Why It Matters
New Hampshire’s rural healthcare network took a significant step forward this week as the state’s Executive Council approved the final contract in the GO-NORTH initiative, a program designed to direct hundreds of millions of federal dollars toward rural communities facing mounting healthcare challenges. The approval of the fifth and final hub contract means the full framework of the state’s rural health transformation program is now in place, with real consequences for patients, providers, and facilities across New Hampshire’s most underserved regions.
The program addresses critical gaps in rural healthcare access, including substance use disorder treatment, transportation barriers, and the financial stability of rural hospitals — issues that affect tens of thousands of New Hampshire residents who live far from major medical centers.
What Happened
During a lengthy meeting on Wednesday, March 25, 2026, the New Hampshire Governor and Executive Council narrowly approved the final contract in the GO-NORTH rural health program, completing the designation of all five community “hubs” tasked with distributing federal healthcare funding across the state.
The approved contract awards $21.6 million to the New Hampshire Community Behavioral Health Association. The organization will direct those funds toward projects addressing substance use disorder in rural areas of the state.
The vote was not without friction. Councilors have repeatedly challenged the structure of the GO-NORTH contracts, particularly the fact that the agreements were awarded as sole-source contracts rather than through a competitive bidding process. At a March 4 meeting, the council tabled all five contracts and demanded the right to review and veto individual projects funded within each hub. A special meeting held on March 16 resulted in approval of four of the five hubs, leaving the Community Behavioral Health Association contract as the final piece to be resolved.
GO-NORTH Director Donnalee Lozeau faced repeated questioning from councilors throughout the process before the council ultimately approved the fifth contract.
By the Numbers
- $21.6 million — Value of the contract awarded to the New Hampshire Community Behavioral Health Association for substance use disorder programs in rural communities.
- $200 million — Approximate federal funding New Hampshire received through the Rural Health Transformation Program in the current year, with similar allocations anticipated in subsequent years.
- 5 — Total number of community hubs now designated under the GO-NORTH initiative to allocate rural health funding statewide.
- $10,000 — The contract threshold above which the Executive Council is required to provide approval under New Hampshire state law.
- 3 — Number of separate council meetings required before all five contracts received final approval, reflecting the level of scrutiny applied by councilors.
Zoom Out
New Hampshire’s GO-NORTH program draws its funding from the federal Rural Health Transformation Program, a provision embedded in the One Big Beautiful Bill Act — President Donald Trump’s sweeping 2025 legislative package that reshaped large portions of federal spending and policy.
The Rural Health Transformation Program was specifically designed to provide a financial cushion for rural healthcare systems, which critics of the broader legislation argue will face significant strain from other provisions in the law. Rural hospitals across the United States have long operated on thin margins, and many advocacy groups have warned that changes to Medicaid reimbursement structures embedded in recent federal legislation could accelerate hospital closures in small and rural communities nationwide.
Several other states are similarly navigating the process of standing up rural health infrastructure programs funded through the same federal legislation, making New Hampshire’s experience with governance, contracting, and oversight a potential reference point for how other state executive bodies approach similar programs.
What’s Next
With all five GO-NORTH hubs now under contract, the program moves into implementation. Each designated organization will begin allocating funds to specific projects within their area of responsibility, which will then return to the Executive Council for individual review given the oversight conditions the council negotiated.
Projects in the pipeline include expanding rural transportation options for patients traveling to medical appointments, broadening telehealth infrastructure, supporting rural hospital billing and insurance reimbursement processes, workforce development in healthcare and child care, and capital improvements to health facilities across New Hampshire.
New Hampshire anticipates receiving additional rounds of federal funding through the Rural Health Transformation Program in coming years, meaning the GO-NORTH framework established through these five hub contracts is expected to serve as the ongoing administrative structure for a multi-year investment in the state’s rural healthcare system.