Annual Report 2016

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Annual Report


About North Country Health Consortium History and Purpose The North Country Health Consortium (NCHC) is 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. NCHC is engaged in activities for: • Solving common problems and facilitating regional solutions • Creating and facilitating services and programs to improve population health status • Health professional training, continuing education and management services to encourage sustainability of the health care infrastructure • Increasing capacity for local public health essential services • Increasing access to health care for underserved and uninsured residents of Northern New Hampshire

Organizational Services • Community health status monitoring and needs assessment • Convening and facilitating collaborative initiatives with regional health and human service providers • Forums on health issues • Strategic planning • Program development and implementation, project management and grant writing • Technical assistance • Education and advocacy for rural health issues • Management and financial services for regional collaborative initiatives

Executive Director & President’s Message Dear Friends & Colleagues,

Nancy Frank, Executive Director

Ed Shanshala II, Board President

Welcome to the North Country Health Consortium 2016 Annual Report. It has been another exciting year of growth and change as we strive to respond to community, regional, and state needs. We added five new staff members over the past year, and look forward to another year of expanding our workforce. The rapidly changing health care environment has influenced the development of new partnerships and innovative programs. The past year required focus on effective ways to assist our health care partners as they face transformation in the way care is delivered and funded. The heroin and opioid epidemic has significantly impacted the North Country, and we have been proactive in our response. Over the past year, the Consortium has enhanced its quality improvement programs, increased participation in healthcare workforce initiatives, and expanded delivery of oral health care services. We were instrumental in the collaborative development of critical resources in our communities to address the substance abuse crisis, and secured funds for our schools to implement Student Assistant Programs. We continue to focus on the strengths of our community partnerships through facilitation of the North Country Health Improvement Group and we were pleased to host the 5th Annual Health Improvement Summit in 2016. As we continue our work in the coming year, we look forward to our leadership role in new initiatives. We will expand our work with the Northern New England Practice Transformation Network as we assist over 500 health care providers around the state to move toward value-based payment reform. As the organizational lead for the new Integrated Delivery Network focused on integration of primary care and behavioral health in the region, we will facilitate increased access to care and make significant strides in improving the health status of North Country residents. It is with deep appreciation and gratitude for our dedicated staff, board, funders, and partners that we present this Annual Report. With your continued support and investment we will continue our work to improve the quality of life in the North Country. Ed Shanshala II Nancy Frank Board President Executive Director

Building Healthc are

Improving Health Outcomes for North Country Residents The North Country Health Consortium has created momentum to move the needle on population health as we work with partners to improve health outcomes. Since the release of the first County Health Rankings report in 2010- now conducted annually by the University of Wisconsin Population Health Institute- NCHC has been the lead facilitator of regional collaboration among community stakeholders and partners to prioritize health needs and to focus on community strengths.

Becky McEnany, NCHC Program Director and trained Motivational Interviewing (MI) trainer, provides education to North Country healthcare professionals to further foster the MI culture in the region.

C ap acity and Access Quality Improvement Through the 3-year Quality Improvement (QI) initiative, NCHC partnered with local Federally Qualified Health Centers around the region to address adult obesity. NCHC supported partnering health centers with a multi-pronged approach. NCHC provided: • Technical assistance to adopt obesity referral processes. • Varying levels of Motivational Interviewing (MI) training to over 100 providers, increasing skills to effectively engage patients in change talk and inform care plans. • The “Ways 2 Wellness” companion toolkit to arm providers and patients with additional health and wellness resources, such as stress management, healthy eating, and physical activity.

community members from across the region gathered around the theme and common vision of “Embracing a Culture of Wellness” in the North Country.

Oral Health Services for Seniors Expanding its reach to the region’s senior population via senior centers, in partnership with Grafton County Senior Citizens Council (GCSCC), this past year, Molar Express: • Added five Senior Centers across the region to its service portfolio • Provided over 27 clinic and health education days between the 5 sites • Connected with more than 50 seniors to help care for their oral health needs • Offered expertise and consultation to partners looking to bring dental care to their communities

• Chronic Disease Self-Management program Leader training to create additional capacity for expanded availability of workshops, allowing providers to refer patients to the evidence-based program.

5th Annual Health Improvement Summit The North Country Health Improvement Working Group culminated its efforts with the 5th Annual North Country Health Improvement Summit in June of 2016. Health professionals, government officials, and local business and

Keynote speaker, Dr. Rebecca Busanich, presents on cultural norms and perceptions to attendees at the 5th Annual Summit.

Building Current and

Left: STEM-Health Career Summer Camp participants intubate “SimMan,” a life-like, state-of-the art medical simulator during the Littleton camp. Right: A Live, Learn, Play in Northern NH student shares her imaging experience during her rotation. Campers experience being a dentist for the day utilizing another modern training simulator named “Simmie.”

Workforce Development in the North Country The North Country continues to experience the residual effects of healthcare workforce shortages that are inherent to rural areas. Current and future workforce shortages span all dimensions of healthcare, including allied health, nursing, primary care, specialty care, mental health, and oral health. Additionally, the region has an aging population, increasing the demand for healthcare services. NCHC strives to alleviate workforce shortages with ongoing workforce initiatives.

F u t u r e Wo r k f o r c e paraprofessional training programs, including Licensed Nursing Assistant (LNA), Medication Nursing Assistant (MNA), and the Health and Wellness Advocate Certificate program. To date, NCHC and WMCC have trained:

Matt Wood, WMCC President, Governor Maggie Hassan, and Nancy Frank, NCHC Executive Director, gather for a photo at the “Gateway to Work” workforce event held at WMCC.

STEM-Health Career Summer Camps 2016 marked the 7th Annual STEM-Health Career Summer Camps, which hosted a total of 39 campers from around the North Country. Together with Hugh J. Gallen Career and Technical Center in Littleton and White Mountains Community College (WMCC) in Berlin, NCHC offers two annual Science, Technology, Engineering, and Math (STEM)-Health Career Summer Camps. The STEM-Health Career Summer Camps provide middle school students with opportunities to experience a variety of health and allied-health professions, including the use of state-of-the-art equipment; foster curiosity and budding ambitions for future health career possibilities.

Health Careers Opportunity Program NCHC and White Mountains Community College (WMCC) have completed year 2 of the 3-year North Country Health Career Initiative Scholarship Program. The partnership provides scholarship opportunities for economically or educationally disadvantaged North Country residents to access

45 LNAs

17 MNAs

6 Health and Wellness Advocate Certificate students

13 Registered Nurses to become trained trainers to expand capacity for LNA and MNA programs

Live, Learn, Play in Northern NH The Live, Learn, Play in Northern NH program (LLP NNH) provides health profession students with the opportunity to complete a community health rotation in the North Country. In addition to the clinical experience, students gain an understanding of the North Country including an overview of the area’s values and the culture of poverty. Students also complete a community service project, which provides a meaningful immersion experience into the rural area they are serving. LLP NNH strives to attract and retain primary care workforce. In partnership with Franklin Pierce Physician Assistant Program (PA) and the University of New England, including the College of Osteopathic Medicine (UNECOM) and the UNE PA Program, students are recruited to participate in the program. Over the past year, 14 PA students and 7 UNECOM students have participated in the LLP program.

B u i l d i n g u p Yo u t h , L o c a l

Substance Misuse Prevention, Intervention, Treatment, and Recovery New Hampshire and its northern-most regions have not escaped the rise of the heroin and opioid epidemic seen around the country. New Hampshire is among the top five states in the nation with the highest drug overdose deaths. Over the past year, NCHC has provided vision and leadership in the fight against this growing epidemic. NCHC continues to provide substance misuse prevention efforts targeting youth in the region through its Youth Leadership Through Adventure Program which has been endorsed as a Promising Practice by the State of New Hampshire.

L eaders, and Communities Naloxone Distribution Working in cooperation with the NH Department of Health and Human Services to expand public access to Naloxone, the NCHC’s North Country Public Health Network (NCPHN) facilitated training and dissemination of life-saving kits. North Country advocates and residents support the opening of the “Hope for New Hampshire Berlin Recovery Community Center.”

Continuum of Care Allying with youth, schools, and local stakeholders, NCHC was able to support and share collective successes and collaboratively increase resource availability across the Continuum of Care. This year, NCHC: •

Obtained funding support to place 3 Student Assistance Program (SAP) counselors at Berlin High School, the North Country Charter Academy, and White Mountains Community College.

Received a Drug-Free Communities Support Program (DFC) grant on behalf of Haverhill Area Substance Misuse Prevention Coalition

Offered guidance and support to facilitate 3 new community coalitions

Introduced 2 new Narcotics Anonymous Peer Support Groups, in partnership with NH State Representative, Linda Massimilla

Helped facilitate the opening of the “Hope for New Hampshire: Berlin Recovery Community Center”- the first in the North Country.

This year, the NCPHN: • Distributed 332 Naloxone kits •

Delivered 19 Naloxone training events throughout the region, including trainthe-trainer education for social service and medical staff to build capacity for distribution

Hosted the largest Naloxone distribution event in the state with 145 kits distributed at the “Rialtopalooza” in partnership with the Black Crow Project.

“Working and collaborating with the North Country Health Consortium has been a huge asset. We were able to host the single largest Naloxone training and distribution event in New Hampshire.” -Erik Becker, Black Crow Project

Building Emergenc y Preparedness

The NH National Guard arrived at the Haverhill Cooperative Middle School via Black Hawk Helicopter to deliver vital medications during the state-wide emergency preparedness drill on August 6.

North Country Public Health Network North Country Health Consortium serves as one of the state’s 13 designated Regional Public Health Networks in New Hampshire, known as the North Country Public Health Network (PHN). The North Country PHN serves Coos and Northern Grafton Counties, and provides leadership to enhance and improve essential public health services in the community. The North Country PHN and the collaborative of local partners address a broad range of health priorities, from substance misuse prevention to emergency preparedness and response.

“It was important to come together, as a state and a region, to play out the protocols standardized for large-scale public health emergencies- we don’t want these basic steps to feel novel in the case of an actual event.” -Amy Jeroy, Public Health Director

and Public Health Response Disaster Behavioral Health Response Team

State-wide Public Health Emergency Preparedness Exercise

For the past 12 years, in accordance with the NH Department of Health and Human Services (DHHS), Division of Public Health Services, NCHC been Dr. Mark Lindberg celebrates retirement from his 12-year tenure as the regional North Country DBHRT liaison with administrator recognition from Amy Jeroy, North for the Country Public Health Director. Disaster Behavioral Health Response Team (DBHRT) contract. NCHC, in partnership with North Country liaison and statewide collaborator, Dr. Mark Lindberg, of Northern Human Services have facilitated an organized response to victims, affected family members, survivors, and communities following an incident. Dr. Lindberg has worked with North Country PHN partners to deliver activities and trainings including development of DBHRT’s volunteer mental health responders. Dr. Mark Lindberg’s 12th year of service to the North Country facilitating DBHRT also marks his retirement, a tenure that reflects his compassion and dedicated leadership to response services for North Country communities.

The North Country PHN activated the MultiAgency Coordinating Entity (MACE) and Point of Dispensing (POD) site in Haverhill, NH on August 5-6, as part of the state-wide DHHS-sponsored public health emergency drill that played out a large-scale infectious disease outbreak. For the North Country PHN, activation of the MACE drill occurred on the first day at the Grafton County Complex. The events on August 6 included the landing of a Black Hawk Helicopter at Haverhill Cooperative Middle School, the designated POD site for the surrounding area, including delivery of vital medications for the mock drill event, reflecting public health emergency.

North Country Health Consortium staff assembled emergency preparedness kits that were distributed to community members for use in case of emergencies or disasters.

Board of Directors


President Ed Shanshala, CEO, Ammonoosuc Community Health Services Vice President Charlie Cotton, Director, Northern Human Services Treasurer Jonathan Brown, CEO, Indian Stream Health Center Secretary Kristina Fjeld-Sparks, Director, NH AHEC/Geisel School of Medicine Assistant Secretary Nancy Bishop, Administrator, Grafton County Human Services

Sharon Beaty, Mid-State Health Center Ken Gordon, Coos County Family Health Services Scott Howe, Weeks Medical Center Russell Keene, Androscoggin Valley Hospital Kristy Letendre, Tri-County Community Action Program Scott Meyer, North Country Home Health & Hospice Roxie Severance, Morrison Nursing Home Pauline Tibbetts, Androscoggin Valley Home Care Services Warren West, Littleton Regional Healthcare Karen Woods, Cottage Hospital Peter Gosline, Upper Connecticut Valley Hospital

Revenue & Expenses

ketplace & NH Health Protection Program

NCHC Program Initiatives: North Country Public Health Network

~ Emergency Preparedness ~ Medical Reserve Corps ~ New Hampshire Immunization Program ~ Disaster Behavioral Health Response Team ~

Molar Express

~ Clinical Services for Children, Adults, and Seniors ~ Oral Health Hygiene Education ~

North Country Prevention Network

~ Youth Leadership Through Adventure ~ Substance Misuse Continuum of Care ~ Student Assistance Programs ~

Workforce Development

~ Northern NH Area Health Education Center ~ Quality Improvement ~ Team-based Care ~ Motivational Interviewing ~ Health Career Opportunities Program ~ Community Health Worker ~ Live, Learn, Play in Northern NH ~ Practice Transformation Network ~ STEM-Health Careers Summer Camps ~

Community Health & Wellness

~ Ways2Wellness ~ Chronic Disease Self-Management Program ~ Community Health Needs Assessment ~

Funders & Members

North Country Health Consortium Funders

Centers for Medicare and Medicaid Services Community Health Access Network Geisel School of Medicine The Dartmouth Institute JSI Research and Training Institute, Inc. HNH Foundation National Association of County and City Health Officials Neil and Louise Tillotson Fund of the New Hampshire Charitable Foundation New Hampshire Bureau of Drug and Alcohol Services New Hampshire Charitable Foundation New Hampshire Department of Health and Human Services United States Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy United States Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce University of New Hampshire, Citizens Health Initiative

North Country Health Consortium Members 45th Parallel EMS Adaptive Sports Partners of the North Country AHEAD Ammonoosuc Community Health Services Androscoggin Valley Home Care Services Androscoggin Valley Hospital Center for New Beginnings Coös County Family Health Services Cottage Hospital Family Resource Center Franklin Pierce Physician Assistant Program Grafton County Human Services Grafton County Senior Citizens Council Indian Stream Health Center Littleton Food Cooperative

Littleton Regional Healthcare Mid-State Health Center Morrison Nursing Home NH AHEC/Geisel School of Medicine North Country Home Health & Hospice Northern Human Services Plymouth State University’s Center for Active Living & Healthy Communities Tri-County Community Action Program Upper Connecticut Valley Hospital’ University of New England, College of Osteopathic Medicine Weeks Medical Center White Mountains Community College

NCHC Staff

North Country Health Consortium Staff

Nancy Frank, Executive Director April Allin, Program Manager Elaine Belanger, Public Health Coordinator Lynda Bloom, Administrative Assistant Drew Brown, Substance Misuse Prevention Coordinator/Information Systems Specialist Annette Cole, Molar Express Dental Hygienist Jennifer Frenette, Program Manager Diana Gibbs, Program Manager Colleen Gingue, Finance Director Jill Gregoire, Practice Facilitator Barbara Groff, Practice Facilitator Laura Hosley, Continuum of Care Facilitator Karen Hoyt, Molar Express Care Coordinator Amy Jeroy, Public Health Director Becky McEnany, Program Director Francine Morgan, Program Director Tracy Page, Accounting Assistant Kayla Ramsay, Molar Express Dental Assistant Anna Shum, Program Coordinator Margo Sullivan, Practice Facilitator

Not pictured above: Drew Brown

“North Country Health Consortium leads innovative collaboration to improve the health status of the region.�

Photo Credit: Jody Whiting

262 Cottage St., Ste. 230 Littleton, NH 03561 Phone: 603-259-3700 ~ Fax: 603-444-0945