This commentary is by Tom Frank, CEO of North Country Hospital in Newport, and Shawn Tester, CEO of Northeastern Vermont Regional Hospital in St. Johnsbury.For North County Hospital and Northeastern Vermont Regional Hospital, collaboration and teamwork to protect local access to services, keep costs down and provide great care to our neighbors in the Northeast Kingdom is essential to serve the vast region we cover. The region also includes Essex County in the furthest northeast corner of our state, as well as portions of Franklin, Lamoille and Orange Counties. We are indeed the most rural region in our already very rural state. Our two small critical access hospitals, along with our partner home health agency and Federally Qualified Health Center, Northern Counties Health Care, are responsible for covering some 2,000 square miles, or 20% of the entire state’s land. We serve 55 municipalities and gores of the state’s total 256 municipalities and gores. So, you can see that working together to reduce wait times, shorten long drives and provide care for patients close to home, or even in their homes, is critical. It can even mean the difference between life and death. READ MORE Our collaborations run deep, and we are always exploring more opportunities. NCH and NVRH are exploring joint recruitment of providers where possible in order to share their services between the two hospitals.Recent work includes recruiting providers in urology and neurology. The NEK Healthcare Collaborative, LLC supports our sleep medicine services across the NEK for patient consults, followups and sleep studies. In the future, other services could be added. NCH has shifted to one orthopedic surgeon who provides upper and lower extremity orthopedic services and refers any hip or knee joint procedures to NVRH. It’s important to note that this has added significant volume to NVRH, but we are adapting to meet patient demand and will need ongoing regulatory understanding and support to maintain this critical service for all of the Northeast Kingdom region.North County, in turn, provides additional pediatric speech therapy services to the St. Johnsbury area. We work together on education and training, including Avade de-escalation training and training of medical assistants. We have also moved toward a regional community health needs sssessment approach to reduce costs and to support greater alignment around local solutions to pressing health needs. Very importantly, we are in discussion on sharing an administrative compliance officer and other combined administrative services to further reduce costs and increase efficiencies.Despite this great work, a recent report prepared for the Green Mountain Care Board states that health care services should be eliminated and consolidated across Vermont, and essentially that hospitals like North Country, Gifford, Springfield and Grace Cottage should close.Specific to North Country, the conclusion is that those patients could just go to NVRH for care, which is not only impractical, but would also harm our patients. This report, as presented, will increase health care costs and weaken or reduce access to critical services. That is simply unacceptable to us. We know that some NEK residents will simply choose not to seek the care they need if long travel distances are required. This is a health equity issue.Instead of cutting services and harming regions of the state like the NEK, we should be investing state resources in the foundations of a thriving society to encourage people to move here, fill our schools with their kids, work in our hospitals and small businesses and pay state and local taxes toward infrastructure, recreation and community-based organizations.That work is hard because it requires us to think differently, but it’s necessary for us to grow again. The state must build thousands of units of workforce housing, invest in a functioning transportation and EMS system and continue to offer community support for those who are aging, unhoused, hungry, struggling with mental health or substance use disorder or otherwise need state help to get by. For our part, we know the work is never done. We know as well as any that there will be challenges next week or a new chance to work together to lower costs or bring in a new service. We never stop looking for opportunities to do better, fill a gap, work with a partner — all in service to our patients and to keep our communities strong. We talk to our staff, patients and community leaders every day and not a single person among them believes that following the direction of this report will reduce their cost of living or strengthen our state. They know, as we do, that the future of the Northeast Kingdom is very bright if we work together to build housing and grow our economy. Together, with our lawmakers and state leaders, we will be hard at work on solutions to make our state stronger and more affordable for all. Read the story on VTDigger here: Tom Frank and Shawn Tester: Rural Vermonters deserve great health care.