New UV CHIP Released

Every three years, the Public Health Council of the Upper Valley (PHC) and our partners compile a Community Health Improvement Plan (CHIP) that highlights work occurring in health care, social service, and many other organizations across our region.

In March of 2023, the PHC’s Board of Directors and Advisory Council approved the release of our latest CHIP: Summary of Community Health Efforts Planned Across the Upper Valley: 2023 to 2025. We hope our partners and community members will use this plan to learn more about our region, find new partners, and mobilize to address concerns our residents care most about.

Click on the image at left to download the CHIP document.

The CHIP starts with the results of the most recent Community Health Needs Assessments conducted by the region’s health care organizations to set the priority health concerns. We then gather information about the many ways partners plan to address the priority health concerns, especially through collaboration with others. The CHIP gives us a road map of what is being done, what is being planned, how we can participate, and what gaps we can fill to improve health in the Upper Valley.

Priority Health Concerns: 2023 to 2025

  • Access to Mental Health Services
  • Cost of Health Care Services, Health Insurance and Dental Care
  • Access to Healthy and Affordable Food
  • Alcohol and Drug Misuse Prevention, Treatment and Recovery
  • Child Wellbeing
  • Socio-Economic Conditions: Housing and Others
  • Public Health Emergency Preparedness

A Summary of a Lot of Work by Many Partners

This summary Community Health Improvement Plan certainly does not include all the community health work going on in our region nor does our listing of Lead Partners contain all the people, organizations and institutions collaborating to improve our community’s health. Please forgive us for glaring omissions and reach out to us to discuss what we can do better to reflect how our community responds to priority health concerns.

Measuring Our Impact

High level indicators should be reliable, comparable and available over time. We have selected a narrow set of indicators that meet these criteria. As strategies are further developed, we will look for ways to measure the process and impact of the work as well, but those measures are not yet available to include in this document. We will also be looking for ways to capture health disparities data for traditionally marginalized groups, explore measures of social vulnerability, and embrace new data sources and tools as they become available.

PHC is Hiring: Part-Time Business Administrator

The Public Health Council of the Upper Valley (PHC) is a 501(c)3 nonprofit coalition of health and human services organizations that works to improve community health by promoting collaboration, advocating for policies and practices that support health, and providing education to partners and community members on priority health concerns. PHC has an office in Lebanon and covers 34 towns in NH and VT.

PHC does not discriminate internally (in its administrative and program operations) or externally (in provision of services) on the basis of race, color, national origin, ethnicity, ancestry, gender, gender expression, sexual orientation, age, disability, marital status, political orientation, religion, military or veteran status, or mental or physical disability or any other status prohibited by applicable law. We are a small workplace and strive to be inclusive, supportive, and welcoming. Please reach out if you need accommodation in applying.

Position Details

Part-Time: 8 to 10 hours weekly

Location: Hybrid  — Applicant must live within 40 miles of Lebanon, NH, office location.

Hourly Rate: $30 to $34 (depending on experience)

Benefits: Position is not benefits eligible.

Work Schedule: Flexible. Some Mon-Fri hours for coordination of tasks. In fall and during Town Meeting season, some evening and weekend hours will be expected.

Reports to: Executive Director

The PHC Business Administrator will complete organizational and management tasks that adhere to best practices and requirements for non-profit business operations and reporting. The PHC Business Administrator will support the productivity and growth of a small, community-based nonprofit focused on improving community health.

Qualifications/Prior Experience:

  • Confidentiality, efficient time management, excellent organizational skills, and attention to accuracy are essential qualifications for this position, as is the ability to communicate clearly.
  • Experience in bookkeeping, business administration, or a related field.
  • Knowledge of QuickBooks and Microsoft Office, especially Excel.
  • Ability to understand financial data, processes, and procedures and understanding of generally accepted accounting principles.
  • Basic understanding of nonprofit bookkeeping operations is preferred, but not required.

Responsibilities include, but are not be limited to:

  • Managing bi-weekly A/P and A/R by reviewing/coding invoices and receipts, providing instructions and documentation to external bookkeeper, and maintaining internal records/filing systems.
  • Managing financial aspects of grants and contracts received by PHC, including internal and grant reporting and invoicing.
  • Preparing financial reports for Executive Director and Board Treasurer monthly and as needed.
  • Working with Executive Director and Board Treasurer to prepare annual budgets for Board approval and supporting Executive Director with financial aspects of grant applications.
  • Support fundraising campaigns by helping Executive Director with preparing campaigns and managing gift recording and acknowledgements.
  • Manage annual Town Appropriation requests to include preparing and delivering annual request letters and Town Reports, coordinating town petition drives (developing petition documents, creating a timeline and schedule for signature collection, and helping to recruit volunteers among Board members and other partners to collect signatures).
  • Plan strategies for streamlining and improving business operations, to include reviewing and proposing updates to PHC Fiscal Manual.

To apply for this position, please send a letter of interest to Alice Ely at In your letter, please tell us what about this position is of most interest to you. What about this position speaks to your experience or your personal goals? Please send a resume or summary of work experience as well. Interviews will begin in the week of June 19, 2023, and will close when a candidate has been selected.

Dartmouth Health Youth Vaping Education and Resources Toolkit Released

Dartmouth Health and the All Together Coalition recently released a toolkit to help anyone interested in supporting teen vaping prevention, education and cessation with evidence-based resources and information: Dartmouth Health Youth Vaping Education and Resources Toolkit

Electronic cigarettes or “vapes” are electronic devices that heat liquid (usually containing nicotine, flavoring, and chemicals) that produces an aerosol inhaled into the lungs. Often falsely marketed as a “safer” alternative to cigarettes, vapes and e-cigarettes are unsafe for kids, teens, and young adults. Youth vape use poses several serious health threats, including harms to brain development and increased likelihood to smoke cigarettes in the future.

The growing availability and variety of vaping devices, the tobacco industry’s manipulative marketing targeting youth, and the prevalence of kid-friendly vape flavors make youth vaping a growing concern in our community and nationwide: in December 2018, the United States Surgeon General released an advisory that declared e-cigarette use among youth an epidemic.

Data trends

According to a 2022 Centers for Disease Control and Prevention (CDC) data brief on national trends in e-cigarette sales:

  • From February 23, 2020 to July 10, 2022, total e-cigarette unit sales increased by 57.3% (16.2 million units to 25.5 million units). During this period, sales of non-tobacco flavored e-cigarettes (mint, menthol, and other flavors) increased by 75.6% (11.4 million to 20.0 million).
  • From February 23, 2020 to July 10, 2022, disposable e-cigarette sales increased by 161.0% (4.9 million units to 12.7 million units); disposable e-cigarette unit share increased from 29.9% to 49.6% of total e-cigarette sales. As of July 10, 2022, 80.3% of disposable sales were of flavors other than tobacco, mint, and menthol.
  • Among youth who used e-cigarettes in 2022, 55.3% used disposable e-cigarettes. The most commonly used flavors of disposable e-cigarettes were fruit (69.1%) and candy/desserts/other sweets (38.3%).

Recent research on youth vaping behaviors raise further concern. The CDC and the Food and Drug Administration’s analysis of the 2022 National Youth Tobacco Survey found the following:

  • 14.1% (2.14 million) of high school students and 3.3% (380,000) of middle school students currently use e-cigarettes. Overall, 84.9% use flavored e-cigarettes.
  • More than a quarter (27.6%) of middle and high school students use an e-cigarette product every day.
  • More than 4 in 10 youth e-cigarette users report using e-cigarettes at least 20 of the last 30 days.
  • The most commonly used device among current users was disposables (55.3%), followed by prefilled/refillable pods or cartridges (25.2%).

Health Outcomes

Studies of vape products report that they contain an average of 6.2 flavoring chemicals, with over 20% of commercial vapes containing flavorings with potential inhalation toxicity risk. Additional studies suggest vape usage may negatively influence cardiovascular health, present risk of obstructive lung diseases, adversely affect brain development, and increase risk of chronic bronchitis and asthma in adolescents. E-cigs contain components that present potential risks for lung, stomach, bladder, and esophageal cancer. Additionally, studies shows a consistent link between current vaping and respiratory issues during adolescence.  Ongoing research of Electronic cigarette or Vaping product use-Associated Lung Injury (EVALI) shows symptoms include shortness of breath, chest pain, cough, and airway obstruction. The initial case series of 98 EVALI patients in Wisconsin and Illinois had a median age of 21, with 26% of patients younger than 18. Health outcomes associated with youth exposure to nicotine in vapes are described in the Nicotine and the Brain section of the Toolkit.

Appealing to Youth

Marketing of e-cigarettes as a “safer” alternative to cigarettes leads to misperceptions about the health risks they pose. Pediatric researchers describe how vapes have become a “gateway to initiate youths to first tobacco use, due to the misperception of the threat among adolescents and caregivers.” Galderisi et al. further discuss youth-targeted marketing of e-cigarettes (translated from Italian):

“The misperception of vaping among adolescents, as the new trendy harmless commercial distraction, originates from an aggressive marketing strategy relied [sic] on media and social networks, whose primary audience is embodied by the adolescents. Despite claims that e-cigs are for adults only, evidence showed that manufacturers actively targeted young people, youth are initiating at younger and younger ages, [and the majority] transition to smoking combustible cigarettes.”

Additionally, research suggests the availability of enticing vape flavors plays a role in youth vaping uptake, continued use, and perceived addiction. According to a 2019 study of 1,492 current e-cigarette users:

  • Flavor was a reason some users initially tried and continued to use e-cigarettes.
  • Most e-cigarette users typically used flavors other than tobacco flavor.
  • Typical flavors included fruit, mint/menthol, sweets, candy, coffee, and others.
  • Satisfaction was greater among users of flavored versus non-flavored e-cigarettes.
  • Perceived addiction was also greater among users of flavored e-cigarettes.

This information is particularly troubling considering the thousands of currently available vape flavors, including options such as “bubble gum,” “milk and cereal,” “grape soda,” and flavors that mimic existing sweets brands (e.g. “Watermelon Sour Patch,” “Snickers,” and “Oreo”).

Who Should Use This Toolkit and Why?

This toolkit is intended for anyone interested in evidence-based youth vaping prevention, education, and cessation supports. For ease of navigation, the resources compiled within this toolkit are organized into two main “stakeholder” sections: one for educators and other health professionals (e.g. school administrators, teachers, social workers, LADCs/SAPs, community health professionals), and one for caregivers (e.g. parents, guardians, families) and students.

Editors Note: Article comes from the introduction to the Toolkit and all data sources are available by downloading the Toolkit.

Lebanon Library Partners for Opioid Overdose Prevention

This article first appeared in the Lebanon Times, Winter/Spring 2023 edition ( Reprinted with permission.

Opioid overdose response training session at Kilton Library in West Lebanon

Opioid Overdose Prevention partnership between Dartmouth-Health and Lebanon Public Libraries, By Charlotte Atkinson

Here in the Upper Valley, we are very lucky to have access to a wide range of resources, especially those that are found in unexpected places. The Lebanon Libraries are of course known for the literary resources that they offer, but now, the library has also become a destination for those who are most in need within our community.

A partnership between Dartmouth Health and Lebanon Public Libraries transpired from a direct need that the library staff found themselves facing on three separate occasions, during which a series of drug overdoses occurred outside of the library building. Both libraries—Lebanon Library and Kilton Library—are located near a frequently used Advanced Transit bus stop, so when these incidents arose, library staff didn’t know how to best handle the situation in this public setting.

Library Staff Trained on Overdose Response

Lauren Chambers, senior community health partnership coordinator for Dartmouth Health

Lauren Chambers, the senior community health partnership coordinator for Dartmouth Health, stepped in to train library staff firsthand on how to respond to a drug overdose situation. Chambers, who works with community partners to increase awareness of and access to substance use disorder services, puts a focus on care for affected individuals from prevention through recovery.

There were no fatalities during the incidents at the Lebanon Library, and EMTs and Lebanon Police were quickly on the scene, though one victim suffered a fatal overdose during a later incident. After the incidents, library director Amy Lappin prioritized giving library staff the opportunity to receive firsthand training from Chambers. Training included demonstrations for the administration of a life-saving medication, known as “Narcan”, in the form of a nasal spray. Once administered, Narcan does nothing to further harm the victim of a drug overdose.

The library staff welcomed the training, and Lappin emphasized that the Narcan administration process is surprisingly, “so simple!” Chambers has returned to the library twice for staff training sessions, and now Lebanon Public Libraries will provide regular opioid-overdose response training, available for both new and long-term staff.

Naloxboxes Provided to Libraries

Narcan, the brand name for the medication Naloxone, is commonly used to reverse or significantly reduce the effects of opioids on the human body. The effect of Narcan, which helps counter shallow breathing, is felt within roughly two minutes of its administration. The medication blocks the effects of opioids for up to 90 minutes, and multiple doses may be required afterward. Usually, the victim can be shocked and are not thinking rationally when they come back into consciousness.

In one instance that Lappin witnessed, a man who appeared dead and who was administered Narcan by EMTs simply got up from the scene and got on his bus, refusing further medical treatment. Now both libraries offer ‘Naloxboxes’ provided by Dartmouth Health, which provide the medication publicly and discreetly with no questions asked. Basic hygiene kits are also available, provided by UV Gear—another organization that supplies donation-based items like tents, deodorant, socks, wipes, and sleeping bags at no cost for the growing number of unhoused individuals in need within our community.

Naloxbox and Narcan provided to the Kilton Library by the HIV/HCV Resource Center. Naloxbox and Narcan provided to the Lebanon Library by Dartmouth Health. — Clarification from Lauren Chambers

“People are hurting…addiction is definitely an issue here,” Lappin said. “We want to help however we can. Libraries are about providing whatever resources our community needs and so we do that. There is just a huge need for a variety of things and we are trying to do our part to help people.” The library is now installing lockers on their facilities for access to essential supplies available 24/7, including access to a porta potty located outside of the building.

This program, with funding from the NH Dept. of Health and Human Services and Bureau of Drug and Alcohol Services (BDAS), provides vital resources for the community, helping to equip at risk or concerned individuals with critical tools that can save lives. “People can and do recover when they are connected with the appropriate care and resources and have a support network in place,” Chambers said. “By installing Naloxboxes in community spaces—visible to all—it sends the clear message that that community, business, or organization cares about its residents/patrons and feels strongly that providing access to this life-saving tool is critically important.”

“The drug epidemic is real, and people need help regardless of what somebody in the community thinks about that,” Lappin said. “Nobody wants to watch somebody die in front of them. The overdoses that the librarians and I had to witness, it’s a horrific thing to watch and it’s even more horrific to feel helpless in it.”

Lebanon Public Libraries and Dartmouth Health make it a point to be present as a resource for the community in ways that are needed the most. Whether checking out a library book, taking the bus, or accessing a life-saving tool such as Narcan, the libraries serve a variety of needs without our community, without a hint of judgement.

Support for Kinship Caregivers

Many lives have been devastated as the opioid crisis has created ripple effects through communities and families. Many parents and family members of people affected by addiction have altered their lives to care for their loved-one’s children. We refer to these people as Kinship Caregivers. Various resources are available to support these Kinship Caregivers as they step into roles they had not expected to fill at this stage of their lives.

New Hampshire Children’s Trust and New Hampshire’s network of Family Resource Centers have partnered to support kinship families through the statewide Kinship Navigation Program.

Upper Valley Kinship Navigator

In the Upper Valley, Waypoint Family Resource Center provides the Upper Valley with services that are “community-based and designed to strengthen and support the wellbeing of kinship caregivers, children, and their families. The program is free, voluntary, and confidential and links kinship caregivers with state benefits, community resources, information and referrals, and offers supports such as food assistance, gas to get to appointments, school supplies, legal aid, additional financial assistance, and much more.” (From New Hampshire Children’s Trust website)

Step Up Parents Fills Financial Gaps for Kinship Caregivers

Step Up Parents began operation in 2019, inspired by close personal friends of the founder who were raising their granddaughter while caring for their daughter who struggles with substance use disorder. Their daily emotional and financial challenges were daunting, and there seemed to be little in the way of available resources. They were not alone in their struggles. With the explosion of the opioid crisis, there are thousands of “kinship” families in New Hampshire. No one plans on raising a second, sometimes third, family. What began as a call to action to help one New Hampshire family is now a safety net for kinship caregivers throughout the state. Step Up Parents is dedicated to supporting and honoring these everyday heroes, preserving their dignity and stability, and responding to their families’ immediate needs.

Step Up Parents offers financial assistance to New Hampshire grandparents and other relative caregivers who have stepped up to raise the children of parents struggling with substance use disorder. They fill gaps in household budgets and respond to a family’s immediate financial needs. By assisting caregivers who are raising children deeply impacted by parental addiction, they give more than monetary support— they give hope and remind the caregivers that they are not alone. Step Up Parents destigmatizes substance misuse and provides a safe forum in which caregivers can ask for help.  Step Up Parents believes that “even heroes need a hand.”

How to Apply for Support from Step Up Parents

People may apply directly or a social worker or case worker may apply on their behalf. Typically, Step Up Parents responds to an application within 24 hours. They try to make funding decisions and distribute within 48 hours. They do not give money directly to families but pay vendors and service providers directly on their behalf or supply a gift card for requested items.  For more information, please visit, call 603-319-4739, or email