Cheshire County officials brief Nelson Select Board on services, costs, nursing‑home pressures and EMS capacity

Cheshire County officials met with the Town of Nelson Select Board on March 25 to outline county services, program costs and the town’s share of county expenditures.

County Administrator Chris Coates told the board the county is trying to improve outreach to municipalities and distributed a handout titled “Cheshire County at Glance.” "They have 500 employees total," he said, and the commissioners are using new communications such as a county podcast to explain services and associated costs.

Coates highlighted Maplewood Nursing Home, which the county recently renovated to better serve residents with dementia. He said the facility has 150 beds (about 70% single rooms), an assisted‑living wing of roughly 20 apartments, and a staffing‑driven operational cap of about 115 residents; he added there is a waiting list of about 100 people. Coates said staffing shortages are constraining occupancy.

On corrections, Coates said the county jail houses about 115 inmates — roughly 70 local and the remainder federal — and stated federal inmates generate about $120 per day for the facility. He also reviewed emergency medical services, saying the county operates five ambulances staffed 24 hours a day with a 24‑hour paramedic intercept, serves 19 contract towns, has applied for a replacement ambulance (with a roughly two‑year wait), and runs a wheelchair‑transport partnership (Smart Ride) that averages about 40 runs per day; residents pay for those trips.

Coates described the Connected Families program, which places trained staff with at‑risk families to prevent out‑of‑district placements that he said can cost a community roughly $200,000–$500,000 per case. He said the program has about 29 staff and that the daily rate for placements is paid by the state.

Coates noted the Sheriff’s Department handles truancy issues for Keene Middle School/SAU29 and that some towns contract with the sheriff when local departments cannot be staffed; he reported there have been residents who favor relying on sheriff services rather than maintaining a full‑time police chief.

The county has also invested in communications infrastructure: Coates said the county partnered with Motorola on a $4.4 million tower‑upgrade project intended to provide coverage improvements for an estimated 15–20 years.

On grants and direct assistance, Coates said the county helps with about 38–41 grants annually, bringing in an estimated $13–$16 million, runs a grant‑writing class and operates a handyman program that provides home modifications (widening doorways, installing ramps) with roughly $40,000 available per year through referrals from Cheshire Medical.

Cheshire County Finance Director Sheryl Trombly told the board that statutorily required services such as the sheriff and jail account for roughly 85.6% of county spending. She said Medicaid‑funded nursing‑home or at‑home care is paid about half by the county and half by the federal government and stated, "This amounts to 8 million dollars in services per year." Trombly provided a chart showing how overall county costs are allocated to towns, noting that a five‑year reevaluation helps equalize shares; under that allocation, Nelson is responsible for about 1.5855% of the county total.

After the briefing, the Select Board voted at 4:00 p.m. to enter a nonpublic session under RSA 91‑A:3 II for personnel; the motion was moved by Chair Brenna Kucinski, seconded by Michael Blaudschun and passed by the three selectmen. Following the nonpublic session, the board voted to seal the minutes and adjourned at 4:30 p.m.

The county presentation outlined several areas that could affect Nelson taxpayers and local services — nursing‑home capacity and staffing, EMS availability, and the budgetary pressure of statutorily required corrections and public‑safety services — and provided local officials with contact points and handouts for follow‑up.