OPINION

Chaos, Change & Collaboration
Chaos is the transition from one ordered state to another. Chaos ushers in change. As we move into the New Year, it might be helpful to remember that since conditions, nationally and locally, will probably seem quite chaotic.
Change is coming. What that change looks like depends on our involvement.

Last month we discussed NH’s State budget and the major difficulties that we face given the national economic situation and lower than projected State revenues. The Departments of Health and Human Services (DHHS) and Transportation are the two largest State Departments, and both depend on federal matching funds to operate. But DHHS has more flexibility, and therefore, is the focus for cuts.
There is a shortfall for SFY’09 and. almost nothing that can be implemented to increase funding by June 30. Spending is pretty much the only option on the table. For example, mosquito control programs and free cancer detection services are being cut. There are no easy answers and DHHS’s work and services impact every one of us.
Medicaid is complex. Covered services under Medicaid include federally required and optional ones. One of the larger “catch all” service categories is referred to as Rehabilitative Services and because it’s optional, could yield savings to DHHS. But, this category of service is widely used by our school systems to receive federal funds for services they are obligated to provide. So your school taxes could rise!
A reduction to Medicaid covered services means a shift back to the local units, county, town and city. There are 3 reasons why the cost shifts could cost the State more: Medicaid requires service providers to bill at their lowest rate; the cost is matched with 50% federal dollars rather than 100% State and; there may be newly created administrative costs as local resources must step in. As property owners or as renters, we see these costs passed on to us.
DHHS finds itself in an extremely difficult situation. Everything is interconnected--services, eligibility categories, federal dollars and the direct or indirect dependency of other programs, service delivery systems and local government needs are involved and must be considered.

ENH encourages citizen involvement and supports the development of an action network for the aging experience. Now more than ever we need to be part of the adaptive process that must go on. About 20% of our citizens depend upon Medicaid. DHHS can not be expected to create change and broad population policies with this imbalance. In fact, its agenda for promoting choice, supported by ENH, has struggled for more than a decade during good economic times.
Commission Nick Toumpas has created three groups of stakeholders to participate in this process of change. ENH was invited and is involved in his Long Term Care group. We appreciate this openness, involvement and the opportunity provided to take advantage of our collective intelligence. We will work as a partner to provide a fair and educated voice that balances both tax payer and service recipients concerns.
Change is coming. What that change looks like depends on our involvement. We encourage you to learn more, become active, contribute a constructive voice in any way that you can. Shape the system you and your grandchildren will live in.
Please see Page 3 for an overview of involved groups that may be of interest to you.

News You Can Use
Home Heating Fuel Costs UPDATE
Venezuela Reinstates Fuel Assistance Program
Energy Cooperatives
Now is the time to consider joining an energy purchasing cooperative for the 2009-2010. The article below is based on membership news from Our Town Energy Alliance.
This season (2008-'09), OTEA predicted that speculators would drive prices to unsustainable levels and that the bubble would burst. OTEA saved its members from locking into pre-buy prices approaching $5.00/gallon. After eight years of early pre-buys, and developed a "rack plus" program for members with prices as low as $1.74 a gallon the end of December.
Last season, the lowest lock-in oil price for 2007-'08 was $2.365/gallon, a saving of approximately $2.00/gallon for most oil customers. The propane prices in '07-08 saved members at least $1.00 per gallon.”
· Why Join? With 16,000 members plus, Our Town Energy Alliance is the largest Fuel group in NH, ME or MA. They work for you, not the fuel company. Their almost ten years of experience saves both time and money. No one can be right all the time but OTEA’s record has been exceptional, including this past year.
· Bargaining Power! OTEA is now large enough to do wholesale buys on energy products. The current buy is a 30% discount on On-Demand hot water heaters. Offers now closed included the Intellicon, a microprocessor guaranteed to save 10% on your furnace's fuel cost at a 68% discount plus negotiated installation price, and 30% off wood pellet stoves from St Croix, now also unavailable.
· OTEA wants more members. OTEA began with a focus on senior citizens and those people on a tight budget. Annual savings of $500 to $1000 are substantial to those on fixed incomes. If members qualify for Fuel Assistance, OTEA’s membership fee of $25 is waived.
· Please try to use the Website for renewal and email for contact. OTEA has only four phone lines and a small staff, so please try and find the answer to your questions on the Website if possible. However, we are happy to take your call and answer your questions if Website negotiation is difficult for you.
Remember - OTEA can't help you if you're late...sending in your application, activating your account (paying dues), or signing the contract with the assigned vendor. Please be proactive; 1)sign up early, 2) read all email notices 3) open mail from OTEA immediately-most notices are time sensitive. Venezuela announced an end to the program negotiated by Joe Kennedy to provide oil to American citizens in need, and then reversed itself. Citing the drop in oil prices which has impact on the country’s revenues and other issues Venezuelan leaders had determined that at least a suspension was called for. But after talks with
Mr. Kennedy, the program was reinstated.
Staying Warm Precautions
NH has experienced a significant increase in deaths related to home fires and carbon monoxide poisoning. There are several things you can do to reduce this risk:
· Test your smoke detectors regularly.
· Install carbon monoxide detectors.
· Have your chimney inspected annually.
· Make sure kerosene heaters are properly vented to the outside.
· Generators should be operated OUTDOORS not in a basement or garage.
· Do not use camp stoves or kerosene lanterns in the house.
· Be sure there are no flammable materials near a stove or space heater.
· Your local Fire Department is a wonderful resource. Many will inspect the safety of your stove or generator installation at no charge. If you have any doubts, call them.

Prepare for the Winter Ahead
The recent ice storm was a wake up call and may lead you to think about your preparedness levels! Below are some more tips to add to your experience:
· Cell phone dependency homes – know which neighbors have a land line.
· Well water households: store water in plastic or glass NOT metal. DO NOT drink water that was frozen in a plastic bottle, as chemicals may leach into the water.
· Have a non-electric can opener.
· Know how to open automatic garage doors using the manual override.
· Have radios and flashlights available with a hand crank recharger,
· Septic systems: fill your bath tub with water to use for flushing toilets.
· Turn on taps to a trickle to prevent frozen pipes. If you’re on a well, shut off power to your pump.

Who, What & Where


Opportunities for the Consumer Voice on Aging Issues:
Medicaid Advisory Committee: Required by federal law to include public review and input on policy, rules and issues impacting Medicaid. It includes long term care issues; DHHS appoints members.
SCOA State Council on Aging: composed of 18 members, 15 appointed by the Governor and 3 by the Legislature. Is advisory to the Commissioner of Health and Human Services and provides advocacy input on issues affecting seniors. Its Concord meetings are generally held the first Monday of the month and are open to the public.
For more information, contact Dr. Owen Houghton 532-6970
Area Committees on Aging: These are county-wide advocacy groups, that work on state and local issues of interest to older individuals. Call Heather Tuttle 1-800-852-3345 ext. 4384 or check either your local paper, or BEAS’s Aging News for the meeting most convenient to you.
Long Term Care Stakeholders: One of 3 committees established by the DHHS Commissioner to assist with examining and recommending changes to LTC. By invitation
Elder Rights Coalition:
Meetings are open to representatives of any organization that shares the mission of the Coalition: "Supporting responsible social policy and its enforcement guaranteeing the rights and choices of every older person in New Hampshire to a full range of quality living, support, and care options that enable all to live in dignity as respected members of society." It is a forum for elder service providers and older adults to share information.
For more information, contact Carol Stamatakis, 271-3236
Health, Human Services, Elderly Affairs: Legislative Committee that oversees bills affecting the listed areas. Local papers and the House Calendar list hearing of interest, which are open to all.
Joint Legislative Committee on Elderly Affairs: A committee of senate and house members focusing on elder issues. Meetings are listed in the House Calendar.
The Long Term Care (LTC) Commission Study Committee: created by the Legislative Committee on Elderly Affairs to refocus efforts on LTC reform by building on a bi-partisan, provider/consumer policy direction. Staffed by AARP, a final report was written, which includes draft legislation to create an ongoing Commission. Legislation is anticipated in ’09.
AARP: Plans to continue their national focus on health and financial security continue in NH. Current initiatives, in addition to the Long Term Care Commission, include a Capital City Taskforce and Long Term Care Volunteer initiative.

Board Notes
Knowing that a strong communication system is the core of an action network, we are thrilled that our newsletter mailing list continues to grow. But this growth also means that there is a lack of background to help new readers understand how we came to be or where we’re going.
We would like to take this opportunity to revisit that background and share with you some of our thinking.
About three years ago a small group of frustrated individuals were complaining that there really was no statewide mechanism to communicate with or involve seniors in policy decisions affecting them. Other groups with unique needs, such as children and those living with developmental delay or mental health issues are well organized and politically involved.
More importantly, these organizations are consumer directed. Policy decisions are highly influenced by the affected individuals and their families and/or caregivers.
We received a grant from the NH Charitable Foundation and held a summit to make a proposal: if participants were willing to work toward a vision of their choosing, we would build the necessary infrastructure to support that.
That building was begun and continues today in both direct and indirect ways.
Other States employ a variety of approaches to reform long term care and all of them face the 20/80 Medicaid/non Medicaid relationship. The more successful programs looked toward improving the system for the 80% believing that the 20% would also benefit. We agree.
Medicaid has a good foundation for the values and mission to support the kind of system that our Summit participants and readers describe. But it needs greater support.
Through our member’s active involvement with various groups,
EngAGING NH
9 Eagle Drive
Bedford, NH 03110












ADDRESS CORRECTION REQUESTED
and our work with the Legislature, ENH hopes to make this vision and these values a new reality. We strive for a more cohesive, comprehensive, and collaborative approach that supports all initiatives, projects and activities working to make NH a better state for all of us, regardless of age.
We’ve brought you articles about the advantage of inter-generational activities being of benefit to seniors (dancing with a younger partner for example). But we know that it works both ways.
Recent research on teen gangs and the angst of being a teenager is most prevalent in cultures with high access rates to TV, movies, cell phones and the Internet. In these cultures teens emulate each other rather than learn from their elders. Focusing on what we have in common and working together will benefit individuals and the whole community.
Have a comment, news item, question or information on to share? Tell us!
lcamst38@peoplepc.com