If there was any question about whether adults with Medicaid in New Hampshire would take advantage of having preventative dental care for the first time, consider this: In the program’s first eight months, more than 8,000 people have seen a dentist, oral surgeon, or hygienist.
Two other numbers are shaping the program’s goals. Only about 145 of the state’s 850 dentists are participating. And a much smaller fraction are seeing patients with disabilities.
With nearly 95,000 adults on Medicaid as of October, more than 15,000 of them with disabilities, both numbers need to grow, said officials heading up the New Hampshire Smiles program.
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The state Department of Health and Human Services and Northeast Delta Dental, which has a $33.5 million contract to manage the program, and DentaQuest, which is handling the administrative pieces, are meeting at least weekly to identify and respond to challenges. A particular focus in the first several months has been recruiting oral surgeons given that patients who’ve not had dental care for years are more likely to have acute dental disease or other problems.
ABLE NH, a statewide disability justice organization, has joined that recruitment effort with a particular audience in mind.
“We really want the message to be clear that oral health care is for everyone, including people with disabilities,” Executive Director Sarah Tollefsen said Wednesday at the New Hampshire Oral Health Coalition’s annual conference.
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In an interview Thursday, she said the goal will be recruiting more dentists, oral surgeons, and hygienists to treat people with disabilities by helping providers feel more confident in delivering that care. “We’re stopped by our fears,” Tollefsen said.
That effort will include developing an oral health care guide for providers on how to care for people with disabilities. The group is developing a toolkit for patients to help them advocate for the dental care they need, especially for those who’ve not seen a dentist in years or ever.
If ABLE NH secures grant funding, it will also hire a liaison who will travel the state, meeting with providers who are interested in taking on special needs adult Medicaid patients but are hesitant.
“I’m hoping that the dental liaison will build relationships with those dental offices,” Tollefsen said, “and those offices will feel comfortable calling and saying, ‘Listen we have this person coming in and here are my concerns and fears and worries. Can you give us a little bit of technical support?’”
While providers may need specific guidance, such as how to transfer a patient from a wheelchair to the dental chair, Tollefsen said the first step should be asking patients how they’d like their care delivered. Would they prefer to be treated in their wheelchair? Would they like a family member or friend to be with them? How do they prefer to communicate their concerns and questions?
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It’s not unlike the way dental offices have responded to any patient’s anxiety by offering them headphones so they can listen to music during a procedure. “It’s really all practical stuff,” Tollefsen said.
Meanwhile, the state Department of Health and Human Services, Northeast Delta Dental, and DentaQuest are supporting ABLE NH’s efforts and pursuing their own. They are mindful that even with 147 providers in the program, adults with Medicaid are waiting months for an appointment, though they note that the shortage of hygienists and other oral health care providers means even those with commercial insurance are waiting months, too.
Tom Raffio, president and CEO of Northeast Delta Dental, said that to meet patients’ needs, the program must add 200 providers.
Aware that low Medicaid reimbursement rates are a barrier, he has worked with the state to increase Medicaid reimbursement rates for some procedures. His company has started a student loan repayment program for newer dentists who sign on. They’ve recruited Solvere Health to offer mobile dental clinics all over the state, with a particular focus on the North Country, where there are fewer providers in the program.
Raffio is traveling the state, having one-on-one conversations with providers, answering their questions. Dr. Sarah Finne, dental director at the Department of Health and Human Services, is meeting weekly, sometimes daily, with Raffio’s team and DentaQuest. They said providers are signing on because a peer has told them they’ve had a good experience.
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At the same time, they are trying to increase the number of patients by contacting adult Medicaid recipients, one at a time. If a patient cancels or misses an appointment, DentaQuest follows up to find out why and help them to reschedule. DentaQuest can also arrange transportation to and from an appointment.
“We realize we need to get that information from the people who are out there on the ground,” Finne said, “and use that information to help guide us, as we tweak the programs so that we’re really serving everybody that we need to serve.”
Gail Brown, director of the New Hampshire Oral Health Coalition, helped lobby lawmakers for years before they agreed last year to expand dental benefits to adults with Medicaid. She said she’s impressed to see that 8,000 patients have been served and that 147 providers have joined since the program launched in April. There were just 78 providers at the start.
“Right now, we’re not where we want with the number of providers,” Brown said. “But I talked with someone from (another) state and they were at like half of the engagement we were and had been operating longer. I’m amazed at what we were able to do.”
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Finne said early success is not enough.
“We’re not done just because it’s up and running,” she said. “We’re not going to sit back and say, ‘Okay, let’s just let it go.’ We are knee-deep in trying to make sure that we achieve what we set out to.”
The Department of Health and Human Services is providing additional information about the program via phone at 844-583-6151 and, for those who need assistance hearing and speaking, at 800-466-7566. There is also information on its website, at dhhs.nh.gov. Enter “smile program” in the search bar.
This story was originally published by the New Hampshire Bulletin
On the ballot this election isn’t just who will be the next president or governor. Granite Staters will vote on whether state judges should be allowed to serve until they’re 75 years old.
Currently, judges are required to retire at age 70, according to a limit set by the state constitution in 1792. If a judge retires before age 70, they can serve as senior active judges, which means a judge can serve on the court they retired from but they can’t fully engage in law practice. After age 70, they can also serve as referees, working on cases in a facilitating manner, in the court they retired from.
(Here’s an official explanation of the ballot question from state officials.)
Across the country, age limits for judges vary widely, according to Bloomberg. Seventeen states have no limit. In Arkansas and North Dakota, serving past a certain age can cost a judge their retirement benefits.Eighteen states have a mandatory limit of age 70, and eight states set their age limits to 75. Vermont is a bit of an outlier, with an age limit of 90.
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Supporters of the proposed amendment in New Hampshire say the increase in age could allow judges that want to serve continue to hold their positions. Critics counter that it could also keep judges who may not be fit to serve, or those whose ideologies are out of step with modern public opinion, on the court longer.
Two-thirds of voters would need to vote yes on the constitutional amendment in order for it to take effect. When voters receive their ballots, the question about the constitutional amendment also includes language about a retirement age of 70 for sheriffs — but the amendment will have no impact on that, since the retirement age is already 70 years old for that position.
If the measure does pass, it could further solidify Gov. Chris Sununu’s influence on the state’s courts before he wraps up his term in office. Nearly three quarters of the justices currently serving in New Hampshire’s courts have been appointed since Sununu became governor in 2017, including four out of five on the state supreme court.
Many of Sununu’s appointees are on track to serve until at least 2040, even without the change in retirement age. If the retirement age is extended to 75, five circuit court judges could theoretically serve until 2060.
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What do retired justices think?
The age limit proposal was co-authored by Rep. Bob Lynn, a retired chief justice of the New Hampshire Supreme Court who now represents Windham at the State House. The Legislature, unlike the courts, does not set a mandatory retirement date.
Lynn, a Republican, said he thinks the current age limit is too young. He said life expectancy was much lower when that cutoff was established, in 1792, and is an antiquated cutoff.
“As a result of that,” Lynn said, “we’ve lost talent of a number of really very, very good judges, very qualified judges who would have stayed beyond age 70 if they were able to.” Lynn said a couple of judges come to mind that should have been able to serve a little longer on court, including his former colleague on the New Hampshire Supreme Court, Carol Ann Conboy.
“She was my epitome of a wonderful judge,” Lynn said. “She was smart and hard working and incredibly fair minded and empathetic.”
Lynn said they had plenty of “vigorous disagreements,” but he was sorry to see her leave the bench.
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“To see her have to retire when she didn’t want to – I think that was a real, a real tragedy for the citizens of the state,” Lynn said.
Former New Hampshire Supreme Court Justice Bob Lynn being sworn in by Gov. Chris Sununu in 2018. Less than two years later, he reached the mandatory retirement cap of 70.
Conboy, meanwhile, said she always joked with her colleagues that they’d have to pry her fingers off the door to get her to retire. Now 77 years old, she lives at an independent continuing care community in Manchester. She started her term on the state’s highest court at age 62 and said she would have liked to serve at least a few more years on the bench, ideally retiring around age 73.
“It was very sad to me to pack up my books and my office furniture and say, ‘You’re done. You’re just, you can’t do it anymore,’” she recalled. “I wasn’t fired for incompetence. I was fired because the calendar turned to a certain day and that was the end. It was extremely disconcerting.”
Conboy said she would have been open to a competency test, as a way to ease public concern over judges’ capabilities.
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But she also suggested there are other factors, beyond age, that could influence a judge’s capacity to serve. Judges might face marital and familial problems that divide their attention, she said, and that might require them to take a break until things are resolved.
“Let’s say a judge is going through a very traumatic personal experience, a spouse dies or a child is in a terrible accident that may require that that judge take some time to deal with it, just as we would hope that people in other walks of life would be given an opportunity to deal with it,” Conboy said.
Judges also face mental and physical health concerns, she said; some of those could impact their performance in the court, while others are more easily managed.
Conboy said ensuring judges remain connected to their communities, to technology and to social advances is an important factor for justices. She gave the example of how cellphones have introduced new ways of thinking around crimes committed not just in physical spaces, but also digital.
For her part, Conboy said by the time she reached the New Hampshire Supreme Court, she had accumulated a lifetime of experience, not just in the legal field: working in the U.S. Air Force, as a high school teacher, working with the state to address drug and alcohol issues, as well as 13 years as a practicing lawyer and 17 years as a trial judge.
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“I handled murder cases all the way down to arguments over where garbage cans were going to be put in a common driveway,” Conboy said. “Those kinds of experiences actually expanded my understanding of the problems of all strata of society – from sophisticated business decisions or problems to very mundane things such as arguments with town officials as to whether you can build a screen porch on your house.”
Some say term limits, evaluations could help
Some others in New Hampshire’s legal field said the constitutional question brings up other questions about how well our justice system is functioning.
Buzz Scherr, a seasoned New Hampshire defense attorney who teaches at the Franklin Pierce School of Law, said the question of age isn’t quite the problem — he can think of some judges who he was sorry to see retire, and others he was glad to see leave the bench.
At age 72 himself, Scherr said he’s found himself paying more attention in general to how people talk about older adults, for good and for bad. He’s allowed to work until he’s 80 as a professor and plans to slowly phase out his work over time. He is also running for a seat at the State House this fall, as a Democrat.
Judges, Scherr said, are in public-facing positions, so it makes sense that people would be interested in whether they are fit to serve.
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A better system, in his view, would be to hold evaluations of judges and their work after age 70, but that would be a tall order. A review on a case by case basis of who is fit to serve would take a lot of time, resources and consideration to execute, Scherr said, so a blanket age limit is more practical.
“I think we over rely in society on people who are advanced age and too often credit them for being wise just because they’re older, old, rather than credit them because they are wise,” Scherr said. “I think it’s easier to have an artificial limit when you’re worried about people who are not as wise or capable as they used to be as they age.”
Edward Gordon, a former New Hampshire circuit court judge and former state lawmaker, also questioned if age is the appropriate measure on whether a judge should serve. Gordon retired before he reached the age of 70 and worked in senior judge status until he reached the age limit. He said that he loved his job.
“I sat primarily in Franklin, and I enjoy the community as a circuit court judge,” Gordon said. “You’re close to the community and you set standards for the community.”
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Gordon said he knows of other circuit court judges that retired before they reached their 70th birthdays, so he said the increase in age might not propose immediate changes for Granite Staters, at least not in the circuit court.
There are things judges consider when serving and plan on stepping off the bench, Gordon said, like whether they can retire with benefits, which depends on both their age and how long they’ve served.
While Gordon thinks age is less of a concern, he is a believer in term limits.
“The question is, is there some advantage of having turnover as opposed to keeping judges or politicians in place for long periods of time?” Gordon proposed. “It’s good to have new blood at times. I think those are issues I think that I would raise when it comes to the issue of whether we should extend the age.”
Vice President Harris on Wednesday picked up endorsements from three longtime Republican leaders in New Hampshire who supported former President Trump’s rival Nikki Haley in the Republican primary.
Former U.S. Senator Gordon Humphrey, former U.S. Congressman and former New Hampshire Supreme Court Justice Chuck Douglas and former New Hampshire Attorney General Thomas Rath condemned Trump as a divisive and unstable candidate in statements declaring their support for Harris. Her campaign said the endorsements reflect growing enthusiasm for the vice president among registered Republicans both in the Granite State and the rest of the nation.
“I voted Republican for fifty years, but I’m voting against Donald Trump and I plead with all Republicans to do the same,” Humphrey said in a statement. “As a father, a grandfather, a veteran, and a former United States Senator, I cannot vote for Trump. He’s dangerous to our democracy.”
Douglas said that Trump “believes in himself over service” and views the election “as the change to jail his political opponents.” Harris would be a “steady hand at the ship of state” in contrast to Trump’s “fragile mental state and anger,” according to the former lawmaker.
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BIDEN CALLS FOR TRUMP TO BE ‘POLITICALLY’ LOCKED UP AT NEW HAMPSHIRE EVENT
Harris arrives to speak at a campaign event at the Throwback Brewery, in North Hampton, New Hampshire, on Sept. 4, 2024.(JOSEPH PREZIOSO/AFP via Getty Images)
Rath likewise condemned Trump’s “campaign of division, anger, thinly veiled prejudice, and rejection of our core values as a nation.”
The Harris-Walz campaign welcomed their support and noted that hundreds of current and former Republicans across the country have backed Harris, including former GOP Reps. Liz Cheney and Adam Kinzinger.
IT’S A TIGHT RACE IN THE BATTLE TO SUCCEED POPULAR SWING STATE REPUBLICAN GOVERNOR
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Harris fields questions during a town hall style campaign event with former U.S. Rep. Liz Cheney (R-Wyo.) on Oct. 21, 2024, in Brookfield, Wisconsin. (Scott Olson/Getty Images)
In New Hampshire specifically, the campaign said there has been a 47% increase in registered Republican volunteers compared to 2022 and a 76% increase in the number of GOP voters who have told canvassers they plan to vote for Democrats next week.
“While Vice President Harris has made clear there is a home in her campaign for all Americans – including Republicans and independents – Donald Trump continues to double down on his extreme agenda,” the campaign said in a news release.
NEW HAMPSHIRE MAKES PRIMARY PICKS FOR GOVERNOR AND HOUSE RACES
Harris speaks during a campaign rally at Throwback Brewery in North Hampton, N.H.(Kylie Cooper for The Washington Post via Getty Images)
Reached for comment, the Trump campaign noted that Haley is supporting his candidacy, along with former Democrats Robert F. Kennedy Jr. and former Rep. Tulsi Gabbard, D-Hawaii.
“President Trump is building a historic and diverse movement to make America great again,” Trump national press secretary Karoline Leavitt said. “He’s been endorsed by many respected leaders from Nikki Haley to RFK Jr., and Tulsi Gabbard. We welcome anyone who wants to secure our border, restore law and order, and end inflation to join our team.”
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New Hampshire has been an important swing state in prior presidential elections, although Harris has held a consistent lead over Trump in public opinion polls this year. Fox News’ Power Rankings rate the state as “Likely D.”
Get the latest updates from the 2024 campaign trail, exclusive interviews and more at our Fox News Digital election hub.
Chris Pandolfo is a breaking news reporter for Fox News Digital. Send tips to chris.pandolfo@fox.com and follow him on Twitter @ChrisCPandolfo.
Republican Kelly Ayotte’s support for former President Donald Trump was a flash point Wednesday in her final debate with Democrat Joyce Craig in the race to become New Hampshire’s next governor.
As a U.S. senator in 2016, Ayotte initially said she supported Trump as the GOP nominee for president but wouldn’t endorse him. She later withdrew her support and wrote in Mike Pence instead after Trump was caught on videotape making crude comments about grabbing women. Eight years later, her support for Trump this election cycle has been “unwavering,” WMUR-TV debate panelist Steve Bottari said.
“As a former prosecutor and a former attorney general, do his criminal convictions just not matter to you?” Bottari asked.
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“It’s not that,” she said. “It’s just that this is the choice that we have in this election. And certainly, I think the country was better off just in terms of costs, what we’re paying, and safety when he was in office.”
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After Ayotte repeatedly declined to comment on Trump’s criminal convictions specifically, Craig jumped in, using her time on her next question to return to the topic.
“Where do you draw the line, Kelly, with Donald Trump? Is it when he sexually assaults women? Is it when he posts about Hitler? Or is it when he tries to overthrow democracy?” said Craig, the former mayor of Manchester. “There is no line with Kelly Ayotte.”
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Ayotte responded with questions of her own.
“Who’s going to fight for New Hampshire no matter what? Who’s going to even stand up to their party when it’s hard?” she said. “I’ve done it. I was the third most bipartisan senator in the United States Senate. I never hesitated to cross the aisle to do the right thing for New Hampshire.”
Ayotte pointed to Craig’s frequent campaigning with Massachusetts Gov. Maura Healey as evidence that Craig prioritizes her party and what she characterized as its “higher taxes, less freedom” philosophy.
“Why is she spending so much time with the governor of Massachusetts when she wants to represent the people of New Hampshire?” Ayotte said.
Craig described her commitment to New Hampshire by saying she is a fourth-generation resident who joined the governor’s race to help New Hampshire families. As for Healey, she said part of being governor is working with other governors throughout New England on important topics, such as energy. But neither was willing to stop there, at one point talking over each other.
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“You’re never going to stand up because you’re a party line person. I’ve stood up to my party and I’ll do it again,” Ayotte said, as Craig said, “You support a convicted criminal for president. He’s unfit to be president.”
Ayotte and Craig are vying to be the third woman elected governor of New Hampshire, filling the seat being left open by Republican Gov. Chris Sununu, who is not seeking a fifth two-year term.
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