1) Why are you running, and what do you hope to achieve in the next legislative term?
a) Please see the campaign flyer and the paragraph from last year you
shared.

b) I have been honored to represent our district, the state, and those I
advocate for as a State Representative. As outlined in the flyer, we
have accomplished a lot in the last two years. I have authored 6 bills
all of which have either passed or are currently in study. I have also
been involved on many committees which are outlined on the
campaign flyer.

c) My focus will remain health care. We have a dying health care
system. Efforts to reform it has led to higher costs to the system and
the individual, less access (dramatic increase in number of under-
insured), decreased efficiency, fragmentation, and death of private
practice. It is my belief that the final factor is directly due to the
previous 4. It is my goal to save health care in NH by

i) cutting costs for provider and insured

ii) improving communication between providers (prior authorization
and technology reform, bills which I have written and passed)

iii) improving the efficiency and responsibility of the Granite State
Advantage Program

iv) increasing access to health care of all sorts, both allopathic and
alternative care, especially by creating models of community-
based integrative care (I created a program to create models of
care which are drawing national attention through HB 66 and HB
1712 which I authored and I chair the committee)

v) increased access to care for those with mental health and
substance abuse, again through creative models of integrative
care

vi) I plan to continue addressing the social determinants of health,
particularly:

(1) .Education

(a) K – 12: I have initiated discussions with teachers groups to
get a better handle on understanding the difference between
rhetoric and reality as we re-design programs

(b) College/affordability

(i) I began a non-profit through my work with the NFL to
better understand how schools look at athletic
participation

(ii) How do colleges finance athletic programs/scholarships.

(iii) What are the ramifications for non-athletes and
athletes using a whole person/whole life perspective

(iv) What are the ramifications for tuition costs again for
non-athletes

(v) Are we helping or harming athletes. In my work with both
professional and college athletes, there is a very real
concern the system is flawed and is harming athletes, yet
nobody has the courage to address theses issues. I plan
to do so

I have began addressing all of these issues, and it is my hope to
be re-elected to continue doing so. One of the more exciting roles
I have is my involvement in the State Health Assessment/State
Health Improvement Advisory Council. I will likely be named chair
of this council in September. I really want to focus on the Social
Determinants for all ages. We actually created a focus on health
aging, a group people seem to forget about. It is imperative we
continue this work as we need to take the findings of this group
from study to reality.

2) Assess the recent performance of Gunstock. If elected, would you keep
it in the same direction or change course?
I would keep things the way they are, and hopefully the new leadership
will continue in the admirable direction Tom Day has charted. My son
works for Vail Resorts. He specifically works at Keystone. He has a
very good feel for the ski industry, and he was very impressed with
where Gunstock is now. It would be a mistake to change it.

3) Given budget constraints for the Belknap County Nursing Home, how
would you stretch county taxpayer dollars and still meet our high
standards of care?
I am fortunate to be a board member for the Catholic Charities Health
Care Committee. Our role is to oversee the 8 Catholic Charities Nursing
Homes, which includes St. Frances here in Laconia. In this role, as well
as in my discussions with leadership at Belknap County nursing home, I
have a unique insight. The big problem is payor source. In all the
groups I work with, whether it is mental health, substance use, or
Nursing homes, when your primary payor source is Medicaid, you will
have major challenges. All these entities struggle with labor shortages,
and that is the primary problem facing BCNH. Simultaneously, though,
we have an influx of new immigration into this country. Historically, this
is the group that has been a source of labor for hospitals and NH’s. We
need to tap into this. This is not just hiring, but also educating, teaching
English, etc. These employees are often very loyal. If we can solve the
staffing problem, we solve all the other problems BCNH faces.
Simultaneously, through the work I am doing, we are addressing other
medical costs which can help the bottom line. It is estimated that SB
561, which I authored and passed, in combination with CMS reforms on
prior authorization will save the health care system more than $15
billion. I am also working to reduce excessive IT costs, which will also
help. We also have significant problems with the cost and efficiency of
the Granite State Advantage program as well as traditional Medicaid. It
is our hope, by reforming these entities, we can reduce costs for
providers. All of this will help.

4) As a member of the Belknap County Delegation, how would you improve
county hiring practices to attract the highest quality candidates for our
nursing home, public safety and administrative positions?
As for the nursing home, I have addressed this in question #3. We need
to remember that the most important factor in attracting new talent is
how happy the current talent is with their job. I think the budgets we
created over the past two years have reversed the previous trend in
which employees were being told they were not important. That is a
trend we need to continue. As important as that is, it does come down
to money, and the challenge is to provide competitive salaries, which we
did take steps to address in the past two years. As a former owner of 5
businesses, I am very aware of why that is important.

5) Should Belknap County manage its own nursing home and county
corrections departments, or privatize them? What about Gunstock
Recreation Area/Gunstock Mountain Ski Area?
a) It has been my observation in the nursing home industry and the
health care industry that privatization, a polite word for corporate
takeover, leads invariably to a transition from a focus on quality to a
focus on the bottom line with an associated decline in quality,
customer and employee satisfaction. I could share dozens of
examples with you if you wish. I would avoid privatization for any of
these entities.

6) What are your ideas for the former 220-acre Laconia State School
property?
One of the biggest problems facing our county and our society is the
problem of homelessness. Historically, this has been associated with
substance use disorders and mental health problems. This is no longer
the case. Because of a variety of economic variables, not the least of
which is inflation in the housing market and beyond, aggravated by a
limited housing supply, the cost of housing has sky-rocketed. When I
began my adulthood, housing was about ¼ - 1/3 of a typical budget.
Now that number is greater than 50 percent. There are also many
budget items that did not exist 40 years ago. This puts too many able-
bodied individuals into the quandary of what items to forgo. Too often it
can come down to housing vs food, education and/or medicine. Mayor
Hosmer told me we have a housing vacancy rate in Laconia of less than
1 percent. It is critical we increase the housing supply and, especially
affordable housing, and I think that should be what this property should
focus on. In association with this, we need to create programs which will
help homeowners and renters foster independence, such as vocational
programs, home economics study (whatever happened to that?), etc.

7) What would you do as a State Representative to improve the opioid and
drug problem in the region?
a) This has been the focus of my life over the past 35 years, particularly
creating a balance between the needs of those in pain and those
addicted. Prior to being elected, I wrote an internationally recognized
book on the subject, worked on local, regional, and national
committees, created two non-profits dedicated to this issue, and
served on a Governor’s commission and an ad hoc commission. I
also initiated and wrote the first opioid prescribing rules for our state.

b) As a legislator, I

i) Served on the following committees all which address this issue

(1) Health and Human Services and Elderly Affairs

(2) Opioid Abatement Commission which I am the Vice Chair

(3) Integrative Pain Care Committee which I created through HB 66
and HB 1712 and which I chair. Our focus is to create
integrative pain care models which are opioid sparing and bring
together the resources of the community to help the 60 million
Americans who suffer from chronic pain

(4) Behavioral Health Crisis Advisory Committee

(5) Drug Fatality Review Board

(6) Therapeutic Medicinal Cannabis Oversight Bo

(7) Governor’s Commission on Alcohol and other drugs

(8) State Health Assessment, State Health Advisory Commission

ii) In addition, I am also involved in a variety of non-legislative groups
nationally which address these issues.

iii) What I have done:

(1) As vice chair of the Opioid Abatement Committee, I initiated a
program to formally create priorities, a sub-committee I co-
chaired. We created a list of preventative, therapeutic, and
harm reduction interventions which will address the effects the crisis

(2) I wrote and passed HB 1604 which will allow opioid abatement
funds to be used to create integrative models of opioid sparing
pain care as well as created models of care which will allow
those on opioid therapy to have access to care without having
to resort to street drugs or suicide. This is a first in the nation
policy which has attracted national attention.

(3) We worked to create a list of cross-talk between government
agencies in volved in assessing the opioid crisis, so we can
improve coordination and minimize duplicity and lower cost

(4) 80% of county inmates have a substance use disorder. This
emphasized the need for three things.

(a) Prevention: in our cross walk, we discovered there is virtually
no attention being given to prevention. We have initiated
programs to address this issue.

(b) Therapy: we have funded MAT in prisons through the opioid
abatement commission.

(c) Housing: we have created a model of temporary, post-
discharge housing for inmates to facilitate transition to a
healthy life

(5) As a member of the HHSEA committee and the Therapeutic
Medical Cannabis Oversight Board, I have been dedicated to
creating policy designed to avoid problems

(a) Cannabis and alcohol are the most prevalent gateway drugs
for SUD and OUD, yet this seems to fly under the radar.

(b) We are dedicated to creating state polices that
acknowledges this reality minimized risk

(6) As a member of the Drug Fatality Review Board, we investigate
causes of the overdose and examine policy changes that could
have prevented these deaths.

(7) I worked very hard with the sponsor of SB 239 and wrote
several amendments to create responsible and multi-
stakeholder acceptable models of drug harm reduction
techniques in this state. Defining this term was crucial, and we
were able to achieve what some said was impossible. This
served as a template for what we can and cannot do. These
techniques are critical in avoiding the morbidity and mortality
that goes along with addiction.

(8) I authored HB 554, 303, 66, and 1712, all of which involve
increased access to alternative, opioid sparing therapies for
pain. HB 66 and HB 1712 passed unanimously and the
program we are creating is drawing national attention. HB 554
and 303 are in study, a group I chair. We are hoping to have a
multi-stakeholder, first in the nation bill passed this January.

(9) This is a partial list of what I have done. Happy to talk morel

8) What do you think is the most important skill of being a good State Rep,
and why?

a) By far, the most important skill is the ability to respect the opinions of
other legislators, lobbyists, departmental officials, and constituents,
and bring them together in multi-stakeholder sessions to make
meaningful legislation. This implies you are willing to work hard and
listen. Most of the work in crafting legislation comes before one
presents the bill. For example, my biggest success was passing SB
561 on prior authorization reform. This was my project and I was the
lead author. Before we even wrote the bill, I conducted dozens of
hours of town halls with all stakeholders, first in individual groups,
then in multi-groups, to refine a bill which I told was impossible. This
culminated in meetings with insurers and the insurance commission.
By the time we were done, hundreds of hours had been spent, we
had a meaningful bill which will save the health care system millions
of dollars and providers, patients, and insurers unnecessary hassles,
and the bill passed both Houses unanimously. If I had not done all
that, the bill would not have had a chance. And they said it couldn’t
be done…

9) What do you see are the biggest needs of Belknap County, and what
would you do to fill that need?
a) Homelessness: see #6. There is way more to this than that, but I will
leave it at that for now.

b) Education: I am very concerned about the divisions that exist on this
issue and the ramifications for our schools and students. There is a
huge gap between rhetoric and reality that needs to be bridged. I
have a had a number of town hall meetings on this issue, and intend
to continue that process

c) Substance Use Disorder and Mental Health Disorder: we recognized
the problems, but we are not addressing them. In the various
committees I am on, I see it as my role to address these issues in a
cost-effective way by bringing all of our providers together in a
functional way. That is one of the big goals for the State Health
Assessment Advisory Council: How do we bring together all or our
resources in a meaningful way, and how do we fund this when grants
are tenuous and Medicaid reimbursement is insufficient while health
care dollars for these issues competes with other, more highly valued
medical issues.

10) What percentage of your campaign funding comes from outside the
county? How much from out of state?

I am self-funded

11) Do you think our current county government should be smaller,
larger, or stay the same?
Stay the same

12) 13) What distinguishes you from the other candidates?

I am politically eclectic. I like listening to everyone, and
independently make up my mind. While party has value to me, the
needs of ALL my constituents supersedes that. The sad thing is that
is a lesson we were taught the first day of our legislative careers, yet
in this divisive world of party politics, it too often falls on deaf ears.
Furthermore, I really think that when creating policy, all voices need
to be heard in a respectful manner, preferably in multi-stakeholder
groups. In my committees, I insist we do three things. First, we
organize chairs so that all are comfortable. I do not like the legislative
system in which a person testifying is surrounded. You do not get the
best out of everyone by doing that. Furthermore, we are all equals. I
also do not like the “snooze you lose” manner of committee hearings.
When I put together a committee, the first thing I do is ask “who is not
here who needs to be?” and we make sure that person or group is
there. By engaging in respectful, multi-stakeholder discussions, I
have been able to created meaningful policy that will positively affect
the people of this state and beyond. The biggest compliment I have
received from the Governor, his assistants, departmental
representatives, mayors, Selectmen, Secretaries, Democrats, and
Republicans is that I am reasonable. I have been told dozens of
times that it is unfortunate there are not more people like me in the
legislature. There are some, and we have bonded together in a bi-
partisan caucus, and that is a really good thing. The problem is we
are viewed as “RINO’s and DINO”s”. I really believe in the beauty of
diversity, and I have promised to bring diversity to both parties. That
was in my campaign promise. I would argue the other candidates do
not share this ethos, and that is too bad. With all that said, I have
been asked to chair one committee, two sub-committees. I am the
vice chair of the opioid abatement fund, a $330 million project, and I
am in line to the chair of the State Health Assessment/State Health
Initiatives Advisory Council. I am not aware of a Freshman legislator
ever being asked to take on that much leadership.

13) What endorsements have you received?
Formal: Teamsters
Informal: Mayors, Selectmen, Clergy, others

14) How long have you lived in Belknap County?
29 years.