In "Rising to the Challenge: Re-Embracing the Wald Model of Nursing" (Special Feature, July), Patricia Pittman notes that there are many other contributors to well-being besides medical cures, and the resources for addressing them reside in the community.

A case in point: The Upper Valley Community Nursing Project (UVCNP) was founded in 2011 to address the gap in health care services that leaves many people in our semirural area of New England struggling with chronic illnesses, care transitions, and aging-related challenges. The UVCNP provides guidance to communities wanting to establish a community nurse program and offers clinical support to the nurses working in their communities. Communities hire their own nurses. The programs are independent of mainstream health care and reimbursement systems, providing free, in-home service to people struggling with issues of health or well-being.

The nurses work collaboratively with local visiting nurse associations and hospices, emergency medical services, aging resource centers, primary care providers, local volunteer organizations, churches, and food banks. All the nurses have a BSN or higher degree, and most have recently retired from full-time practice. Many live in the communities they serve.

This close association with the community builds trust and enables tapping into local resources. We believe that the programs of the UVCNP provide service at the intersection of centralized health care and community. We recognize that they are effective in part because of our small scale, but believe they could be more broadly realized through bundled payment systems.

Joanne Sandberg-Cook, MSN, ANP/GNP-BC

Sarah Jo Brown, PhD, RN

Founding directors, Community Nurse of Thetford

Thetford Center, VT