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Library: Articles of Interest

Corporate Managed Care and New Hampshire
How might corporate managed care affect long term care services in NH? Bob James, Executive Director of One Sky, explains what we know as we head toward 2012, and what questions remain.
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How Will Managed Care Affect Us?
New Hampshire faces the biggest change ever attempted by state government: turning over our social safety net for the most vulnerable citizens to outside, for-profit businesses. The Legislature has voted to bring managed care to New Hampshire’s Medicaid programs, to take over the developmental services system, including day and vocational services, residential programs and the like. What will this look like?
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Considering Alternative Futures
The Great Recession of 2008-2010 has expanded the ranks and deepened the suffering of vulnerable populations in the United States. This report, from the Institute for Alternative Futures, sets out alternative scenarios of how our society and its vulnerable populations could change over the next two decades. 
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Managed Care: Commonly Used Terms
In discussing managed care, it helps to know the definitions of commonly used terms such as ‘utilization review’, ‘capitation’, ‘carve out’ and ‘medical home’. These terms and many more are found in this glossary.  
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NH Challenge: Managed Care Q&A
From Wendy Thomas in a special edition 2011 of the NH Challenge: questions and answers about managed care.
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The Bill That Requires Managed Care in NH Medicaid
Senate Bill #147, passed by the NH Legislature in the spring of 2011, mandates that the state enter into contracts with vendors of a managed care model to provide for managed care services to the Medicaid population by July 1, 2012. Click to read the bill in its entirety.
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Guiding Principles for a NH Medicaid Care Management Plan
The following guiding principles have been proposed to serve as benchmarks for the process of designing, developing and implementing a care management plan for the NH Medicaid population. The numbers are for reference only and do not indicate priorities.
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Medicaid Managed Care: Challenges for NH
The NH Fiscal Policy Institute has produced this primer on managed care and some of the issues facing New Hampshire as it prepares to implement managed care for Medicaid recipients.
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Long Term Care Managed Care Options in NH Developmental Services
A fact sheet on Medicaid managed care for persons with intellectual and developmental disabilities and acquired brain disorders, prepared by the Community Support Network, Inc., the consortium of New Hampshire’s ten area agencies for developmental services.  
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Medicaid: A Key Source of Insurance in New Hampshire
It will be difficult to achieve budgetary savings through reductions in Medicaid spending in New Hampshire, and lawmakers must be aware of ramifications for both vulnerable residents and the health care industry.  An issue brief from the NH Fiscal Policy Institute.  
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The Case For Inclusion
The annual analysis of Medicaid for Americans with Intellectual and Developmental Disabilities from United Cerebral Palsy.

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One Sky 2010 Redesignation Review
In April 2010, One Sky was once again approved by the state of New Hampshire to be the ‘area agency’ for Region VIII: the primary provider of services to people with developmental disabilities and acquired brain disorders in Upper Rockingham County.  While the NH Bureau of Developmental Services routinely assesses various aspects of One Sky and its nine regional counterparts on an ongoing basis, all ten area agencies undergo comprehensive state reviews once every five years.  Required by NH regulations, the ‘Redesignation Review’ is necessary in order for the state to continue designating an agency as a regional ‘area agency.’ To find out how One Sky is currently meeting its responsibilities, read our 2010 Redesignation Review.  
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What is a person receiving SSI or Medicaid allowed to own?
Written by attorney John Kitchen, this document may be helpful in discussions about Special Needs Trusts. It also provides important links to relevant laws and regulations.    
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Meet New Hampshire's 'Home Provider of 2009'
Gloria Peel of Seabrook won the first 'Home Provider of the Year' award in the state of New Hampshire.  She was picked from a pool of the state's top 20 home providers, by an independent panel, for the N.H. Council on Developmental Disabilities.  She's been providing a home for people with developmental disabilities in the One Sky region (Region VIII) for more than 15 years.
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What One Sky Has Done for Michael
A Region VIII parent shares the experience her young son and family have had through One Sky Community Services.
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Spectrum Mom on the Road
Region VIII resident Viki Gayhardt, board member of the Autism Society of New Hampshire and an autism family support specialist, recounts her personal story of life on the road with kids on the autism spectrum.
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What is a Direct Support Professional?
For many persons with developmental disabilities, Direct Support Professionals make the world go round. They're hard-working and deserve greater recognition. Get the basics in this description from One Sky.
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A Personal History with Undiagnosed Asperger's
One man's personal history of living with undiagnosed Asperger's syndrome in childhood and adulthood. Author Tim Page was finally diagnosed in 2000. Originally published in 'The New Yorker' 8.20.07.
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UNH Engineers Communications Tools
Engineering students at the University of New Hampshire work to create communication aids for Luke, a young man with cerebral palsy who is eager to communicate. Originally published in The University of New Hampshire Magazine.
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Health Care Reform: Long-Term Services and Supports for Citizens with Developmental Disabilities (2009)
The National Association of State Directors of Developmental Disabilities Services (NASDDDS) seeks to ensure that health care reform efforts fully consider the needs of individuals with developmental disabilities and their families.
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Transforming New Hampshire's Mental Health System
In the past 10 years, admissions to New Hampshire's public psychiatric hospital have doubled. Local communities have seen reductions in psychiatric hospital units, group homes that provide residential treatment, and intensive outpatient services. Per capita expenditures at the state's mental health centers have been reduced by nearly half. Primary care providers have seen significant increases in mental health issues in their medical settings. The rate of incarceration for people with mental health issues has risen. It is vitally important that improvements to the system are made in effective, measurable, and sustainable ways. New Hampshire citizens must recognize that the development and maintenance of an effective system will require continuous maintenance and financial support. – From the Commission to Develop a Comprehensive State Mental Health Plan
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Lessons Learned: Deinstitutionalization of Mental Health
The provision of long-term services and support for people who are elderly or have significant disabilities is a major policy focus at federal and state levels. While the deinstitutionalization of people with mental illness differs somewhat from reform of policy for long-term services, some parallels and lessons are relevant. – From the Kaiser Commission on Medicaid and the Uninsured
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Merger of Area Agencies?
Putting New Hampshire's area agency system in turmoil by forced closings and mergers to save money would be penny wise and pound foolish. Ironically, it may actually undercut the best solutions to the most important goals of Medicaid reform. This commentary from 2005 has renewed relevance in today's discussions of restructuring social service systems and Medicaid reform. – From Bob James, Executive Director, One Sky Community Services
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Governor's Commission on Area Agencies
In 2005, New Hampshire Governor John Lynch commissioned a study of area agencies, to include identification of essential agency operations, ways in which agencies may operate more efficiently and cost-effectively without compromising service, and to recommend proposed legislation and rules changes. The resulting report analyzed consolidation and reduction in the number of area agencies – From the Governor's Commission to Study Area Agencies and their Role in Providing Services to New Hampshire
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Direct Care in the Granite State
Autumn 2007 issue of "The Rap Sheet", dedicated to the subject of Direct Support Professionals (DSPs), with an introductory essay by One Sky Executive Director Bob James, entitled "The Growing Crisis in Attracting and Keeping Direct Support Workers and Home Providers, and What We Can Do About It." – From the Institute on Disability at the University of New Hampshire
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The Supply of DSPs
A report on the growing need for direct support professionals (DSPs) in the nation's system of services for persons with developmental disabilities. The increased need for DSPs occurs at a time when the labor force is expected to grow much more slowly than in the past. There will be increased competition for people to work not only as DSPs, but as health and long-term care workers in general, as well as other occupations that need workers of comparable education and skill levels. – From the U.S. Department of Health and Human Services Office of Disability, Aging and Long-Term Care Policy
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New Hampshire State Budget 2010-2011
New Hampshire faces a potential budget deficit in the 2010-2011 biennium that may be more problematic than past deficits. As a result of changing revenues, states across the country are adjusting both revenue and spending plans to account for the current economic downturn. The state legislature received revenue estimates that fell $100 million below those projected as part of the previous budget. This analysis of revenues for 2010-2011 reveals that the gap between historical growth in revenues and the recent decline, could be as much as $286 million or more if the economy does not recover in the next two years. – From the NH Center for Public Policy Studies
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