SAU16 Joint School Board Meeting 05/18/26

001It is 6:01. So hopefully we can uh get things started and call the meeting to order. Uh I know you're probably perhaps thinking, "Wait a minute, we voted for the taller guy. Patrick is under the weather today, so uh I'd be standing in his uh shoes for the moment." Um so first thing is pledge of allegiance and do that sides. >> I pledge algiance to the flag of the United States of America and to the republic for it stands one nation indivisible and justice for all. >> Okay. >> Thank you. Uh, second order of business. Um, we do have two board members who aren't able to make it tonight. Uh, Patrick and Jennifer Scraffford, and we'd like them to be able to participate electronically, but that requires a vote of this board. Uh, so is

002there a motion to allow uh Patrick and Jennifer to permit uh to participate remotely? >> I'll put the motion forward to let them participate remotely. >> Thank you. Is there a second? >> Second. >> Okay. All those in favor? >> I as if the motion carries. >> Thank you. All right. Um, next order of business is public input. Is there a member of the public who would like to make any comments? With no one coming forward, we'll leave the public open public input open for at least 30 minutes until 6:33. All right. Um, next order of business. Do you want to do the insurance first or approval of minutes? >> Oh, do let's do minutes and then we'll get right into curs. >> Um, next order of business will be the approval of minutes. We

003have public and non-public minutes from our last meeting. Does anybody have any comments on either set of minutes? I have a comment on the public minutes and there's a typo on pledge of allegiance where it says pledge it. So with that change, would there be a motion to adopt the public minutes as amended? >> I'll make a motion. >> Thank you. Is there a second? >> Thank you. All those in favor of the minutes as amended. Uh, any abstensions? >> Jane, Heather, Cameron. >> Okay. >> And any opposed? Okay. Um, is there a motion to adopt the non-public minutes or does anyone have any comments on the non-public minutes? With no comments, is there a motion to adopt the non-public minutes as presented? >> Thank you. Is there a second? Second. >> Thank you. All

004those in favor? Any abstensions? >> Got it. >> Okay. And any opposed? >> Thank you. All right. Item number four tonight is SA16 administration and in particularly healthcare insurance presentation. and we have a guest tonight uh Kirsty Karpowitch who is going to present to us about the medical benefits. So >> yeah, let me just give a little background. So I know we're getting ready uh next year to start doing um negotiations with a number of our different unions and CBAs. One thing we heard a lot this year was the increase in health insurance. And so uh myself and our team have been, you know, meeting uh quite regularly to talk with different companies, talk about the landscape both locally and nationally. and it was really enlightening and and uh gave us a lot of education

005that we can think about as we go into negotiations for next year. What are some local trends? What are some national trends? So, we thought it'd be really important that you all heard that message so that you're aware of it. We did also meet with um members of all the unions to give them that and we really feel if nothing else next year really doing more education for everybody about how we can save money but not necessarily always changing our the the what we offer for different um benefit packages. So that was the enlightening part I think for myself and my team as well as from the union members is that people felt if we change you lost certain uh doctors that you you would not be able to see which might have happened in

006years past but is not kind of the case today. But I don't want to steal any more of Kirsty's kind of thunder. So I'll let her get up and and kind of walk through uh and give you that kind of education that we had. So thank you Kirsty for coming and and uh being able to present today. >> Sure. Um, okay. So, good evening everybody. I'm uh Kirsty Karpich and I work for Boris Low Insurance. Um, and I've been the broker/conultant for the exit school district for your ancillary benefits for over 20 years. So, the life and long-term disability, etc. And about 20 years ago, we actually did a bunch of consulting work with you. Um, and uh, back then we helped you get off the JW and the JY plans. So it was a

007long time ago. Uh and uh we're still doing the same work. So we work um uh I've worked throughout uh New Hampshire in the municipal sector for over 20 years and we work with a lot of the SEUs in the municipalities. Um we work with the city of conquered you know we work with a lot of the larger school districts um on many things including um sometimes consulting on medical. And so, um, what I'm here tonight to do is to kind of just walk you through the landscape. Um, not even necessarily just the New Hampshire SAU landscape, but this the macro landscape because we're all, regardless of whether we are in New Hampshire, Maine, Vermont, Massachusetts, you know, out west, down south, a public entity, a private entity, a small group, a large group, like

008we are all subject to some macro trends that um that we really can't get out from under. and they impact all of us. And so it's kind of important to know that environment as you think about collectively your health insurance. Um so to start out, it's a little awkward because I'm like facing this way, but the slides are this way. But to start out, um so there's this concept called trend. So trend is, uh I have a procedure today. A year from now, what's that procedure going to cost? Okay, it could be surgery. It could be. >> There we go. All right. Thank you. Okay. It could be um so there's a medical trend and there's a prescription drug trend. And um what we're seeing right now is that the trends are the highest that

009they've been in ab by by far the highest they've been the entire 20 plus years that I've been doing this. But they're really at ex like unprecedented, which is an overused word, but highs. And so we'll we'll talk about why. So on a medical side, we're seeing trends consistently um around 9% um and from a prescription side around 11%. Okay, prescriptions used to be about 18% of the overall cost. Prescriptions are now um getting into the low 20% of the overall cost. It's not uncommon to have high cost claims that are just prescriptions. So all those prescriptions that you see advertised on TV at night, we see them all in the claims. So there's just a ton of um really effective prescriptions that can do a lot of great things that um we didn't used

010to have. You know, we see a lot of people living great lives with um MS and we see um people with stage four cancer prolonging life for years, but it all comes with a cost and we see those costs in the claims. So anyway, so that's what trend is and we're seeing trends about nine on average for medical and about 11 on average for prescription drugs. Then there's this subcategory of prescription drugs. It's the fastest growing category. It's called specialty. And those are the those are the ones those are your skyrizies, your heas. You can you can sing all the jingles. They're all the ones that you see on TV. And I swear to God, it's like a direct line from what we see on TV to what we see in the claim pick. And

011I will tell you that the average cost for these, like it's so common to see a a drug be 85,000 a year, 100,000 a year, 300,000 a year. I mean, we have some drugs that are 24,000 a week. Like, it's insane. So, this is it's it's it's rapidly growing. There's tons of pharmaceutical innovation, but the actual cost of these drugs in the plan is usually in the multiple tens of thousands of dollars, even though, you know, you might see just a small co-pay, but behind the scenes, the school district is paying the whole amount. And so that's why the specialty trend is growing so fast. Um, dental, um, oh, there's a typo here, but dental, it's so interesting. I'm just going to do a little tidbit. We're not here to talk about dental. Dental used

012to be the sleepiest, most boring thing. It was like two to three% a year. It was so predictable. And then COVID happened and then we that we saw a big spike in claims. Well, nothing during CO, nothing. And then huge spike after that. And we kind of thought it would settle back to the sleepy 2 to 3%, but it didn't. And so we're seeing a lot of dental like dental increases, 4%, 5%, 6%, 8%. We never used to see that. And when we talk to Delta or some of the bigger carriers and say why they say well think about it what are dentists but like small businesses a ton of small businesses and it's so expensive to run them and so all of the cost that it takes to run things is just getting translated

013into your claim. So if you end up with a dental increase it's higher than you've ever gotten like you are not alone. It's just another you know phenomenon that we're all living under right now. Um so what impacts trends? So a lot of innovation. So you know a a lot of medical technology um provider consolidation. So you we are you know you know in New Hampshire like this hospital you know one hospital emerges with a Massachusetts chain then another one gets bought out by the hospital corporation of America. All this consolidation definitely increases the cost. Um we're also seeing you know in our more rural parts of the state and in our rural states that we work with like Maine. Wow. like the the more rural the state, the higher the cost of care. These

014poor rural hospitals can barely keep their doors open. They're getting so much less federal support. It costs a fortune. So, or like up in the Lakes region, no more OBGYn. You want to have a baby, you got to drive down to conquered. Like, you just literally cannot afford to keep the services going. So, it's really expensive to run a hospital. And one of the things that we're starting to see because we work with a ton of big self-funded groups and we're just seeing claims so much claims inflation everywhere is that the standard cost of hospital charges the starting point is I mean sometimes it's double what it used to be. So just the baseline cost. So it's like you may have the same amount of hips or babies or knees or surgeries that you had

015before but they just cost more and it's because it it's so expensive to run these hospitals. So all of that creates this medical inflation which we call trend. So here's some New England states. Um and you can see what I meant about Maine. I mean it's heartbreaking. Um but in New Hampshire um you know I mean we're kind of in the middle of these New England states, but you can see a medical range. And what we did here is we consolidated all the different carriers that we work with. So we had Health Trust, we had School Care, we had Sigma, we had Anthem, we had Harvard. just consolidating what they were giving us for medical trends, pharmacy trends and total trends. So again, trend is just for a pool a big pool of risk um

016within that what a service costs today is projected to cost a year from now. That's what trend is. Yeah. >> The the low end of New Hampshire is lower on pharmacy than any other states. Is there a reason for that? >> Yeah. You know what drove down the low end of New Hampshire? The health trust. So I literally went in and adjusted the New Hampshire because the health trust had lower trends than anybody else. That's the honest answer to the the low end of New Hampshire. That's the health trust reported trends. >> Thank you. >> So this is um again some of the drivers. So the price inflation hospitals, you've all heard about like the travel nurses and how expensive that is and that that brings up the cost of care. um you know increased

017demand for physician services. So the older our population gets the more chronic conditions there are. It's just a statistical fact. And so as our population ages, there's just more more chronic conditions. And so that there's more utilization. There's two different ways you can increase cost in healthcare. You can have a big a big high claim or you can have a lot of claims. And both of them increase the cost of care. So the utilization would be just a lot more volume. um advances in me medical technology. Okay, so gene therapies in here. So gene therapy, the these are new. These are drugs and they'll typically be a onetime um application. So we we had our first gene therapy claim this year and it was a one-time application. Um and it w it's you it can

018be a shot. I mean it they edit your gene. you. A lot of times it's for um younger children that have a very severe condition and it can be life-changing and it can either halt the progress of a disease or cure it. Um they run in the millions. So it can be a $3 million one-time application, a $5 million um that right now there's like 27 approved gene therapies. They're saying by 2035 there's going to be 90. as these gene therapies start to um become um able to solve more everyday problems or more common problems, then we're going to see them in the claims more because more people will have those conditions. Right now they're for very very unique conditions. Um but we're we're we're we used to read about them. Now we're seeing them

019in in New Hampshire claim pickics. So, that can be really challenging if you're, you know, the health trust or a carrier because imagine like all of a sudden you have to absorb a a $5 million one-time application. Um, and that and that gets put into the the whole pool which ends up in, you know, increasing medical trend and making your, you know, your your increases higher. So, but they're out there and they're, you know, these are FDA approved and and they're available now. that it's new. Um, we talked about hospital consolidation. We talked about a lot more chronic conditions as we age. We see so I was just on a call today. Um, cancer. Yeah. So, this is like universal cancer, cardiovascular disease, muscularkeeletal, and also mental health. Those are the big drivers right now

020of claims. Um, and we're seeing it. And here's mental health. Like, it's it really doesn't matter. Like the call I was on had nothing to do with SAUs, but it was the same information, right? This is just what we're seeing across the board in the United States right now. And then for prescription drugs, um so um let's see what we haven't talked about here. Um 80% of all FDA approvals fall into the specialty category and can cost over $100,000 a year. Definitely see that all the time. the aggressive direct to consumer promotions. Those are the TV ads. We're the only country where you can like advertise on TV and then have people take the drugs. Um it it it it definitely sells the drugs. I will tell you that. Um lost more. >> I think

021we pretty much covered all of those. So this is a slide on the hospital price increases. So I thought this was interesting. This is a 2006 seagull study which is a big massive um United States health plan study. And so what it shows for hospitals is both price inflation and utilization. Um and then for physicians price inflation and utilization. Um and you know what are the the drivers which is basically the rising labor cost, the workforce shortages. Um the financial strain and inflationary pressures of these health care systems and these hospitals. And you know there's profit centers in hospitals. The ER is a profit center. Um labs are profit centers. you know, there's certain things that, you know, cost a lot more. And that's why if you have a plan that um steers you to

022an ambulatory surgical center versus a hospital, those are really good things to educate your your your members on because um again, you could have the same surgeon do a knee at an ambulatory surgical center or at a hospital. It could cost five times more at the hospital and your plan's paying that. That's in your claims. you you you're not paying it. Like you may pay the same small amount, but the plan is paying it. And if you multiply that times all the people, then it ends up starting to be a big inflationary claim pick and then that gives a bigger increase. So that's why these things matter. Where you go matters. And then the prescription drugs. Um so again, we're seeing, you know, the the 11% and then the specialty drugs. um you know the

023the 11.9 right now and those are um there's there's also something called um biologics which so bioimilars would be um like a generic for a biologic but there there the innovation in prescription drugs right now is just um it's it's fastm moving it's it's quite something all right so New Hampshire so 2025 which you're all living there So, this probably isn't any news to you, but was crazy in the municipal landscape. Um, it it was a wild ride. Um, so we started the year with three pools, three municipal pools. Um, the health trust, school care, and the interlocal trust. In April, the interlocal trust folded. Now, they were the smallest. They had Harvard Pilgrim. They only had 5,000 lives, whereas the health trust has 72,000 lives. So, they were little. Um but one of the

024things we saw in 2025 across the board were these giant macro trends um that that that made the interlocal trust go under that made um blue blue cross of Massachusetts have a $600 million deficit that made Harvard Pilgrim 32 Health have a $600 million deficit. Like 2025 was just brutal. that made school care have to assess their groups for $30 million on top of premiums just because claims outpaced what they'd projected by so much. So, this is something that wasn't unique to the municipal pool municipal pools. It was just like all of a sudden like the it just felt to me it was almost like the ground felt unstable. Like I was like all these institutions that we'd worked with for so long suddenly one after another were just really faltering and it was because

025the claims were in the claim costs were increasing so fast faster than the actuaries could project and so um so this was a rough year. Um you're with the health trust so to be honest you were in uh a more stable position by I mean certainly because the groups that were with the interlocal we had to help them. It was a fire drill in April. They had to literally find new insurance carriers in the middle of the year, which is not what you want to do. And then with school care, it's been really rough with the um the assessments and super challenging. So anyway, you were the health trust. Um they are the largest and oldest nonprofit risk pool. They were founded in 1985. Um as you know, um they have been trying to build

026their reserves back with the it's about a 5% load every renewal. Um and that to be honest is fiscally um appropriate because as we can see if you don't have enough reserve you either fold or you have to do an assessment. So sometimes in this world it feels frustrating when things are costing a lot but then when you see like when you see what we see which is a little bit behind the curtain you realize like you have to keep up with it. Like if you if you don't charge enough what can happen is you can suppress it, suppress it, suppress it and this huge increase and that's not good for anybody either. So yeah, >> can you explain what a municipal pool is and how the lines are drawn like how maybe >> Yeah.

027So it's the RSA um 5B. So So there's a there's a um the municipal pools in New Hampshire are formed by this RSA. Um and um there's a lot of discussion about that. There's two bills in the house um right now about it. Um but yeah, it's RSA 5B framework and >> Christie, would you mind just stepping back to the mic just for people watching from home? >> RSA 5B is is the um is what uh has created the municipal pools and it's the structure under which they operate. There's a lot of public discussion right now about that and and how that will take shape moving forward. There's two bills in the house that are moving through right now. So, but currently RSA 5B is the structure and that's where under which there's the health

028trust and school care. >> Yeah. >> Thank you. >> Mhm. So, just for the range of increases. So, for 7126 the health trust average was 10.2%. It ranged from a minus 5.1 to a plus 26.6. Um, school care the average was + 17.3. It ranged from plus 7.8 to plus 34.8. And I will um there's there's a concept called credibility. So the bigger you are, the more credible you are. If you have 500 subscribers, not members, members would be um spouses and kids, but just the the employees, the employees, 500 employees on the plan, then you'd be fully credible. The more credible you are, the more your claims dictate what your increase is. Okay? Okay, the less credible you are, the more then it's a percentage of your claims and then a percentage of how

029the pool's doing. Okay, so the bigger you are, the more you control your increase. And then the more what you say to your members about, you know, different ways to use like the site of service or whatever, that's why that's there in order to help your members be wise consumers of healthcare to to the extent that we can. Um, okay. So the health trust, so I just took this is all directly from um their statement that they posted in last September. Um but you know, right now the health trust is stable. Their cash flow is good. Their reserves are good. They're building their back their reserves as we know. Um and they seem to be weathering the storm. I mean, they are not going to be immune to these trends that we're all under because

030they're nobody is. So, you know, it's almost like you have to look at this as a point in time, and that doesn't necessarily mean that tomorrow's going to be the same as today, okay? Because it does we don't know what the claim pick's going to be. Um, but if I had to be in a municipal pool in New Hampshire right now, I'd want to be in the health trust because I wouldn't have just gotten a $30 million assessment or had my pool closed, right? So, um, so they're trying to build back the capital adequacy reserve and, um, they're these metrics here are lower than what we're seeing nationally. And I guess that's the only thing that I would say is a point in time because I can't say that just because they're saying that their

03112-month medical trend here is 7.2 that that's going to be what it's going to be in the future. Um, I, you know, I I I don't work for the Health Trust, but I do see claims across all of the New England states for tons of large groups, and the Health Trust is much lower than what we're seeing elsewhere. So, I don't know why. Um, but I guess I don't want people to just think it'll always be low because it's it's it's like at some point medical trend is medical trend and groups are are like there's a predictable amount of risk that will happen. Um, so there the 2026 pool ranged from minus 5.1 to 26.6. The average renewal was 10.3. Um, what what is the health press doing? They're renegotiating their relationship with Anthem. They

032added stop-loss at a million dollar spec level and they did have seven gene therapy members that totaled 13 million. So that was the new gene therapy I was talking about. Um the the what a the spec level the million- dollar spec level is that's the pool buying reinsurance which is a very good idea because all of a sudden like it's not uncommon to have a transplant claim that'll be a couple million dollars. We see we dealt with three transplant claims last week. Like people are getting transplants so much more commonly than they used to. It's not uncommon to have 13 gene therapies. They had 13 gene therapies in a year. This is in New Hampshire. So you need to have protection even if you're the health trust with a big giant pool. So now they

033have protection above a million dollars. So, in your renewals, you'll see a fixed charge, which is going to be them buying stop-loss for claims over a million dollars, and you pay us a fixed fee, but then that protects the pool. Um, which is that's good financial that they should do that. They need to do that. >> Uh, school care. So, claims were 13.3%. Um, but they only projected seven. So this is where what happens. This is what happens when the actuaries and they have all these high paid super smart people and they say we think it's going to be seven. We're looking at the world. We're looking at this and we think it's going to be seven and it's 13.3 and then you have to issue a $30 million assessment. So that's um you know

034that that that was unprecedented. It never happened in New Hampshire. Um but again school care I mean happened at the interlocal trust it happened for all like tons of big carriers around New England. So they were not the only ones but we are just felt like we were seeing this like new new era where claims were going up so fast that even actuaries couldn't predict how fast they were going to go up. Um so as a result they ended up with really low reserves. They were projecting a deficit. They had to issue a $30 million assessment. Um, and then they had the regular increases which were averaging 17.3%. They're using a trend combined medical and RX of 11.24%. So when we started tonight, we were talking about trend. So they're using a combined of 11.24,

035which is high. I mean, you know, double digit trend, that's basically saying if a group is running well, they're going to get an 11. That's what that means. Which that sounds like a lot, right? if you're having a good year and then you end up with an 11, but that's just because that's what the cost of your claim pick this year is going to cost next year. So, what options do you have? Um so right now you're in this RSA 5B which allows municipal municipalities, school districts and other public entities to join um poolled risk management programs and members share risk to stabilize cost. Um when groups talk about if they left the municipal pools, what would they need to do? So I put a bunch of questions here, but these are questions to ask

036yourselves, right? If you were ever thinking of leaving. So, um, do your CBAs indicate a particular carrier or plan design? So, like if we went and got Anthem quotes and they mirrored your current plans, is that okay or not okay? That's a question. But if if it's if if you want to put yourselves in a position to ever look at maybe getting Anthem plans that look like the health trust plans, that's something to think about when you go through bargaining. Um, okay. What are the additional benefits that you get in a municipal pool? Um, and I think I there's a big one I didn't put down here, which is an intangible. It's not something you like it's not a cost that we'd have to figure out how to get outside, but that's customer service. So,

037I will say the Health Trust has a bunch of people that sit in cubes that answer questions all day long. So, if you have a problem, you can call the health trust and you guys, they'll work on it for you. Okay? If you move out of the health trust, you're either your employees are either calling Anthem on the back of their card if you were with Anthem or you're buying a concier service that's going to help do that. Okay? So, that's something just to know. That's one of the things these because these municipal pools like they don't just serve like big SEU16. They also serve these teeny weeny little towns up north that have like two people that work there, right? They don't have time. They don't know. So that's kind of the point of

038the health trust is or these municipal pools is to be able to take bigger or smaller public entities and help streamline this and make administratively it it it ease the administrative burden. Okay. So, if you did leave, um, we would we or somebody would need to help you find a COBRA vendor, figure out how you're going to integrate with the New Hampshire Retirement System. Um, get medical and um, dependent care flexible spending count set up, get your HA set up, HSA administration, EAP programs, and wellness. I did price that little bundle out um for another SAU just to illustrate to them and it came to about $18,000 in admin costs a year. So, it's not like a fortune, but it it is administratively not as easy because right now it's all taken care of. >>

039Okay. So, there's kind of work that exists there. And then if you do leave then or any school does leave and they want to go out on their own, what what are your options? Right? So you kind of go from left to right. You can you can go fully insured. So fully insured is um probably what most people know. And so that's like um you write you sign a contract and it has rates on it and then you set it and you forget it and all the risk is on the carrier, right? So they it's all they do it they do everything. You just pay for it. Okay. And you pay the same amount kind of like you kind of have now where they give you like your single and your two person and your

040family rates. Same thing but it's a premium fully insured premium. Okay. If we move one level over to level funded. So now you're moving from a fully insured platform to a self-insured platform. Um but you're going to pay a fixed premium like you are fully insured. So people like this because it's predictable, it's budgetable. Um, and then what happens is at the end of the year, if you run well, you can get either half or 2/3 of the amount that you ran better than expected back. Um, so if you're self-insured, you would get all that back, but you would have a lot more unpredictability. So, you're kind of paying for the predictability. And if you're in a self-funded platform, you don't have to pay premium tax. You're not subject to state mandates. You have more

041control over your plan. So that's one of some of the reasons why an entity would think about level funding. If you go to a captive, you might hear about captives and we actually at Warso run a captive for private schools. So we work with like Philips Exit or Philips Andover, Proctor, Tilton, Al KUA, all these private schools. So they're in a captive. It's kind of like the health trust, but it's it's it's a pool of um like entities that are working together and then they share risk and they're self-funded. Captives are a lot better for groups that are a little bit too small to self fund. So like if you had a bunch of groups that were between like 50 and 150 50 and 110 people on the plan, they could work together. So that's

042kind of what works well with captives. They can be very complicated. There's lots of pieces and parts um to manage a it's much there's it's disagregated. So like there's a pharmacy benefit manager and there's a third party administrator and there's a stop-loss carrier and there's a lot of point solutions and it all there's all these pieces and parts that need to be put together. And then uh all the way to the right is self-insured. So you could go self-insured and there's two ways to go self-insured. You could go self-insured with a carrier. So, Anthem all up and down or you could disagregate it and you could get a pharmacy benefit manager and a third party administrator that gives you the Anthem network and or another network and then you and get a stop loss carrier

043and point solutions kind of like the captive. So, we work with literally all of these. Um there's no right answer or wrong answer. It depends on the organization. It depends on the management team. It depends on how much time they want to spend on healthare. It depends on how predictable they want their budget, what their appetite for risk is, etc., etc., etc. If you ever leave um the health trust and you go into any sort of the self-insured arrangements, there's a concept on the way in called lasering. So, in a self-insured world, if you have a high-cost claimant, um well, first you're going to buy um reinsurance over a certain level. So, for a group of your size, maybe that's $300,000. So you'd be paying every claim for for every person you'd pay the first

044300,000 and then after that there'd be reinsurance. A laser only happens on the way in. When you enter self insurance, but say you had an ongoing cancer situation where it it seemed like it was going to be going on for a few years, you might have to pay the first 400 or four or 500,000 for that person. So it's just something to know. Usually what you do is you have to laser on the way in if you have a really high cost claim and then you get a renewal that's no new lasers but a rate cap on the fixed costs. And so sometimes people wait until they don't have that situation to enter self-unding because then once you're in then you wouldn't have a laser moving forward. But it is something to think about because

045it can be a financial hit on the way in probably more than you ever wanted to know about health insurance, right? But this is how it works. Okay, that's it. Um, so I I think the point of me coming tonight was just to kind of say um that there are these macro trends out there that we are all subject to and so no one is really immune from them and so it is something to keep in mind. Um, in the municipal space there is a lot of turmoil right now. The health trust seems the most stable of all. Um, and there are a lot of SAUs that are looking at different you know options and talking about it. I don't think I mean I think that it's it's it's a healthy discussion. Um I don't

046I think just be wary if anybody says like there's a magic bullet, right? Or if you do this then all of a sudden budgets will pass, rates will go down. Like it is it it there are there are wise decisions to be made. Um but it isn't necessarily um there isn't any sort of one right answer right now. It's really just navigating it to the best you can and paying attention and educating yourselves and then educating your members. So questions. >> One more from Heather again. >> All right. What this this is like the altruistic question, but what happens if SAU our size were to leave our municipal pool? What happens to the rest of that pool since we're such a large? So the good part about health trust with 72,000 members is that it

047can with so it's not a pool like school care is smaller like if a big entity left schoolare that could make a big difference I would never I would be consulting and I wouldn't let groups go into the interlocal I'm like no don't do it like it's teeny like you don't want to be the big fish in the small pond like the whole point of this is to have to spread the risk so but you you wouldn't make a measurable difference if you left the health trust because they're so big. Yeah. >> Yes. >> The so the main driver of the increase in healthcare cost are the prescription drugs, right? >> Well, so prescription drugs represent between 18 and 22% of the overall cost. So they're they're only say 20%. So they're only 20% but

048they're growing the fastest, >> right? >> Okay. So 80% are the medical. Um, now the thing that we get a lot now in medical are infusion drugs which go in medical. So the prescription drugs are what you pick up at the pharmacy, >> right? >> CVS, Walmart, you know, whatever, Walgreens, that's that's the prescription drug that's a 20%. There's a whole world of prescription drugs that get build through medical now. So, we'll have a high-cost claim it and it'll be $900,000 of of prescription and like 20,000 of of medical and it'll be delivered in the hospital. So, it comes through as a hospital charge. So, there's now two kinds. There's the the hospital drugs and then there's the kind that you pick up at the pharmacy. >> So, looking at this slide for the two-year

049estimate, >> those are the those are the pharmacy ones. So the two-year stack for each for outpatient is 24% and the two-year stack for the specialy drugs is 27%. >> Okay, >> does that make sense? Is that does that math? I just multiply them with each other. So that I'm asking because when we get asked the question why are health care costs going up? I know there are trends and that people delay patient care and COVID and all that stuff, but a significant portion of the increase is specialty or other drugs. >> Yeah. A big part of it are drugs, but whether they're hospital drugs or prescription drugs, that's a huge part of it. >> Large pharmaceutical costs. >> Huge huge huge part of the the increase. >> And then also um you know the

050the hospital costs. You know, I I just feel like we have um it's really challenging right now to to keep hospitals running >> and part of that's because the the federal government changes reimbursement for some >> there's a lot of there's a lot of changes in funding. There's a lot of changes in trends in how healthc care is delivered. I often say I think like say like 50 years ago it's going to feel like the hospitals are like how we feel about malls now, right? Like we used to go to this one place and it was a brick building. you went there for everything and like you know there were all these germs there. No, because everything's getting like you have wearable technology, you get infusion at your house, like it's things are moving away

051from the hospital, these amulatory surgical centers, you get um MRIs at shields, like all of these services that you used to get at the hospital, they're it's disagregating. They're all moving out and so it's harder for the hospital to make money. So then they have to charge more for the baby and the surgery and the ER because they have to stay keep their doors open, but not everything's there anymore and then they're not getting the funding. So it's very multiaceted. You've got private equity entering healthcare, too. So that doesn't help because then they're trying to make a profit on everything and turn things quicker and >> then that increases the price. So drugs are one part, but I I really feel like, you know, the hospital costs are a really big part, too. >> Thank

052you. >> Yeah. What do you think private equity is driving? How much? Oh my gosh. Going from nonprofit to forprofit, >> right? I mean, I feel like you walk into your vet, you're like, "Private equity." And then you walk into the dentist, you're like, "Private equity?" Like, you can just You feel it. It's like it I mean, >> they're making record profits. >> Yeah. No, I know. I I mean, I I I think it's raising the price for sure. >> You definitely >> not that I can fix it. >> Yeah. Um yes, thank you. This was really helpful and I really appreciated you sharing some of not only the larger landscape but also examples of things that um consumers of healthcare can do to potentially um save some money. So this question I think is

053maybe if it's appropriate either for somebody within so maybe either you or or Chris just curious um do we in our uh in our SAU for the the members who have health insurance through the SAU are there any mechanisms in place or um I know in my workplace we have all sorts of initiatives so that we get our part you know preventive screening things and we go to our annual wellness and you know smoking sessation and um and we get educated on where to go to get the most um efficient cost for this test or that test. I'm assuming and hoping that those mechanisms ex exist in SC16, but I don't think we've ever had any conversation about that at our local level. So, I would love to hear if we have if you're ready

054for that, we can share it. If not, maybe could we just learn about those later? Sorry, let me >> actually I would love to bring that to the um to the joint board. That would be great. We There's a lot of new programs that Health Trust is putting forward. They have a new EAP program which is the employee assistance program. We brought them into our professional development day that Jill um organizes so wonderfully. Um they did a presentation there. Um and they um also have new a program called Hinge. A whole bunch of different things that are going on. We've started sending out monthly um wellness emails to folks letting them know about the in in bite-sized pieces, right? because sometimes too much is too much. And so just to let them know what opportunities

055are out there. We're starting to really think, this is part of my update, so I'll I won't have to do it later. Um but um we're starting to think about what can we do throughout the year just to remind people of different things um because we just get bogged down, right, in our day-to-day and we forget to do that self-care. Um that's so important to help us not have to go to the hospital and and um you know, that kind of thing. So we're working really hard on those pieces. Um Kim Gong in our office who's our benefits administrator is part of the um health trust wellness group. We have different um people throughout the district that sit on that um statewide team. Um so it's really exciting what they're bringing back and um what

056we can provide to to our our um our personnel and and staff. So love to be able to talk more about that or even bring somebody in to talk about it. >> That's awesome. And then I How do you what's the sense of the engagement that our members have with that? like is it growing? Uh is it >> that's a that's a good question. Some of these programs are just new this year. So when we get our report um at the end of the year, usually it's it's around right at the beginning of of the next school year. We should have a better idea of how many people might be engaging in it. >> Yeah. just because I I have seen they really can have a huge impact on cost utilization on on all of

057these variables that we talked about here and I think in the end can actually potentially decrease the continued increase of spend um based on all the things you're talking about. So really >> like the connect connecting the it's it's connecting where you go to what the increase that you might get out of your paycheck. I think that's it, right? Like basically having people understand that like if they made a decision cuz it's so darn easy to just go to the local hospital, right? But if you if if people start be having an awareness like of where I get my lab or where I get my surgery or if there's an option that I look at the price pricing tool or you know that as these transparency tools come out that people use them and that

058collectively if everybody uses them it really will lead to a lower increase and and it like like literally is a line item right to the lower increase. So, but it it's like people have to make that connection. And trust me, we're all busy, right? And you're working and you're raising your kids and you're going here and there and so it's like then now I have to figure out like where I'm going to get my surgery. But if they I I think the biggest thing these carriers need to do is make these tools easier to use, more available. Like this would be it's a great idea. Help us all understand how much stuff costs and where we can go so that we can navigate this and have some agency in in in this inflationary time. So

059that's my biggest wish is that these carriers continue to kind of like improve in that area of transparency and giving people the ability to easily navigate because right now it's not easy. >> So >> I do want to say one more thing Dr. tell you if anybody um sits in my the off my office area when Diane LCO who's our um uh b you our HR coordinator who does all of our onboarding sometimes I sit in my office and I giggle because she is so excited about the different um health options for people the wellness different things and she goes through everything she she brings out her own portal she talks about all the things she's doing and all of that kind of stuff so um if you're a new employee you definitely know about

060the services >> yeah and I'll just tell you like the um just one crazy step. But so the the most expensive hospital in New Hampshire is Memorial Hospital up in Conway and all the rural hospitals are super expensive. So an MRI there will cost you over $10,000 and that same exact MRI at Dairy Imaging will cost you $400. So think about that. It's crazy. And we have a group of 500 employees that we work in the North Country. We were trying all these creative things like give them a they get a day off and we'll pay them money. But it doesn't it's hard because they have to drive really far to get their MRI. But I'm just saying like the discrepancy in price in a small state like New Hampshire is unbelievable. And so those

061are the type of things that we need to that healthcare transparency will help illuminate and then maybe things will kind of coales towards a lower number which would be good. So >> yeah. >> So two maybe new person questions. Uh, so as health trust members, what control does SAU16 have over plan design? Like does this group get to say this year premiums are going to go up 5% and out of pockets going to increase 2% in order to sort of keep our total cost down? Like do we have the ability to design our plan for SAU 16 employees like that? And then I guess the related question is how do we think about that going into negotiations within our districts? Like is there an expectation that each of the school districts are relatively similar in

062terms of the plans that we're offering our employees if we buy into this as the district or is it one district can offer the world and the other less so and they find a way to pay for it? >> Yeah. directed to >> each contract's a little bit different. What do we have over nine different plans that we offer throughout all of our different districts? So, and the percentage of what we pay is a little bit different based on each district as well or teacher group or pair professional group or administrative group. So, that really has to go to that negotiation. That was one of my takeaways is that can we collectively look at the number of plans we're offering and can we condense them? Can we look at more high deductibles that will actually

063cost less for the employee in the district and you're not going to lose sight of service or going to the physician that you want or there's uh lower rates for going to a different site of services as Kirsty, >> right? So that would be a really smart plan. So basically you have a higher deductible so it costs less to come out of your paycheck but there are elements of the plan where if you use it wisely you can get things for like free or very low cost. It's good plan design, creates steerage, helps the overall cost of everything, right? So, and I think that sometimes it's smart to take a look at the plans every once in a while and try to figure out like are these all working for us or some of these

064a little antiquated and maybe they're now undermining us and can we move collectively forward. So and to answer your question on how much you have some control you don't have complete control because you have to work within the suite of the health trust but you have you definitely have voice as far as like can we can we you know can we go to them and say can you know can we have you know a better award for this kind of site of service or something like that. So the bigger you are kind of the more voice you have basically. Yeah. >> Thanks. >> Um sorry go ahead. >> Oh okay. Uh, I was just trying to clarify, do we need to have, if we wanted to be able to make any changes, do we need

065to do that during contract negotiations or can we do that in, you know, at any time? >> So, you can do oneoff, you can do or memor understanding, just an addendum on that piece. So, I think what Heather and I talked about is trying to get in front and do education for all of our members and how we could possibly shift plans, reduce plans, and get them out there. when we talked just with the union about 30 people that were there, they had no idea that that these shifts could happen that it saved them money in their pocket, too. So, wanted to educate you first and then get to all of our members. So, we'll put together a plan to say, here's everything that we're learning. Can we work together on that? Some some some

066unions you might say, we're going to wait because our we really like our health insurance for the next three years and we're not willing to do that. Others might say, hey, if we work on that, that might be the difference between us having to let a staff member go by us still getting to do that. So that's part of the education and the ask. Um but you don't have to wait till your contract. That could be a one piece and that's the only thing that you would talk about if the union uh in your district is willing to have that conversation. >> Yeah. and doing stuff ahead of like anticipating it and being proactive is so smart because what can happen is groups won't do anything and then and then it's like they don't do

067anything, they don't do anything and then all of a sudden there's this huge increase and it's so frustrating and it's like okay now we have to course correct and then hindsight is 2020 and if you kind of tweaked things and tweak things along the way because we like trend march is on there it this inflationary environment that we're in right now is the foreseeable future. So we that's a that's a fact. So then how within that can you structure your plan so that you still can give people really good care but they can use the if they have they use the plan wisely and so that's a smart thing to start gravitating towards >> this question I had just so we just went through budget season and I know our biggest increase in East Kingston

068was related to insurance cost healthare cost. Um, so the data that you just presented, does that reflect potentially those increase that we just saw or is this something that is more anticipatory for >> No, that's that that's um within the increase that you just saw. Yeah, because that was that was all the math that was used for 7126. Uh if a school board member is new or just wants to do some factf finding into the plans offered within their district, uh what's the most direct way to find out the sort of financial makeup of the plans offered currently? >> That lady that's standing up right there would be the best person for me set up a time. Come on in and her and Kim or and Diane, they'd be glad to go through that with

069you. It'd be really helpful. >> Cool. Are there any further questions for Kirstste? >> Well, thank you Christie. That was very uplifting. >> I know, right? >> But informative nonetheless. Um, before we move on, there was I know we've devoted a lot of time to healthcare and before we move on from that, I don't know, Heather, if you have anything that you want to add specific to the I say you're walking towards the mic, but you just kept going. Okay. Um, >> no. >> All right. Thank you. Um, is there anyone who'd like to make a public comment? Seeing none, I guess we can close that at 6:54. Right. Um our next item is superintendent endofear goals. >> Yeah. So thank you for uh looking at the um packet and report that we put together.

070It's been a really uh quick year. I appreciate all the support from the boards uh in my role as as superintendent. I think I highlighted you know some of the things that we're trying to do is just provide you with as much information as we can as it for today or anything that's coming through. uh obviously, you know, uh wish could have given more information on the amicus brief earlier and we're working through that and almost working through it as it's being developed. So, I I appreciate that. But part of what I wanted to highlight is just how we're continuing to build relationships with community partners. Um I put in there, you know, really the 16 and 16 is a different communication style, but the number of views we're getting, uh about 1300 views per

071per comments. Um and if you look, the PTO uh was the highest watched that was close to 7,000 views. So just looking at at that communication device compared to, you know, superintendent blogs or or what's going out through written communication. It's not just how people are perceiving or taking in information anymore. Uh so that's been something that's been really good feedback. Um you know, at first when I started those 16 and 16s, no one wanted to do it. They didn't want to be on the camera and and by January I was getting emails weekly, can we do this? Can we do that? So I think I've got a whole uh outline for next year on what can be shared by staff and students. So that's really exciting that people are asking to do it now.

072and and my content's really already uh driven that way. Um I also wanted to share just we're in a really fortunate SAU if you see the number of people that are continuing education credits both at the mast's um CAGS or doctoral level you know it's really unheard of and and the reason why is that you we hire really good people but they want to continue to learning because the the uh faculty member to the left or right of them is always continuously growing um and that that kind of um uh competition amongst them for for our students is is is telling when you walk into schools. Um and the last piece that I I kind of highlighted is just the the presentations of learning. So the fifth grade, 8ighth grade, and 12th grade um portfolio

073defenses or celebrations. Uh and then our celebrations of learning that are happening really right now have been amazing. Um we got to go view um auto tech. So it was our second year auto tech students. Uh and the passion and and the uh excitement they talked about they're learning and the certifications they're learning. A lot of these these students are are walking out of our high school with either massive amounts of college credits or certifications to enter in the job field immediately and have put themselves way ahead of competition from other high schools or people who are in the workforce. So these are just the highlights of of all the great things that are happening in our schools, you know, starting when they enter in prek and and then when they're leaving. So those are

074a lot of the highlights and then we'll start populating the strategic plan um once we get all of our academic data. So get some surveys going out to staff which will be there. There most of the data will be able to give us our first um pinpoint. Uh I think the only thing that we'll be waiting on is our HSA data which is the social emotional which will be a benchmark for for next year. Uh but really excited to start that so we can put that on the forward facing. So I'd say by the end of July or the beginning of July we should have most of that data and we'll go there but I'll let you know when it it goes forward and then that will be the time point from year to year

075of when we'll be able to update it. any questions from the report that I shared with you or the the goals I've been working through this year. Thank you. I'll turn it over to my team. I know they all wanted to highlight something that they were really proud of this year or the work that they've been doing. So, I'll turn it over since uh Heather, you have anything more that you'd like to add um in regards to >> Yeah. So, we we always get very excited to be able to share some of the things that we've been doing throughout the year. Um we did um successfully negotiate um we only had five pass but we successfully negotiated six contracts this year. Um we've done eight before so we've you know done more but but it

076was the I got to tell you this year the the feeling that we had during negotiations and those of you that were in them tell me if you felt differently but they were so positive so productive um and it just really felt good to partner with our associations to make sure that they um felt heard, felt valued and all of those things. So I just really appreciate everyone that participated in that from the board level and the association. I just think it was a a really remarkable season of of negotiations. So that was one thing we are doing a lot of work or trying to get to. Um that focus on the wellness piece um which is exactly what you were talking about Dr. Kelling. Keep digging and plugging away at that. Um we are

077doing a lot I think Dr. Andi you mentioned this with our reertifications. I I think most people will say it's one of our happiest times in the year. we get just get to sit down and hear about the amazing things that um our staff are doing to grow themselves but also how that growth is impacting their students. And one of the things that we're that we've actually talked about being so excited about is when they talk about they're getting feedback like intentional feedback through surveys or discussion groups circles that kind of thing from their students on how did how did that lesson plan feel to you? you know, they're being vulnerable um with their kids and they're getting so much really great feedback from them and I think that's so important um to get that

078student perspective um because they're the ones that are being impacted by it, right? So, um just a lot of really great things um that are happening and um a lot of um introspect reflection on how we can do better. We continue to look at our transparency and communication regarding our relationship with um with payroll and how can we improve that so that we can be a better service to those that we um that we serve. >> Molly Michelle, you want to give your update? You guys do so much together. Come on up and then hit anything. >> Yeah, so the business office has been busy. Um, so it is the end of the year, so we're very busy trying to figure out where all of you are at in reporting in your May meetings and

079June meetings your fund balances so we can make some really important end of year decisions regarding tax rates. Um, we continue to grow in school ERP pro and learning different functionality in that. Um, we have a lot of professional development within the business office. Michelle and I are actually headed to Vermont tomorrow for after the co-op meeting. um to go to a conference with all the business administrators across the state. Um our department continues to grow in education, too. We had someone um earn their degree in walking graduation just the other day. Um and we continue to improve the financial reporting across the district. Did I forget anything? >> Repeat, Dr. Bryant. Good evening. I was just thinking this afternoon that a year ago, I think I came to this meeting to um to meet

080you and so it's really been a year of of highlights and celebrations. So, I just wanted to thank you first for for that. Um I just wanted to talk just really briefly about the grants because there's a lot of pieces to the grants and I think it highlights some of the great work we're doing. Um, all of our districts receive some combination of title one, title two, and or title 4 funding. And, um, the springtime is when we write our consolidated applications. So, we work with our stakeholders. It's really the building leaders who are working with the stakeholders in the district to determine based on data what the priorities are going to be to use that funding. and then we submit the application and then we write activities that are in line with the priorities

081that the stakeholders have identified. So that's kind of the year-long process. In the fall, the high school approached me about writing an activity to fund a um community-based activity. It's something that had been previously funded by the New Hampshire State Council on the Arts. So if you see the murals out on the stairwell, that's what that activity was. Um but we utilized we wrote an activity using title four um funding and the actual writing of the activity happened in collaboration with a staff member, a building administrator and me and we worked together to meet the the uh requirements of the grant and it was approved. And so what came of that was um an activity for our nth grade students that was focused on helping students to feel a sense of belonging as they came

082into the high school because we knew that that transition from 8th to 9th grade was really crucial. Um the question for the project was how can one person make a difference and it was a six-week um interdisciplinary act um project with the English and history classes as well as a community collaborator and artist Eric Gold. The students researched local and uh national and global social issues and then um they they did all sorts of research and and um work around that and from that they chose um people that they wanted to portray in their their murals which will be added to the stairwell. Uh right now I think they're still working on finalizing them so those will be coming. Um, but some of the feedback from the students, I just wanted to read some of

083these quotes so that you could feel the real impact of the whole process from writing the grant, getting the funding, making it happen. Um, students responded with comments like, "That teamwork makes the whole painting come together. It feels like my thoughts became a permanent shout on the wall, turning a private doodle into a public heartbeat. It makes me feel seen and acknowledged." And another one which I just love, I talked to a kid I had never met. I'm joining their after club after school club soon. So real real learning, real impact um made the difference that we were hoping at least for those students as we're trying to make sure that they feel like this is their home here at Exit High School. Thank you, >> Dr. Bennett. I didn't bring any quotes. Um but

084um what I what I really wanted to highlight and what I think SAU16 this joint board and all of the board should be really proud of is the cohes cohesion and collaboration between student services which is what I oversee and Jill Lizier the instruction curriculum and assessment. Two years ago we made a really strategic decision that Jill and I were going to lead the MTSS systems within SA16 and that we were going to work in tangent. The purpose being we wanted um to in include all students in core instruction but also we really wanted to align our messaging for all of our our principles and all of our systems. So two years ago our message through every building and Jill and I go together and present which is a level setting on how do we

085define our multi-ter system of support in SA16. What are the four pillars and what do you need to look at in your building to make sure your MTS systems align. These are the tights and this is how we give messages to what we value. And then this year Jill and I focused on universal design for learning and high leverages best practices. And one of the quotes we say a lot in our presentation is you can't tear two your way out of tier one. So the message really is all students are general education classroom students first. And what are some high leverage best practices that we can all do to um include all students? And we've continued to see um the fruits of our labor through um I do have we do have emails from parents

086talking about how important that inclusion has been um and they've celebrated it. But also you're going to see it in academic scores and outcomes because what would work for some of a student with a really specific learning disability and an accommodation a classroom teacher would give that student. offering that to all students or the different modalities from which students can access the core content. All students benefit from that. Jill and I have presented at a conference um this winter on our cohesion and our partnership and hearing from other districts that we're really unique and how your curriculum instruction and your student services make all of the decisions together. We and we have a whole system for how we check in when we have to make a decision, how we communicate that message. We know that

087familiarity breeds trust and understanding. So, we want to make sure we're giving the same message um all the time. So, we are two years into what was a 5-year plan to align all of our systems and all of our schools around MTSS. And I would say we are on target if not further along in the alignment. And also the message um about aligning all of our system bleeds into some specific programs for student services. Um a highlight for the board to know is next year we will go through our program approval for all of our special education um programs in all of our districts. They've changed the model. It's a pretty intense um program. because we have such a foundation of aligning all of our systems that we we have done a lot of the

088work already when we go and we get audited by the state starting in August for our program approval. So we're awesome around MTSS. Um we're we're really aligning our conversations and then we've set up some great systems and student services. So a person's experience in stratum is going to be the same in new fields because we have all of our systems alive. And then when they go to the middle school, it's the same language. We're really talking about what does a multi-ter system of support mean for all of SAU 16. So that's what I wanted to highlight. >> Yeah, Bobby question. >> That last thing you said was really uh interesting to me. I was curious um uh how regularly do the programs get approved? I wasn't aware. >> They have to do them every

089six years and they and so a minimum of every six years. Um but they can do them anytime they want. We have this we're on a we haven't had it done in six years. So this is the sixth year for all of our buildings in all of our districts. And um it's depending on what programs we have in each building, but the process is more intense than it's ever been. um because um the federal government audited the state of New Hampshire and they made the state of New Hampshire change how they approve programs. So now it is a half a year event including discovery um a monitoring plan, findings, observations. Um so it's it's it is intense, but when Ellen and I went to the meeting um a couple weeks ago over all the things

090that were done and we were patting ourselves on the back because we had a lot of it done. We had our manuals, we have our forms, we had everything done. So, really, we're just ready for them to come to our buildings and check files and have those conversations. >> Yeah. I'm sorry. Is there any other questions before Thank you. >> All right. We'll segue right into Miss Lizzier. >> Well, she talked about curriculum a lot. I thought it was a good segue. >> All right. Hi, everybody. Jill Liz here, chief academic officer. Um, I hope you were able to take some time to read this. If not, I put um quite a bit of information in there. It's, you know, if you want to fall asleep or bored or something, there's a lot of stuff

091in there. Um, but I was trying to think of some words that really highlighted the work, um, that we all do as a senior leadership team and an SA16. It's collaboration, systems, structures, and um, as Dr. Bennett said, it's coherence. Um, and really just being like clear about the work that we want to do to support our students. Um, because we know, as um, Bnee Brown said, clear is kind. Um, and so that's what we want to do. Um, and so what I would like to highlight, and I think I wrote this, um, yes, I did. I wrote this in my report. Um, our SAU16 in service day. Um we it's one of the days we bring all of our teachers together and we can't do that often because as you know we have um

092different calendars and also our schools definitely sometimes need different things. We have um student led conferences on our PD days sometimes or um sometimes one school might need um like a math training where the other one might have done the math training um at a different time. But in the March day, we get everybody together um and during this March day, we typically um bring our educators um and we allow that time for our educators just to connect with each other and share expertise with each other. Um and this year we also brought in some community partners. Um and as um Heather shared, we had Health Trust in. We had um Water Street Bookstore come in. Um we also um we had um epilepsy um seizure training. We had the Epilepsy Foundation come in and

093do some um seizure um uh training for school personnel. So, it was a really um it was a day really focused on um really building up our school leaders and also bringing in some community partners. Um and so some of the quotes not from students but from educators. I tried to highlight some of the valuable aspects on the last page of the report. Um um so collaboration and networking was a highlight of the day. connecting, sharing ideas, learning from colleagues across the district or SAU16, many of whom are the presenters, was a key benefit, helping to build community and lateral growth. Um, and so that is just something that I really wanted to hold on to and share with everybody. Um, and something that we're really lucky to have within our large community of educators.

094Any questions about anything that I said here or anything that you've heard? >> I just want to make a comment. I like the way you presented it with the outcomes and so if you haven't read it read this presentation is very very good and uh looking forward to the AI policy Thursday at policy committee then you'll all hear about it at your next June meeting. >> So I'm really glad you brought that up. So I'm just going to talk a little bit more. So I like to connect the dots as well and I think it's really important that we do that in education is like try to you know stay on the path. Um, and it's kind of like what Dr. Bennett and I are doing is like trying to like bring some coherence in

095what we're doing so it doesn't always feel like one-offs. So, our other PD that we're doing this summer is also being run by our internal SA16 presenters. Um, and I even listed their names in here to give them shoutouts because they're amazing. But they're presenting on AI and UDL. Um, and also talking about tier one instruction. And so it's really trying to like bring all these things together and also highlighting the leaders that we have within our schools. So thank you. And then we'll write a policy too. >> It's great. >> Misca. >> Okay. Thank you. Good evening everybody. We'll bring this down a little bit. Um okay. So to add on to what Dr. Bennett and uh Jill Lazier have already talked about. Um I will say that um as someone who works in

096student services myself, I'm the assistant officer for student services. Um the the collaboration that they have um accomplished is really significant and I'm very grateful for it. It makes um student services run more smoothly and that alignment is extremely helpful. So, one of the things I wanted to highlight is the work that be being done um specifically in Newfields Elementary School to um add on to the incredible foundation that's already been laid when we talk about our multi-tered systems of support in our schools. So, that um I mentioned at our January meeting that Newfield Elementary School sent a team of folks to the um solution tree conference on PLC's at work. So, professional learning communities at work um in October. And so a lot of what I've been doing is helping new fields to make

097sure that we are synthesizing that information that we were able to um take away from the conference and um making sure that our teams are really solid and that we have a lot of consistency and we're making really clear decisions as to who's on our teams, how often are those teams meeting, what data um is the team looking at in order to be making these really student- centered decisions to ensure that the work that we do is serving all students, not just some students. but that we're keeping all students at the forefront when we're making decisions. And I would say that, you know, we are really doing a lot of that great work to be more specific and be more clear and be more intentional with our multi-tered systems of support and with our teams

098that are um established at Newfields. And then an area of celebration that I wanted to talk about is uh the Renew um program at Exit High School. and Renew is basically a strength-based uh futures planning process for students who are at risk for potentially not graduating from high school. It also speaks to the spirit of our community partnerships that Dr. Andriski mentioned. um the fact that uh we collaborate with the renew program with the institute on disability from UNH as well as we partner with COS mental health to help our program to be sustainable and comprehensive and I'm really excited to celebrate the work of Renew especially right now because Renew has for those of you who don't know Renew has been in existence at exit high school for over a decade but it's waxed

099and waned over time and there have been points where the sustain ustainability was in question. So, we've done it, we did a lot of planning last spring and summer to make sure that we were able to give it a boost and lift it up so that we were really focused on sustainability. We added an additional um Renew coach um so that we can make sure that our program is running and that we're matching our students with basically each student that's identified for being at risk um is matched with a renew facilitator. And then the facilitator engages the student in the mapping process to really um plot out that student's future and gauge their interests and help the student to build self-awareness as to like where are their skills, where are their interests and develop some

100really clear actionable goals. Um, so we've done a lot of work with the sustainability for that program this year. And I also promised the implementation team that I would mention it here tonight because we bet we've also been talking about talking about Renew for a while at a board meeting because it's something that I don't think we talk about enough um in terms of just a lot of the pockets of work that we do in SAU 16 that support our students. And you know, when we're talking about all those pockets, they all align with all the other work that you've heard here tonight, which is just a beautiful thing that you know, all of our arrows are pointing in the right direction and everyone is collaborating and working really hard for all of our students.

101>> Yes. >> I'd never heard of the Renew program, so I just Googled it. Just want to make sure. Is that I'm on the UNH's website, the Center for New Implementation. Is that the organization? >> It's the Institute on Disability >> through the Institute. Yes. Yes. I'm going to >> Yep. >> Looks like a pretty good website. Yeah, it's been around also another point of celebration. They are celebrating their 30th year of implementation. And Renew doesn't exist just in schools. It exists in community mental health centers. It exists in some residential facilities that around for that are around for students. Um so a variety of venues. Okay. Thank you, >> Miss Petta. >> Hey. >> Hi everybody. I feel like I'm going to take this off. All right. Um hi. Thank you so much for

102taking the time to read our reports. There's a lot in here. Um, I included a lot of pieces that I could celebrate. Um, and one of the pieces would be community partnerships. I spend a lot of time event planning, but I think what's most important for me to highlight is that this year we've had an increase in discrimination incidents. I think it's important for me to share that with you all. There are a number of reasons for that. I talked to Dr. Andriski about bringing that information to you more fully, that data to you in the fall. and sort of picking that apart together. One of the reasons is more consistent reporting. Our processes are better. Our anti-discrimination protocols are clearer and I think students have more access to understanding how they can make reports

103and we've done a lot more training on those pieces. And I think it's true that the polarized climate nationally has also contributed to the rise in discrimination incidents. So what's important for me to highlight about that is that we do have great frameworks for responding. So, we have restorative practices. We had over 50 staff being trained in restorative practices this year. We also have an anti-discrimination task force. I think we're like we might be the only SAU left in the state with an anti-discrimination task force and we have really clear protocols that all of our administrators and staff have been trained on and use. what I think is the most so we have these I think effective forms of responding to discrimination and where I think we have opportunities for growth is preventative work so

104I wanted to highlight some of the pieces we've been doing around that and to talk about how we want to move forward around action steps and preventative planning so we've done a lot of building of programming for students and staff to learn about bias discrimination for us to engage in conversations that can be hard and new for a lot of people. One of the ones I want to highlight um so I I talked a lot about the identity units, identity belonging units. I talked a little bit about freshman seminar and where we've integrated some of that work. We had um a significant rise in anti-semitic anti-semitic discrimination incidents at the middle school and high school along with racialized discrimination. And so we've done some work around um something that we're calling words matter. So recently

105I worked with facilitators from out outside of SAU16 to come in and facilitate assemblies for our middle school in particular. We have an assembly series now called words matter. And we involved three students came forward and said I really want to be part of this. This means something to me. This matters. I've been impacted by this. Can we be part of this? So on Friday was the second in our words matter series and we had three students come forward and share their experiences um being impacted by discrimination and that they want to create community communities of belonging for all of our students. And so they joined myself and Quincy Worthy who is an external facilitator and we did a presentation um on that for sixth, seventh and eighth grade. And then the sixth, seventh, and

106eighth grade groups will have debrief sessions in their classes that have sort of guided questions and scenario work around how they can stand up, who they can report to, um how they can find a trusted adult, and how they can also think through strategies that they might use themselves if they hear something or see something. So, I feel like it's it's super important that we continue to do this kind of education, especially in the elementary schools, because by the time we start to see this at middle and high school, we've lost our opportunity to engage in those conversations around the things that make us different and the same and celebrate those things, some of the biases, right? And discriminatory language, they've heard over and over, and it's become solidified by the time we our brains

107start to develop. So the earlier we can start to have these conversations about the ways that we're the same and the ways that we're different and really positive ways, the better off we'll be in having these conversations later. So that preventative work feels really, really important. And we've started to do a lot of great pieces around that. Chris and I had a great conversation with a student the other day who advocated for preventative work, who's been in SA16 since she was very little and is now in high school and talked to us a lot about how it feels really important for us to have these conversations early and often. So, those were the things I wanted to highlight. Any questions? Yeah, Sophie. >> Um, this is less of a question, more of just a celebration

108that I'm really proud of our district for being the only one in the state to still have um the chief equity officer. And I think we're really like walking the walk of you belong here and showing our students that they belong here. So, thank you for your good >> Yeah, I appreciate the support. And I will say that Manchester does have someone now. So we do there is a there is a role in Manchester that's similar. I want to give them a shout out. >> No for I have two comments. I complimented Miss Lazir on her uh presentation. You have the same format. So >> yes >> likewise. Congratulations. Thank you. Um >> Jill and I love a little consistency. >> Yeah. Who copied who? >> Oh, I copy pasted Jill's. I I Jill is

109an incredible incredibly organized thoughtful person. So if you want to like visually see how things roll, look to Joe. >> And second, just to echo a little bit of what Sophie said, I think you're highlighting incidents, responses, how to address those things, I think is important, and I appreciate hearing it and having it out here for not only this group, but everyone watching. >> Yeah. And I think it's going to be really important to continue to dig into that. Um, I think often we we have a lot of great kids. We have a lot of great staff. We have a lot of great people. And we I think sometimes we can fall back on thinking, oh, this isn't happening here because I interface with it every day. I know that it is. So, I think

110talking about it, talking about responses and preventative measures is really important. >> Yeah. >> I just want to echo all that. I really appreciate just being the honesty of your report. Um, and I think that's the only place we can grow, right, is to be honest. I'm curious, you know, often I think we talk about, you know, how are we preparing students to ident, you know, to um report incidents and, you know, or even interrupt. And >> I'm curious if you could speak a little bit more about how I want to say like we're creating a culture of accountability for our staff and teachers to model that and also you know how do you because our young people are look are they're looking at us as adults right are they behaving in ways that um

111are modeling you know what we're being taught and I just am curious it's a big SAU 2016, you know, um I'm just cur I know it's a process, but I wonder if you could speak to sort of how >> um we're doing that for our adults. >> Yeah. Yeah, I would love to. Yeah. So, a couple of things. So, we've done a series of different trainings on topics related. Um Ellen and I do a training early on about anti-discrimination protocols and title 19. Title 19, Title Nine. What in the world? That was weird. Title N. and we offer scenario work and have people talk through what we think are real experiences in the SAU and how you might respond using our protocols. So that's one piece we've done. I've done some work at the high

112school and middle school now on navigating critical conversations. So like how do you interrupt? What frameworks can you use? Um what are some strategies? I think the biggest thing right because people feel really there's a lot of discomfort around navigating these conversations. So how do you practice? How do you we do a lot a lot of scenario work and real-time practice around like what does it look like to interrupt a framework we use is the idea framework um so interrupt discuss explore ask and that is also what we've been working with students on so we did a sort of an adultoriented framework training around that and now we've done a student oriented training work around that piece to try to give people opportunities to think about how they can respond and intervene when these things

113come up and it's just ongoing right because that really is truly the Only way to be able to do that effectively is to practice it over and over, especially when our emotions are heightened. Yeah. So, there's been a lot of different ways and we do that through restorative practices as well, through circle work. There's just a lot of different strategies that we use for that. >> Yep. >> Sorry, I'm like trying not to ask any questions. Just a question on the data that you're going to present like coming from an elementary school thinking like self-reports or things students are reporting are probably the older kids. Do you are you using like guidance? I know we have like the stoplight like rep. They can like report things to guidance. Like are you tracking data at the

114elementary level >> that's not self reported through like the reporting systems I guess. >> Does that make sense? >> Kind of. Um you mean sort of can you say more about that? >> Like if students self-report incidents I'm assuming that's like a website or a an email person. So for elementary students who might not >> Yeah. Yeah. >> do that. Are you tracking data like through guidance reports and >> Yeah. We have a lot of different reporting mechanisms and all of our schools have slightly different processes for that and we have a system that things go into right incidents are reported into our system. We're actually transitioning systems to infinite campus. I think you all have heard about that. Um we also have internal reporting systems. There's lots of different checks that the administrative teams

115do around that part of our protocol. You would think that it happens most frequently at the middle school and high school. >> Unfortunately, we have a lot of incidents that happen at our elementary schools. Um I respond to many many all the time. Um part of the protocol is every time that there is an incident where there's respect uh suspected discrimination or bias that typically someone would call me and loop me in and we will troubleshoot some of those pieces and think about what restorative measures might need to be in place. But we try to always be consistent about reporting that. Um because reporting these trends really matter when we have students come to us in high school and say I've been experiencing discrimination since I was six and we don't have any record of

116it. So the reporting piece is really really important. We're still working on that. >> Okay. >> Yeah. >> One other quick thing. If anybody um on the joint board is interested in being part of like a parent/ community group that focuses on equity issues, let me know and we can add you to the list serve. >> Thank you. >> Well, thank you Dr. Nriski and all the members of the city staff. Really impressed of the written reports and the oral reports and also engagement from the board on all of this. Tonight, um, we get to bring Dr. Bryant back up to talk again about legislative updates and trainings. Switching gears just a little bit. Um, so there's uh there's still a lot going on in conquered and um a lot of decisions that still haven't

117been made. So, we're really just going to focus tonight on the open enrollment legislation. So, Senate Bill 101 is um laid on the table right now. It's to the side, but it's House Bill 751 that the um the legislators are talking about. There was a committee of conference today. So, representatives from the um both the Senate and the House of Representatives met for about an hour this afternoon to try to hash out some of the details of House Bill 751. Uh there was not a vote. Uh they're going to meet again in the next couple of weeks to try to work out some of the details including um what the language is going to be around the definition for capacity um the def definition of statewide enrollment cap. They're talking about a concept of trying

118to spread out um the number of students who can access open enrollment like spreading it out among the states. So they're trying to figure out if the department of if the state board or if the department of education would make the decision around how many students would be able to access open enrollment in different regions. Basically, there's just a lot of conversation still happening. Um but that it's look but the but it's still the conversation is very alive and well still and um that if there was legislation that passed it looks like that would be come into effect in um 2027. And so this week at the policy committee um we will be looking at a policy a new policy which is titled enrollment and enrollment capacity. So, if you're on that committee, you saw

119that probably come through your email and everyone else will see it at your June board meetings. And that's really an opportunity for our boards to set some policy around what capacity means for each of our buildings. There's a lot of information that will be included in that report for boards to look at. So, we're in the process right now of gathering that data. Um, how many classrooms we have, what's the capacity for our students in each of those classrooms, etc., etc. So, the policy that we'll look at would would support um the really districts having voice in what capacity looks like in our buildings. I don't know if you want to add anything, Dr. Andrisky, or >> Yeah. So, it's um it's a recommended policy. It's not required at this time, but it's for us

120to get ahead of if if and when open enrollment does happen. Um you'll see a lot of what we're doing is based on all special services because you might have a 900 foot classroom but when you have students with mo mobility or access issues that does impact your square footage when you have number of adults that are supporting students that that reduces your square footage. So it's not just a 900 foot classroom with 20 kids. There's so many other things that go in there and I don't think um the general public understands that. So we are actually putting together a report and for the for the co-op it's a lot bigger but you'll look at the report and you'll see the function of the room. Some classrooms such as lab spaces you can only have

12124 students per per uh RSA or ED 306es. Kindergarten's the same way of 24 students. So but again take into consideration do you want 24 students in a class with all the other factors that go on. So we'll put that report to you. It it will be great for for conversation in June and then we can continue that conversation for next year. So, if you're not comfortable, cuz we are still building it um uh to get that for you so that we're ahead of the curve. That is really the purpose for those June meetings, but wanted to highlight it today. >> I two more bills. It ties back to something Kirsty mentioned, and these aren't really school specific, but two bills that might affect health trust. So, Senate Bill 661 and House Bill 1491 both

122passed and are going to the governor. Um, Senate Bill 661 I think would have a greater impact on the way health trust is structured. It may require assessments um and maintain regulation underneath the Secretary of State which under RSA 5B is where uh these are regulated and Senate or House Bill 1491 might move health trust to regulation under the insurance commissioner and allow a little bit more flexibility for the operation of health trust moving forward. So both of those are moving forward. One or both may pass into law. It's unclear what will happen, but there could be further changes to health trust based on those bills. >> Thank you. >> Right. Um before we move on to the meeting schedule for next year, I Molly and Michelle do have the financials at the back of

123the packet. I just want to make sure people they have a question opportunity to ask questions about that if they would like but it's very succinct and so forth but I don't mean to put you on the spot Molly but I just want to make sure people have >> um yes I did put in the board pack a print out from school year pro showing where you are and then just below that I put um the fund balance calculation because if you remember the SAU fund balance is not given back in the tax rate like your individual districts So, I put where we ended FY25 and then the anticipated revenue expenses to come down to the fund balance. And I just want to remind everyone that we when we made next year's budget, we also

124included a some utilization of the fund balance. And um I tell them they're never allowed to retire, but some people do have retirements coming up. Um but I don't want them to retire. So So did anyone have any questions? Sorry, Molly. On here, you have two projected FY26 ending fund balances. What's the difference between the two? >> Oh, I have two. >> Oh, here. >> Sorry, that should say FY27 because it's the work down. So it says the projected FY26 fund balance and then I say FY27 numbers below that. So that should actually be FY27. >> Okay. Thank you. >> Sorry about that typo. >> Any further questions from Molly? >> And the intention of that was just to show that we plan to utilize fund balance. >> Thank you. All right. Um, the third

125to last item third to last page of our packet uh is the proposed joint board meeting for next school year. Uh, we have five meetings on the calendar and I think we'll need a motion and a vote to approve if nobody has any comments or if people have comments we can discuss it. just offer before you do that, I just want to offer one. So you uh in January asked if we could talk with the governing board for SST to get our calendars sooner to you. Uh Tammy and I were there today for a governing board. I did bring that up. Uh there was not a lot of interest from the other surrounding communities to get it ready by October. So part of it is um how they build their schedule and the model schedule

126that comes out from the the state doesn't come out until late October. um we talked about possibly drafts at that time but um I when we were working through it there wasn't a lot of interest before that time so I just want to let you know that that question was asked and that was the answer I was giving and the calendar next year projects a little bit differently so we can start working on it in that September October but we defer drafts but I won't have anything as hopeful for that October meeting at this time we can continue to work through it but that was an ask in January I just wanted to give give an update and Tammy if there was anything else that I missed please fill them The only thing I wondered

127when that came up. I'm assuming we have to meet in October. We couldn't push it back because I know there's a lot of stuff that happens in October that we >> for this board, we do have to meet in October for our budget for the SAU. Um but there's nothing that says we couldn't add a meeting. I just don't want to add meetings to to do the calendar. But so I'll continue to work on it um with those superintendents, but I just wanted to be totally transparent with you all. >> Thank you. Um the only question I I have and I think you you do this Chris the Thank you. Um is just noticing that gap between January and April. I'm not asking for more meetings, but if we can I think as you do

128just have regular updates from SLT and uh any legislative updates that might be appropriate both obviously through our local uh board meetings, but um if anything happens in between those meetings, it's just helpful to have those. Thank you. I'll make a motion to approve the draft meeting schedule. >> Thank you. Is there a second? >> Second. Thank you. All those in favor of adopting the draft meeting schedule as presented. >> Any opposed? Any abstensions? Motion carries. Thank you. >> All right. Uh do we have need for a non-public session >> at this time? >> All right. Um there's a motion to adjourn. >> We want to highlight the superintendent evaluation. >> you do. Okay. Yes. So and there'll be a motion to enter non-public pursuant to >> RSA 91 A1. Okay, >> Patrick, >> I'm

129going to leave you as the host so you can stay on. >> Okay. So, >> um public. >> Um All right. So, >> uh >> you're making a motion to enter nonpublic. That's correct. That's correct. >> All right. >> Under 91A >> A. >> Um, is there a second? >> Second, Dr. Kelly. All right, we have to do a roll call vote. >> Yes. >> Uh, Bobby present. >> Brian, yes. >> Jane Walsh, yes. >> Kate Pratt, yes. >> Tim Reed, yes. >> Shy Holmes, yes. Heathermire, yes. >> Katie Capola, yes. Megan Fitzgerald, yes. Ky, yes. >> Annie Bear, yes. Yes. >> Yes. >> Ryan Duffy. Yes. >> Yes. >> Eric Miller. Yes. >> Yes. >> Chain O'Brien. Yes. >> Yes. >> Sophie Salenstall. Yes. >> Tom Cronin. Yes. >> All Doyle. Yes. >> Steph.

130Yes. >> Shut. Yes. >> Okay. So, that motion passes and went through non-public at 7:40 Yeah. We are back live on camera and back in public session. >> Uh be looking for a motion to authorize members of the superintendent evaluation committee, the chair of the joint board and the vice chair of the joint board to meet with do Dr. Andris Andrriski to present the results of the evaluation. Is there such a motion? >> I'll make that motion. >> Thank you. Is there a second? >> I'll second. >> All right. All those in favor? >> All right. Any opposed? Any abstaining? Thank you. All right. Is there a motion to adjurnn? >> Motion to adjurnn. >> Thank you, Jane. Is there a second? Thank you. All those in favor? I we this way.