Mascoma Community Health Center

village

Right Care, Right Costs, Right Here.

  • Local Health Care
  • The Plan
  • History
  • Board
  • Fund Raising
  • Future

Great News!

The two major pieces of the health center financing is a $2,805,000 mortgage for the land and building and a $478,000 loan for the equipment in the center. USDA has formally committed the money for both the mortgage and the equipment loan. The last piece of the funding needed is the balance of the operating reserves needed to fund the center for the first two years. We would like at least $775,000 in operating money. We have raised $323,000 to date and have requests out for another $350,000 from area foundations. We need the help of individuals to raise the last $100,000. Click here to see our donation form. Any amount will help but larger gifts will mean that we can go out to bid for construction. The bid process will start when we reach $600,000 of the $775,000 goal.

Total raised and committed to date is Three Million, Six Hundred Thousand Dollars.

The Right Care. The Right Cost. Right Here. We need your help Right Now!

Help us raise the last $100,000 from our five Mascoma communities.




Mascoma Community Health Center


What?

A community owned and operated, non-profit health, dental, behavioral health center and pharmacy

Where?examining room

Corner of Route 4 and Roberts Road in Canaan

Why?

°Lower Cost – Up to 50% savings

°Comprehensive Care – health, dental, behavioral health, pharmacy, education, x-ray, & labs

°Local Control – Local ownership and board of directors

°Easy Access – Route 4 but not high traffic

°Long Hours – Nights and weekends

°In-Depth Care – More time with staff and more coordination

°Open to anyone – Families, Young, Old, Insured, Un-insured

When?dental chair

Open in 2016

Who will pay for it?

The non-profit corporation will seek federal and state loans and grants to build it and provide seed money.

How do you know it will save money and offer quality?

There are more than 10 community health centers operating in New Hampshire now that save 50% and offer high quality, comprehensive care. We are modeling our clinic after their success.

Can I use my insurance?

Yes. The health center will take most major policies.

Can I get insurance?

Yes, through a bi-state consumer cooperative insurance company with traditional coverage or a direct purchase plan for local primary care, dental and medicine.

What you can do now!

We have received 2,500 pledges to use the new health center in 2016. We want you to join with us and your neighbors when it is built and operating.

Fill out the card that says you'll use it by mail, in person or on-line using the link in the left side-bar labeled "PLEDGE."

It's feasible. It's real. It will be of great service to kids, mothers, workers, seniors, low income families and our communities but it won't happen without your pledge to use it.

Local – Quality – In-Depth – Convenient – Lower Cost

Health, Dental, Education, Behavioral Health, Pharmacy, X-ray, Lab all in one location in our towns.

Health, Dental, Education, Behavioral Health, Pharmacy, X-ray, Lab all in one location in our towns.

Better quality, more accountability and greater savings.





test pits on siteMascoma Community Health Center

Coming to the corner of US 4 and Roberts Road in Canaan spring of 2016

PO Box 550, Canaan, NH 03741
603-523-4501 ext 5


The Plan: Create Good Health Care!


The Nature of Good Health Care

examining roomGood Health Care offers several local general practitioners who are teamed with a specific nurse practitioner to give every patient more depth in their care and coverage and at least two care providers that the patient knows personally and feels comfortable with. The health care providers work as a team with other services of the clinic like lab services.

Medical care should include pediatrics, pre-natal and professional mid-wives

Dental care including a dentist and dental hygienists should be included.

dental chairLaboratory services, Physical Therapy, Pharmacy, Nutrition, Therapy, Hospice, Home Visits and minor X-Ray services should be available.

Medical care should be coordinated with hospitals, specialists, local schools, daycares, senior programs, government programs, Veterans Administration, public housing and community assistance programs.

Assistance in getting insurance and maintaining insurance that is affordable should be provided.


Access to Good Health Care

blood draw stationGood health care should be local. It should serve the entire community and entire families. Care should be a matter of choice. There should be no requirements for use.

Appointments should be readily available and happen in a timely manner. Evening and weekend appointments need to be available. Appointments should allow enough time with the professionals to truly understand and manage health problems.

We should try to include current primary care doctors if possible. All patients should have access to local hospitals and specialists as needed.


Quality Control of Good Health Care

Good Health Care has built in quality control. It assures:

  • an organized health team that integrates patient, doctor, nurse practitioner, lab services, rehab, social services, mental health counseling, pharmaceuticals, nutrition, and dental care

  • close communication between the patient, the providers and between providers

  • that the team coordinates external services

  • full communication with the patient regarding plans, procedures, results and revisions

  • that the patient shares in the decision making with understanding, cooperation and agreement

  • that there is sufficient time available for the communication and coordination

  • independent quality control using a patient advocate to review records and patient history to assure that the goals for communication, understanding, decision sharing and coordination with external services is achieved

  • integration of team health care around a patient that include the doctor, a nurse practitioner, lab services, rehab, social services, mental health counseling, pharmaceuticals, nutrition, and dental care


Financing Good Health Care

labCost of Care that is affordable assures that the cost of professionals, drugs, tests, procedures and rehab are as reasonable as possible, fair for all and the same for insured and uninsured patients.

It should adopt a sliding scale system for those who can't afford insurance or full payment for service based on what they can afford.

Develop a community insurance policy that is affordable.

labReduce waste and duplication of service and offer service in the lowest cost environment (not an emergency room).

The goal is to cut primary care costs by 50% and drug costs by at least 75% and reduce or stabilize insurance premiums to keep insurance affordable.

New money isn't needed – there is enough existing money to fund the change.


Accountability in Good Health Care

medical check-in deskThis clinic would be controlled by the users in the community, not by a hospital or the State or federal government or a town government. It would be funded by the users with a shared sense of responsibility and shared expense but with generally much lower expense.




The currently proposed organizational and services schematic for the local clinic:
organization chart for 8000 patients

Click to View PDF

History & Progress....

Mission and Goals

Mascoma Valley is Enfield, Canaan, Grafton, Orange, and Dorchester. Mascoma Community Healthcare, Inc. is dedicated to creating a community designed, managed and funded comprehensive health center that addresses medical, mental and dental health issues with complementing lab, x-ray, pharmaceutical and physical therapy services. The goal is to have the health center in operation with at least 2,400 patients by the end of 2015. We currently have more than 2,500 people who have pledged to use the health center.

The health center will provide services at a cost that is at least 25% less than what is currently paid by individuals and employers through insurance plans. Mascoma Community Healthcare, Inc. is working to develop insurance products that capture these savings and reduce premium costs by as much as a quarter. The health Center will serve all people regardless of age, income, or insurance status.

History

Under the sponsorship of the Town of Canaan, a citizen dialog about health was undertaken for the five towns in May of 2013. All members of the five Mascoma Valley communities were invited to share their thoughts on what constituted good health care as well as their fears and concerns. More than 400 people from Grafton, Orange, Dorchester, Canaan, and Enfield participated in nine community wide meetings between May and December 2013. People spoke to their frustration with rapidly increasing premium costs, high deductibles, dropped coverage, and premium sharing. They told of their dissatisfaction with 15-minute appointments, delays in getting appointments and fragmented care where there was little communication between providers.

A steering committee, formed from attendees of these community wide meetings, set about to design a clinic model that offers preventive healthcare, treatment of illness, ob-gyn service, gerontology, family practice, mental health, dental care, x-ray, laboratory and physical therapy services. It will be a clinic that serves children, families, elderly, working moms, people working two jobs, rich, poor, insured, underinsured and uninsured.

The community-wide organizers took the plan back to the communities and asked people to commit to using the health center once built. The clinic has won the support and pledges for the use of the facility from over 2,500 community members that represents about 25% of the residents of the five towns. This pledge number continues to grow.

Organizational Structure and Achievements

A group of incorporators then created a 501(c)3 corporation (with tax exempt status) in April of 2014 that will fund and manage the new clinic under the direction of a 25 member board of directors with 17 directors coming from patients using the facility. The Board includes three physicians, a nurse manager, a nursing educator, a pharmacist, billing coder, architect, medical manager, financial advisors, clinic operator, fundraisers, and public health professionals. A list of Board members and their brief biography is attached.

A location equidistant for all the Mascoma residents located at the corner of Roberts Road and Route 4 in Canaan, NH was optioned by the Board. That site is 5 miles from Enfield, 9 miles from Grafton Village, 2 miles from downtown Canaan and 6 miles from Dorchester.

Facility

After consulting with several engineers and architects the Building Committee has determined that a 10,600 sq. ft. structure can accommodate the planned services of medical, dental, pharmacy, laboratory, radiology, behavioral health and physical therapy. Its design will fit into the rural nature of the community and the immediate surrounding environment. It will be slab on grade and have a wood exterior. The site will be leveled from the center of the property to the north end. The lot includes approximately two acres of the 4 acre site. It will meet all local ordinances as well as any appropriate medical/dental regulations. Septic will be handled on site and meet all certification requirements. Parking will be created to accommodate anticipated traffic flow for a health center servicing 8,000 patients. Appropriate water runoff management will be a component of the site plan.

The cost of the land, building, contingency, engineering, architectural work and closing costs is estimated to be $3,000,000.

Equipment

A complete list of equipment needed and vendors has been prepared. The Start-up budget (sufficient for 5,000 patients) includes:

Office and general areas $65,353, Pharmacy $66,860, Laboratory $348,604, Dental $314,419, Examination Rooms $37,051 and Radiology $100,137. The total budgeted is $932,424. Additional equipment will be added out of cash flow generated by patients over 5,000.

Funding

The project will cost $3,500,000 and will be designed to serve up to 8,000 patients. Initially, staffing and services will be sized for a patient population between 2,400 and 3,600. We are seeking to raise $350,000 in community donations of which $180,000 has already been pledged. A total of $750,000 of local donations and state grants will be maintained as an operating reserve with mortgage payments and loans receiving priority.

Business Plan Highlights

Source of numbers: All financial projections are drawn from actual numbers. All equipment costs are actual, full retail costs. Building costs are guaranteed at no more than $200 per square foot. Salaries and utilization rates were generated from Ammonoosuc Community Health Services in Littleton, NH, Goodwin Community Health in Somersworth, NH, The Health Center in Plainfield, Vermont and The Uniform Data System (UDS) that is part of the Health Resources and Service Administration. Reimbursement rates were derived from Anthem Blue Cross October 2013 schedules and current Medicare reimbursement rates. Dental rates were obtained from Ammonoosuc and Plainfield. All non-salary expenses were derived from Ammonoosuc and Goodwin and the most conservative (highest) costs were used. Goodwin's Medical Director with 14 years of experience through 2012 sits on the Board of Mascoma Community Health Center. The Director of Ammonoosuc provided all of their financials to use as well as personal guidance. We have used and will continue to use Helms & Company of Concord, NH to independently review our business plan.

Source of patients: Before the business plan was started, Mascoma Community Healthcare solicited 1,600 pledges of people in the five towns who committed to join the new practice. That number has grown to more than 2,500 pledges or 25% of the five towns. Of the pledges, there are at least 150 people from 28 other towns who have also pledged to join the practice.

Make a contribution to support the health center as we organize. It's tax deductible. Checks should be made payable to Mascoma Community Healthcare, Inc. and mailed to PO Box 550, Canaan, NH 03741.


Click to view the final plan from 2013 for healthcare in Mascoma Valley.


Proposed Organization & Services Plan


Click to view larger

flow chart of services




Rankings of Health Care Issue Exercise:



Slideshow and Video of the Organization Meeting: May 2013

graph of increasing health costs 
PDF Version (Slides Only)
YouTube Video (Slides and Narration of Discussion)


video lilnk

Video from 2012 on how towns, schools, and employers can work together toward affordable care.

Affordable Care Video

Board of Directors

Articles of Agreement and Bylaws

The new Mascoma clinic will be owned and operated by a non-profit corporation located in Canaan. The management of the corporation will be by a Board of Directors. The Board sets budgets and fees, hires and fires, sets management policy and evaluates the effectiveness of the service.

The Board has 25 members of which about 16 will be voting members and patients (or pledges prior to opening). The remaining 9 members will be non-voting and professionals or people who may eventually provide services to the clinic. No one receiving compensation may be a voting member of the Board. In the future, nominees for new Directors will be selected by a committee of community members and existing Directors. Suggestions for Directors will come from the patients in the communities. Terms for Board members will be two years and staggered.

There will be committees reporting to the Board of Directors on various topics, and the committees will be composed of Directors and community members who are not Directors.

All Board members, as well as employees, must follow very strict rules prohibiting conflicts of interest.

Board Members

Board Chairman: Dale Barney (603)523-4407

  • Carolyn Barney, Canaan
  • Dale Barney, Ex-Officio, Canaan
  • Dave Beaufait, Ex-Officio, Enfield
  • Scott Berry, Ex-Officio, Canaan
  • Barry Clause, Enfield
  • Lori Dacier, Grafton
  • Barbara Dolyak, Canaan
  • John Dow, Canaan
  • Karen Ewer Gray, Canaan
  • Tim Jennings, Enfield
  • Gili Lushkov, Canaan
  • Ed McGee, Ex-Officio, Canaan
  • Sean Murphy, Canaan
  • Michael Paine, Ex-Officio, Canaan
  • Mary Paquette, Canaan
  • Mike Samson, Ex-Officio, Canaan
  • Alice Schori, Canaan
  • Jim Spaulding, Grafton
  • Peter Thurber, Canaan
  • Linda Von Reyn, Canaan

We have a very talented team!
Read their BIOGRAPHIES here!

Board Committee Chairs:

Building Committee: John Dow (603)523-3033

Collaboration Committee: Mike Samson (603)523-4501 ext 5

Communication Committee: Scott Berry (570)412-9474

Equipment Committee: Peter Thurber (603)523-9832

Finance Committee: Mary Paquette (508)965-6539

Fundraising Committee: Carolyn Barney (603)632-4127

Staffing Committee: Gili Lushkov (603)523-4354


Mascoma Community Health Center is almost ready for construction. It just needs your help raising the last $450,000 with $350,000 in grants, and $100,000 in local donations!


Mascoma Health Center – A local health center with comprehensive services that's affordable for all.

The Health Center is a $4,058,125 project. The Health Center has two applications for $3,283,125 from USDA Rural Development for this community facility. One is a 30 year mortgage for $2,804,242 for the land and building and one is an 8 year note for $478,883 for equipment. We have satisfied the conditions necessary to secure the loans and expect a final decision in the next few weeks.

The remaining piece of the financing is to raise the operating reserves we need to open. This is the money to guarantee cash flow during the first two years of operation. We have very cautiously estimated that the cash reserves we need during the first few years is $775,000. We currently have $323,000, and anticipate an additional $350,000 in grants.

Our need right now is to raise another $100,000 by October 2015!



Budget

The plan is to obtain the $450,000 from two primary sources.

  • Grants from institutional, government and private foundations
  • Local gifts and donations


Foundation Grants

Goal:

Raise at least $350,000 more in private and institutional foundation grants and government funding.

Local Gifts and Donations

Goal:

Raise at least $100,000 more in donations and pledges from residents and businesses in the Mascoma Valley.

Your donation means we will be able to go out to bid this fall and open in 2016.
Mascoma Community Health Center is a 501(c)(3) organization and a registered New Hampshire Charity. Your gift is tax deductible

Click Here for Donation Form



There are a number of opportunities to dedicate a gift in memory or recognition of an individual or cause:

  • Pediatric Dental Suite $10,000**
  • Pediatric Medical Suite $10,000**
  • Family Practice Suite $10,000**
  • Gerontology Suite $10,000*
  • OB-GYN Suite $10,000*
  • Social Service and Community Support Suite $10,000**
  • Administrative Services Suite $10,000
  • Physical Therapy and Rehabilitation Center $25,000
  • Health Center Community Care Reception Room $25,000
  • MCH Triage Area $25,000
  • Community Pharmacy $25,000
  • Health Maintenance Laboratory $10,000
  • Remote Read Radiography Center $10,000
  • Behavioral Health and Counseling Services $10,000
  • Mascoma Valley Community Room $10,000**
  • Dental Restoration Laboratory $10,000
  • Provider Team Consultation Room $10,000
  • 12 examination rooms $5,000 each
  • 5 dental chairs $5,000 each
  • Phlebotomy Room $5,000
  • Dental Provider Office $5,000
  • Staff Lounge $5,000
  • 3 Social Services offices $5,000 each
  • Education Center $5,000
  • (All dedications are subject to Board approval.)
  • *Indicates that this designation is not available yet.
  • **Areas reserved by donors to date.

NOTES:

All gifts to Mascoma Community Healthcare, Inc. are tax deductible. Mascoma Community Healthcare, Inc. is a 501(c)(3) organization and a registered New Hampshire Charity. A copy of all registration documents is available. This organization is locally managed by prospective patients and is not part of a larger institution. Checks must be made payable to Mascoma Community Healthcare, Inc. and should be sent to PO Box 550, Canaan, NH 03741. Tax deduction receipts will be provided to every donor.

Gifts may be made confidentially with the donor's name restricted from public access. Gifts may be made at any time, but our greatest need to open the center is to raise $415,000 by August 1, 2015. Gifts toward the opening of the facility must be completed by May 1st of 2017. We ask that donors making gifts over the two year period make part of the gift by August 1st of this year. While some of the donated money is needed immediately for architecture and engineering services, most of the donated money will be used for operating reserves when the health center is open. In the event that the facility does not open, all money donated will be returned to contributors on a prorated basis.


architectural rendering of future building
Architectural Rendering of Mascoma Community Health Center: Stratton Brook Associates