John Stephen

To the editor:Mark Hounsell's recent column on the funding relationship between the State of New Hampshire and the counties raised some questions and had some factual inaccuracies. I would like to take a moment to answer these questions and correct his errors.First, I'd like to say that I have a great deal of respect for Mark, who I got to know when he served in the state senate with my father, Bobby Stephen. While I haven't seen Mark in a few years, I had certainly appreciated his support in the past.To answer his questions, he first asks me, "As commissioner, when you turned money over from the Division of Health and Human Services to the state general fund did you do so aware of the present shortfall?"In short, DHHS turned no money for nursing homes over to the state general fund. A state law passed last year (HB 721) mandated that every dollar directed for nursing homes be given to the facilities, so there was nothing given back to taxpayers, despite a significant surplus in the account as the number of patients in nursing home beds on Medicaid dropped considerably. Every bill that was sent in during my tenure was paid in full. There was no shortfall when I left the department.Secondly, Hounsell inquires, "Why did you prepare budgets to your agency knowing that you did not include enough to cover mandated programs?"DHHS prepared a budget that adequately compensated patient care for nursing homes, based upon historical patterns. In fact, reimbursement rates for nursing facilities increased dramatically during my term as commissioner. However, the number of seniors in these facilities also dropped sharply, as we were successful in allowing many more seniors to receive care in their homes, so they were not forced into nursing homes. Considering that there was a nearly $8.6 million surplus, when I left DHHS in August of last year, available to be given to the nursing homes, it is hard to imagine why there would be any shortfall.The new nursing home rates that were set after I left the department are simply not something that I am familiar with, and as such, I would not feel it is appropriate for me to comment on the topic. However, I can state that the nursing home rates were the most debated issue in the DHHS budget by the legislature, who ultimately set the rates with the funds they put in the budget.Finally, Hounsell asks, "Given the news that local taxpayers will have to pay for your budget shortfalls for years and years to come, would you like to rescind the portion of your resignation letter to Governor Lynch, wherein you boast on returning $143 million to the general fund?"Over my four years as commissioner, there were no budget shortfalls for DHHS. In fact, the department never asked for even a nickel in new taxpayer funds during my time there. The $143 million returned to the state taxpayers comes from audited figures from the department and outside auditors, and represents about $450 for a family of four New Hampshire residents. How a surplus becomes a shortfall must involve the type of accounting that got Enron in trouble. Not only do I stand behind that figure, I would reemphasize its importance, given the current fiscal troubles in Concord.The idea that the taxpayers of Carroll County will pay any additional taxes because of what happened while I was commissioner is flatly inaccurate and shows a lack of research on the issue. Since there was an $8.6 million surplus, not a shortfall, when I left the department, one would be hard pressed to see why local taxpayers would be impacted negatively.County and nursing home funding issues are unbelievably complicated matters and worth discussing in a rational manner. It is unfortunate that some choose to take mental shortcuts to demagogue important issues that affect the lives of many poor seniors for political gain. The key, though, is taking the time to do your homework and get the facts right.I hope that in the future everyone follows that strategy.