Roy Hayward, who lives just around the corner from Will's Store in Chelsea, Vt., steps out into the rain Tuesday, Sept. 25, 2018. The store, with its ice cream, beer, wine, tobacco products and greeting cards, has seen an increase in business since adding a basic assortment of grocery items since the neighboring Chelsea Country Store closed. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.
Roy Hayward, who lives just around the corner from Will's Store in Chelsea, Vt., steps out into the rain Tuesday, Sept. 25, 2018. The store, with its ice cream, beer, wine, tobacco products and greeting cards, has seen an increase in business since adding a basic assortment of grocery items since the neighboring Chelsea Country Store closed. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Credit: James M. Patterson

Even as rural towns throughout New England struggle with the loss of basic retail services and core institutions such as schools and churches, some Upper Valley communities are exploring innovative ways to get back to a future of at least modified self-sufficiency.

Take Chelsea, for example, a town of 1,430 in east central Vermont. As staff writer Jared Pendak reported last week, a new pharmacy opened recently at the Chelsea Health Center, two years after Kinney Drugs pulled out. The lack of a pharmacy in town had been a real hardship for many, especially seniors, who had to travel 20 miles or more to Bradford, Barre or Randolph to get a prescription filled.

The Medicine Shoppe, a Barre-based pharmaceutical franchise, has stepped in to open and operate a “remote” location, that is, one staffed by a full-time pharmaceutical technician supervised via video teleconferencing by a managing pharmacist in Barre. A web-connected tablet and telephone are also available for customers who want to consult with a more experienced pharmacist.

This use of technology meant that the Medicine Shoppe did not need to recruit a full-fledged pharmacist, who typically might earn $150,000 a year, to operate the Chelsea location, according to Bob Frenier, a trustee of the health center, which provides primary care locally as part of the Gifford Health Care network.

And speaking of primary care, Chelsea is also fortunate to be part of First Branch Ambulance’s house calls program, in which crew members make regular visits to enrolled members to perform wellness checks. This is an important tool to keep people healthy, not only because it provides preventive health checks such as blood pressure monitoring, but also as a source of social contact for people living alone.

Residents also expressed relief that gas pumps reopened last spring in town as part of the Route 110 Quik Stop convenience store and deli. Frenier, who is also a Republican state representative, told Pendak that the next priority is getting easier access to groceries for residents. The nearest supermarkets are 25 to 35 minutes away, and a grassroots group of Chelsea residents is exploring options that include seeking to have one of the bigger supermarket chains deliver groceries that have been ordered online to a central location for pickup. If they pull it off, Chelsea may serve as a template for provision of pharmacy and grocery services in other communities.

The Mascoma Community Health Center is another example of an effort to provide needed services in small town settings.

It opened in June 2017 in a new, 13,000-square-foot building in Canaan. The object is to provide better, more convenient access to primary care and reduce costs for Mascoma Valley residents who otherwise would have to travel to Lebanon. They seem to be responding. Staff writer Nora Doyle-Burr reported that by August of this year, the health center was serving nearly 1,900 patients, a base that was still growing at the rate of 100 new patients a month. Moreover, the center had broken even financially in three of the previous six months and was looking to add additional services.

The news from Cornish Flat is not so encouraging. An 18-month attempt to revive the Cornish General Store as a center of community life ended in disappointment with the recent announcement that it would close again. As staff writer John Lippman reported, despite the best efforts of proprietors Mark Abrams and Maureen Jenks, they discovered that not a large enough segment of the community supported the store on a regular basis to make it profitable. Abrams attributed this to pricing. The Cornish General Store simply could not buy food and other items as cheaply as the chains and big markets do, he said, and therefore had to charge higher prices.

That is a cautionary tale for any community that wants the convenience and camaraderie of a general store: There is a price tag attached. Are there other ways forward? In Barnard, residents banded together to reopen the general store there by raising money and forming a nonprofit to buy the building and bring in new operators to run the enterprise. A similar effort is playing out in Brownsville.

Population loss and the ascendancy of the online economy represent a profound challenge to small-town life in New England and elsewhere, disrupting settled patterns of access to services and shopping. In this context, it must be remembered that having basic services and amenities available locally in isolated communities is not only a matter of convenience. For the elderly with limited transportation, it can be the difference between being able to stay in their home or having to move closer to health care and other services. And badly needed newcomers who have an urge to try small-town life may have second thoughts if the institutions that make up a genuine community are falling away one by one.

Technology may provide one answer by which to shore up these services and institutions while making the economics work. Communities throughout the region would do well to think about what is disappearing and how, or if, it might be brought back to vibrant life.