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By Karen Pellicano, Community Health Case Coordinator

In my work, I encounter a number of challenges in getting people the help they need. Transportation is a lynchpin, and it impacts access to many other forms of assistance. Lack of transportation limits medical care, access to medicine and healthy foods, the ability to find work, visit family, get to child care, and so on. In our rural region, transportation access and availability is a big issue. In this blog post, I’ll talk about the barriers to transportation in our area, the resources currently available and how you can play a part in addressing it.

The Problem as I see it

Getting to Work: One of the struggles people are facing is the need for transportation to work. Small towns have limited employment opportunities, and most people need a car. There is no public transportation service in our region that can get you to another town. Some local people are walking over 10 miles each way to get to work. I’ve met several people who lost their jobs because of lack of reliable transportation. In addition, if you are collecting SNAP or Medicaid benefits, the new eligibility rules dictate that you need to work a minimum of 20 hours a week or 80 hours a month. People who receive these benefits are less likely to have reliable access to a vehicle, and this creates a barrier to adhering to the eligibility requirements.

Food and medication access: Many medical procedures require appointments before, during and after the actual procedure. This can mean 4 to 5 appointments in Concord over a few weeks. Several local seniors have opted not to have procedures, because they were not comfortable that they could get into town that often. Access to medical services is already difficult, but transportation barriers can make it feel impossible.
I recently spoke with a senior who does not drive. They explained that they ask friends to take them over to Shaws to pick up groceries or prescriptions that cannot be sent through their mail order pharmacy. Each time they need a ride, they are asked to pay for gas to get to Hillsboro. In 2025, they paid over $700 just to get to Shaws.

Current Transportation Resources in our Area:

• Keep NH Moving connects people to available transportation in their area. If you visit their website, and select transportation in the Monadnock Area, it has several services available in Keene. One in Vermont and volunteer service for the rest of the area.
• The Community Volunteer Transportation Company (CVTC) is a volunteer organization that matches volunteer drivers with people who need transportation. They require a 5 day notice period to match riders to drivers, and drivers are reimbursed for mileage. They are always looking for volunteers and do a fantastic job helping people get to doctors appointments, grocery stores, banks, post offices or pharmacies. Because they rely on volunteers, they are not able to meet the transportation needs of everyone in the area, but if they are unable to match a rider to a driver, they notify the rider within two days so they can move or cancel appointments. It’s important to note that if you live outside of the ConVal school district, CVTC isn’t able to provide service. If you live in the Hillsborough Area, you can call Belknap Merrimack CAP Volunteer Driver Program (BMCAP) to access their volunteer ride service. It is volunteer based as well and they also require a week’s notice to match a driver to a ride.
• The River Center in Peterborough recently started a program called P-22 with Sweenfleez driving service. They will offer a one time ride to a medical appointment and request a 5 day notice period. The River Center has a grant to pay for this service, but because it is a paid service, they need to limit the amount of rides available. Sweenfleez has extended the same discount rate to the Grapevine, and we are able to pay for rides as well. These are paid rides, but even with the discounted rate, a trip to Concord will easily cost $200.
• Medicaid and Medicare offer reimbursements to drivers that transport family members or friends to medical appointments, and Medicaid has a ride service for patients to go to medical appointments. They too request a five day notice to find a ride. In those instances, Medicaid pays for the ride to and from the doctor, but they do not support stops at a pharmacy or grocery store.
• The Peterborough Area Community Aid (PACA) can assist with paying for car repairs. PACA will support families in the ConVal school district who use the Peterborough Food Pantry. If you live in the Hillsboro area, PACA is not able to provide service. There are other charities that can sometimes help with a car repair bill, but funding is limited. If you need help with a car repair, please let me know and we can brainstorm ideas. Often two or three organizations will come together to cover the cost.

So if you have a doctor’s appointment, and have a week’s notice, you can work within the existing system and get a ride to and from your appointment. If you have a medical emergency, you can call 911. But what about getting to work? Or a grocery store? Or even a food pantry? In provider agency meetings throughout the area, this is such a common challenge that we discuss it at almost every single meeting. It’s become part of the language. “So-and-so was going to sign up for job help but… transportation.” “That person couldn’t get to the hospital to visit their loved one because… transportation.” “There’s a great program for that in Keene but… transportation.”

What we can do:

People frequently call the Grapevine and ask how they can help. In my own role, I saw an opportunity to help people reach me more easily and have started offering appointments at the Hillsboro Library, schools, the Family Health Center in Hillsboro and other sites, because getting to the Grapevine can be an issue for people who lack transportation.

If you have time to volunteer, check out CVTC or BMCAP to sign-up to be a driver. Because of insurance limitations, scheduling and capacity, we can’t reinvent the wheel, but by supporting other agencies who are already doing this work, you can be an active part of the transportation solution.

• If you attend a church, let your pastor know you’d be willing to offer rides to other parishioners.
• If you are going to the grocery store, check in on your neighbor and see if they need you to pick something up for them.
• If you are headed into Concord or Keene, consider taking a friend and running errands together.

This really is an issue where every little bit helps, even if it’s just being aware of the needs of your neighbors and stepping up when you can! Give us a call or email us if you’d like more ideas on how you can be a part of the solution!

By Karen Pellicano, Community Health Case Coordinator

“Hunger is not a problem. It is an obscenity. How wonderful it is that nobody need wait a single moment before starting to improve the world.” –Anne Frank

We’ve all heard the stories. Seniors choosing between medications and food. Kids who only eat at school because there isn’t any food at home.  Parents who go without so their kids can have a meal before bed. In November 2025, when the SNAP Food Assistance Program was on hold because of the government shutdown, these stories grew to a fevered pitch and brought attention to health equity and the right to healthy food.  5.4% (about 75,900 people) of NH residents receive SNAP benefits. That includes families with children, seniors, and disabled individuals – and all of them are struggling to make ends meet. 

The federal government has recently intensified the work requirement for people receiving SNAP benefits. State advocacy groups like NH Hunger Solutions and New Futures are tracking bills that will limit eligibility and impose food restrictions for people using SNAP benefits.  (SB615 – read more here). One of the food restrictions that is being discussed would limit the kinds of food SNAP can purchase. SNAP benefits would no longer be able to be used to purchase sugary treats, like candy and soda.  (Just like you already can’t use SNAP to purchase alcohol or tobacco).  And it would seem to make sense – sugar is not essential to health.  Except when you learn that Twix is covered by SNAP (because, flour?) and Snickers is not. Think about all the little “mom and pop” shops that would now have to figure out exactly what they could and could not charge to SNAP.. Some may make the decision not to accept SNAP at all. It’s too complicated and the risk of penalties is too great. 

Transportation can be another barrier for people to access healthy foods. Many of our towns only have small, local stores. For instance, in Antrim the closest large grocery store is about 10 miles away.  Not everyone has reliable access to a vehicle, and those that do need to be mindful of how they use their gas. The recent hike in gas prices has made a trip to Keene or Concord more expensive and less likely. If there isn’t a local grocery store, that makes food far less accessible.  

I witness the impact of the changes in food access programs on a daily basis. I regularly see an older adult who lives in subsidized housing and has a very limited income. Just as her rent was being increased, her SNAP benefits were reduced from $147 to $24 per month.  A neighbor she had relied upon for rides to get groceries and medicine recently passed away, and now she is paying $10 to a different neighbor to get to and from the store. At the same time, her prescription medications, which used to be at no cost to her, are now at a cost of $600 per month.  For someone who is barely getting by, these new costs are unmanageable. The increase in rent, decrease in SNAP benefits, change in prescription coverage and added transportation expense has been overwhelming. She is so stretched that she now faces the possibility of eviction from her home.  

Between the new work requirements, changes in eligibility, reduction of benefits and rising costs, SNAP isn’t the safety net it used to be.  But there are a lot of people and organizations committed to food access in our region! Food pantries, like the Antrim Bennington Food Pantry and Peterborough Food Pantry are lifesavers. They receive funding and support from the community and they get low cost foods in bulk from the NH Food Bank. Recently, food pantries have been more vigilant in requiring ID information for people coming in for help. So, it’s important to bring in the necessary information to  receive food. This information is shared with NH Food Bank for a number of reasons, including applying for grants and tracking needs around the state. Here at the Grapevine, we have a small shelf unit of food and hygiene items available and we aren’t required to collect personal information. Both food pantries and the Grapevine benefit from individual donations of non-expired, non-perishable foods.  

 You can find more information about Food Resources in our region here. And, we ask you to use your voice about the SNAP regulations moving through our state legislature!  Please visit New Futures  or NH Hunger Solutions to learn about these current bills and how to contact your local representatives.