Proponents Continue Push for Mascoma Valley Clinic
‘Convinced It Will Happen’
Celia Hester, left of Enfield, N.H., and Nettie Olson of Canaan, ask questions of Peter Thurber, a member of the Mascoma Community Healthcare Inc. Board of Directors, during an informational session at Cardigan Mountain School in Canaan, N.H., on August 18, 2014 regarding a proposed $4 million clinic to open in Canaan in October 2015, bringing personal care closer to people who regularly make a 40-minute drive to Lebanon hospitals.
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Celia Hester of Enfield picks up information related to a proposed healthcare clinic to open in Canaan in October 2015 during a community reception organized by Mascoma Community Healthcare at Cardigan Mountain School in Canaan, N.H., on August 18, 2014.
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Canaan — About 75 people gathered at the Cardigan Mountain School this week to support plans to build a $3.95 million clinic that could eventually provide a range of medical, dental, mental health and related services to residents here and in four neighboring towns.
“Come together as a community and we can make this happen,” Scott Berry, a former executive at Dartmouth-Hitchcock who is the project manager for Mascoma Community Healthcare Inc., told the audience gathered around tables Monday evening in the school’s modern cafeteria.
“I am convinced it will happen,” said John Dow, the owner of Canaan Hardware, who compared the skepticism about the Mascoma Valley’s ability to support a 10,000- to 12,000-square-foot clinic to skepticism he had faced when he expanded his store to 6,000 square feet.
Organizers said they have gathered 2,150 pledges to use the clinic, which will serve five communities — Enfield, Orange, Grafton and Dorchester as well as Canaan — with 11,000 residents. About 400 pledges came from the Cardigan school on behalf of its employees and students, said Mike Samson, the town administrator in Canaan.
“This isn’t about money,” said Dale Barney, a Canaan insurance agent who is chairman of the board of directors of the project, which aims to have 4,000 pledges in hand before the clinic’s target opening date in the autumn of 2015. “This is about moral support.”
But it’s also about money — as shown by the closing of Lebanon College in the face of lagging enrollment and a hefty debt. That news became official Monday evening, just a few minutes after attendees at the clinic event had finished mingling and munching on hand-carved ham and turkey, sipping wine and nibbling from platters of pot stickers and cheese.
Clinic organizers say they need to raise $200,000 by the end of the year and another $150,000 by September 2015. So far they have applied for $225,000 from six potential donors, with applications for another $22,500 expected to be delivered within two weeks. “We are optimistic about the funding,” a flyer handed out Monday night by Mascoma Community Healthcare stated.
Samson said that most of the financing for the project would come from loans secured by land and a clinic to be built at the corner of Route 4 and John Roberts Road in Canaan. A $2.4 million rural development loan from the U.S. Department of Agriculture would be used to buy the parcel and build a facility with 10 examination rooms, five dentists’ chairs and two special rooms for the treatment of obese patients. That loan would get repaid in 360 monthly installments of $11,458, according to budget information distributed at this week’s forum.
Organizers are looking for additional financing in the form of a 10-year equipment lease that would add $9,112 to monthly overhead. Working capital would come from state tax credits and from donations, according to Samson and the budget documents.
Canaan has had no doctors or dentists since 2011 when Dartmouth-Hitchcock, facing a budget squeeze, closed a pediatric clinic that had been hit by the retirement of a key staffer and declining patient volume. Dow, a lifelong resident of Canaan, recalled that a lot of residents complained about Dartmouth-Hitchcock’s pullback: “That was a big loss.”
The proposed Mascoma clinic aims to serve at least 1,450 patients at the outset, with the equivalent of one full-time doctor, three additional trained medical providers, two dental workers, part-time housekeeping and a manager and a bookkeeper each working two days a week. That would incur about $3 million in annual expenses and generate $2.9 million in revenue, organizers estimate.
Eventually, the clinic could serve 8,000 patients and employ more than four doctors, 15 other trained medical personnel, 13 dentists or assistants, three pharmacists or assistants, three mental health workers, four housekeepers and nine administrators. At that point, annual revenue of $15.4 million would exceed expenses of $15 million, organizers estimate.
Littleton, N.H.-based Ammonoosuc Community Health Services, which operates five clinics that serve 9,400 patients and employ 94 in northern New Hampshire, fell just short of breaking even with revenue of $7.2 million in the fiscal year that ended June 30, 2013, according to its tax filing. Mascoma’s higher revenue and expense estimates reflect anticipated volumes of pharmacy transactions and dental services that would far exceed those at Ammonoosuc, Samson said.
Samson expressed confidence that a pair of two-day-a-week administrators could handle Mascoma’s initial administrative workload. He noted that the town of Canaan employs a bookkeeper three days a week to manage its $3.5 million budget and a payroll with the equivalent of 20 full-time employees.
Patients would comprise a majority of the clinic’s governing board, and no board member would be allowed to collect more than 10 percent of his or her income from selling products or services to the clinic, said Berry, who described the project as “a real opportunity to say we’re gong to take control of this and manage it to meet our needs.”
Project organizers expect to “have a pretty good idea by December if this thing’s going to go,” he said.
Rick Jurgens can be reached at firstname.lastname@example.org or 603-727-3229.