In 2026, the Bi-State Primary Care Association (“Bi-State”) marked 40 years of supporting community health centers and expanding access to primary care in Vermont and New Hampshire. Founded in 1986, when the network included two health centers that served 10,000 patients, Bi-State has grown into an association of 26 member organizations, including 23 community health centers. Together, its member health centers serve more than 340,000 people annually across 175 sites.
The organization’s mission is to advance access to comprehensive primary care services for everyone, especially people most in need. Central to that role is Bi-State’s work in policy advocacy and government affairs. Bi-State helps promote the perspectives and policy needs of community health centers (CHCs) at both the state and federal level, by educating policymakers and stakeholders. Its advocacy and government affairs work informs policy that addresses the day-to-day challenges of health center operations. This policy role is foundational to the association’s mission, and has helped achieve key goals to advance primary care in both states.
Alongside that advocacy, Bi-State supports its members through training and technical assistance, data initiatives, quality improvement and workforce development. These activities help health centers respond to evolving community needs while sustaining the staff and systems required to deliver care. Bi-State’s Recruitment Center, for example, supports the recruitment and retention of health care professionals across New Hampshire and Vermont which is an important part of maintaining access in underserved communities.
Recognizing that health is shaped by factors beyond the exam room. Bi-State’s programmatic initiatives have addressed a range of issues including the challenges of substance use, behavioral health and food access. In rural Vermont, Bi-State’s Food Access in Health Care (FAHC) network has established partnerships to address food insecurity, helping health centers develop sustainable strategies to address hunger and promote community wellness, incorporate screening, referrals to food resources, Food as Medicine and produce prescriptions and medically tailored meals. Recently, Bi-State collaborated with three Vermont CHCs to help expand food access programs for at-risk patients with chronic diseases. This work illustrates the association’s commitment to help its members respond to broader health and social needs.
Bi-State’s 40-year history is not only a story of organizational growth, but of effective advocacy, robust collaboration and practical support for the health centers serving communities across two states. As New Hampshire and Vermont confront increasing community-level needs and ongoing health care workforce and access challenges, Bi-State’s policy engagement and member support remain central to its work, and essential to improving community-based care.
