LEBANON — After the City of Lebanon stopped providing community nursing services to residents in Enfield and Grantham last month, officials in the two towns are evaluating their options to continue the program.

In January 2024, the city entered one-year contracts with the two towns as part of a pilot program. Under the terms, each town paid Lebanon for one of the city’s two community nurses to visit patients in their towns.

At the time, Lebanon had two community nurses: one who worked part-time and another who worked full-time. The full-time nurse left her role with the city recently, Lebanon Fire Chief Jim Wheatley said. The city’s part-time nurse will use her time to see Lebanon patients.

“We took an opportunity to re-evaluate our ability to provide nursing services to Enfield and Grantham,” Wheatley said in a phone interview. “Based on the data we had, we thought it better to not continue.”

Now, Enfield is exploring continuing the program on its own, while Grantham is putting it on pause.

The Enfield nurse would not be a town employee, and instead would sign a contract with the town to provide 10 hours of services to Enfield each week, Town Manager Ed Morris said. The program would be funded by donations and grants, with no cost to Enfield taxpayers.

“We should be back up and going, I hope, within a couple weeks,” Morris said, adding that he would need the approval of the town’s Selectboard before signing a contract. “We have enough in the fund now to do another year, maybe two years even.”

Grantham, for its part, will not be including funding for community nursing in the budget it will present to residents at Town Meeting, Town Administrator Melissa White said.

There are currently no plans in the works to resume the program, but that could change in the future depending what residents request, she said.

Lebanon’s community nurse program is part of the Lebanon Mobile Integrated Health, which is a partnership between the Lebanon Fire Department and Dartmouth Health, a Lebanon-based nonprofit organization.

The mobile integrated health program launched in 2020 and is funded by DH through 2026, according to information posted to the city’s website.

While the partnerships with Enfield and Grantham made sense, in part because the towns share borders, the geographic area was a challenge.

“The staffing demands, travel logistics, and coordination efforts required have proven unsustainable,” Wheatley wrote in an email.

Enfield paid Lebanon about $30,000 for 10 hours of service per week, Wheatley said, and Lebanon’s community nurses were seeing 15 patients.

Grantham spent around $50,000 for 15 hours per week and nurses were seeing 13 patients.

Enfield funded the contract through donations and grants, while Grantham included the expenditure in its town budget.

“There’s no financial loss to the City of Lebanon,” Wheatley said. “It’s cost neutral.”

Kristin Barnum, executive director of Community Nurse Connection, a nonprofit organization that supports community nurse programs in the Twin States, said the arrangement the three municipalities had was different from other communities, which typically have nurses that serve only residents in a single town.

“It seems more efficient, however, it may not be because of the drive time,” said Barnum, who lives in Enfield and helped advise the town’s Community Nursing Program committee. “It’s harder to do, not impossible, but it’s harder to do.”

Enfield had more phone call check-ins from community nurses instead of home visits compared to other community nurse programs, she said.

Val Stinson, of Enfield, was among the residents who found the program helpful in the last year.

Before Stinson’s partner had a total hip replacement surgery, she got in touch with a Lebanon community nurse to do a home assessment to figure out what she needed to do to make their two-story home better for his recovery. While Stinson knew that she needed to install more handrails, the community nurse pointed out more places where rails would be helpful. She also suggested where to install grab bars in the bathroom.

While Stinson researched options on her own, having someone with a medical background offer suggestions and provide a different point of view was a game changer. “The hands-on aspect of it is just so beneficial,” she said.

Grantham Police Chief John Parsons also has been a supporter of the program.

“This was just another means for our residents to talk to somebody about their medical needs,” Parsons said. “If the Lebanon Fire Department could bring their staffing back up, if we could offer this service, I would be 100% for it because I’m still 100% for it right now.”

Liz Sauchelli can be reached at esauchelli@ vnews.com or 603-727-3221.