More Vermont towns are turning to community nurses, offering free health care

Every Wednesday, Sunny Martinson visits Richard Starr. He’s 80 years old and taught middle school woodshop for 40 years. He lives in Thetford, in a house he designed and largely built himself.

“There wasn’t a plan. I added and added and added — my wife added her contributions too,” Starr said.

Inside, the house is full of light. The walls are decorated with photographs Starr made, the ceiling has exposed wood rafters, and a spiral staircase leads upstairs.

“I’m happy to be here,” he said.

These days, Starr sleeps on the first floor. His wife died a few years ago and it’s hard for him to get upstairs, where his computer is, or to the basement, where his workshop is.

He has issues with his memory and earlier this year, a home aid moved in. But they can’t provide medical care, so Martinson comes to help Starr with his medications.

She’s the community nurse for the town of Thetford. It’s a role she’s been in for a year, after retiring from working as a triage nurse at Dartmouth Hitchcock Medical Center.

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On a recent visit, she brought Starr the newspaper, with a list of community events. They talked about adding a railing to his staircase, and she looked at his blood pressure readings. She’s become a big part of his life.

“Last fall his refrigerator broke, so I helped him get a new refrigerator. Or this driveway is impossible, and he didn’t even have anyone to plow it until January, he had no snow tires for the car,” she said. “So I mean I’m doing more than just filling the pill box.”

And all this stuff she does for Starr — he doesn’t pay for it. That’s the case for all of her clients, and for anyone in the town of Thetford — working with Martinson is totally free.

The role is not meant to replace a doctor. But it helps fill in gaps our health care system just isn’t set up for.

“Right now the health care system is reactive. Something has to happen, and then you call 911, and then you go,” said Kristin Barnum, who runs a nonprofit called Community Nurse Connection. “But these community nurses are health coaches, health advocates, to prevent bad things from happening.”

The nonprofit is based in Lebanon, New Hampshire, and supports about a dozen community nurse programs in the region.

These all look a little different: In Thetford, Martinson works for a nonprofit, and the position is largely grant funded. In Tunbridge, the community nurse is a town employee, paid for with taxpayer dollars. And in Lyme, New Hampshire, the job is run through a church — it’s been that way for years.

These positions are mostly part time — they cost an average of $30,000 a year. But Barnum thinks this saves towns money in the long run by preventing unnecessary 911 calls and expensive trips to the hospital.

“It’s a very inexpensive way to take care and keep older adults safe and in their towns,” she said.

And more towns are looking to replicate this model, like in Strafford, where Sheila Keating started working as the town’s first community nurse last year.

“Having the liaison between community and healthcare is just so important,” said Keating, who’s been a nurse for 30 years. “I never realized how important until I actually started doing this job.”

The towns of Hartford and Putney are in the middle of hiring for nurse positions, both new roles. A group in Windsor is planning a community nurse program, too.

And besides saving money in preventing emergency medical care, these programs offer another big benefit — reducing isolation.

That’s been true for Martinson’s clients, in Thetford.

She left Starr’s house after about an hour. She was going to follow up with his doctor, and offered to get his guitar restrung.

“I’ll bring my mandolin over and we can do some duets,” she said.

Then, she was going to stop in to see an 89 year old down the road. She’d picked up asparagus from a nearby farmstand to bring her.

“Sometimes there are real medical needs, but more than anything you keep hearing about people who were isolated in rural Vermont — boy, are they isolated,” Martinson said.

“I think they just like to have people visit,” she said.

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