Executive Council narrowly approves fifth rural health program contract

During a lengthy meeting Wednesday, the New Hampshire Executive Council approved the contract for the fifth “hub” in the state’s marquee rural health program.

The contract will provide $21.6 million to the New Hampshire Community Behavioral Health Association. The association will in turn spend the money on projects aimed at addressing substance use disorder in rural New Hampshire.

New Hampshire received roughly $200 million through the federal government’s Rural Health Transformation Program this year and hopes to receive similar amounts over the next several years. The money comes from President Donald Trump’s signature legislative priority of 2025, the One Big Beautiful Bill Act, which touches nearly every part of the federal government. The Rural Health Transformation Program was designed to offset other provisions of the new law, which critics say will decimate the rural health care economy.

Gov. Kelly Ayotte established the GO-NORTH initiative to spend the money. Now that it has approval from the council, which is responsible for approving state contracts over $10,000, GO-NORTH has designated five “hubs,” or community organizations throughout the state that will in turn allocate the funding to rural health projects. That includes projects aimed at improving transportation options to and from rural doctors, expanding telehealth, and helping rural hospitals navigate the process of being reimbursed by insurers.

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Previously, the council approved funding for the four other hubs: the University System of New Hampshire and the Community College System of New Hampshire will handle health care workforce development projects; the Community Development Finance Authority will work on capital improvement projects for health and child care facilities; and the Foundation for Health Communities will handle projects related to primary care access, new technologies, and other issues.

Councilors have grilled GO-NORTH Director Donnalee Lozeau with questions about the contracts and demanded the opportunity for more scrutiny. At their March 4 meeting, the councilors, upset that the contracts were sole source rather than being put out to bid, demanded the ability to veto individual projects within each hub. The council tabled the contracts at that meeting.

During a special meeting to approve the contracts on March 16, the council approved four of the hubs after GO-NORTH agreed to the terms for veto power and renewal dates where the hubs had to come back for further approval. 

Wednesday, when councilors took up the fifth hub, they debated for hours, at one point pausing the debate, tabling the bill, and then coming back to it at the end of the meeting. Some on the council again sought the opportunity for more scrutiny. However, by the end of the meeting, Councilor Joe Kenney, one of the skeptics, relented after getting more information from GO-NORTH and joined Councilors Janet Stevens and Karen Liot Hill to approve it in a 3-2 vote.