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A special meeting of the Board of Aldermen was held Monday, November 20, 2017, at 7:10 p.m. in the
City Hall Auditorium.

President Brian S. McCarthy presided; City Clerk Patricia D. Piecuch recorded.

Prayer was offered by City Clerk Patricia D. Piecuch; Alderman Tom Lopez led in the Pledge
to the Flag.

The roll call was taken with 8 members of the Board of Aldermen present; Alderman Clemons, Alderman
Cookson, Alderman Caron, Alderman Siegel, Alderman Schoneman, Alderman McGuinness, Alderman Moriarty
were recorded absent.

Corporation Counsel Steven A. Bolton was also in attendance.

Members of the Nashua Delegation in attendance: Representatives Martin Jack, Suzanne Harvey, Jan Schmidt,
Sue Newman, Patricia Klee, Mariellen MacKay, Allison Nutting and Senator Bette Lasky

COMMUNICATIONS

MOTION BY ALDERMAN WILSHIRE THAT ALL COMMUNICATIONS BE READ BY TITLE ONLY
MOTION CARRIED

From: Brian S. McCarthy, President, Board of Aldermen
Re: Special Board of Aldermen Meeting

MOTION BY ALDERMAN WILSHIRE TO ACCEPT AND PLACE ON FILE
MOTION CARRIED

DISCUSSION WITH NASHUA DISCUSSION MEMBERS

President McCarthy

This evening, the sole item on the agenda is a discussion with the Nashua Delegation. | want to keep it fairly
free-form. It might be a good idea if we just go around and everybody introduce themselves. If you’re a State
Rep or a Senator and you're involved with specific legislative things that we might be interested in, tell us about

those. If you’re an Alderman or an Alderman-Elect, talk about what things you might want to talk about and we'll
see where the discussion goes from there.

Alderman Lopez

My specific priorities of alderman are infrastructure, road repaving, sidewalk repair, public transportation, and
then we also have a continuing meeting for low income housing or fixed-income housing, particularly for the
elderly here in Nashua.

Representative Allison Nutting, Ward 7

I’m Representative Allison Nutting from Ward 7.

Representative Mariellen MacKay, Ward 7

I’m from Ward 7. | filed legislation this year to repeal 155-D, with the assistance of the Nashua building inspector
and with the BCRB (Building Code Review Board). The reason | filed it is because it’s a moot point. New
Hampshire started that legislation before we all adopted the International Energy Conservation Codes. Because
of that reason, we filed it.

[Unidentified Representative]

| sit on HHS. One piece of legislation, my Guardianship for Grandparents, the preference on that one. Because
we were first in the country to introduce it, I’m going to Nashville the beginning of December to introduce that
legislation as model legislation for the country.

Representative LeBrun, Ward 5

| have 5 pieces of legislation I’ve filed that are pertinent to Nashua. The first one is based on the state building
code. | have one on exploitation of the elderly and disabled. Another one | have is enabling the Department of
Health and Human Services to enter into a contract with an Academy Society for Addiction Medicine. Also, |
have one on food service inspections; inspections of restaurants and food service purveyors. And the last one |
have is relative to pharmacy interns and vaccinations. In the past, | have had legislation passed to enable
pharmacies to give the pneumococcal vaccine, the Zoster vaccine and such, and this is just a continuation of
that.

Alderwoman Melizzi-Golja

| represent Ward 8. In terms of priorities for this city, | chair Planning and Economic Development, and certainly
feel both sides of that are important. On the Economic Development side, |’ve begun conversations during the
summer with the National Regional Planning Commission (NRPC) about looking at the economic impact of the
arts within the region covered by NRPC. That conversation is actually going to move forward next month with
members of the arts community here in Nashua. So we’re really trying to look at what exactly does the arts bring
to our community and what can we do to better position the Nashua region within the state, as well as any
supports that may be needed. Within Economic Development also, looking at what’s happening in the city and
looking at housing and workforce housing. Looking at people who are coming in and maybe entering our
community with college degrees but entering their profession at the beginning in a lower level job, and looking at
what they can afford to pay and what we have available for them in terms of rentals or even properties to
purchase, so they’re able to both live and work in the same community and stay here and grow their families. As
we look at trying to bring young families in, affordability of housing is one of the things we need to look at.

As a past School Board member, | am always interested in what’s going on to support families, birth through
adult, and looking at funding for our schools, and how they’re being supported.

Alderman Dowd

I’m the Alderman from Ward 2. As Chair of Budget, | have two things of concern: One is looking forward to the
kindergarten funding coming down from the state, and the other is I’d like to find out from the delegates if there
are any unexpected bills that we might get in the next budget season.

Alderwoman Melizzi-Golja

Some of you were at the meeting for the Ten Year Transportation Plan, and | think you heard us discuss the
pedestrian and vehicular traffic situation in South Nashua. So looking at funds there and what we can do to
assist with the congestion around Exit 1 (Spitbrook Road/Daniel Webster Highway). As many of you know, we
have a very high concentration of citizens who live in that area, as well as businesses that are developing there.
So we have concerns about both foot traffic and getting cars in and out of the area. So looking at where the Ten
Year Plan is going, we have one item on the plan that addresses the pedestrian issues, and the other item that
we spoke to that evening, which is not on the Plan but is a concern about getting traffic in and out of the property.

Representative Marty Jack, Ward 9

I’m Marty Jack from Ward 9. | sit on Public Works and Highways. The three main areas that | work on are
infrastructure (roads, bridges and rail), and | appreciate the alderman bringing up the item on the Ten Year Plan.
We'll be getting that shortly and I'll make sure | keep my eye on that. The other is public education. In the context
of where | sit on the committee, that primarily means making sure that the community colleges get money that
they need to start up programs. The community colleges are a wonderful bang for the buck in terms of getting
people educated, keeping them in the state, and getting them jobs. And then the third is healthcare. That means

getting as many people on to health insurance as possible. Representative LeBrun didn’t mention House Bill
124, which was held over from last year. That I’m pleased to report came out of the Ways and Means committee
with a 22-1 on to passed as amended. That will be taken up on the first Wednesday in January.

President McCarthy

And that’s the reduction of aircraft registration?

Representative Jack

Yes, that’s the aircraft registration bill.

President McCarthy

Our lone success story from last term | think.

Alderman-Elect Laws

I’m considered Board of Alderman-Elect and I’m here to listen and hear what the state and the city has to say.

Representative Schmidt, Ward 1

I’m Representative Jan Schmidt from Ward 1 and my committee up in Concord is Labor. | have quite a few bills
in with my name on them, but! don’t think anything is going to impact the city itself, although | have looked
through most of the bills that have been flipped. There are some really interesting bills there that are going to
affect the city. I’d really like to work with everyone here to make sure that they don’t impact us in a bad manner.

Representative Mangipudi, Ward 8

I’m State Rep from Ward 8, Latha Mangipudi. My focus — I’m really excited to say that one of the first bills that |
ever introduced by myself passed. That was the Rotary license plate, and it’s a special kind of plate that has a
decal on it and Rotary District 7870 was the first one to get the decal approved. So it’s in law and it’s a special
plate. The state gets all the funding; the extra $15.00 that people have to pay to get that special license plate.
And they put the decal on it so it’s a specialty plate. So I’m happy about that. And my other focus has been local,
in terms of culture and art exchange. Last year, after the Sister City initiative passed, there were five people that
went from Nashua to Mysore, and there was a team that came from India on integrative medicine and yoga, and
the Indian government has shown a great deal of interest in starting a Center for Excellence here in Nashua,
which means the partnership — and I’m trying to figure out who is going to put the first dollar down. So I’m not
going anywhere. I’m going to stay here and work hard to make that happen. Especially the focus is on Heal the
Hurt for the pain management and substance use disorder population, to build resiliency and sustainable cost-
effective alternatives in building the mental health resiliency. Other same area is increasing your mental health
and well-being and resiliency in schools. I’ve been talking with Superintendents and also, again, Mysore Yoga
Center and NIMHNS (Nashua Institute of Mental Health and Neurosciences) are very interested in having a
collaborative work. This is in the works. So a lot of work, a lot of phone calls, a lot of driving around.

Alderman Wilshire

| chair the Human Affairs committee. | think my focus over the last 18 years on the board has been to work to
help the nonprofits in the city provide services to those at risk in our community. | also am the liaison to the
Police department. | like to make sure that our streets are safe and that we continue to support the needs of our
public service members — police, fire, especially with the opioid epidemic out there. Our community has really
stepped up and done some really great things.

President McCarthy

Brian McCarthy, the President of the board. | think a lot of my focus, at least, with respect to discussions with the
State, has been on the general financial well-being in the city and things like the retirement system, as well as

issues around economic development, such as the aircraft registration fee change, which | think is very beneficial
to Nashua in particular. Beyond that, | spend a lot of time on planning issues and budget, etc.

Representative Lasky, Wards 3,4,6,7,8,9

I’m Betty Lasky and | am Vice Chair of the Judiciary committee and serve on the Commerce committee. | will be
prime sponsor — our bills from the Senate we’ve not yet had to sign off on them, so they are still in somewhat of
flux. But! will be doing a couple of election law bills; our city clerk will be happy to hear that. One is about not
sharing information, such as the fiasco we had with our Secretary of State this summer. The other would be
closing a loophole for campaign finance, from spending general election funds in a primary, which was done by
soon-to-be former Mayor of Manchester. | believe I’m prime on another one and | will be doing many co-
sponsoring. | know one we hope to have the repeal of the death penalty back again. There will be quite a few
other bills coming through Judiciary which I'll work on. Certainly, if there is anything that the board needs to put in
— oftentimes, it’s easier to get a late bill in through the Senate than it is through the House, so happy to do that.

Representative Harvey, Ward 2

Suzanne Harvey, State Rep from Ward 2. I’m on the Science, Technology and Energy committee which is
particularly wonky about the electric grid, sources of electricity, all the utilities, the Public Utility Commission,
energy efficiency, renewable resources for energy. These are the kinds of bills that we deal with, and I’ve been
on that for several terms. Energy efficiency is high on the list of priorities for me and a lot of my colleagues
because it’s the cheapest form of energy; it’s the energy that you actually don’t use. So the goal of most people
interested in this is to have an electric grid that’s reliable, and hopefully is based on clean energy sources.

The other thing | want to mention is I’ve been involved for many years on the issue of human trafficking. I’m on
the state-wide, collaborative task force on human trafficking. It’s not the task force that’s doing it but actually
Harbor Homes and the school system are putting on, on December 6" at Harbor Homes on High Street at
5:30pm, a forum on youth homelessness. And my particular interest is that homeless youths are so much at risk
for human trafficking. They’re the first, easy prey for a trafficker. So | urge you to show up if you're free that night
and learn what you can, because this is a very important subject. We do have several hundred homeless kids in
Nashua and we want to keep them safe.

Representative Newman, Ward 2

Sue Newman, and |’m in my first term as a state rep from Ward 2. | am on Public Works & Highways with Marty
Jack, and | would echo his comments that there was a lot of infrastructure — roads, bridges, and quite a bit of
presentations about the bus systems that are in the state. | particularly was interested in rail. Any comment about
rail did not get very far in our committee this session; things might change, | don’t know. As an old school board
member, | remain exceptionally interested in public schools and how they are funded, ideally to be adequately
funded.

Representative Klee, Ward 3

I’m Patricia Klee, the Ward 3 state rep and Ward 3 Alderman-Elect. I’m on the State, Federal and Veteran’s
committee, and we deal with almost nothing with veterans. We deal mostly with constitutional law -- changing our
Constitution, trying to secede from the United States. Different things like that. | was a little disappointed that we
don’t deal with as many veterans’ issues as we thought. Latha is on that committee so she understands what I’m
talking about. It can be very frustrating, we should be doing more for our veterans and we’re not. That was my
hope, after working 26 years with the Veteran’s Administration, I’d hoped that some of my experience would help
there and it really didn’t. We are hoping to create a Veteran’s Administration within the VA, but even that, | don’t
think, is going to be what they were hoping it would be.

As an Alderman-Elect for Ward 3 and for Nashua, | guess the things I’m interested in are the infrastructure, trying
to do affordable housing, what we can do, much of which you were talking about. The affordable schools and
school funding is also something extraordinarily important to me. | want to see more public school dollars, and
that doesn’t necessarily mean that’s something | can do as an Alderman, but I’m hoping that, as this is my first
year, I’m hoping to have a second year and maybe we can work on some kind of more alternate funding, less for
the private schools and more for the public schools. I’ve been working with NAMI now since late spring and

trying to come up with ideas, plans, funding, grants, etc., to reduce the amount of warehousing of mental health
patients in our ER’s. The last time | got a figure, | think it was 57 throughout the state, and that’s 57 patients that
are living in our ER’s throughout the state. Concord has the most of them and they create these things called
“Yellow Pods” where they keep the patients in. It’s literally a small ER room for mental health patients, and they
can live up to a year or two. The average length of stay, | think, was 37 days, which is a long time, and that’s
because there’s no space at the state hospital.

There’s only one bill that my name is on and I’m a co-sponsor of that, and that’s HB-1236. That is, again, dealing
with mental health. Right now, the way the statute is written is the Superior Court or Circuit Court can just say,
with the stroke of a pen, mental health court is done, without taking into consideration anything with the presiding
Judge or anything like that. So what we’re trying to do is put a committee together that would say that the
presiding judge, the mental health court manager, law enforcement, the prosecution and the defense
representatives would need to have a committee, and they would have to say that it wasn’t necessary.

Alderman Tencza

My name is Dave Tencza, I’m the Alderman-at-Large in Nashua. My concerns and areas of focus would be
making sure that the city is implementing all the best practices as they relate to their response to the heroin
crisis, that we are working together and making sure that people are able to get the services that they need
locally here. I’m also interested, as Alderwoman Melizzi-Golja talked about, in housing issues, particularly as it
relates to working families, families who are trying to decide if they want to stay here or not.

Alderman O’Brien

Good evening. I’m Alderman-at-Large Michael O’Brien. | work for the city on the Budget, Finance and
Substandard Housing Commission, and also was just recently appointed to the newly-formed Rail Committee
and am very excited about that. As far as the State, I’ve been up at the House for about 10 years. I’ve been on
the same committee, the Transportation committee, and served twice as its Vice-Chair. | didn’t write any bills
this year; the other 399 of you are doing okay with it. What | choose to do, as far as my committee, | watch what
comes through and pick and choose which ones have the merit that need to come through. One of the ones
was no texting while driving; that took two terms to work on it and | think it’s one of the best laws we ever
passed in the state. | can’t tell you how many kids or people we have saved in that endeavor.

The other thing is on the transportation. We come to talk a lot about the commuter rail service. Unfortunately,
this year, we received a bill that came through that was to eliminate the Rail Authority in its entirety. Well, |
think, Mr. President, the other great save from the delegation was to keep that Rail Authority for the state in
place. It’s going to go before the House and everything else; it’s too bad that it came up in a form to get rid of it.
And | think that’s going to go hand-in-hand with the new city objective, with what we’re entering into with the
new group at the Providence Surface Rail Commission. We're going to need the DOT and everything else. I’m
very proud of our delegation in Nashua; we seem to be, no pun intended, all on board for commuter rail in the
state House and working with it. | do believe that’s going to be one of the key economic things that if we can
punch a hole through 128 and get commuter rail from Boston, get it up here to Nashua — it goes both ways —
we’re going to open up the door to an economic vibrancy in the city that we have never seen since probably the
1800's. | think this is something that really needs to be done in the future.

Alderman-Elect Jette

My name is Ernie Jette and I’m the Alderman-Elect from Ward 5. I’m new to the board so I’ve got a lot to learn;
| Know that. But while I’m here, I’m a little disappointed that there aren’t more representatives here this evening.
| see Alderman LeBrun is here, who is also a state rep from our Ward, and | appreciate him being here. | wish
there were more reps here, because when | was running for office, a couple of the themes that people kept
talking to me about was, number one, the schools and what they feel is a lack of support for our schools in the
city, and also taxes, and the two kind of work hand-in-hand. People legitimately don’t want their taxes to go up,
but people tell me that the reasons the city is under such pressure for taxes is because the State legislature
keeps pushing financial responsibility down to the local cities and towns. | would hope that our representatives
in the State legislature would be watch dogs for us and would resist this trend that has been going on for a
number of years of pushing responsibility for education, responsibility for roads, infrastructure down to the cities,
and the retirement fund. Pushing more and more fiscal responsibility to the city, which is putting the city in a

very difficult position to avoid raising the taxes. People see their taxes going up and they blame it on the city,
but | think a big part of the problem is the federal government is giving us less money and the state is giving us
less money. So you representatives, | hope that you will protect us as much as you can; | know you’re only a
small number of the 400 up there, but | hope that you watch out for us.

City Clerk Piecuch

I’m Patricia Piecuch, I’m the City Clerk.

Attorney Bolton
I’m Steve Bolton; I’m the city corporation counsel. Among other things, myself and the other two lawyers in the

office provide support, guidance and counsel to the Board of Aldermen, largely in the form of preparing
legislation and giving advice and opinions on law at all levels.

Representative Mangipudi
This question is to the legal counsel. In terms of the MOU that was signed for the Sister City initiative, it was a
very broad thing, is there a specific way at the government level or city to city in exchange of funds or programs

establishing? | seem to be going in circles in terms of finding a landing spot. If you could shed a little bit of light,
it would help.

Attorney Bolton

Are you talking about this initiative for the rail?

Representative Mangipudi

No, the Sister City initiative between MYSOR and Nashua. | think there was technology, ideas, programs,

exchange of those very broadly-specified that, and | think with the cultural exchange and art exchange kind of
things, there’s an opportunity to do it. If it’s financially — cities are coming into play.

Attorney Bolton

| am unaware of what might be going on in that regard. This question might better be addressed by, and
unfortunately, they’re not here tonight, but the Mayor or the Economic Development Director, Tim Cummings. |
have not been contacted concerning any further legal issues surrounding the program.

Representative Mangipudi

Not legal issues. How does the addendum to the MOU — would that be a full board vote or is it just adding the
addendum to the MOU?

Attorney Bolton
Well, it would certainly be possible if it was a desire to enter into further programs, exchanges or something to

modify the MOU by adding addenda to it or alter provisions that presently exist. |’ve not been contacted in that
regard at all, however.

President McCarthy

Actually, the issue that you’re bringing up is not about the interaction with the legislature particularly. | would
advise you to take it up with the Mayor.

Alderman LeBrun

| want to go back to HB-124, the Aircraft bill, and explain it for those who are not familiar with it. The reason |
filed the bill is because New Hampshire finds itself in a unique position. All the surrounding states have either
eliminated or drastically reduced their registration fees. In New Hampshire, a corporate aircraft can cost
$300,000 to register; in Massachusetts, you can do it for $300.00. Massachusetts has also done away with
their sales tax on aircraft and aircraft parts. That was the reason | originally filed the bill. What we did, as we
were going along we modified it and changed some of the registrations on private aircraft as well. There is a
10-year plan similar to the automobile registration, that it decreases over a period until you get to 10 years and
you pay nothing. But the corporations -- in fact, in Portsmouth, Green Mountain Coffee was at the negotiating
table when they got a phone call and said “Knock off negotiations with New Hampshire, we’re going to
Massachusetts.” The green building down on 128 or 28 is what Green Mountain Coffee built. There are
probably 10,000 jobs that they took down there with them. That was the reason for filing the bill. We have to
come in line with what the states around us are doing. We're surrounded by states that have either eliminated
or drastically reduced their registration fees.

President McCarthy

Just to follow-up on that, there was a lot of discussion when that bill took place of what are we going to do with
the revenue we lose, because we won't be getting the $300,000, to which the response was “we're not getting it
now.” | talked with people who deal in airplanes and they would say their customers would come and say, “|
want you get me one of these and | want it to be 10 years and 1 day old when | take possession of it so that |
get out of the registration fee.” We currently have a fairly large number of very expensive jets operating out of
Nashua, to our great economic benefit. The jets now — it used to be we had a lot of worries about noise, but
with the Stage 3 noise regulations, the jets that are here are very quiet. There were at one point 21 of them on
the airport, which | hardly ever see them out. They’re either in the hanger or they’re flying. But that has brought
a number of companies to Nashua that were beneficial. There’s a company that’s developing new infrared
cameras so that planes can basically land in zero visibility. We're getting some really good economic benefits
out of those planes being there.

Alderwoman Melizzi-Golja

Just to add on to that, that bill is so important, and | think most of us just think that the airport is there and it’s the
airport and none of us fully appreciate the economic impact the airport has, in terms of companies who are here
as well as just the jobs that are there and the services that are being provided to the planes that are flying in
and out. Increasing traffic at the airport is certainly something that’s important for our community.

Alderman LeBrun

Just to add to what’s been said about this bill, we have found a way to make it revenue neutral. Putting in this
$1.2 million we were going to lose if the bill went through in its original form, and we found a way by amending
the bill and re-amending it as the process went along, to make it revenue neutral. So the state is not going to
lose anything.

Alderman Lopez

Not to completely pivot, some other comments were made following mine regarding the vulnerability of children
to human trafficking when they’re homeless and the need to have affordable housing. | was just reminded of an
effort that Alderman and Representative O’Brien was working on towards the beginning of last year, where it
came to light through discussions at the Substandard Living Conditions committee that it’s a fairly regular
practice for a landlord who is filing an eviction of a tenant to file it in a city other than where they are necessarily
able to appear in court to defend themselves. This is a protection against inappropriate eviction. If anything, it
doesn’t seem very just to me that somebody who is in the process of being evicted and may not have
transportation to a different city has to go there to just defend themselves. | know this was an effort that did not
succeed in the State House, but | would love for it to be re-evaluated or looked at and followed up on. | think if
somebody is going to face eviction or be told to leave their home, the least we can do is make sure they can get
to the court.

Alderman LeBrun
| have a bill in on that this year, Alderman Lopez. |’ll pass that on to you and let you take a look at it.
Alderman O’Brien

To Alderman Lopez, unfortunately, it ran into a wall there where some people up there come from many walks of
life, and some people who said, particularly in the Senate, were former landlords themselves. Did | think it really
got a fair shake? | don’t know. | have my opinion on that particular matter. But | think the climate up there right
now is not conducive to a bill like that, and I’m hoping maybe in the next biennium things might be a little bit more
for a bill such as that. Because you're correct in bringing it up, just because the bill failed, the need did not go
away. That could happen very well today as well. So it still needs to be addressed. | agree with you and I’d be
happy to sponsor that or if Representative LeBrun has one of equal and tenured, | would support that equally as
well.

Alderman Dowd

One of the things that has concerned me over the last couple of years, because I’ve had family experience with
it, is healthcare in the state of New Hampshire. Two areas that | think the state is trying to assist with but failing
miserably is healthcare for the elderly and the veterans. Veterans — any kind of hospital service they have to go
out of state to get it. You have a clinic where they used to have a hospital. | know there’s a lot of work being done
on that to help that, so that’s good. | don’t know how many of the reps have been to the nursing homes in the
state of New Hampshire. | have to say they do a great job, but they have very limited resources, limited staffing,
very limited funding. Through no fault of their own, | don’t think the elderly are getting the services that they
actually deserve. | think that needs to be looked into.

The other thing is | heard a lot about Medicaid and Medicaid funding and not having enough of it. If you ever had
to apply for Medicaid here in the state of New Hampshire, you'd find out it’s a daunting task. It’s extremely
difficult for the people who actually need it, the elderly, trying to figure out all the paperwork in the process. | will
say the Department of Health and Human Services has great people. They go out of their way to help you, but
they’re understaffed and probably underfunded. | think they need some help. | talked to former Senator Ayotte
about this and it’s very disheartening to see how many people are missing out on the healthcare that they could
get through Medicaid funding and through the Department of Health and Human Services. They don’t know
where to start; they don’t know how to figure out the paperwork. The paperwork is huge. You could probably buy
a major building somewhere in the state easier than you could apply for Medicaid here in New Hampshire.
Something has to be done and I'll be putting my two cents in soon.

Unidentified Speaker

| think in nursing homes, mental health, corrections system, everywhere, the underlying issue we cannot ignore
is the workforce; the need for workforce. County nursing homes — that was the big thing in Hillsborough County
because they didn’t have people. They were trying to advertise, and again, it’s a vicious cycle in terms of people
with addiction, and they’re not able to get people. | think we still, as a state, are acutely in need of good youth
and workforce, and whatever we can do — especially being the second largest city and part of the largest county,
it is one of the issues. Whatever we can do to work together to have bills that would support and help in terms of
workforce, sustaining, bringing new people would have a big impact. | can tell you as a first generation
immigrant, | can see the community contributing, but it’s not enough. The incoming international
students/visitors, that has impacted tremendously. That’s something | don’t know how we address it. It’s going to
affect small states like this which short-term solution to the workforce is inward migration.

President McCarthy

| think you were talking more about just healthcare costs and —

Alderman Dowd

One part of it is healthcare costs. When you balance the cost of a nursing home to somebody who would be in
there versus what they get for aid and what is spent for staffing, there are some inequities. Of course, with a
nursing home there is a lot of liabilities, and I’m sure a lot of that takes it into account They may have one nurse
that’s overseeing 20 or 25 patients and these are people that need a lot of help and they’re not getting it. They’re
not getting the help that they should get. | can’t blame the people that are working there; they do an outstanding
job and they do what they can. But having been closely related with nursing homes, like | said, over the last two
years, | can tell you that they’re crying for help. | think the state legislature has to do something to help.

Representative Klee

On the veterans, | know what you’re saying about it being a clinic. On the federal level, the Manchester VA has
kind of disbursed it to various other hospitals, where they can do care there now. So it’s the VA doctors are able
to care for the patients in other facilities. That’s something that the state can’t do. The veteran’s bill that they’re
trying to put through to create a veteran’s administration is not going to create a hospital, but what it would do is
kind of be a focal point to help veterans get care, whether it’s to help them get benefits and so on. The way the
VA works — | worked for them for 26 years, | agree with you — the majority of our veterans either go to the Boston
area, because Bedford, even though it’s probably the closer hospital, is not really a medical facility as much as it
is a geriatric care facility. Up in the north, they all go to White River Junction, but that’s only really the Hanover
area that takes care of our patients there, but a patient can go anywhere. Hopefully, they will make a decision as
to what they’re going to do with the Manchester VA. My angst is that they’re going to try to close it. They’re going
to say that it’s useless; just give them vouchers and send them on. The veteran’s community — I’ve been
working with two veterans groups — has mixed emotions about it. And again, this goes beyond the state; it’s still
the federal level on that particular thing. I’m not sure that the state can really get involved, other than for us to
have resources. Like Massachusetts has a state veteran’s hospital; we don’t have that here. We would have to
actually create something like that. Like | said, the veterans groups that I’ve been working with have mixed
emotions of whether or not they want to be in the VA, where they’re with their own kind, so to speak; with their
uniqueness, versus going into the public arena. And they are split on that.

As far as the Hillsborough County nursing home, I’ve worked with them, and one of the concerns was things
weren't getting processed. They get kick-back. They have to reapply every time a patient came in or when the
one year was up, trying to get the funding from the state. That’s something the state can do. We can try moving
that. As far as them not having the resources, when | spoke to them, the bodies aren’t there to hire. They put out
applications, they have job fairs. They’re just not getting it. Again, that’s something the state can do. | know we
did have legislation at one point to try to help with the cost of the education, and most of them failed. In that case,
yes, | think the state can get involved in that. As far as the VA is concerned, it’s very federal, and unless we
create our own state hospital, which many states have, they’re going to continue to go out of state unless the
federal voucher program comes through. And I’m not sure that’s a really good thing either, because what
happens is the federal government notoriously doesn’t pay on time, and they’re not reimbursing these people.
And what happens so far with what they call “VA Choice,” is — | spoke to one person who had knee replacement
surgery. The doctor took a year and a half to get paid for that knee surgery. He refused to do the other one
because he was not a VA doctor. One of our committee members was approached by a gentleman who had
coronary issues, and the cardiac specialist in NH said to him, “Well, you’re not critical right at the moment. Go to
Boston.” Basically, sent him on to Boston and refused to treat him. These people are taking anywhere from six
months to a year and a half to get paid, and it comes down to the bottom line. That really is an issue with the
federal government, they’re failing us.

Alderman Dowd

| Know that the VA is a federal issue, unfortunately. There’s very little, if anything, you can do at the state level.
My only concern is, as a veteran, you go out and put yourself in harm’s way so that people can actually have the
freedom’s they enjoy. Then they come back and they’re wounded and they need help, they should get the best
help they can get and all too often they don’t get it. They should be able to go anywhere — Dartmouth Hitchcock,
and get their services paid for by the government.

Representative Klee

And that’s actually kind of what the Voucher program does, but there’s limitations to the Voucher program the
way they put it through. It took a while to get it through. The choice was — each doctor had to apply. CMC
couldn’t apply or Concord Hospital couldn’t apply so that they could give services. Each doctor providing service
had to apply. They did kind of streamline that on the federal level to make that a little bit better. | know exactly
what you’re talking about. | have a husband who was drafted in ’69 during Vietnam and he goes through the
same thing. He also worked for the VA. | hate to see the dismantling. And | agree with you, they should be able
to go anywhere they want. That’s where the veterans groups kind of have — the healthier veterans want to be
able to go anywhere they can. Many of the veterans have PTSD and mental health issues and want to stick
together. They want the VA to stay. So you can see both sides of it. New Hampshire was granted 30 miles
versus the actual 50 miles, so that meant they could go to CMC or they could go to Concord Hospital or they
could go to Elliot. But these hospitals don’t want them because they’re not paying their bills.

Alderman Dowd

My experience is with one of the private nursing homes, not the state-funded, which | can imagine is even worse.
One of the problems they have hiring people is that, first of all, you have to be a special person to want to work
with the elderly because it’s a tough thing to do. But they’re not getting paid what they would get if they were
working at the Elliot; not even close. And that’s why they’re having a problem hiring people. We're not paying
them. At least we ought to try to close that gap so they can have some chance of getting additional staff.

Representative Klee

That’s kind of the same problem that we’re having with our mental health doctors, on the state level. We haven't
given them a raise in almost a decade. | think it’s 11 years. That’s why we can’t get mental health physicians
here. That is a state issue.

Alderman LeBrun

| just want to respond to some of the things | just heard about the VA. | go to the VA. | go to specialists that the
VA sends me to. The only thing | need is prior authorization. It’s not that they don’t want to send us and it’s not
because they’re not getting paid. They send me to specialists regularly, outside the VA. There’s nothing wrong
with Manchester VA, nothing at all. They've made great strides in trying to accommodate veterans with the
specialized cases they have. | can’t say anything bad about the VA. The other thing is on the nursing homes.
Hillsborough County has the only nursing home in the entire state that’s in the black. No other nursing home is
in the black except Hillsborough County. And you mentioned White River Junction — White River Junction has
closed. There is no White River Junction anymore.

Representative Klee

When did that happen?
Alderman LeBrun

About a month ago.

Representative Klee

You misunderstood me when | said about the not getting paid. | didn’t mean the VA wasn’t getting paid. | meant
that the specialists aren’t getting paid timely. It may be your doctors are putting in the paperwork exactly the way
that they want it. The cases that | did, in fact, soeak to, the one from [inaudible], the cardiac specialist there, it
was a year and a half. The gentleman that | spoke to, from Manchester, with the knee surgery where he wouldn’t
go for the second one, that was 19 months that he did not get paid. | agree with you. | worked for the VA for 26
years; | don’t want to see it dismantled. | think it’s the most incredible program, considering the number of
hospitals they have throughout the entire country, including Guam and Puerto Rico. | think it’s the most fantastic