Health Care Leaders Address Dramatic Challenges Facing the North Country

Franconia, NH — Protect Our Care New Hampshire hosted a community discussion at Ammonoosuc Community Health Services in Franconia to examine the challenges and opportunities facing health care in the North Country. The forum was set at a clinic set to close in the face of stark national and state cuts. North Country leaders tackled the tough issues of what cuts mean, and how they will impact their region. Watch the Event Here

On the panel were

• Edward D. Shanshala II, CEO of Ammonoosuc Community Health Services
• Angel Larcom, Executive Director of the Littleton Area Chamber of Commerce
• Daniel Sherman, MBA, Clinical Services Officer at Speare Memorial Hospital in Plymouth

Jayme Simões, representing Protect Our Care New Hampshire, welcomed attendees, thanked the panelists, and provided context on the pressures currently impacting rural health care systems.
Panelists shared perspectives on how local health services are adapting to increased demand, financial uncertainty, and workforce shortages. Discussion included the importance of community health centers and hospitals for families in the region, the connection between reliable health care and the stability of small businesses, and the broader impact that access to care has on the North Country’s economy and quality of life.

Participants also addressed the strain of rising premiums and staffing challenges places on businesses and providers, and the need for collaborative approaches to protect access to care for residents.

“This conversation is about ensuring that every family in the North Country can count on the care they need close to home,” said Edward Shanshala. “When we look at the bill that was passed in July, the economic impact Ammonoosuc Community Health Services is a disinvestment of $500,000 that we're anticipating due to the changes to Medicaid expansion and Medicaid in general. We could not wait to take action, so we announced the closure of the ACHS Franconia site, of which we are sitting in one of the exam rooms. And no later than the end of the year, we will redirect patients to our Littleton site and to our Whitefield site. We're sorry to have to do that, yet that's the economics and it's a decision that we had no other choice to make.”

Daniel Sherman emphasized the importance of long-term solutions: “Sustainable rural health care is vital for patients, providers, and entire communities. I can say personally I've been a patient of ACHS for 22 years. I've used this facility many times because it's very convenient to be working in Plymouth. And it breaks my heart to know that it's closing and that the patients in this community won't have access to care here. And there are some folks that are going to have to travel quite a ways.”
Angel Larcom added “health care access is not just a personal issue — it’s an economic one. Businesses depend on a healthy workforce, and the costs are real,” Many people are so busy trying to make ends meet, so busy trying to put food on the table and make sure that their housing is paid for, that they don't even have the time or the energy or bandwidth, especially if they're young parents or parents of teenagers. “

Shanshala worries about the loss of insurance. “They may come to us, and we do have a sliding fee scale, and the sliding fee scale comes out of a base grant of our tax dollars of $2.2 million that we generated $12 million. has not seen any economic increase in a decade. So that's an erosion of three quarters of a million dollars plus the $500,000 of negative impact on Medicaid. Or they don't come to us and they end up in the emergency department.”

“The cost of housing has increased,” Sherman said. “The inventory is low. That's a challenge, especially for our seasonal workers. That workforce housing just isn't in place. We need to solve that yesterday. And so people, I think a lot of people are so busy trying to make ends meet, so busy trying to put food on the table and make sure that their housing is paid for, that they don't even have the time or the energy or bandwidth, especially if they're young parents or parents of teenagers. They're just surviving, right? And so if you run into people, have those conversations with them because they don't have the bandwidth to even begin to think about it until, as you said, it taps them on the shoulder. I'd encourage people to really feel a sense of pride. You feel a sense of pride in your community, in your family, in the groups you belong to. Feel a sense of pride in your health center, in your local hospital, in your care provider. You're part of that close-knit community with your provider.”

Protect Our Care New Hampshire plans to continue convening conversations across the state to raise awareness and build understanding of the challenges local providers and families face.