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2014 Annual Report

Innovation Innovation Collaboration Collaboration Education Education


Dear Friends and Colleagues,

Nancy Frank, Executive Director

Welcome to the North Country Health Consortium’s 2014 Annual Report. It has been a busy and productive year for the Consortium. We have had opportunities to strengthen our existing programs as well as to begin new initiatives. Our mission, … ‘‘To lead innovative collaboration to improve the health status of the region,” is central to all of our work, and is reflected in the activities and accomplishments over the past year. As you will see, we are making great strides in all of our program areas, and have touched the lives of residents of all ages. Over the past year, we have launched two new programs, Ways2Wellness and Youth Leadership Through Adventure, and have had a strong presence enrolling individuals in the New Hampshire Health Insurance Marketplace. We have had opportunities to share our skills and expertise in the areas of oral health care, youth leadership development, and program management with our members and community partners. We have collaborated with our partners to react to the many challenges presented by the changing healthcare landscape and priorities. Through our North Country ACO and North Country Health Improvement Initiative, we are responding to national changes that are focused on a value-based health care system centered on population health, chronic disease, and prevention. Many thanks to all of you who are committed and dedicated to the health of the North Country. Our work would not be possible without you.

Roxie Severance, Board President

NCHC Programs Set the Bar High for Public Health Services!


North Country Health Consortium Board of Directors Directors:

Officers:

President Roxie Severance, Executive Director, Morrison Nursing Home Vice President Tony Poekert, Director, NH Catholic Charities Treasurer Nancy Bishop, Administrator, Grafton County Secretary Ed Shanshala, CEO, Ammonoosuc Community Health Services Asstistant Secretary Charlie Cotton, Director, Northern Human Services

Sharon Beaty, Mid-State Health Center Elaine Bussey, North Country Home Health & Hospice Michael Coughlin, Tri-County CAP Rob Darling, 45th Parallel EMS Kristina Fjeld-Sparks, The Dartmouth Institute/NH AHEC Program Scott Howe, Weeks Medical Center Russell Keene, Androscoggin Valley Hospital Shirley Powell, Indian Stream Health Center Maria Ryan, Cottage Hospital Margo Sullivan, Androscoggin Valley Home Care Warren West, Littleton Regional Healthcare Adele Woods, Coos County Family Health Services

NCHC Staff

Nancy Frank, Executive Director Elaine Belanger, Community & Public Health/Coordinator/Marketplace Navigator Drew Brown, Program Specialist/Systems Administrator Annette Cole, Molar Express Dental Hygienist Nathan Gair, Marketplace Navigator Diana Gibbs, NCHC Program Manager Colleen Gingue, Finance Director Ken Gordon, ACO Administrator Amy Holmes, Community & Public Health Director Emily Jacobs, Marketplace Navigator Kathleen Kennedy, Administrative/Molar Express Assistant Iris Marcus, CADCA VetCorps Prevention Coordinator Becky McEnany, Program Coordinator Francine Morgan, Senior Program Manager- Molar Express & Marketplace Outreach & Enrollment Nick Nelsen, Prevention Programs Field Staff Coordinator Sean O’Brien, Youth Prevention Programs Coordinator Kayla Ramsay, Molar Express Dental Assistant Bob Thompson, Senior Program Manager- Prevention


Molar Express provides North Country Students with hands-on dental experience through use of state-of-the-art dental simulator.

Molar Express


Molar Express

Molar Express is a mobile dental clinic that provides oral health care to school-aged children, nursing home residents and adults who are Medicaid recipients, uninsured, underinsured or do not have a dental home. Molar Express Staff: • Teamed up with Ammonoosuc Community Health Services (ACHS) and Coos County Family Health Services (CCFHS) to provide adult clinics. • Developed a cooperative structure to share staff between the Molar Express and ACHS’s new dental clinic opening late fall/early winter. • Created tailored treatment plans and coordinated schedules for high school students needing restorative dental care that will be provided at the ACHS dental clinic. • Implemented an evidence-based risk assessment process and sealant initiaitve for school-aged children.

• Collaborated with the state of New Hampshire to produce a senior center survey identifying significant needs in that population. • Teamed up with the dental hygienist at CCFHS to provide oral health screenings to Berlin Middle School 7th graders.

“At the end of the day, it’s not about the teeth, but about keeping them healthy.”

- Francine Morgan, Sr. Prog ram Manager

“ The Molar Express team is professional and easy to work w ith. They prov ide ser v ices that can change children’s lives.”

- North Countr y School Nurse


North Country Prevention Network

YLTA students complete high-ropes course as part of 9th grade orientation.


North Country Prevention Youth Network The Youth Leadership Through Adventure (YLTA) model is youth led and adult guided, and empowers youth to lead and promote a healthy chemfree life style and improve the overall school climate. YLTA offers summer leadership development opportunities, annual regional conferences, in-school curriculum, and outof-school student leadership development. YLTA is designed to have a positive impact on students’ schools and their communities through service learning projects, social norm campaigns, and environmental strategies. North Country Health Consortium has developed a student assistance program network of trained counselors that is funded through the state Bureau of Drug and Alcohol Services, with a goal to staff trained counselors in eight high schools and five middle schools. NCHC provides guidance, technical advice and supervision.

Significant Findings

Among YLTA students during the 2012- 2013 school year, pre- and post-surveys reflected the following: Increase in the % of students who think that the problem of underage drinking, tobacco use, abuse of prescription drugs or marijuana use can be solved by the work of people in their community. Increase in the % who think that their actions can make a positive difference in their community. Increase in the % who strongly agree with the statement, “If a child begins drinking before the age of 15, they are more likely to develop alcohol dependence.”

YLTA students thrive on outdoor recreation and leadership activities.

•From 2009-2013: Among schools with an active YLTA group, last 30-day use of alcohol, as self-report by students on the Youth Risk Behavior Survey, declined by 8.2% as compared to a decrease of only 4.4% in schools with less active or no YLTA groups prior to 2012.

Statistics YLTA members in 10 North Country High Schools – 206 School Climate Prevention Projects served 934 students in North Country middle and high schools. Kids in Prevention programs served 183 students grades 4-6 in North Country elementary schools. Middle and High School Annual Prevention Conferences served 331 students, student staff, and adult advisors.


Northern NH Area Health Education Center

Littleton STEM-Health Career Summer Camp attendees perform life-saving procedures on SimMan in simulation scenario.

Littleton STEM-Health Career Summer Camp 2014 featured Optometry!


Workforce Development

During Fiscal Year 2014, the Workforce Development Program delivered continuing education opportunities that reached over 1,000 health and human service professionals in Coos, Grafton, Carroll, and Belknap Counties. Nearly 80 continuing education credit hours for physicians and nurses (CMEs and CEUs) were made available locally.

North Country healthcare professionals gather at the Mountain View Grand for continuing education.

To better accommodate learner needs and geographic barriers, the mode in which trainings have been delivered has been expanded to include virtual meeting software, videoconferencing, and online training platforms. Pilot trainings using this technology were highly successful, especially for area school nurses.

Academic Partnership

Health Careers Initiative

In collaboration with the WMCC, the 1st Annual North Country Healthcare Symposium, a day-long, local continuing education opportunity for nurses and medical assistants, was offered.

The Northern NH Area Health Education Center’s Health Careers Pipeline Initiative activities included health career presentations to middle and high school students using handson, state-of-the-art dental simulation equipment. Classroom presentations as well as larger-scale presentations included distribution of health career catalogs and job outlook information for the region. An emphasis has been placed on high school and college preparation, helping students to understand the initial steps and items that they must be mindful of if they wish to pursue a health career.

Over the last year, NCHC partnered with White Mountains Community College’s Allied Health Program (WMCC) to provide an online refresher course to prepare Medical Assistants for certification as required by the Affordable Care Act.

Berlin STEM-Health Career Summer Camp attendees experience nursing simulation lab!


North Country Public Health Network

MRC volunteer, Yvonne Claffey, administers flu shot during Profile school-based flu clinic.


Public Health Emergency Preparedness The North Country Public Health Network has identified six locations known as Points of Dispensing (POD) where antibiotics, vaccines and other medical supplies can be quickly distributed in the event of a public health emergency. • Three Point of Dispensing Walk Through exercises were completed in the past year (at Colebrook Elementary, Berlin High and Lancaster Elementary). • 120+ local community leaders, Emergency Management personnel, Medical Reserve Corps volunteers, hospital and health care representatives and school leaders participated.

PSU intern, Hillary Pakus, preparing for Berlin POD exercise.

North Country Health Improvement Initiative • The 3rd Annual Health Improvement Summit was held on June 27 with a focus on Worksite Wellness, including healthy eating and physical activity.

• Access to Healthy Eating subcommittee formed to strategize/develop a community-based local foods project. • Health Improvement Working Group hosted quarterly educational sessions focused on local, regional, and national obesity data.

Public Health Advisory Council (PHAC)

Health Improvement Summit attendees enjoy wellness breakout.

• Recruited 20 PHAC members. • Prioritized community health issues: • Obesity • Substance Misuse Prevention • Access to Mental Health Care Services


North Country Accountable Care Organization


North Country Accountable Care Organization (ACO)

Local doctors and other health care providers working together to provide high quality service and care for their patients make up the North Country ACO. The focus is on prevention and wellness through care coordination, health screenings, better management of chronic illnesses and reducing unnecessary or unwanted care. • $1.3 million saved in the 1st year of the program, representing a savings of 2.9% over national average. • 6,100 Medicare beneficiaries served.

Better Choices, Better Health Program

Ways 2 Wellness

The Ways 2 Wellness program offers training for clinicians and others working at area health centers to incorporate motivational interviewing as a way of engaging patients in a practical way, building on their strengths to make positive health changes as they are ready to reduce obesity in northern New Hampshire. • Trained over 100 health professionals working at four health centers. • Created and printed 1,000 personal health journals for distribution, with space for personal goals, questions and reflections, and incorporating recipes, inspiration and a community resource website.

The program offers classes that help individuals with chronic diseases self manage their health. • 57 attendees at six Better Choices, Better Health Chronic Disease Self-Management workshops. Thirty-four individuals are expected to complete the course in the remaining three workshops underway. Becky McEnany, Program Coordinator, promotes Chronic Disease Self-Management Program, “Better Choices, Better Health!”, at 2014 Women’s Health Conference.


Marketplace Outreach

Marketplace Outreach was developed to assist consumers in purchasing insurance through the Affordable Care Act. Trained Navigators, also known as Marketplace Assisters and Certified Application Counselors (CACs) explained a variety of insurance options in a manner understandable to consumers. • Hired two full-time temporary assisters and trained two existing employees. • Developed the training and tracking methods required by three different funders to ensure that no one was counted twice.

Emily Jacobs and Nathan Gair, Patient Navigators, collaborate with local librarian, Bernie Prochnik, to conduct Marketplace enrollments for local residents.

• Coordinated meetings with regional health care centers and providers to strategize methods of delivering information, with the goal of keeping community members at the heart of the program.

“I feel value in my job when the convenience store clerk I see

• Assisted individuals in the New Hampshire High Risk Pool — those with complicated health problems — acquire the insurance they needed.

ever y week came in to see me for help w ith insurance. She has always made sure her kids were insured and, for the first time, could finally take care of herself. The ACA has allowed the ones who care for ever yone else to take care of themselves, too. “

-Elaine Belanger, Marketplace Nav igator

Nathan Gair and Elaine Belanger, Patient Navigators, have provided first-hand, Marketplace enrollment assistance to several North Country residents over the last year.

Marketplace Outreach & Enrollment


NCHC Revenue and Expenses

Funders Centers for Medicare and Medicaid Services Community Health Access Network Dartmouth Medical School The Dartmouth Institute JSI Research and Training Institute, Inc. Foundation for the National Institutes of Health 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


“North Country Health Consortium leads innovative collaboration to improve the health status of the region.” North Country Health Consortium Members 45th Parallel EMS Adaptive Sports Partners of the North Country American Cancer Society Ammonoosuc Community Health Services Androscoggin Valley Home Care Androscoggin Valley Hospital Center for New Beginnings City of Berlin Public Health and Home Health Nursing Coös County Family Health Services Cottage Hospital Dartmouth Medical School Family Resource Center at Gorham Franklin Pierce Physician Assistant Program Grafton County Human Services Grafton County Senior Citizens Council Granite United Way-Northern Region Indian Stream Health Center

Jane MacKay Littleton Regional Healthcare Mid-State Health Center Morrison Nursing Home NH AHEC Program NH Catholic Charities North Country Home Health & Hospice Northern Human Services Personal Touch Home Care Plymouth State University Center for Rural Partnerships ServiceLink Speare Memorial Hospital Tri-County Community Action Program Upper Connecticut Valley Hospital Weeks Medical Center White Mountains Community College

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

North Country Health Consortium 2014 Annual Report  
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