North Country Health Consortium 2021 Annual Report

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Annual Report Community

Success Collaboration

Leading Health Innovation Goals Communication

Partnership

Innovative Collaboration


History and Purpose Leading innovative collaboration to improve the health status of Northern New Hampshire. We are a rural health network, created in 1997, as a vehicle for addressing common issues through collaboration among health and human service providers serving Northern New Hampshire. We are engaged in activities for:

About NCHC

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Letter from Leadership

3

Our Programs and Highlights

4

Heart, Weight & Wellness

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CHW Training

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Preparing and Responding

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R egional forums on community health issues

Continuum of Care for Substance Misuse: Prevention through Recovery 10

C ommunity needs assessment and health status monitoring

Mental Health and Wellness

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Oral Health

14

Northern NH Area Health Education Center (AHEC) 15

Social Determinants of Health 16

ogether with other T organizations throughout the region we provide, coordinate, or facilitate: raining and continuing education for T all levels of healthcare professionals I mproved access to services for underserved residents

Solving common problems and facilitating regional solutions

P rogram development and management

Creating and facilitating services and programs to improve population health status

ervices for regional collaborative S initiatives

Providing health professional training, continuing education, and management services to encourage sustainability of the healthcare and workforce infrastructure Increasing capacity for local public health essential services Increasing access to healthcare and other resources for underserved and uninsured residents of Northern NH

Please contact us to get involved or to learn more about our programs.

NCHCNH.org 603-259-3700

Health

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NCHC Staff

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Communications

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Turning a Page in Programming

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NCHC Financials

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NCHC Members

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NCHC Funders

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NCHC Board of Directors

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From our Board President and Executive Director

As we reflect on this past year, we are reminded of the North Country Health Consortium's (NCHC) extraordinary courage, agility and resilience in meeting the everchanging public health needs of the North Country. During these unprecedented times, our team has demonstrated a renewed and deepened commitment to the NCHC mission by "leading innovative collaboration to improve the health status of Northern New Hampshire." As an organization, NCHC responded to each public health program and event with thoughtfulness and intention. Our staff members have shown incredible dedication, resourcefulness, and perseverance. Additionally, NCHC staff have creatively adapted to new models of care and telecommuting.

– Lauren Pearson, NCHC Executive Director

With the closing of Substance Use Disorder residential services, NCHC pivoted to collaboration with our community partners to ensure our area's needs were met. NCHC’s AskPETRA and Drug Treatment Court of Graton County remain vital forces in our emphasis to address substance misuse. Through the Community Health Worker (CHW) Training program, community health workers are continually expanding and embedding in our communities to meet the needs of those we serve. Throughout the COVID-19 pandemic, NCHC's public health team partnered with community stakeholders and municipalities to provide education and vaccines to those eligible, addressing the equity issues by meeting community members where they are. With the support of our local, state, and federal partners, we have been equipped to address the health disparities and social determinants of health for our region. Finally, this year reinforced that teamwork is alive and well and remains a critical component of the Consortium's formula for our vision of innovative collaboration. We are incredibly proud of NCHC's accomplishments over the past year and extend a sincere thank you to all who have contributed. As NCHC enters its historic 25th anniversary, the future is bright and filled with tremendous opportunity because of the ongoing support and guidance from the Board of Directors, staff members, and stakeholders. With gratitude and hope, Lauren Pearson, Executive Director and Michael Lee, Board President

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– Michael Lee, NCHC Board President


We are NCHC... Public health services include: increasing awareness and access to substance use disorder prevention, treatment, and recovery services by monitoring and enhancing continuum of care systems; ongoing development to ensure public health emergency preparedness; and strategic planning to mitigate the health impacts of climate change and other disease prevention and health promotion activities.

The Substance Misuse Prevention Network collaborates with schools to implement proven strategies to improve school climates and train students to lead and mentor peers and younger students to understand the consequences of substance misuse.

Leading Innovation Collaboration

Substance Misuse Programs includes activities to address the entire continuum of care from prevention, identification, early intervention, and treatment, to recovery supports.

Health Communication

Drug Treatment Court of Grafton County is a multi-phase intervention program designed for adults, who have been convicted of a felony and diagnosed with Substance Use Disorder, as an alternative to prison time.

The Northern New Hampshire Area Health Education Center (NNH AHEC) ensures a rural focus on workforce development for statewide health professions. The center serves health and human service organizations and educational institutions in Coös, Carroll, Grafton, and Belknap Counties.

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Success Partnership Community


Innovative Collaboration is our mission. ORAL

Health

North Country Health Consortium’s Oral Health Program focuses on community outreach and education. The program engages community members of all ages, to connect oral health to overall health.

PROGRAM

Ask

AskPETRA is the North Country Health Consortium’s response to Northern NH’s Substance Use Disorder (SUD) crisis. This free service provides local training and one-on-one help to connect providers, adults, and families with the help they need to understand, prevent and treat SUD.

Ways2Wellness CONNECT links Community Health Workers (CHWs) with patients age 18+ who are struggling with unmanaged chronic disease and experiencing barriers to achieving health and wellness.

Our Wellness And Recovery Model program (WARM) is a federally funded initiative to reduce the impact of substance use/opioid use disorders (SUD/OUD) and overdose deaths in the North Country by increasing awareness, education, capacity, and access to recovery and treatment resources.

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Heart Health, Weight & Wellness Community Health Workers (CHWs) at NCHC help their clients to adopt healthy habits. Ways to Wellness Connect remains a client-centered program that focuses on overall health and wellness. This year Ways 2 Wellness Connect expanded its ability to work with

adults living with chronic diseases.

• The team now serves clients age 18 and over • The program has increased its capacity to lead Chronic Disease Self-Management and Chronic Pain Self-Management Program workshops as trained leaders of the evidence-based Stanford University program.

CHW hours spent working directly with clients Contact Hours

5070 NCHC celebrates 10

Encounters where time was not tracked

70

years of bringing

Chronic Disease Self-Management

classes and trainings to Northern NH!

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24 hr. access to local resources: Ways2Wellness.org


More Trained CHWs = Access Community Health Worker

Access to knowlege

TRAINING

NCHC developed an 8-week course with integrated

Community Health Worker (CHW) core competencies, offered through combined virtual

100% Online and Interactive!

Prepares you to work as a

interactive classroom and independent off-line study, with self-paced homework.

Home Vis itor Health Assister

Community Health Worker

or in other roles W CH under the umbrella or at of Community Patient Navig Health! Patient A dvisor r

ke Wor

18 + 7

Ready to sign up?

h reac ecovery Coach R Out Patient A dvocate

18 CHWs completed the course in 2021

Access to opportunities AskPETRA and the Wellness and Recovery Model (WARM) programs have worked to

coordinate workforce development and training for individuals seeking employment as Recovery Coaches and Certified Recovery Support Workers.

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7 more individuals are in progress!

CHWs trained live and/or work in Coös, Grafton, Carroll, Sullivan, Merrimack and Hillsborough Counties.


Preparing.... Improving resiliency of our communities In normal times, we are busy planning and training for responding to public health emergencies based on the U.S. Centers for Disease Control and Prevention’s 15 Preparedness Capabilities. This improves the overall preparedness and resiliency of communities, while also developing specific emergency response capabilities across the public health, healthcare, and behavioral health systems. We’ve put these plans and trainings in play this year through the activation of the Northern NH Medical Reserve Corp and promotion of vaccination clinics.

Newly acquired equipment includes drive-thru tents and heaters. Community volunteers help continue to build the region’s capacity for Emergency Response by organizing the new supplies.

Supporting the needs of the North Country: Being the rural voice

4755 Doses of COVID -19 Vaccine administered in Coös and Northern Grafton Counties

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4276 338 141

With the availability of COVID-19 vaccines at the end of December, the North Country Public Health Network (NC PHN) began the process of acquiring and delivering vaccines to populations as they became eligible. In the spirit of "the North Country takes care of each other," the

Moderna Pfizer

NC PHN addressed the equity issues of rurality and poverty to deliver vaccines early to homebound

Janssen (J&J)

individuals, low-income and age-restricted properties and frontline workers.

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and Responding Stepping up and working as a team The Northern New Hampshire Medical Reserve Corps (MRC) Unit focused on recruitment, engagement, and retention, and has increased by 70 new recruits over the last year.

The unit is now home to 106 vetted and trained volunteers. The unit remains fully activated with volunteers engaged in ongoing deployments in healthcare, administrative and logistical workforce support in the North Country and beyond.

194% increase in MRC volunteers

Access to care is the priority Community Health Workers helped navigate clients through Vaccine Administration Management System (VAMS)- the online registration system. At the beginning of 2021, area partners were working to set up community members with vaccine appointments at their facilities. NCHC Community Health Workers were called on by local hospital care

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coordinators to help reach out to

patients who were having issues setting up an online appointment. This was the key to making sure they could access the vaccine.

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Continuum of Care for... Prevention: the broad definition The Wellness and Recovery Model (WARM) and AskPETRA teams took a

multiprong approach to addressing Substance Use Disorder in the North Country through the distribution of “Save One Life” kits, building a speakers bureau to delivering a provider education series, and through the formation of the North Country Recovers Together initiative.

1000+

Save One Life kits and materials distributed to our community

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people trained in Naloxone Administration

134

WARM Clients recieving 1:1 assistance from a trained Community Health Worker / Recovery Coach

WARM 4 Women (W4W) has worked with community partners to educate, raise awareness, screen, and provide opportunities of early education in safe care. We welcomed 24 new clients into the program! Top resources provided: Recovery Support Prenatal Care Housing Emergency Shelter Substance Use Disorder Treatment

Bringing Resources to Where the People Are... Community Health Worker/Recovery Coach (CHW/RC) at the North Country Health Consortium (NCHC), Savanah Miller, delivered kits containing a display of Substance Use Disorder (SUD) Recovery books and resources to organizations participating in the AskPETRA Library Project, including Littleton Police Department (left).

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Recovery Libraries delivered to businesses, recovery centers, libraries, prisons, police departments and recovery centers.

Ask

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Substance Misuse: Prevention through Recovery A community that comes together

The Haverhill Area Substance Misuse Prevention Coalition (HASMPC), a Drug Free Communities (DFC) Support Program, remains active in its mission to reduce local youth

substance use and to creatively get the message out

to the community.

300

red tulip bulbs planted, each representing a promise to stay drug-free

A staple at the Woodsville & Wells River 4th of July Parade and Celebration— one of the biggest annual traditions in the area that draws in nearly 10,000 people— HASMPC distributed 1,800 beach balls to community members along the parade route. The beachballs were imprinted with positive substance misuse prevention messaging.

...the best leadership strategy that I can share. Students will listen if you listen to them, truly listen.” -Grace Frink, WMRHS student and North Country Youth Advisory Council member

Teamed up with the North Country Youth Advisory Council, NCHC Sign hosted 2 UP Granite Youth Conferences over the past year through an interactive livestream experience. Headlined by inspirational speakers, NBA star Chris Herren and Comedian Juston McKinney, the events were followed by opportunities to “Find your Passion” and“Follow your Dreams” to learn something new with free activites and use of state-of-the-art equipment!

for your

Passion Project Podcast Production

Film Making

and so much More!

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Mental Health & Wellness... Leading lead prevention Mental Health First Aid

43 The North Country has some of the state’s highest rates of lead poisoning. To reduce the burden of childhood lead exposure, the Lead

Poisoning Prevention Initiative brought outreach and education to the region. Offering training and education to multisector groups, NCHC worked to reduce the negative impacts lead poisoning has on individuals by offering trainings with a focus on: • How to reduce lead’s significant negative impact on cognitive ability, speech and language, hearing, visual-spatial skills, attention, impulse control, social behaviors, emotional regulation, and motor skills— even at low levels of exposure • How to improve childhood lead poisoning prevention

Working with children, I now have a better understanding what lead actually does to the body at a young age.” -Lead Initiative Training Participant

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4

# total people trained in Mental Health First Aid # virtual live events for Mental Health First Aid

You are more likely to encounter someone in an emotional or mental crisis than someone having a heart attack. That’s when first aid could be YOU. With 2 Certified Mental Health

First Aid (MHFA) trainers on staff, NCHC delivered trainings in MHFA in-house and to community partners across the region.


Supporting Our Minds Promoting healing and reducing risk in communities NCHC partnered with NAMI NH on a regional suicide prevention initiative to

increase training and education opportunities in suicide prevention, intervention, and postvention. The project engaged in customized suicide prevention planning sessions and will continue to build the capacity of trainers and trained North Country individuals.

682+

people trained

The project trained prevention trainers and offered remote suicide prevention training to more than 682 North Country educators, health, and behavioral healthcare professionals.

Making connections that count

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Student Assistance Program (SAP) Counselors help

Student Assistance Counselors

2,400 Local Student Assistance Counselors highlight their work in short videos, available on YouTube, that spread the word about the support they offer.

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Students Served by Student Assistance Counselors

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youth with issues such as substance misuse, bullying, dating violence, and peer pressure.

NCHC provides supervision for 9 SAP Counselors across the region. Check out our website and YouTube channel for more information and videos.


Oral Health = Overall Health

Good habits start early

Funding for the Molar Express Oral Health Education and Connection Project was provided, in part, by the NH Children’s Health Foundation and Northeast Delta Dental

603-259-3700 | NCHCNH.org

20 158 526 12

The oral health program modified its outreach and education approach to virtually reach 20 preschools and daycare locations

Connected with 158 childcare providers and teachers about oral health care and establishing a dental home for infant and young children

Provided resources and supplies to 526 children

To further support the dental home model, outreach has been provided at 12 general dental practices throughout the region

ORAL

Health

PROGRAM

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Area Health Education Center Available anywhere, NCHC brings together partners, communities and healthcare professionals to increase knowledge in the North Country.

Professionals, learning The North Country Health Consortium’s Northern NH Area Health Education center works as a regional training center for the North Country workforce, including medical and behavioral health, and health and human services. Sessions covered topics around clinical trainings, COVID-related issues, mental health care, motivational interviewing, tobacco cessation, chronic pain self-management, skills and knowledge on Substance Use Disorders and more.

68 766 464+

Engaging online training experiences We offer: Video technology Interactive live presenters Livestream Group whiteboard Subject matter experts Evidence-based trainings

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# continuing education programs provided # people in attendance # professionals receiving continuing education, including Continuing Medical Education, Nursing Professional Development, Behavioral Health Continuing Education, and more!


Social Determinants of Health Social Determinants of Health (SDoH) are conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.

NCHC programs are designed to focus on SDoH North Country Recovers Together (NCRT): Priorities

North Country Recovers Together seeks to strengthen Substance Use Disorder (SUD) through the

creation of a Greater Recovery Community. Recovery may begin on an individual level, but as individuals recover, communities recover, and as communities become stronger, individuals become stronger.

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Northern NH Medical Reserve Corps

How to live a substance-free life?

People, Places & Things The Drug Treatment Court of Grafton County oversees individuals who are charged with crimes that are generally non-violent in nature. The

participants receive intensive supervision and treatment rather than a lengthy prison term. The team works with participants to

address social determinants of health such as people (who do you spend your time with?), places (housing, location), and things (transportation, belongings).

NCHC Staff, ready to coordinate with and work alongside Medical Reserve Corps (MRC) volunteers in the community.

Drug Treatment Court works! Here is what our participants say:

With many in the North Country out of work, coupled with families who typically depend on free and reduced school meals, the region experienced higher rates of food insecurity

"All of us who graduate are living examples of why this program should exist... All these kids have their parents back."

during the pandemic. Northern

NH Medical Reserve Corps Unit partnered with the NH Food Bank’s Mobile Food Pantry to respond to the increase in food insecurity in the North Country, helping to distribute

"The program is the exact opposite of what I thought it was... you guys save lives."

"I am truly happy today without any substances, which I didn't think was possible."

thousands of pounds of food for Northern NH residents in need.

"Thank you for never giving up on me! I don't know if I ever would of got clean if it wasn't for drug court... We also just closed on our new house, I have an amazing life! One I never thought was possible."

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NCHC Staff The people make the place

Provider Outreach and Education I want to express a sincere thanks to our dedicated team for their patience and persistence as NCHC innovatively renovated and restructured this past year. Such dedication is needed for the organization’s wellbeing, and your willingness to accept every task is admirable. I am very fortunate to be a part of such a talented group of employees, and I know the team is poised for success in our endeavors yet to come. - Lauren Pearson , Executive Director

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Bringing Information to Our Communities The goal of NCHC’s Marketing and Outreach is to increase access to trustworthy, accurate health information and amplify the work of our partners.

27,000 unique visitors to our main website 25,000 more people viewed content from

NCHC’s primary Facebook Page this year!

57,556 Facebook Page Reach

CALL 603-2 TEXT 59-17 “TALK 29 ” TO 60 3-259 -4820

Total number of page views on the AskPETRA website:

10,293+ Top 5 pages (listed in order): Resources Education Upcoming Trainings and Events Prevention Treatment

Let us know your opinion on the priority needs and concerns in your North Country Community by connecting to our social media sites. Interact with us by liking and sharing posts, sending direct messages and commenting.

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Turning a Page in Programming Over the past year, the following programs have concluded as part of NCHC’s portfolio. It is with deep appreciation that we thank partners and staff that were key to their success and bringing services to the North Country. Region 7 Integrated Delivery Network (IDN7) was a collaboration to improve the health status of Northern New Hampshire. The Building Capacity for Transformation project is a statewide initiative focused on bringing together physical healthcare, mental health, and substance use disorder treatment. As part of the project, partners in Coös, Carroll, and Northern Grafton Counties have joined together to form IDN7.

Delivery System Reform Incentive Payment program ended in December 2020, NCHC continues to leverage the connections and relationships strengthened under the IDN to improve the health and wellbeing of North Country residents. This year saw new discussions with stakeholders around the state related to sustainable solutions for enhanced care coordination, improving protective factors for children and young families, and enhancing the health and human services workforce in rural areas.

Substance Use Disorder Clinical Services included residential, outpatient, and intensive outpatient services. Impaired Driver Care Management Program assisted those seeking reinstatement of their driver’s license.

Although the formal demonstration period for the

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Friendship House was a facility for residential clinical services for substance use disorder in Bethlehem.

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Financial Overview

October 2020September 2021 Revenue Sources: $6.295 million (unaudited)

October 2020September 2021 Program Expenses: $6.565 million (unaudited)

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NCHC


Community Health Improvement NCHC Members 45th Parallel EMS

Center for New Beginnings

Mid-State Health Center

Adaptive Sports Partners of the North Country

Coos County Family Health Services

Morrison Communities

AHEAD, Inc.

Cottage Hospital

All Saints’ Episcopal Church

Family Resource Center

Ammonoosuc Community Health Services

Grafton County Nursing Home

Androscoggin Valley Home Care Services

Indian Stream Health Center

Androscoggin Valley Hospital

Tri-County Community Action Program, Inc. University of New England

New Hampshire AHEC

Littleton Regional Healthcare

North Country Healthcare

Upper Connecticut Valley Hospital

North Country Home Health & Hospice Agency

Weeks Medical Center

Northern Human Services

White Mountains Community College

OAKS RS Consulting

NCHC Funding Sources Dartmouth Medical School/ Geisel School of Medicine/ Area Health Education Center Endowment For Health Grafton County Human Services Integrated Delivery Network Region #7 JSI Research & Training Institute, Inc. NAMI New Hampshire Neil and Louise Tillotson Fund, NH Charitable Foundation NH Children’s Health Foundation

New Hampshire Bureau of Drug & Alcohol Services

Southern NH Area Health Education Center

New Hampshire Charitable Foundation

University of New Hampshire Institute for Health Policy and Practice

New Hampshire Department of Health & Human Services New Hampshire Division of Public Health Services New Hampshire Healthy Families New Hampshire Judicial Branch North Country Education Services Northeast Delta Dental

US Centers for Medicare & Medicaid Services US Department of Health & Human Services, Health Resources & Services Administration, Office of Rural Health Policy US Substance Abuse & Mental Health Services Administration, Center for Substance Abuse Prevention

SAU #7, Colebrook

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One Community at a Time NCHC Board President (O) Michael Lee President, Weeks Medical Center

Tara MacKillop Executive Director, Androscoggin Valley Home Care Services

Vice President (O) Ken Gordon CEO, Coos County Family Health

Michael Peterson President and CEO, Androscoggin Valley Hospital

Treasurer (O) Suzanne Gaetjens-Oleson Regional Mental Health Administrator, Northern Human Services

Jeanne Robillard CEO, Tri-County Community Action Program

Secretary (O) Karen Woods Administrative Director, Cottage Hospital

Community

Heidi Barker Community Member Scott Colby President & CEO, Upper Connecticut Valley Hospital Ed Duffy, MD Executive Vice President, Chief Medical Officer, Littleton Regional Healthcare

Partnership

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Leading innovative collaboration to improve the health status of Northern New Hampshire.