Fall in New England
BiState PCA
Green Mountains of Vermont

About Bi-State Primary Care Association


Healthy individuals and communities with quality health care for all.



Promote access to effective and affordable primary care and preventive services for all,

with special emphasis on underserved populations in Vermont and New Hampshire.



In 1986, Bi-State Primary Care Association was formed by health and social service leaders to ensure access to care for our most vulnerable citizens. Two Health Center executives were at the helm of this endeavor, David Reynolds, former executive director of Northern Counties Health Center in Vermont and Ann Peters, former executive director of Lamprey Health Care in New Hampshire. Our mission has endured for 30 years, with a steadfast commitment to improve access to comprehensive primary and preventive health care for the residents of both states.


Primary Care Associations (PCAs) are state or regional nonprofit organizations that provide training and technical assistance (T/TA) to safety-net providers. This T/TA is based on statewide and regional needs to help health centers improve programmatic, clinical, and financial performance and operations. PCAs can help health centers and look-alikes plan for the growth of health centers in their state, as well as develop strategies to recruit and retain staff. 


Bi-State has served as a catalyst for diverse groups, with varying interests, to organize around a shared vision of equal access to health care for all. Bi-State unifies Health Centers and community partners to speak as one voice to reduce barriers to health care. We consider the social factors that impact health outcomes including poverty, rural and social isolation, homelessness, cultural norms and language barriers. Bi-State advises state and federal lawmakers on health care matters important to their constituents; educates on the impact of government legislation, regulation and policies that affect health care; actively recruits providers for the Health Centers, supports clinical and technological advancements and we support the continued expansion of Health Center services.


Bi-State Full Staff List 


Departmental Contacts


Bi-State Primary Care Association is a nonpartisan, nonprofit organization that represents Community Health Centers and supporting organizations that provide health care to more than 300,000 people at 121 locations throughout New Hampshire and Vermont. Bi-State supports access to high quality, effective and affordable primary health care with an emphasis on reaching medically and geographically underserved populations. Bi-State Primary Care Association was founded as a 501(c)(3) charitable organization in 1986 with offices in Bow, New Hampshire and Montpelier, Vermont.

Tess Stack Kuenning, CNS, MS, RN


(603) 228-2830 x 112


Bi-State Membership 

Bi-State members include Community Health Centers (inclusive of Federally Qualified Health Centers, rural health clinics, private and hospital-supported primary care practices), critical access hospitals, health care for the homeless programs, area health education centers, clinics for the uninsured and community action and community service agencies. Please contact us for membership opportunities.

Lori H. Real, MHA

Executive Vice President/Chief Operating Officer

(603) 228-2930 x 114


Community Health Accountable Care LLC

61 Elm Street, Montpelier, VT 05602

Community Health Accountable Care is a primary care-based network of providers, ideally positioned to provide access to high-quality, low-cost, comprehensive primary care services to all patients seeking care within the communities we serve.

Kate Simmons, MBA, MPH

Director, Community Health Accountable Care and Vermont Operations

(802) 229-0002 x 217 


Primary Health Care Partners LLC

NH Management Services Organization

525 Clinton Street, Bow, NH 03304

James Zibailo, Director

(603) 228-2830 x 124


Recruitment Center

525 Clinton Street, Bow, NH 03304

Bi-State's nonprofit Recruitment Center provides workforce assistance and candidate referrals to Community Health Centers, rural health clinics, and private and hospital-sponsored physician practices throughout Vermont and New Hampshire. Bi-State is a resource regarding the eligibility requirements and availability of recruitment incentive programs such as state educational loan repayment, Conrad State 30, and National Health Service Corps programs.

Stephanie Pagliuca, Director

(603) 228-2830 x 115