NH doing it on the cheap has its costs

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A former National Education Association-NH lobbyist once told me “Never underestimate the New Hampshire Legislature’s proclivity to be cheap.”

After watching the workings of state government in Concord for about 30 years, it is obvious New Hampshire likes to do it on the cheap.

New Hampshire always wants a Cadillac, but only wants to pay Kia prices for the high-end vehicle.

There are many examples of this over the years.

In the 1990s, when nursing homes could not be built fast enough to keep up with the state’s aging population, then Health and Human Services Commissioner Terry Morton and his staff developed a proposal to expand services to elderly folks who wanted to stay in their homes, instead of going into a nursing home because they can no longer take care of all their needs.

To slow down the march to nursing homes, which was costing the state more and more money with the growing populations because it paid half the Medicaid program costs, the state would provide similar services at people’s homes, which is where they wanted to be anyway.

And of course, the cost of providing the nursing and other services would be cheaper than a nursing home.

It would appear to be the perfect New Hampshire plan.

However, the chair of the House Finance Committee at the time, Rep. Neal Kurk, R-Weare, and others were worried about the “woodwork effect,” people not receiving services would come out of the woodwork to partake in the new program thus driving up costs and not saving the state any money.

Consequently, the program was chronically underfunded and few people took advantage of the expanded services and they ended up in nursing homes anyway.

The program still exists and the current biennium budget upped the rates paid to service providers for the first time in a decade.

The state eventually took care of its nursing home costs by making a deal with the counties to take over a majority of the non-federal, Medicaid share in exchange for the state taking over all the costs of the Children in Need of Services or CHINS program.

Not long after that arrangement was approved, the state legislature eliminated the CHINS program in the budget as a cost savings measure.

But the outcry over ending the mission resulted in restoring a more controlled program that is in place today, while the last two budgets proposed by Gov. Chris Sununu increased the cap for what counties have to pay for Medicaid nursing home services.

Two years ago the legislature maintained the existing cap and the legislature has yet to make a decision on that this year.

Another example concerned overcrowding in the state’s prison system. A commission was created and proposed a plan to release hardened criminals who refuse to participate in rehabilitation programs and served their full sentences only to be released back into their communities.

In order to be released early, the prisoners had to agree to participate in services and programs that would help acclimate into society.

Again it was sold as a way to save money, and reduce overcrowding in the prisons where it is more expensive to house prisoners than half-way houses.

The program had wide bipartisan support and was sold as an innovative way to both take care of the hardened criminal going back to the streets with no rehabilitation and to end overcrowding.

But the “wrap-around services” were never funded or even stood up before some of the prisoners were released and a couple did some very bad things soon after they were out.

The next session several of the sponsors of the legislation were introducing bills to walk back the program which soon ended almost before it began.

And this year, the roll out of the COVID-19 vaccination program used the federal government scheduling and data collection system.

Almost all other states decided the federal program was inadequate and created their own, but not New Hampshire.

As most remember, the federal system was a bust, scheduling was nearly impossible and once you had the first shot you could not find an appointment for the second shot in the recommended time frame.

The federal system was cheaper but eventually the state had to produce their own system in order to improve operations.

Not only are specific programs underfunded chronically in the state’s budget, some of the neglect is institutionalized.

For example, the education funding system and support for higher education.

New Hampshire has been at the very low end of the scale among the 50 states in both categories resulting — in the first instance — in high property taxes for homeowners and businesses, and in the other some of the highest student debt in the country.

The lack of state funding also has a great deal to do with what lawmakers are facing as they decide Sununu’s proposal to merge the University System of New Hampshire and the Community College System of New Hampshire.

Both systems are experiencing declining enrollment and are probably overbuilt for the number of students who will graduate high school in New Hampshire for a generation.

But along with the declining number of student graduates, graduating seniors are finding cheaper higher education in Maine or Massachusetts or even private colleges with ample endowments to provide sufficient financial aid than in the state systems.

The chair of the University System of New Hampshire Board of Trustees Joseph Morone told a sub committee of House Education exploring the proposal last week, New Hampshire is the number one exporter of college students in the country. And why wouldn’t it be with the minimal support the state provides.

Traditionally state support met “the needs” for higher education which means provided enough money to make tuition affordable in the two systems.

“Funding the needs” ended with the 2012-2013 fiscal year biennial budget when state aid to the two higher education systems was cut in half.

The reduction in state aid sent tuition skyrocketing and, particularly the university system, chasing out-of-state students who pay more to maintain the revenue stream to support the institutions.

The two systems have yet to return to the level of funding they received prior to the 2012-13 budget cuts and that has compounded the enrollment problems.

So now the Legislature and higher education are in panic mode as Sununu pushes for a quick overhaul to merge the two systems. Among the chief concerns is a merger will decimate the community college system at a time when it is really needed to help retrain the workforce post pandemic.

You could make an argument the systems could have taken a more longer-term look at the best ways to address the declining enrollment and greater student need if the state had continued to fund the systems’ needs.

But that is not what happened and lawmakers find themselves in a situation that House Education member Rep. Mel Myler, D-Hopkinton, called “sobering,” and House Education Chair Rep. Rick Ladd, R-Haverhill, called “scary.”

Just as elections have consequences, so does underfunding programs like stay-at-home services or higher education.

The legislature’s proclivity for cheapness often results in much greater costs in the future and that may be the case again with higher education in New Hampshire.

This week the House Finance Committee will wrestle with the governor’s merger proposal, but is likely to want to take a little more time than the governor would like to find a solution.

Garry Rayno may be reached at garry.rayno@yahoo.com.

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