The Participant Directed and Managed Service (PDMS) Coordinator will be responsible to facilitate planning meetings with individuals and their family/representative to identify services and supports and to design quality, meaningful, individualized cost effective services with an eye toward community involvement, natural supports and creative options.  Provide teams with information on available community resources and other pertinent information as needed.

Bachelor’s degree or high school diploma with one or more years of college level education and a minimum of three years working in human services.

Senate Finance Committee Submits HB1 and 2 to Senate Floor For June 6 Vote

On Tuesday, May 28, by a party line vote of 4-2 the Senate Finance Committee sent HB 1 and HB 2 to the Senate floor for a June 6 vote, but this is not the end for the Senate process. It is anticipated that additional floor amendments will be introduced, when the budget is debated on the Senate floor next week, making various changes to the committee’s recommendations.

Who spent more, House or Senate?

Both chambers of the Legislature, the Governor, and political parties have issued press releases taking differing positions about budget expenses. Based on Legislative Budget Office information, the Senate budget “spends less than the House.” However, the “spend less” definition is of “total funds” (i.e. funds from all sources: State, Federal, County and others such as fees.) In terms of General Fund or state spending, the Senate actually spends more than the House.

No new taxes

The Senate removed four tax/fee increases from the budget as proposed by the House. There were two fee increases, one to the Salt Water Fishing License and one to the Marriage License; both were deleted. In addition, the committee removed tobacco and gasoline tax increases. The Senate did predict that the State of NH will bring in over $100 million in additional revenue from existing fees and taxes based on economic growth. This growth in revenue allowed for increased spending.

What about the DHHS budget?

When looking at DHHS, the Senate spends more than the House (nearly $24 million more). However, the DHHS Commissioner has said that because of low budget estimates for caseloads and other “back of the budget cuts” made by the Senate, the DHHS budget has a $40 million deficit. There was never an official amendment drafted to cut many of the programs that are in jeopardy because of this “deficit.” The Commissioner verbally told the committee that the following programs are at risk with the Senate’s version of the budget: DD/ABD waitlists, CHINS, mental health, community health centers, family planning clinics and payments to counties. At this point in the budget process, the “deficit” in DHHS remains and will be discussed during the June House/Senate Committee of Conference on the budget.

Medicaid Expansion Update

The Senate Finance committee removed Medicaid expansion from HB 1 and HB 2 in favor of studying the issue. It is interesting to note that DHHS contracted with the Lewin Group several months ago to provide the state with an analysis that would assist with informed decision making. The Lewin study reached many conclusions that strongly favor NH choosing Medicaid expansion, but the Senate has elected to further continue study of this issue.

Innovation in Medicaid Delivery – I-MD Commission

HB 2 now calls for an “Innovation in Medicaid Delivery” or an “I-MD” Commission. This commission will work to create a new Medicaid waiver application, an 1115 Medicaid waiver. According to the proposal, the waiver’s goal is to “Obtain federal matching funds for so-called costs not otherwise match-able to improve access and quality of care for Medicaid-dependent patients.”

Consumer Assistance Grant

The Senate Finance committee did not include any federal funding for the Health Benefit Marketplace that will soon be created as part of the Affordable Care Act. NH has been approved for a federal grant to set up a consumer assistance program. There was a proposal by Senator Larsen to accept $5 million in federal funds in HB 1; this did not happen. The money would be used for training to assist people — many of whom have never had insurance coverage — in navigating the new marketplace. With the grant New Hampshire will be able to launch a program designed in NH. Without the grant, NH would cede control of this to the Federal government.

The House has now responded to the Senate’s inaction on this issue by tacking on the federal funding for this program on to another bill, SB 129, relative to court-ordered placements in shelter care facilities and at the Sununu Youth Services Center, relative to the children in need of services (CHINS) program, and establishing a committee to study programs for children in need. That bill, like the budget, will likely end up in a Committee of Conference.

What’s next?

All this isn’t over yet. There is still a month to go in this budget process. Steps to come are:

  • the full Senate vote on Thursday, June 6;
  • the appointment of the Committee of Conference, by Thursday, June 13;
  • votes in both houses to accept their report;
  • action by the Governor;
  • then back to the House and Senate if it does not get her approval, for another try.

Stay tuned for further developments.

Thanks to Stonewall Farm and the Family Council, MDS Children’s Services and Partners in Health (PIH) have started a community garden for families. Stonewall Farm in west Keene has generously donated the land for the project, as well as compost (manure), water and a shed to store gardening tools. As of mid-May, the land has been prepared, the beds put in, and the garden is ready for planting.

A number of the families supported by MDS have limited income and struggle with being able to afford fresh vegetables. Many live in apartments and would never have the opportunity to have their own garden. Some families struggle with cooking skills.

“Setting up this community garden with several dozen families will go a long way to encourage healthy eating, physical activity and provides a free activity that allows families to connect with one another,” says Janet O’Brien, PIH coordinator. “It’s a great way to significantly enhance the quality of their lives in many ways.”

Families who decide to join the project will participate in planting and caring for the garden and then receive a portion of the vegetables and flowers. They’ll also get simple and healthy recipes for the foods they grow. A family’s time commitment is part of a day for the group to prepare and plant the garden, then approximately an hour or two every other week for garden upkeep.

Stop by Stonewall Farm and see how the MDS garden is growing!

phicase2webMonadnock Developmental Services has been highlighted in a series of case studies that showcase exemplary employers in the eldercare/disability services industry. During the past two years, MDS has actively engaged its staff in the PHI Coaching ApproachSM, which uses a relationship-based, “train the trainer” path to strengthen direct care workers. The PHI Coaching Approach promotes five core skills – active listening; self-management and self-reflection; clear, nonjudgmental communication, and collaborative problem solving. In 2010, MDS received a grant through DirectConnect and the University of New Hampshire Institute on Disability, and jumped headlong into the process. In two years, more than 250 staff members at every level of the organization have been trained. Click here to read the full study.

PHI_Case_StudyAlan Greene, MDS executive director, strives to instill a culture of respect at the organization. “For many years, we’ve been using the Gentle Teaching approach to help our DSPs work more effectively with individuals,” he explains. “This opportunity to incorporate specific process-oriented PHI Coaching tools with our staff to establish a relationship-based philosophy has been timely.”

Results for staff and individuals have been very promising, which is what prompted PHI to highlight MDS in its case studies of success.

When up against a tricky situation or issue, staff members find themselves stopping to ask: “How can I use my PHI skills here?” Meaningful conversations and problem-solving among teams are becoming the rule rather than the exception.

Much of the success of the program has been the result of committed leadership. Jessica O’Connor, MDS training coordinator, has led the charge by training staff, trainers and peer mentors. It is these peer mentors, providing ongoing training and support to DSPs, who are the key to sustaining this relationship-based process. Jessica’s energy, organizational skills and natural talents also ensure the program’s effectiveness.

Because of this success in embedding coaching approach skills into the culture of MDS, PHI has chosen MDS along with four other national organizations as a pilot site for another grant that continues the training with a focus on building teams.

MDS will continue to use PHI and Gentle Teaching as the organization moves forward with its goal to provide innovative, high quality care based on mutual relationships between workers and the people supported by MDS.

Click here to read the full case study.

Although there is no firm news from DHHS on progress for the implementation of Step 1 of Medicaid Managed Care, there is progress on another aspect. Governor Maggie Hassan issued an Executive Order in April to create the Governor's Commission on Medicaid Care Management.

This Commission will bring together members of the public representing a broad range of experience in health care issues to review and advise on the implementation of an efficient, fair and high-quality Medicaid care management system. Donald Shumway of Crotched Mountain and Yvonne Goldsberry of CMC-DH-Keene are serving on this very important Commission that will advise the Governor on the implementation of the Managed Care program.

Meetings are open to the public, and the next one is next Wednesday, May 22 from 1-4 p.m. at the Legislative Office Building Room 301-303,  on State Street in Concord. Members of the public are encouraged to attend.

Future meetings of th Managed Care Commission are scheduled for first Thursdays from June to December (except 2nd Thursday in July), with future meeting places yet to be determined. An informational web page will be set up on the Governor's website ( by the end of May.



Janet O’Brien, Partners in Health Coordinator for the Monadnock region, is one of fourteen dedicated family coordinators who were recently honored as a group with the New Hampshire Pediatric Society Public Citizen Award. This award recognizes an individual or group who has performed extraordinary work in the effort to promote the health and welfare of New Hampshire's children and families and to advocate for children and children’s healthcare.

Janet, who lives in Keene, has served as PIH Family Support Coordinator for more than six years and brings tremendous energy and experience to her efforts on behalf of families in the Monadnock region. From her office at Monadnock Developmental Services, she assists families to access appropriate services and resources, arranges for special needs during hospitalization and, after discharge, helps with school planning. PIH coordinators also provide recreational and respite opportunities, serve as advocates, listening and responding quickly and meaningfully. Problem solving around financial concerns or just finding the information needed is an important aspect of the day-to-day work of local PIH coordinators. Janet is shown in the photo at right with Greg Prazar, M.D., Preisdent of theNH Chapter of the American Academy of Pediatrics.

By a split vote of 3-2, members of New Hampshire's Executive Council approved the $2.3 billion contract establishing a Managed Care system for the state's Medicaid recipients. These contracts still need to be approved by the Centers for Medicare and Medicaid Services in Baltimore, which will take up review in coming weeks and months. Timing on the switch-over is still tentative but current plan is to start Step 1 – Acute Care – by the end of this year. Please stay tuned via our Advocacy page.

In early May DD wait list funding was once again in peril, but as of mid-May appears still to be on the table. The NH House voted on Wednesday by a 247-93 vote to kill HB 1652, which would have provided $3 million to the DD wait list. That vote wasn’t necessarily against wait list funding but rather because of other elements, in particular internet taxes, the House didn’t like.

Fortunately, the House Ways and Means Committee amended another bill, SB 399, to include $1.5 million in General Funds for the DD wait list. This action is thanks in large part to the persistent work of the Peterborough chapter of ABLE-NH. The revised bill was then passed by the full House next and will go back to the Senate for further action ….so it’s stay tuned once again.

Are you looking for a summer camp for your child or children? The 2012 edition of the MDS Regional Camp Guide is now available online.
Click here to access the Guide which is available as a downloadable pdf.

Monadnock Developmental Services and the Family Council welcome CarolAnn Edscorn who will present “Illuminating Autism: Accommodations and Modifications in a Life Framed by Autism” on Wednesday, June 9th from 6:00 to 8:00 p.m. This presentation will be at MDS, 121 Railroad Street in Keene. The cost to attend is $10.

CarolAnn Edscorn of Jaffrey didn’t speak until she was four, didn’t read until she was in the 4th grade and had a childhood with few friends. In 1994, she was diagnosed with Asperger Syndrome after her husband read an article about Temple Grandin, an animal scientist who has autism.

With a BFA from the University of Rhode Island and a MS in Urban Affairs Management and Public Policy Analysis from Southern Illinois University, Ms.Edscorn has also completed further studies at Antioch University in Keene as part of the Autism Spectrum Disorder Graduate Certificate Program. She has worked with Erin Gruwell of the Freedom Writers Diary toward tolerance and creative education, publishing an entry in their book Teaching Hope. She lives in Jaffrey with her husband Christopher, four of her five children, and her service dog, Shakespeare.

Ms. Edscorn has addressed the Institute On Disability’s Autism Summer Institute and has given many workshops for schools and community groups. Her goal is to generate hope and a culture change toward kindness and presuming competence: “It’s not about programs, it’s about acceptance with joy! I wish to encourage other persons with autism and their families to share their stories as we can do much in our culture to educate, enlighten and empower all persons of difference. Anger, fear and ignorance need to be replaced by hope, courage and strength.”

Cost for this event is $10 per person.  For more information and to register, call the MDS office at 603-352-1304.

May 2010…Monadnock Developmental Services announces several additions and changes to its team of professionals in Keene and Peterborough. Alison Scalia has been promoted to the position of ASC Supervisor. Earlier this year, Richard Reho and Vivian Williams joined the Peterborough office as ISO Program Managers. Andrea Bazarnicki joined MDS as EDS Document Coordinator, and Gayle Treat is now in the Keene office as Receptionist and Administrative Assistant.

Alison Scalia of Keene has been promoted to the position of Supervisor of Adult Service Coordination. Prior to joining MDS as an Adult Service Coordinator in early 2009, Alison spent several years as High School Program Manager for Best Buddies in New Haven, CT where she coordinated leadership development training for students. She has also worked as a Direct Support Professional for MDS and as a Special Education Teacher/Assistant in Monadnock area schools.  Alison earned a Bachelor of Science in Sport Biology at Springfield College in Springfield, MA. She is originally from Rindge, NH and is a graduate of Conant High School. She lives in Keene with her husband, Derek.

Richard Reho brings many years of experience to his role as ISO Program Manager in Peterborough. He worked for MDS in the 1990s as one of the first ISO Coordinators, as Case Manager and as Community Resource Coordinator. Richard has worked in New York, North Carolina and California on many inclusive community-based projects, developing new models on themes ranging from self-determination, inclusion, person-centered planning and community development. He lives in Peterborough.

Vivian Williams of Rindge also joins the Peterborough office team as ISO Program Manager. After a successful career with a computer manufacturer in Massachusetts, Vivian moved to New Hampshire eight years ago. She brings her experience as a direct support professional to her new role at MDS.

Andrea Bazarnicki of Gilsum joins MDS as EDS Document Coordinator. Originally from New Jersey, Andrea moved to the region eight years ago. She is also a real estate agent and a member of the Monadnock Board of Realtors.

Gayle Treat of Winchester joins the MDS Keene office as Receptionist and Administrative Assistant. She brings with her many years of experience in customer service and account administration at Smith Medical in Keene.