BELLOWS FALLS-North Star Health has announced that the organization has made the "difficult decision" to close the Rockingham Health Center effective Jan. 1, 2025, when the Health Center will be combined with its Springfield and its Charlestown, New Hampshire locations.
Affected by the consolidation will be both the primary care and the urgent care facilities, located in the former Rockingham Memorial Hospital, which was built over 70 years ago.
After a financial crisis in the late 1980s, Springfield Hospital took over inpatient services as the hospital began a long transformation to a community health center model, a change that kept access to medical services at Hospital Court.
In 2022, Springfield Medical Systems began using the North Star Health brand after emerging from a years-long bankruptcy proceeding.
Since 2020, the number of primary care patients at the Rockingham Health Center has decreased by nearly half, a trend that lawmakers say accelerated after the bankruptcy.
In the same time, in 2023 and 2024, Vermont health care costs have risen nearly 29% and are estimated to increase another 20% in 2025.
"The combination of the low numbers, financial challenges, staffing shortages, and aging facilities make it clear that we must rethink how care is delivered to ensure sustainability and access for all," the medical center said in a statement about the consideration. "Though unsettling, consolidating services into fewer, better-supported locations are essential to the bigger picture of preserving access to quality care to those who need it most."
"We value our patients and understand that any changes to health care can feel overwhelming," North Star CEO Joshua Dufresne said in the announcement, a prediction immediately borne out by a barrage of distressed and negative comments on social media from a number of people in the greater Rockingham region criticizing the decision to leave Bellows Falls.
The Rockingham Health Center has been the home of the primary care physicians for many area residents, and urgent care was often the first placed visited by citizens with health issues.
No announcement was made regarding layoffs, and the news release indicated that staff members would be reassigned to health centers either in Springfield or in Charlestown, New Hampshire. North Star's website shows a team of 13 medical providers working in Bellows Falls.
Other tenants in the former hospital are unaffected by the announcement.
The 5.85-acre medical complex is also the home of Springfield Hospital's Windham Center for Psychiatric Care, a 10-bed inpatient unit; Springfield Hospital's outpatient rehabilitation and physical therapy services; Front Line Foundations of North America, a mindfulness program for first responders living with trauma; HCRS (Health Care and Rehabilitation Services), which works with families and those navigating mental health, substance abuse, and developmental disabilities; Greater Rock Fitness; and FACT, Rockingham's public-access community television station.
The campus is owned by the nonprofit foundation Greater Rockingham Area Health Services, Inc.
Bellows Falls resident Doug MacPhee briefly raised the topic of the closure at a tri-board meeting of the Rockingham Selectboard, the Bellows Falls Village Trustees, and the Saxtons River Village Trustees.
"I want the local government to do what they can," MacPhee, who served as board president of Rockingham Memorial Hospital in the 1980s, told the three boards at the meeting on Oct. 22, one day after the announcement.
"The closure of the health center - we don't know all the details yet, but it's going to be a serious problem for a number of people, and the local government has to do whatever it can to assist those people," he said.
Health care system reviewed
Dufresne referred to a recent state-commissioned study as the guiding force behind the decision to consolidate the health centers in the Rockingham/Springfield area.
"Vermont's health care system is at a crossroads," Dufresne wrote. "This necessary decision reflects the evolving health care landscape and our commitment to ensuring long-term access to care."
A 2022 state law commissioned the study into improving the sustainability of Vermont's health-care system and reviewing the financial health of state hospitals, with a goal of creating sustainable, affordable, and equitable future for Vermont's health care providers in general and its 14 hospitals in particular.
The Green Mountain Care Board hired consulting firm Oliver Wyman to conduct the study, with infectious disease specialist Dr. Bruce Hamory heading the 10-month investigation. Hamory's team met with all of Vermont's hospitals and held public meetings around the state to discuss their findings.
Both the public discussions of the study around the state this past summer, and Oliver Wyman's final report released in August conveyed a sense of urgency.
"Unless decisive action is taken immediately to transform Vermont's health care system, it will be financially unsustainable by 2030," read the lead of an article in July 24 issue of The Commons following a presentation by Hamory at Brooks Memorial Library in Brattleboro on July 17.
That sense of urgency permeated the findings of the study.
The study's conclusions were dire and urgent, but hopeful that there would still be a limited time to make changes that would both improve Vermont's health care and help it become financially sustainable.
Transportation concerns
One theme in public-facing comments by citizens on social media was the added patient time and expense for travel to Springfield or Charlestown.
"We know this may feel challenging," Dufresne wrote, "and we're here to help. You will have the option to follow your primary care provider to either our Springfield or Charlestown Health Centers (just a short drive from Rockingham), or you can choose another provider within North Star who is accepting new patients.
"Our team will work with patients to find the best solution based on their needs," he said. "We're committed to helping patients make this transition as smooth as possible."
Those with transportation concerns should contact the Community Health Team - which helps patients with care coordination and "overcoming physical, financial, social and emotional barriers," according to the center's website - to see what resources are available.
Community forum on Nov. 14
Citizens concerned about this consideration are invited to a public community forum in the waiting room of the Rockingham Health Center on Thursday, Nov. 14, at 5:30 p.m. to discuss the change.
"We appreciate the community understanding and flexibility as we navigate these changes together," the health center stated. "Your trust and support mean the world to us, and we are committed to being here for you - today and in the future - providing the care you deserve."
"Why are you holding a public forum after the decision has already been made? What is the expectation of what participants and facilitators will accomplish at this public forum?" Kayla Bernier-Wright of Bellows Falls asked North Star in response to the facility's post of the announcement on Facebook. Six days after she posted the question, it remained unanswered.
There are likely to be more changes and consolidations of medical services around the state. The study found that nine of Vermont's 14 hospitals are operating at a deficit, and the rest are not far behind.
In addition to the cost of health insurance, the study also mentioned a lack of access and transportation to medical care, a shortage of doctors and nurses, long waits in emergency departments, a lack of communication informing patients about possible help from financial services, and long waits for medical procedures as major problems in Vermont.
Combining health centers, hospital specialization, and greater cooperation and communication among health specialists and facilities were also among the recommendations.
Lawmakers react to announcement
Michelle Bos-Lun and Leslie Goldman, who jointly represent Rockingham in the House of Representatives, both characterized the closure as a blow.
Goldman described the loss of primary and urgent care in Bellows Falls as "a tragedy for the community and another example of our failing health care system."
A retired family nurse practitioner with a master's degree in public health, started her career with her husband, Matthew Peake, M.D., at Rockingham Memorial Hospital in 1982, Goldman said she has been in contact with staff at the Agency of Human Services, the office of U.S. Sen. Bernie Sanders, and leadership at North Star Health to talk about the situation.
Goldman is also consulting with the Bi-State Primary Care Association, a consortium of 16 community health centers in Vermont and New Hampshire, including North Star.
"We need to ensure that all patients get established with new providers in a timely way and the transportation systems are reliable," Goldman told The Commons. "Bellows Falls is still in the North Star Health catchment area, and we will be looking to them for leadership."
Bos-Lun called the clinic's impending closure "a devastating loss for our community."
"There will be a lot that needs to get worked out in the months to come to insure our community continues to have its health needs met," she said.
"North Star has some mobile services, and I am hoping they can work out a way to continue to provide some services here in Bellows Falls," she said.
Bos-Lun has met with the clinic's leadership several times, including on Oct. 8, as shown in a photo posted to North Star's Facebook page.
She pointed out the overarching health care challenges in Vermont that have contributed to North Star's woes, including low Medicaid reimbursement rates, "which makes it hard for providers to bring in enough funds to sustain a program and keep providing care," she said. "This is a huge problem in Rockingham where they had a high percentage of Medicaid patients."
Bos-Lun also noted "another huge issue": the same staffing challenges that have plagued the business community as a whole, creating stress and long waits for patients.
"This issue also contributes to high costs with very expensive travel nurses filling essential roles," she said.
Bos-Lun and Goldman are facing challenges for their seats in this election cycle, from independent candidate Casey Cota and Republican Ryan Coyne.
Whoever fills the Windham-3 seats will find that "figuring out how to meet health care needs of Vermonters is going to be one of the most important challenges facing the Legislature in the next biennium," Bos-Lun said.
"We have an aging population that needs access to local care. If providers like the program in Rockingham are going to close, increased transportation options will need to be established to help Vermonters get access to the care they need," she added.
Additional reporting by Jeff Potter.
This News item by Robert F. Smith was written for The Commons.