New Hampshire Deep Dive: Inside the $204M GO-NORTH Model

A state-profile special edition on how New Hampshire built, staffed, and started spending the first dollars of its Rural Health Transformation award — and what to watch for going forward.

Apr 17, 2026

What’s new: $131M appropriated, $25M Evaluation RFP due this month

New Hampshire received $204,016,550 in its first annual Rural Health Transformation Program (RHTP) award.

The biggest movement was in late March 2026 with the establishment of a sole-source contract between the newly established Governor’s Office of New Opportunities & Rural Transformational Health (GO-NORTH) and the New Hampshire Community Behavioral Health Association (CBHA), with a price limitation of $131,648,590 through September 30, 2031.

The first budget period alone is $21,648,590, fully federal, and the contract commits CBHA to sole-source a management services organization arrangement with Helms and Company, a Concord-based healthcare consultancy, to centralize administrative, operational, and CCBHC implementation support for participating Community Mental Health Centers.

Easrlier this week GO-NORTH posted RFP 2026-001 for the RHTP’s statewide external evaluator, with proposals due May 22 and an anticipated ceiling of $25 million over five years.

What makes New Hampshire stand out is the speed and structural clarity of their implementation. It has a dedicated executive-branch unit — GO-NORTH — to run the program. A named director, Donnalee Lozeau, is signing contracts. Five initiatives are scoped and timelined through FY2031, with 18 named contracts, 10 statutory legislative actions, and stage-gate milestones mapped to federal fiscal quarters

The Architecture: GO-NORTH

Governor Ayotte’s Executive Order creates the Governor’s Office of New Opportunities & Rural Transformational Health — GO-NORTH — as an independent unit under the authority of the Governor’s Office that leverages DHHS subject-matter expertise and internal controls without living inside DHHS. NH modeled the structure on the Governor’s Office for Emergency Relief and Recovery (GOFERR), which administered CARES Act money during the pandemic.

The reporting structure is clean:

Governor’s Office → DHHS Commissioner / GO-NORTH Director
Under the Director: GO-NORTH Project Director overseeing 11 FTEs
Five functional leads: Policy Lead, Population Health Lead, Behavioral Health Lead, Workforce Lead, Evaluation Lead, Finance Lead
Plus program integrity specialists and finance officers
A GO-NORTH Advisory Board of five gubernatorial appointees
Dotted-line coordination with NH Department of Education, NH Department of Transportation, and the State Health Assessment / State Health Improvement Plan Council

Donnalee Lozeau is the current Director; she signed the March 20 CBHA contract. Whitney Hammond, the Interim Project Director, is a social worker and public health professional who served as Chronic Disease Director, Program Coordinator for the NH Comprehensive Cancer Program, and Policy Analyst at DHHS, with prior experience as a Trainer at Dartmouth’s Geisel School of Medicine. Tom Broderick serves as Legal Counsel and is the sole procurement point of contact for RFP 2026-001. Robyn Guarino signed the March 20 contract on behalf of the Attorney General’s office.

The Plan: Five Initiatives, $1B+ Over Five Years

NH’s RHTP is organized as five synergistic initiatives, each tied to one or more CMS strategic goals. At an assumed $200M/year the state projected roughly $1B total; at $204M in year one, that ceiling rises. The narrative redacts initiative-level dollar amounts, but the structure and sub-components are public.

Initiative 1: Rural Population Health

Prevention-first infrastructure: community health workers, closed-loop referral systems, community-based access points, virtual-first primary care telehealth, pharmacy lockboxes, a rural work health hub, a polypharmacy risk-reduction pilot for Medicaid-Medicare duals, and a partnership with the NH Department of Education on the Presidential Fitness Program and school-based oral health. Launches NH’s first Dual-Eligible Special Needs Plan (D-SNP) by January 1, 2029.

Initiative 2: Rural Healthcare Access

The behavioral-health backbone. Converts NH’s seven remaining Community Mental Health Centers into Certified Community Behavioral Health Clinics (CCBHCs), on top of the two already certified in Manchester and Nashua. Also builds the REACT 9-1-1 rural emergency access and telehealth triage system, mobile integrated health (MIH), new EMS units in deserts, a rural crisis stabilization and transitional housing network, a rural children’s behavioral-health care management organization, mobile obstetric simulation labs, and a Perinatal Mental Health Access Program.

Initiative 3: Rural Workforce Recruitment and Retention

The Governor’s Health Scholars Award Program, a five-year service commitment model for in-state residency and college graduates in behavioral health, nursing, primary care, respiratory therapy, life sciences, and regenerative medicine. Establishes NH’s first rural dental residency and the White Mountain Rural Family Medicine Residency at the North Country’s White Mountain Medical Education Consortium (partnering North Country Health and Coos County Family Health Services in Berlin). Adds a Common Campus network of clinical simulation hubs linking CCSNH and USNH, an EMS paraprofessional training academy, and a “Ready for Rural” shared urban-rural staffing model.

Initiative 4: Rural Health Technology

Statewide closed-loop referral (CLR) adoption; a shared interoperable EMR across all CCBHCs; a unified ride-share application for non-emergency medical transportation; an Electronic Dental Record for six school-based oral health programs; AI-powered polypharmacy tools; remote patient monitoring in nursing homes (including robotic assistance pilots); a rural EMS communications tower upgrade program; and a provider-to-payer digital health system targeting real-time prior auth and claims management. The narrative caps EMR replacement spending at 5% of total funds in any budget period.

Initiative 5: Rural Financial Solvency

A Medicaid rural hospital value-based payment model co-developed with hospitals — using global-like budgets with rural adjustments to avoid punishing hospitals for successful population health improvements. Also bolsters ACO readiness for FQHCs, launches a VBP for children with complex behavioral health needs, creates a VBP for crisis stabilization and transitional housing, and funds capital improvements at county-run nursing homes in Merrimack and Coos — the Coos County facility in Colebrook alone holds 50% of the county’s nursing beds. A new inter-facility transport ambulance program tackles the empty-return-run problem that drains rural hospital margins.

Every initiative carries performance objectives (CCBHC counts, CHW placements, MIH home visits, virtual primary care panel size, preventable ED visit rates by county), and each is staged in quarterly increments from FFY26 through FFY31.

The Contracts: What’s Moving Now

Two contract actions are already in public record.

The CBHA Sole Source — $131.6M

Contract: Coordination and Support for CMHCs/CCBHCs (SS-2026-DBH-05-COORD-01) Vendor: New Hampshire Community Behavioral Health Association (VC#355870), 1 Pillsbury St., Concord, NH Signed for CBHA by: Margaret Pritchard, Board of Directors President Price limitation: $131,648,590 through 9/30/2031 First budget period: $21,648,590 (100% federal) Renewals: Three one-year options subject to G&C approval (FFY29, FFY30, FFY31) G&C Agenda: Late Item B, March 25, 2026

The contract funds four connected investments: a shared electronic health record across all CMHCs; shared infrastructure; workforce development; and CCBHC certification support for the seven remaining non-certified centers. CBHA is explicitly authorized to sole-source Helms and Company as the management services organization — the same Concord-based firm that has advised NH hospital and behavioral-health clients for decades.

Evaluator RFP — 2026-001

Released: April 14, 2026 Vendor inquiries close: April 21, 2026, 5:00 PM Final responses to inquiries: May 6, 2026 Proposals due: May 22, 2026, 2:30 PM Anticipated selection: June 5, 2026 Contract term: G&C approval through September 30, 2031, with one-year extension option Ceiling: Up to $25 million over the term Sole point of contact: Tom Broderick, Legal Counsel, RFP@go-north.nh.gov

Key structural requirements: the evaluator must have at least three years of experience with federally-funded grants for a state or federal client; individual evaluators are disqualified; and the vendor must be based in NH or have a 60-day plan to stand up a NH presence. Scoring is 1,500 points total — 1,000 for the technical proposal (Qualifications 300, Technical Approach 200, Collaboration and Support 300, Staffing and Management 200) and 500 for the price proposal. Minimum technical threshold is 500 points or the price proposal is returned unopened.

Deliverables include quarterly progress reports (Q1 due November 7, Q2 February 7, Q3 May 7), annual reports through 2030, and a final evaluation report at contract conclusion. The evaluator is also expected to support GO-NORTH’s annual RHTP summit.

Implied: the evaluator will work across the five contracted hub organizations — the term NH uses for the organizations delivering the initiatives, which appear to map to CBHA plus four others still to be named publicly.

The Legislative Agenda

NH committed in its project narrative to pursue nine legislative or regulatory actions during the 2026 and 2027 legislative sessions. No bill numbers exist yet. Watch for:

Executive Order establishing GO-NORTH (issued or imminent).
Legislation requiring the Presidential Fitness Program in NH schools.
Executive Order directing CCSNH, USNH, and the NH Department of Education to align on rural healthcare career pathways.
NH joins the Physician Assistant Compact and EMS Compact.
Expanded pharmacist scope of practice to include independent prescribing and lab test ordering.
Independent billing authority for dental hygienists in appropriate settings.
Nutrition and healthy-lifestyle continuing medical education mandate for providers.
Launch of NH’s first Dual-Eligible Special Needs Plan (D-SNP) by January 1, 2029.
Executive Order directing high school technical education programs, CCSNH, and USNH to collaborate on rural career pathways.

For RHTP legislation trackers: none of these bills are currently numbered, but the Policy Lead position at GO-NORTH is specifically responsible for drafting bill language, preparing fiscal notes, and providing testimony. Expect the first bills to drop during the NH 2026 legislative session.

The Partner Ecosystem

NH’s RHTP runs through a dense web of statewide associations and educational institutions. The Accounts that will shape five years of rural health in the state include:

New Hampshire Department of Health and Human Services (DHHS) — the parent umbrella for Medicaid, Division of Public Health Services, Division of Behavioral Health, Office of Rural Health, Bureau of Procurement, and the Commissioner’s office.
NH Community Behavioral Health Association (CBHA) — first sole-source partner; will run the CCBHC expansion and shared EMR.
Helms and Company — management services organization to CBHA; deepest private-sector footprint in the program to date.
NH Hospital Association — represents 26 hospitals including 13 critical access hospitals; partner on the VBP model.
Bi-State Primary Care Association — the FQHC trade association for NH and Vermont; partner on primary care transformation.
Foundation for Healthy Communities — NH’s statewide nonprofit that convenes hospitals, insurers, and community partners; the project narrative redacts a contractor name in the RGG structure description that is almost certainly this organization.
NH Ambulance Association — EMS partner on REACT, MIH, and new unit deployment.
White Mountains Medical Education Consortium — consortium of North Country Health (three hospitals, one home health agency) and Coos County Family Health Services (FQHC in Berlin); home of the new family medicine residency.
University System of New Hampshire (USNH) and Community College System of New Hampshire (CCSNH) — joint owners of the Common Campus clinical simulation network.
University of New Hampshire (UNH) Institute on Disability — research partner on children’s behavioral health.
Dartmouth College / Geisel School of Medicine / Dartmouth-Hitchcock Medical Center — the state’s only medical school and rural academic medical center.
NH Department of Education — partner on the Presidential Fitness Program and school-based oral health.
NH Department of Transportation and the State Coordinating Council for Community Transportation (SCC) — partners on the unified ride-share app and NEMT expansion.
Families Flourish Northeast (FFNE) and The Doorways — SUD treatment partners.
NH Alliance for Healthy Aging and NH Commission on Aging — partners on transportation access for older adults.

People to enter into the Rolodex now: Governor Kelly Ayotte, Donnalee Lozeau, Whitney Hammond, Tom Broderick, Margaret Pritchard, Robyn Guarino. Additional named personnel will surface as the Policy Lead, Population Health Lead, Behavioral Health Lead, Workforce Lead, Evaluation Lead, and Finance Lead positions are filled.

The Watchlist

May 22, 2026: Evaluator proposals due. Likely bidders: Mathematica, RTI, NORC, IBM/Watson Health, Health Management Associates, Deloitte, Manatt Health, plus NH-local firms partnering with academic medical centers (Dartmouth, UNH).
June 5, 2026: Evaluator selection announced.
Q2–Q3 2026: GO-NORTH Advisory Board appointed. Four remaining hub contracts expected.
Q4 2026: Proposed legislation introduced for the 2027 NH session.
2027: First CCBHC planning awards issued; first Governor’s Health Scholars Awards issued.
Q2 2029: D-SNP launch.
Q4 2031: Final RHTP summit.