first year to maintenance appropriations and retain waitlist
appropriations, which did not
lapse within the biennia.
According to the audit, NH
DHHS cannot accurately track
ABD and DD program expenditures. This is a fertile field for an
insurance company to operate in
to maximize future profit.
The new practice of DHHS
to increase the difficulty to
flexibly move funding under
the former Commissioner effectively disconnected legislatively
appropriated funds from their
assigned purposes and the stated
intent of the legislature how the
funding was to be used. It led
to an estimated $6.8 million of
maintenance expenditures being
misreported—as unspent waitlist funds. It effectively kept the
money hidden from the BDS.
BDS was never aware these
funds were available to AAs
to potentially increase service
delivery.
The audit clearly identified inefficiencies within the
service delivery system result-
ing from newly BDS imposed
requirements on AAs. These
inefficiencies revolved around
restricting the flexibility in reallocating unspent funds. The
inefficiency directly contributed
to the non-delivery of services to
both ABD and DD clients and
resulted in the massive underspending. The audit found an
understaffed BDS lacked management controls necessary to
track and redirect unspent funds
efficiently and effectively. These
new controls restricting flexible
movement of funds kept precious NH tax resource hidden.
The New Hampshire Challenge will continue to cover
and report on this issue until
resolved. n
Important Quotes from
the LBA Audit of NH DHHS
Assembled by John M. Krumm, Editor, The New Hampshire Challenge
Concerning fiscal constraints placed on
Area Agencies:
“In addition, subsequent budgets limited the
number of clients that could be removed from
the waitlist and remain funded during the next
biennium. Budgeting for the DD program was
based on DD clients known to the BDS early in
the budgeting process. However, individuals added
to the waitlist after the start of the budget process
and any estimates for other clients who might
request services during the next biennium were
not projected and were excluded from the budget.”
Concerning inflexibility to move funds
imposed on Area Agencies:
“Other inefficiencies can be traced to statutes, rules, and guidelines, which lacked clarity
and did not provide overall timeliness requirements for service delivery.”
Concerning funding not spent as intended
for clients with ABD:
“ABD client service delivery was incompletely incorporated in statute, and rules were
unnecessarily complex. Rules left gaps in the
regulatory framework, which were bridged by
BDS ad hoc rulemaking.”
Concerning the dismantling of BDS and its
resulting fiscal failures:
“The BDS inconsistently enforced compliance with rule timeliness requirements, and the
client budget and prior service authorization
processes contained inefficiencies. The BDS did
not complete redesignation processes for AAs as
required by statute and rule, and lacked management controls over information technology
systems upon which the service delivery system
relied. The BDS was also challenged by a wide
span of control for the administrator and several
vacant mid-level management positions.”
Concerning NH DHHS and BDS losing visibility
of authorized funding:
“BDS guidelines imposed substantive requirements for waitlist and fund creation and
management, contained discretionary decisionmaking provisions without objective criteria, and
comingled maintenance and waitlist funds for
certain uses, all without clear basis in statute
or rule.”