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A family’s quandary: Autistic boy’s family concerned N.H. facilities won’t stack up

By Adam Urquhart - Staff Writer | Apr 3, 2019

Courtesy photo Teddy Canfield enjoys his time exploring a playground.

NASHUA – One local family is fighting for what they believe is best for their severely autistic son, Teddy – that being to continue his education out-of-state despite the desire of New Hampshire officials to relocate him to the Granite State when he turns 21.

Theodore Canfield, better known as Teddy, has been attending Nashoba Learning Group day school program in Bedford, Massachusetts since he was 5. However, when he turns 21 later this year on Nov. 29, all he has known could change drastically.

That is because in New Hampshire, he will be aging out of the education system at 21. In New Hampshire, he ages out of the education system at 21. In Massachusetts, the age is set at 22.

Despite this discrepancy, NLG is willing to continue with Teddy, and officials there even have a spot ready for him in their separate adult program – if the Canfields can work something out with Gateways Community Services in Nashua.

“Gateways is like the bank for the state, and they pay the New Hampshire vendor,” Teddy’s father Brad Canfield said. “If you’re going out-of-state, it’s set money that they’re telling you, you’re going to have to pay that money. So, they’re not going to make any money on Teddy.”

Right now, Brad is running out of time, as he is waiting for an official decision from Gateways on the matter. Once that decision has been issued, he will have 30 days to appeal. He is already working with an attorney, and needs to have Teddy get neuropsychological evaluations for both NLG and the new facility Gateways wants to send him to in Greater Nashua: the Institute of Professional Practice Inc, or IPPI.

“They don’t have the facilities that Nashoba Learning Group has, and they don’t even have a staff person that would take on Teddy,” Brad said. “They don’t even have a daily schedule that they’re going to do with him to fill his time that needs to be so structured.”

The reason Teddy needs so much structure is because he is severely autistic, and has been tested for Landau Kleffner syndrome – which is why even NLG has struggled to train him in basic bodily functions. Brad said Teddy is non-verbal, experiences seizures, has sleep disorder, anxiety, eating disorder, chronic skin disorders, flat feet syndrome and many other physical ailments which require constant attention.

Brad said Teddy engages in self-harming behaviors, such as hitting his head, and cannot control his bodily functions, such as urination, defecation, drooling and loud verbal yelling sounds. Due to Teddy’s condition, the family believes continuing with NLG is the best option.

“They’ve known him all these years,” Brad said. “It’s the same set up where he’s structured right from the time he gets there.”

Right now, Brad drives 100 miles per day to take his son to and from school. He is concerned that by sending his son just down the road to IPPI in Merrimack that all the progress Teddy has made in Massachusetts will regress. Given his son’s situation, he believes there is no place in New Hampshire that can handle Teddy, especially not IPPI.

“He’s going to reverse. I mean they have no program,” Brad said. “They’re going to bring him out in the community here and they don’t even have vocational programs set up.”

Currently, at NLG, Teddy has a unique model that helps to keep his behaviors in check, and they use Applied Behavior Analysis. They also provide a vocational program in a controlled indoor environment with sensory input at a tolerable level.

However with Gateways being the funding source, if officials there believe there is a program in the state that meets Teddy’s needs, they will ask the family to use those vendors. However, the Canfield family said IPPI gave Gateways the budget costs if they were to provide a limited version of what Teddy would have at NLG. Brad said NLG’s projected budget for this was lower than IPPI’s. If the numbers they have are correct, this indicates that it is cheaper for Teddy to continue on with the NLG adult program.

“They have a spot ready for him. They just need New Hampshire to say, ‘We’re good to go,'” Brad said.

Brad said the family was told through Gateways that Medicaid pays the funds to every state through the federal agency. He said each state wants to keep their Medicaid money in the state so they can spend it how they see fit. He said IPPI is a vendor of Gateways, and believes there would be a conflict of interest if Teddy is relocated to Merrimack.

According to the New Hampshire Department of Health and Human Services Division of Long Term Supports and Services Bureau of Developmental Services, on Jan. 16, 2014 the Centers for Medicare and Medicaid Services (CMS) issued a final ruling, stating that agencies cannot provide direct service and case management to the same individuals. IPPI is listed on Gateways’ website as being one of their vendor partners.

Brad believes Gateways wants to keep their funds through Medicaid in state. In any event, he said his attorney got in touch with folks at Gateways, and they are now waiting on a date for when the family can meet to learn if Teddy can continue at NLG.

Monday, Brad heard back from a representative Gov. Chris Sununu’s office. Brad hopes to get some help from the executive branch.

“Nobody has an out-of-state place to go, and I do,” Brad said. “It’s a special circumstance.”

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