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.
