Hello! What an exciting time to step into the role of President of NHPHA. Just around the corner on November 15th is the Team Up, Take Action Conference. This year we are collaborating with the Vermont Public Health Association and Dartmouth Hitchcock Medical Center to create a fabulous event focused on the theme of Partnering for Health Equity. Come to cultivate new ideas to advance health equity and network with colleagues within and across state boundaries. Bookending the impressive set of breakout session speakers will be keynotes James Weinstein, D.O., who chaired the Committee on Community-Based Solutions to Promote Health Equity in the United States for the National Academy of Sciences M.S., and Camara P. Jones, M.D., M.P.H., Ph.D., past APHA President and powerhouse speaker who shares simple allegories to grow understanding about the many layers and nuances of racism, societal inequities and the impact on our communities. Register now and get ready to be blown away.

The topic of advancing health equity is near and dear to the core of why I became a public health profession. Throughout my career I have sought opportunities to contribute towards creating physically, mentally, socially, environmentally and economically thriving communities. I truly believe as Paul Wellstone once said, “We all do better when we all do better.” I am passionate about the work of public health - research and action based on the science of what works.

Thank you for the warm welcome I have received to date in my new role as President. Katie Robert left an incredible legacy that deserves all our efforts to sustain and grow. I look forward to partnering with you to expand the impact of NHPHA on ourselves, our organizations, our profession, and the health of every New Hampshire resident.

Mary Ann Aldrich, a NHPHA Board of Directors member received recognition from Pastoral Counseling Services (PCS) early this month along with three other individuals.

Over 200 people attended the PCS 22st Annual Good Samaritan Awards Dinner at the Manchester Country Club in Bedford, N.H. Over the past two decades, PCS has honored more than 125 individuals who have gone above and beyond in their community. This year’s event honored four individuals who were all nominated by their peers for the distinguished recognition of a Good Samaritan.

"The Good Samaritan Awards are an annual tradition to honor individuals who pursue extraordinary measures to strengthen communities and improve life in New Hampshire," said Dr. David Reynolds, PCS Executive Director. "Each honoree has a different story, different backgrounds, but they each have a common outlook on how to live their lives - and that's helping others. We are honored to come together and celebrate them."

We extend our congratulations to Mary Ann!

Photo Caption: L-R David Reynolds, D.Min., LPP, PCS Executive Director, Hon. John T. Broderick Jr., Change Direction & Dartmouth-Hitchcock, Susan A. Manchester, ESQ., Sheehan, Phinney Bass & Green, PA, Dan Forbes, Meelia Center, Saint Anselm College, Mary Ann Aldrich, RN, MS, Dartmouth-Hitchcock and Cal Genzel Ph.D. LP, PCS Director of Clinical Services
Following a series of failed attempts to repeal the Affordable Care Act, the bi-partisan Alexander- Murray proposal is an encouraging and important move in the right direction to maintain health care coverage for millions of Americans and tens of thousands of New Hampshire residents. The agreement would continue cost-sharing reductions (CSRs) through 2019. This means that insurers would continue to receive funds to lower flagACA 1deductibles and co-pays for lower-income consumers thus avoiding higher premiums or forcing insurers to leave the ACA marketplace. The latter would leave people with limited insurance options. Both New Hampshire Senators Shaheen and Hassan were co-authors of the bill with 10 other Democrats and 12 Republicans. They have both been ardent supporters of a collaborative approach to health care reform that continues to cover New Hampshire residents in need, that is affordable and sustainable, that continues to provide for those with pre-existing conditions and that covers preventive services.

The proposed agreement restores partial funding for outreach and education for consumers and enrollment assistance that has been cut by the US Department of Health and Human Services. Therefore, we as advocates for assuring the health of the public, need to get the word out to consumers relative to open enrollment.

The NH Department of Insurance has distributed a press release providing information on how New Hampshire residents can sign up for insurance for 2018. Open enrollment runs from November 1, 2017 to December 15, 2017 through the federally facilitated Health Insurance Marketplace (www.Healthcare.gov) Individuals who are currently covered through the federal Marketplace must go through the enrollment process again. There have been changes in insurers for 2018 so some people will need to choose a new health plan.

Help is Available

This process can be confusing and unwieldy. Fortunately, there is help for those trying to find their way through.

  • Health insurance assisters are available, free of charge, in communities throughout the state to answer any questions about health insurance and enrollment through the Bi-State Primary Care Association.
  • Those enrolled in the New Hampshire Health Protection Program will receive information from the New Hampshire Department of Health and Human Services about how to select a plan for 2018
  • If individuals are enrolled in the federal Marketplace for 2017, they will receive renewal information from their insurance company and the Marketplace
  • The NH Insurance Department website can help people find an enrollment assistant to walk through the how to use the Marketplace or a licensed agent who can help select a plan.
  • If people have questions in using the Marketplace and obtaining coverage they can call the federal government at (800)318-2596 Once they have coverage they can call the Insurance Department with questions or concerns at 1-800-852-3416 or contact outreach coordinator Eireann Apsell at 603-217-3781 or Eireann.aspell@ins.nh.gov
Marilyn Sullivan, Project Coordinator for Outreach and Enrollment at Bi-State Primary Care Association emphasizes, “The New Hampshire Health Insurance Marketplace is open for business. Consumers still have options for a valuable and important insurance product. People looking for insurance can call one of our assisters to help them through the process.”

Let’s keep New Hampshire residents insured and assure they have access to health care by letting consumers know about the enrollment dates and resources available to help.

Team Up, Take Action: Partnering for Health Equity
Breakout Session

Presenter: Donna Burkett, MD

This session will introduce attendees to the six new contraceptive National Quality Forum (NQF) quality measures, their history and development, and the response of the Reproductive Justice community to them. These NQF measures were developed to measure disparities in access to quality reproductive and perinatal care and in outcomes among different racial and ethnic groups as well as sociodemographic disparities. There is concern that the new NQF contraceptive care measures may be misused, thus impacting access to care.

The workshop will include an illustrative and practical discussion of how the measures are being used and might be used across New England. We will use Planned Parenthood of Northern New England’s internal practice and the Vermont Blueprint for Health’s Women’s Health Initiative as examples of regional use of the measures.

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Team Up, Take Action: Partnering for Health Equity
Breakout Session

Presenters: Matthew Houde, Vice President of Government Relations at Dartmouth-Hitchcock and Kevin C. Stone, Helms & Company

This session will include a comparison of the two states’ approaches, discussion of the direction they are taking, including the All-Payer Model in VT and scenarios with respect to Medicaid expansion reauthorization in NH, as well as implications for health of relevant populations.

Work in the mental health and substance use disorder arenas will also be discussed.

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Team Up, Take Action: Partnering for Health Equity
Breakout Session

Presenters: Kalyn Rosenberg; Jazmin Miranda, MAE, CHW; Jennifer Goulet, CHW; and Wanda Castillo, CHW

This session will highlight two exciting service delivery models that seek to improve health outcomes by addressing individual and systemic barriers to optimal health.

Vermont will describe its work with immigrant farmworkers as it relates to linguistic barriers, rural setting, financial challenges, work schedule conflicts, and health care policies. Utilizing a care coordination model carried out by regional Migrant Health Promoters, the program, Bridges to Health, empowers farmworkers to make timely health decisions. In addition to offering care coordination to migrant farmworkers in need of health care services, Bridges to Health creates capacity building opportunities for local health entities to implement linguistically and culturally appropriate services.

The New Hampshire panel will provide an overview of the Community Health Worker movement and discuss different service delivery models that incorporate CHWs in systems to improve the health of our communities. CHWs support community members by assisting with navigating the health care system, providing peer education, and addressing social determinants of health. CHW panelists will describe the setting in which they work, explain how they act as the bridge between the community and the health care system and provide insights into the opportunities and challenges they face in their day to day work.

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Team Up, Take Action: Partnering for Health Equity

Breakout Session

Presenters: Terry Johnson, Foundation for Healthy Communities; Dan Quinlan, Vermont Climate and Health Alliance; Rob Werner, NH League of Conservation Voters

The impacts of climate change are increasingly evident. Vulnerable and underrepresented communities are at particular risk, with health equity and social justice implications that must be considered within public policy. Many of these same communities lack safe, complete sidewalks or bike paths, and convenient access to transit, making walking and biking difficult.

The session will review community engagement efforts to address climate change adaptation planning, transportation system planning, and developing public policy actions at the state and local level that decrease inequities.

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Team Up, Take Action: Partnering for Health Equity

Breakout Session

Presenters: Greg Crowley and Alice Ely

In this workshop attendees will be presented a tool for convening and facilitating a conversation with members of your community on how to collaborate to achieve health equity. This tool is inspired by the Health Equity Lab of Reos Partners, funded by the Robert Wood Johnson Foundation. The Lab seeks to give momentum to a nationwide movement to create the conditions in which everyone has equal opportunity to achieve optimal health and well-being. The workshop utilizes a peer learning approach to help you gain insight into how you can think and act differently in order to successfully address health equity in your community.

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Team Up, Take Action: Partnering for Health Equity
Breakout Session

Presenters: Mary Evanofski, MPH, MHCDS and Sally Kraft, MD, MPH

In this workshop, participants will learn how to collect and analyze data to inform local improvement projects and implementation of interventions. Participants will consider the strengths and limitations of data that is used to inform improvement work and will apply that knowledge to create a data collection plan. Participants will explore the association between variation and equity and how variation can signal opportunities for improvement.

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Team Up, Take Action: Partnering for Health Equity

Breakout Session

Presenters: Trinidad Tellez, M.D., Director, NH Office of Health Equity and Amy Parece-Grogan, M.Ed., Cultural and Linguistic Competence Coordinator, NH Office of Health Equity

Culturally effective organizations enable, cultivate, and support the delivery of high-quality care and services for all people. This session will review disparities data and recognize that changes in policies and procedures are needed to improve equity in access, use andoutcomes across social determinant of health domains. The session will explore the elements of a culturally effective organization and discuss helpful strategies and resources for implementing them.

Participants will explore enhancements to their organization’s policies and procedures, and consider how to operationalize the various evidence-informed elements of a culturally effective organization for systems improvement resulting inenhanced care and services for all.

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Rare and Beneficial Opportunity for Students

Students will have the unique opportunity to interact with Camara Jones, M.D., M.P.H., PhD  They will be able to meet Dr. Jones in a small group setting; and will have the chance to ask questions and share thoughts with Dr. Jones, a renowned subject expert regarding matters pertaining to all aspects of health equity. Dr. Jones is the immediate past president of the American Public Health Association.

Click here to download a full-sized flyer to share with your colleagues and peers.

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Closed POD Drill resizedSullivan County Health Care and the Greater Sullivan County Public Health Network recently conducted a public health emergency preparedness drill. The drill, which took place at the Sullivan County Unity complex on September 13-14, 2017, simulated a large-scale influenza outbreak creating a need for Sullivan County, which serves as a closed Point of Dispensing (POD), to open and provide medication to their residents and essential personnel.

Public health emergencies can result from various hazards including natural disasters like hurricanes and tornados, disease outbreaks like pandemic flu, and deliberate acts such as aerosolized release of anthrax. If a public health emergency did occur, residents in the Greater Sullivan County region would be directed to an open POD to receive medication. “When looking at the geography of this region and taking into account the logistics of providing lifesaving medications to upwards of 47,000 people through one or two open POD locations, it became clear we needed to look at more options,” said Kirsten Vigneault, Director of Community Health Preparedness.

Closed PODs are not open to the community members at large; instead, they serve a specific type of place/person. Agencies that choose to become closed PODs benefit the community by decreasing the number of people accessing designated open POD locations, and helping the region dispense medication more rapidly. Sullivan County employs about 300 people, cares for 156 residents in the Sullivan County Nursing Home, and 155 inmates at the Department of Corrections. Including employees’ immediate family members, Sullivan County could provide medications to over 1,000 people and is currently the only closed POD in the region.

“It was a pleasure to work with Kirsten from the Greater Sullivan County Public Health Network as well as Golden Cross Ambulance Service and many of our SCHC staff during this emergency preparedness drill,” said Patti Henderson, Director of Nursing for Sullivan County Health Care. “It is comforting to know we have a plan in place for our residents, inmates, employees, and their families should there be a medical emergency requiring mass dispensing of medications or vaccines.”

The Greater Sullivan County Public Health Network appreciates the time and efforts of Sullivan County Health Care as well as Golden Cross Ambulance who also participated in the emergency preparedness drill. “This exercise is an excellent example of how the County works with its partners to support the people of Sullivan County,” said Derek Ferland, Manager for Sullivan County. “By utilizing the County’s Unity complex as a closed dispensing point, we could provide lifesaving medications to our staff, their family members, residents, and inmates without interfering with normal operations or patient care.”

The Greater Sullivan County Public Health Network is an affiliate of Dartmouth-Hitchcock and serves as a system of organizations and individuals that work together to identify and address public health challenges in the region. The network is made up of educational institutions, community organizations, healthcare systems, first responders, law enforcement, government agencies, businesses, and volunteers dedicated to improving the health and wellbeing of our community. You can follow the Network on Twitter and Facebook at @GSCPHN.
Friends and colleagues,

For the last two and half years, I have had the great pleasure of working with and learning from so many dedicated and passionate public health professionals through my NHPHA work. As of October 1, I am pleased to pass the proverbial Board Chair baton to Rebecca Sky, Project Director at the Foundation for Healthy Communities.

As I reflect upon my time serving NHPHA and our members, a few memories notable memories come to mind, as does the recognition of personal growth - in particular, a deepened understanding and internalization of the multi-faceted equity issues facing our nation today.

In 2015, NHPHA celebrated its 20th anniversary in a joint celebration with the Community Health Institute JSI. We celebrated our colleagues in the field with poster sessions and Ignite-style presentations at the Red River Theater. And in 2016, our policy efforts contributed to the continued funding for Medicaid Expansion, protecting the health of tens of thousands of NH residents, and ultimately the continued vibrancy of our economy.

Last year, we also shared a collective gasp of concern when an incredible shift in national politics shook the ground beneath us, potentially threatening the public health, climate, and social justice advances of the previous eight years. From that perceived political rubble rose a powerful, unified voice speaking on behalf of our neighbors who face inequitable barriers to health, social, and economic prosperity for any number of reasons.

That collective voice was never louder than at the NH Women’s Day of Action and Unity rally on January 21, attended by more than 5,000 people in Concord and many more around the world. I had the incredible honor to speak on behalf of public health and climate, and what I remember being most proud of was seeing my NHPHA colleagues in the crowd, carrying an NHPHA banner and a multitude of posters, adding our message to the developing narrative. As the underlying injustices and systemic inequities built into our country’s fabric continue to be brought to light and are more widely understood, I hope NHPHA continues to promote the health equity message and impact real change at all levels of government, and across all sectors.

I realize what has made these particular memories so meaningful is the sense of community and common purpose that we all share – to make sure that everyone has equitable opportunities to achieve their best health and best lives. And I strongly believe that NHPHA is in a better position than ever to contribute to that purpose, by supporting and enhancing all the public health work and continuing our promotion of sound public health policy.

As I close this final President’s Message, I think back to a recent conversation with a colleague for whom I have great respect. We were discussing what inspires us to volunteer for various purposes, and recognizing the privileges in our lives that allow us to do so. This colleague shared a motto passed down by a parent, likened to a certain athletic brand’s slogan – “Just do it.” I have had great privilege in my life affording me the opportunity to “just do it”. At the risk of sounding like an award ceremony speech, I must thank my husband, my children, the NHPHA Board of Directors, and my incredibly supportive employer, JSI for giving me space to serve and grow and support the public health field and our constituents.

Thank you, for this space and this time.

Be well,
Submitted by Adelaide Murray, Project Associate, Community Health Institute/JSI

My name is Sabryna Therrien, and I am a senior at Rivier University in Nashua, New Hampshire studying public health, and minoring in biology. I have always been passionate about investing my time in the needs of others, and how I could help them better, which is what prompted me to major in public health my sophomore year. Studying public health at Rivier has taught me how vast the public health field is, and what people like me can do to make our communities healthier.
Since taking a collection of classes at Rivier that ranged from Food Safety and Hygiene to Epidemiology, I soon found myself interested in Public Health Research and Health Promotion, Marketing, and Communication. During those classes I invested my studies in researching maternal health care initiatives in refugee camps due to recent international multimedia events in 2016. Karyn Madore, Operations and Communications Director at
JSI Research & Training Institute, heard that I was interested in Maternal and Child Health, through her class at Rivier, and invited me to intern with her at JSI and CHI in Bow, New Hampshire. This opportunity has landed me a yearlong internship until I graduate in the spring, working on Multimedia Services for a Maternal and Child Health Program called Healthy Families America. So far I have researched and worked on a literature review for our team to analyze and determine better ways of retaining and configuring the Healthy Families America Program. Overall this internship has taught me the importance of group work and diligent research, and I am elated to see what my next steps will be through this internship.
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