OSSIPEE — Carroll County commissioners are seeking proposals from elder-care consultants to look at the need for assisted living in Carroll County.
Commissioners have sought a study on the need for assisted living in the county since 2017. A public forum on aging, which attracted over 100 people, was held in April 2017 at the Gibson Center for Senior Services in North Conway.
In February 2018, commissioners refused to go forward with RS Consulting from Whitefield, saying they only had a budget of $10,000, and part of that money would have to be used to leverage grants.
The study was a source of contention between the commissioners and the former delegation of state legislators.
Many of those legislators, however, lost their seats during the “blue wave” at the polls last year that swept many Republicans out of office, replacing them with Democrats. In state House Districts 1, 2 and 3, all the Republican incumbents were voted out on Nov. 6, 2018.
In addition, a new county commissioner, Terry McCarthy (R-Conway), was voted in to replace incumbent Mark Hounsell.
Fast-forward to this month. The board of commissioners agreed to post a new request for proposal on the assisted living study. It was posted on the county's website Oct. 16. Letters of interest are due back on Nov. 8.
The commissioners are asking consultants to determine whether affordable assisted living is needed, and if so:
• Where in the county such a facility should be located.
• How large the facility should be.
• What the financial implications are to the county, both short and long term.
The county's budget the study is now $25,000. It is supposed to be completed 90 days after the notice of proposal award. The consultant is expected to meet with the commissioners twice.
Commissioners discussed the request for proposal with Mountain View Community nursing home administrator Howie Chandler at their Oct. 9 meeting.
"The next step is to ask the big question: Is something needed, should we be doing it, where and what might it look like," said Chandler, adding the study might determine there's no market and no reason to do anything.
"We all assume that there is, but we all know about assumptions, so we have to test that assumption," he said.
Chandler told the Sun the RFP was advertised through the county website, as well as the New Hampshire Construction News & Information, New Hampshire Municipal Association and direct solicitation to at least six known qualified potential applicants.
One issue with having a county assisted living facility is what it would cost taxpayers would depend on the number of Medicaid recipients living there. The higher percentage of Medicaid residents, the more taxpayer subsidy it would require.
"That is clearly a determination of the commissioners," said Chandler.
Chairman Amanda Bevard (R-Wolfeboro) said she was under the impression that a 50/50 mix of Medicaid and non-Medicaid residents would break even.
Chandler said that's possible, and he's been able to make that work in the past.
"Why should the county get involved in taking care of all the wealthy?" Chandler asked rhetorically, explaining why it makes sense to have Medicaid residents in the facility.
"I'm looking at this as a county initiative to do what the private side is unwilling or unable to do."
In all of Carroll County, there are only about 15 assisted living beds for people on Medicaid.
"That's why I would make it 75/25," said Commissioner David Babson (R-Ossipee), who wants to see a greater percentage of Medicaid residents.
Bevard said they should determine the break-even point and then see what the county can afford.
McCarthy said the public should be invited to a meeting to help commissioners decide what the resident mix should be.
"That's down the road," said McCarthy.
In the event the consultant says an assisted living facility is necessary and the commissioners agree, the next step would be to talk to a developer or another consultant to look for land or a building and draw up a detailed proposal.