Power of one

VNA merger expands home health, hospice services

Visiting nurse associations Concord Regional VNA and Central New Hampshire VNA & Hospice have merged to form what is now the Granite VNA, providing certified home health care and hospice care to 82 communities throughout the greater Concord area and central New Hampshire. President and CEO Beth Slepian, formerly the president and CEO of Concord Regional VNA, discussed the merger.

Why was Granite VNA formed?

Industry-wide, [VNA] organizations have been looking at how to be sustainable for the long term. … Over the last five years, and even longer than that, home care and hospice has become challenging because of Medicare payment cuts; our fees are reduced. … We provide over $5 million in community benefits, which is unreimbursed … and we’re seeing our reimbursements declining. We’re also seeing [an increase] in patients to care for. Our biggest costs are labor wages and benefits; how will we be able to continue to both support our workforce and provide those community benefits? … Both Concord Regional VNA and Central VNA & Hospice were very strong financially; neither had to embark on this journey now, but we were looking toward the future to make sure that we could leverage scale and volume to meet the needs of the entity in the long term.

How will the merger improve health care in the state?

In the Lakes Region, Central New Hampshire VNA did not have IV-certified nurses, and that’s something we’re looking to bring to that area. We have more wound care nurses and certified lymphedema therapists in the Capital region that [were part of] Concord Regional VNA, so we’ll be able to spread them throughout our entire service area. We’re expanding the maternal child health services that we provide in the Lakes Region. [Central VNA] had a program, but it was small, so we’re staffing that to address the pediatric and maternal health needs of mothers and babies. … Finally, we’ll be able to spread our community education programs [like] Powerful Tools for Caregivers [and] Better Choices Better Health throughout the communities we serve, based on an assessment [of their needs].

Who will benefit most from these expanded health care services?

More people are receiving care in their homes now than ever before. … We have an aging population in New Hampshire, and an expanding group of people requiring care, [including] patients who have chronic illnesses like diabetes and congestive heart failure, have had joint replacements or an accident, or need IV therapy. We’ll also be able to give patients in the remoter areas of New Hampshire greater access to visiting nurses and home care and specialty care.

How is Granite VNA operating as of now?

The main office is located in Concord, with two branches in Laconia and Wolfeboro. … We now have five home care teams, two hospice teams and a hospice house. We’re currently still operating on two different electronic health records, and once we’re on one, we’ll be able to really resource all 82 towns that we serve with one workforce.

Did the pandemic impact the merger process?

It was hard, as we went through the pandemic, continuing to care for our communities while also working toward this big project … but we persevered … and methodically worked our way through the process to integration. … Discussions [about the merger] had been happening for a year prior [to the pandemic], and they were very collaborative discussions; we were working closely together to create this new entity, so [by the time the pandemic happened] we had already formed a relationship and could support each other and share knowledge and processes on how to handle the new [pandemic] rules.

How has Granite VNA taken care of its staff throughout the merger?

Mergers are not successful when not enough work is done on creating a new [workplace] culture. That’s why we created a new name, instead of keeping either [organization’s] name, and a new identity. It’s really important to us that as we go through this integration it’s a shared experience and a shared new culture for everyone. … We actually [have a] consultant who is working with both organizations to bring them together … and [help them] acknowledge what each is feeling and really understand each other.

What do you anticipate will be the biggest challenge for Granite VNA?

Workforce, workforce, workforce. [Health care organizations] are all competing for the same people [to employ]. We would hire as many nurses as we could find right now, but it’s really hard. We’re doing what we can … and we’re trying to get creative. We have a nurse graduate program so that we can train nurse graduates … and that’s a slow but steady build of our workforce.

Featured photo: Beth Slepian

News & Notes 21/06/17

Covid-19 updateAs of June 7As of June 14
Total cases statewide98,94199,143
Total current infections statewide353280
Total deaths statewide1,3571,363
New cases215 (May 31 to June 7)202 (June 8 to June 14)
Current infections: Hillsborough County9380
Current infections: Merrimack County3228
Current infections: Rockingham County5026
Information from the New Hampshire Department of Health and Human Services

Covid-19 news

New Hampshire is on the brink of 100,000 overall confirmed cases of Covid-19 since the pandemic first began, but cases continue to be on a sharp decline. During the state’s most recent public health update on June 10, state epidemiologist Dr. Benjamin Chan said New Hampshire has averaged approximately 50 new infections per day over the previous week, with the average test positivity rate 1.6 percent. “Community transmission statewide continues to decrease,” Chan said. “A majority of our counties throughout the state are either now in a minimal, or a low or a moderate level of community transmission.”

The state has also now crossed the threshold of more than half of its population being fully vaccinated — 52.3 percent as of June 14 — or just over 700,000 people. “At this point, our supply is exceeding the demand, and there’s plenty of vaccine available,” Dr. Beth Daly, Chief of the Bureau of Infectious Disease Control of the New Hampshire Department of Health & Human Services, said later during the press conference. “There are over 450 locations now across New Hampshire that [have] access to the vaccine. This includes our hospitals, pharmacies, some outpatient provider offices, community health centers, as well as those community clinics that are being run by our local health departments and the Public Health Networks.”

Also during this press conference, Gov. Chris Sununu announced that the Covid-19 state of emergency, in place for more than 15 months, would end at midnight on June 11. “The state will continue to remain at work under what we call a ‘public health incident,’” he said. “We have been for quite some time and that will stay in effect, and that’s necessary for Health and Human Services to employ staff and volunteers as needed.” Sununu originally declared a state of emergency due to the pandemic in mid-March 2020.

Budget approved

Manchester’s fiscal health and economic outlook are strong, Mayor Joyce Craig said in a statement last week, after the city’s FY2022 budget was adopted by the Manchester Board of Mayor and Aldermen by a vote of 9-4, and after the city’s final FY2021 general fund expenditure and revenue forecast was released, showing an expected operating surplus of $2,928,500. Meanwhile, according to a press release, the Assessor’s Office is projecting $73.3 million in new valuation since December 2020, as a result of new construction. “In the last year, we’ve endured challenges some of us never thought possible,” Craig said in the statement. “With this budget, we are beginning to rebuild.” The budget also includes a 1.87-percent property tax increase, pushing the tax rate from $24.66 to $25.12, the release said. That increase equates to $4.2 million, with approximately $2.2 million allocated to the city and $2 million allocated to the schools.

No super yet

On June 8, the Nashua Board of Education sent out a letter thanking everyone in the community who contributed time and input to help find the next Superintendent of Schools for the Nashua School District, and announcing that the position is still vacant. “Regrettably, the Board was unable to reach consensus on the hiring of a candidate and, therefore, will be suspending the search until a later date,” the letter said. The board will continue to work with search consultants BWP and Associates and will communicate further information in the near future.

Staying substance-free

Creating Connections NH is bringing its Alternative Peer Groups to Nashua and Manchester. According to a press release, the groups offer youth with substance use disorders opportunities to engage in fun activities while developing healthy strategies and building relationships to maintain their recovery. The groups are led by young adults with experience in recovery, who are also trained to help youth maintain recovery despite the stresses of adolescence and young adulthood. Starting this month, Revive Recovery Center in Nashua will offer Alternative Peer Group activities for middle and high school youth every Friday from 5 to 6 p.m. and a Parenting in Recovery group on Fridays from 4 to 5 p.m., while Hope for NH Recovery in Manchester will offer Saturday group activities from 10 a.m. to noon. According to the release, the Creating Connections NH Project is a collaboration between the NH Bureau of Children’s Behavioral Health and the Institute on Disability at UNH and is designed to support youth and young adults ages 12 to 25. The 2019 Youth Risk Behavior Survey showed that more than 26 percent of New Hampshire high school students smoke marijuana, 14 percent binge drink and 33 percent use electronic vaping products, the release said.

Affordable housing

On June 15, the Manchester Department of Planning and Community Development announced a Request for Proposals for $4.7 million to develop new affordable housing units in the city – a $3.7 million increase in funding for affordable housing projects that was originally allocated in the Mayor’s FY22 budget. According to a press release, these additional funds are from the federal HOME program from the U.S. Department of Housing and Urban Development. It is the most funding that Manchester has allocated to affordable housing development since the HOME program was created more than 30 years ago. The funds will help create housing for individuals/families making between 30 percent and 80 percent of the Area Median Family Income, and require that these individuals not pay more than 30 percent of their annual income on total housing costs, the release said. Proposals are encouraged to include commercial space, market-rate residential units, public green space and public art, and are due July 16, at which time the requests will be reviewed by a selection committee that will then make recommendations to the Board of Mayor and Aldermen for final approval, according to the release.

Molly Reckford, 28, who learned how to row at Phillips Exeter Academy in Exeter, will compete on the U.S. Olympics rowing team in the lightweight women’s double, according to a June 11 report from WMUR. The Dartmouth College grad will head to Tokyo for the games this summer.

The fourth annual Pride Flag Raising will be held at Manchester City Hall on Friday, June 18, at noon. According to a press release, the event will be led by members of Queen City Pride and Mayor Joyce Craig.

On June 11, the daring jumping spider was signed into law as the official state spider of New Hampshire. According to a press release, Gov. Chris Sununu signed the bill at the Hollis Primary School with third-graders from the environmental science class that championed the bill.

The Nashua Public Library is supplying kids 18 and younger with free bag lunches throughout summer vacation. According to a press release, the program started June 16, and lunches are available Monday through Friday from 11 a.m. to 2 p.m. (except Monday, July 5). Bags of nonperishable food are also available, Monday through Thursday from 10 a.m. to 7 p.m. and Fridays and Saturdays from 10 a.m. to 2 p.m. Food can be picked up by asking a staff member or using curbside pickup; no ID or registration is required.

Music is back

The Covid-19 pandemic has wreaked havoc on many industries and altered many futures forever. The industry casualties include office space, travel (especially the cruise ship industry), brick-and-mortar retail, higher education and more. These industries are going to need significant retooling to survive in the future. In the end I believe that we, as a nation, will be strengthened as a result of having gone through this. While that’s easy for me to say, try telling that to the millions who’ve lost their jobs, or, even worse, lost family members or friends.

An industry near and dear to me that was devastated over the past year was entertainment, especially live music. While some local venues like Tupelo Music Hall (Derry) came up with inventive ways to socially distance while providing live entertainment, many around the country saw their doors close and lights turned off for the better part of a year. But venues are opening up, tours are back on the road, and folks are gearing up to see their favorite acts.

Here in New Hampshire, we are blessed with some great venues. In addition to Tupelo we have the Hampton Beach Casino, the Bank of New Hampshire Pavilion (formerly Meadowbrook) in Gilford, and the Flying Monkey in Plymouth. These venues should be staples for every 603 music lover.

Tupelo Music Hall started as a smaller venue holding 200 to 300 people but sufficiently flourished to the point where they built a beautiful new 700-seat facility. If you haven’t been there, you’re missing out on a great venue to watch a show.

The Hampton Beach Casino Ballroom has been entertaining New Hampshire folks and tourists for decades. It’s a beautiful old venue that seats about 2,000. They have had so many legendary shows there. I saw Tina Turner at the Casino when “What’s Love Got to Do with It” was the No. 1 song in America.

The Bank of New Hampshire Pavilion in Gilford is a large outdoor venue that seats 9,000. On beautiful New Hampshire summer nights it’s a wonderful place to catch a show.

The Flying Monkey in Plymouth is a former 1920s theater that seats about 700. It is yet another of Alex Ray’s amazing contributions to New Hampshire, which include the Common Man restaurants, the Tilt’n Diner and the fabulous facilities he has constructed at liquor stores and truck stops around the state.

Do yourself a favor and go see some great music in New Hampshire.

Fred Bramante is a past chairman and memtber of the New Hampshire State Board of Education. He speaks and consults on education redesign to regional, state and national organizations.

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