Naloxone in NH (& the Upper Valley): Anyone. Anytime.

(Reprinted with permission from the NH Bureau of Drug and Alcohol Services Monthly Brief, February 2017. Adapted to include information from the Upper Valley Public Health Region.)

NaloxoneFor thousands of Granite Staters the opioid overdose-reversing medication naloxone (commonly called Narcan) has literally meant the difference between life and death. This life-saving medication has prevented people from making a deadly mistake, and provided them an opportunity to recover from addiction.

In 2015, the State ordered 6,000 naloxone kits to help combat the opioid crisis. These kits were provided free of charge to anyone without the means to pay for naloxone and were distributed through the state’s 10 community health centers, three additional clinics, and regional community events coordinated by the state’s regional public health networks. In June 2015 DHHS launched a survey of partners who received kits, designed to get feedback about distribution. To learn more about how naloxone has been distributed throughout the State and it’s impact, please see the Executive Summary.

The Bureau of Drug and Alcohol Services has worked diligently to expand access to the medication. Working with a broad coalition that included the Division of Public Health Services, the Emergency Services Unit, and the Bureau of Emergency Medical Services at the Department of Safety, the state has distributed free kits for individuals unable to afford the kits. Many people are alive today because of the dedication of first responders, Regional Public Health Network staff, and concerned citizens.

Available Through Pharmacies and Physicians
Many pharmacies across the state now have standing orders, which means naloxone kits may be purchased without a prescription at more locations. In addition, any physician or licensed prescriber may write a prescription for naloxone, even if individuals are not clients. Individuals are not required to indicate whether they need the medication for themselves or a loved one, and they may ask for more than one script.

How Can You Access Naloxone?
The bureau recently completed a short booklet called Naloxone in NH outlining the ways people can access the medication. We urge you to share this document with anyone who might be at risk for an overdose.

In the Upper Valley, Aita Romain, of the All Together Coalition and Dartmouth-Hitchcock Community Health, has led the charge to provide training and naloxone kits to individuals and businesses who request them. In partnership with the HIV/HCV Resource Center and HALO Educational Services, Aita has provided training and over 100 kits to local businesses like Molly’s and Jesse’s Restaurants, Peanut Auto, Fore-U, and Trumball-Nelson, and at community events. She has also provided training and kits through agencies such as Listen Community Services, WISE, and the Perinatal Addiction Treatment Program at Dartmouth-Hitchcock. There are plenty of kits to distribute in the Upper Valley. Please contact Aita  if you want to arrange a training or want additional information.

To sign up to receive the BDAS Monthly Brief, please go to: BDAS Monthly Brief

PHC Grateful for Flu Clinic Help

Dr. BoyleWe are extremely fortunate that the Upper Valley has many people and organizations who work together to make our communities healthier and better places to live, work, and play. With help from many parts of the community, the Public Health Council of the Upper Valley, the largest and broadest coalition of people and organizations that address public and population health issues in our region, hosted four community-based, free flu vaccine clinics this Fall. Between September 29 and October 27, these clinics provided flu vaccine to 836 adults from across our region, and exemplify the great things we can accomplish when we work together.

On behalf of the Public Health Council’s Board of Directors, we want to thank all those who made our flu clinics possible, especially Dartmouth-Hitchcock Medical Center, which donated the vaccine and supplies for the clinics, and the medical students at the Geisel School of Medicine at Dartmouth who volunteered their time to administer the shots. We also want to thank the volunteers from Plainfield’s Caring Neighbors and the communities of Enfield, Canaan, and Orford where the clinics took place. Many members of our Board of Directors and friends of the Public Health Council also stepped forward to volunteer. Finally, we want to express our sincerest gratitude to Dr. Bill Boyle, who has championed these flu clinics for the past six years. His hard work to pull all the partners together, including colleagues like Drs. David Beaufait, Peter Mason, and Joe O’Donnell, who provided medical oversight at the clinics, is a testament to the huge benefits of collaboration.

The Public Health Council is a dynamic organization with the flexibility to forge solutions that respond to the needs of its grassroot members. Organizations, professionals, and citizens come together through the Public Health Council to support what our communities need and want. The Public Health Council operates with funding and support from local towns, private donors, foundations, the State of NH DHHS, Alice Peck Day Memorial Hospital, and Dartmouth-Hitchcock.


Julia Griffin, Chair, Public Health Council Board of Directors
Alice Ely, Executive Director

MVHI Now Part of the Public Health Council of the Upper Valley

thumbnail_alice_ely_08-2Lebanon, NH — On October 19, 2016, the Mascoma Valley Health Initiative (MVHI) became part of the Public Health Council of the Upper Valley. “This change makes the organization stronger and will help us fulfill our mission of making Upper Valley communities better and healthier places to live,” said Alice Ely, who now becomes the Executive Director of the Public Health Council, served as the Executive Director of MVHI and the Coordinator of the Public Health Council for the past six years.

“The Public Health Council is a truly innovative partnership that brings together leaders in public health, community organizations, and health care providers to forge solutions that require a broad and diverse coalition,” said Greg Norman Director of Community Health, Dartmouth-Hitchcock. “I’m excited that this change will help them more effectively aid communities that we serve.” Dartmouth-Hitchcock and Alice Peck Day Memorial Hospital have been instrumental is shaping and supporting this model of shared public health leadership and community health improvement.

Prior to this point, MVHI and the Public Health Council shared staff members and mission elements, but differed slightly in their areas of focus. The Public Health Council currently serves 12 communities in New Hampshire and 22 in Vermont. “People from Vermont who wanted to collaborate with us often wondered if they could take part given the New Hampshire focus of ‘Mascoma Valley,’” said Ely. “So, while the answer has always been a most definite ‘yes,’ we want to make it even clearer that we are serving the whole of the Upper Valley and both sides of the Connecticut River.”

MVHI started in 2001, serving five Mascoma Valley towns. When Alice Ely joined in 2010, the mission had already expanded greatly with new contracts, programs, and an extended service region of 13 towns, indicating a name change might be appropriate. “The Public Health Council and MVHI have played critical roles in improving the lives of our citizens, and I expect to see even more progress in the coming years as we continue to work together,” said Mike Samson, Town Administrator, Canaan, New Hampshire.

“The name ‘Public Health Council of the Upper Valley’ better describes what we are doing,” said Ely. “For members and potential partners, this clarifies who we serve, where we already have influence, and where we expect to have more of an influence in the future.”

While the name is changing, the Public Health Council will continue to support initiatives previously established under the MVHI umbrella including the Mascoma Valley Prevention Network and the popular Upper Valley Flu Immunization Clinics. The next meeting of the Public Health Council is Friday, October 20, 2016 from 9:00 to 11:00 am at Hypertherm, 71 Heater Road in Lebanon, New Hampshire.

Finding a Path to Affordable Prescription Medications

doctor-woman-public-health-council-webThe Public Health Council, in partnership with Dartmouth Hitchcock and Alice Peck Day Memorial Hospital are excited to announce the availability of “Finding a Path to Affordable Prescription Medications: A Resource Guide.” This tool will help individuals and their trusted health advocates develop a plan for getting the medications they need at a reasonable cost.

The frontiers of science seem to expanding every day, and now more than ever before, our health care system can offer life changing and life saving medications. However, the cost of prescription medications is also on the rise. This spring, a report from IMS Health found that the list price of drugs increased 12 percent in 2015, which is in line with a 5 year trend of increasing cost. Insurers and pharmacy benefit programs still demand deals from drug manufacturers, which decreases a drugs effective cost. In fact, the net price growth – what insurance companies or employers actually pay, has only risen 2.8 percent. However, the burden of increasing drug costs is felt most by those least able to pay. Uninsured people often are asked to pay the full list price, and even insured individuals are required to pay a significant percentage of the list price. Notably, cost exposure (in the form of co-pays and pharmacy deductibles) for patients with commercial insurance has increase over 25 percent since 2010.

If you or someone you know is struggling to pay for your prescription medications, you are not alone. The PHC heard from community members and providers alike that the financial burdens of prescription medications were impacting the health and well-being of the Upper Valley. Additionally, we heard from healthcare providers and social service organizations that, though there are many potential solutions for someone who has unaffordable medications, sorting out the best options for that individual is a challenge in itself. Certain programs may be especially helpful for one class of medications, but not others. Some are only available in one of the states in our region, and others have specific eligibility requirements.

To address these challenges, the PHC set out to sort through the various resources that can help someone pay for their prescription medications. We compiled information on national, state and regional programs to find the best tools available in the Upper Valley. We also spoke with community health care and social service organizations to learn from their expertise – we asked, what programs were they using, who could access them, how does someone decide what is best for their needs and where are the gaps?

The result is “Finding a Path to Affordable Prescription Medications: A Resource Guide.” This tool is intend for case managers, community health workers, community nurses, clinicians, and others to use in partnership with someone who is having difficulty paying for their medications. It begins with a self-assessment to help the health advocate and the individual determine their needs and their options. Then, it offers resources that include local provider programs, community supports, insurance options, medication assistance programs and pharmacy programs. Finally, it outlines a planning tool for the individual and advocate to use to identify short term and long-term strategies for making medications affordable. You’ll find this guide out in the community soon!

2016 Free Flu Vaccine Clinics

Mascoma Valley Health Initiative (MVHI) and the Public Health Council of the Upper Valley are pleased to offer four FREE flu vaccine clinics in September and October this year. Annual influenza vaccination provides powerful protection to yourself, your family members, and all the people you come in contact with throughout the “flu season.” Many people agree that getting a flu vaccine is valuable, but getting around to it can be tough.

Trying to Make it Easy
We want to make it easy for you and your family members to get a flu vaccine this year. All New Hampshire and Vermont residents age 10 and older are welcome at the clinics listed below.

Please note that most public schools in the New Hampshire portion of our region offer flu vaccine clinics during school hours in the fall. This is the easiest place for your children to receive the vaccine. This year school clinics will only offer injectable vaccine. Because the CDC has determined the nasal vaccine has not been as effective as the injectable form, you are not likely to find it being offered anywhere.

Schedule (For printable details and a list that includes four free vaccine clinic opportunities at Dartmouth-Hitchcock, click here.)


Dr. Boyle responds to questions about flu vaccine at the October 2015 flu clinic in Enfield.

Plainfield (Elementary School)
Thursday, September 29 from 4 to 7

Orford (Congregational Church)
Thursday, October 13 from 4 to 7

Enfield (Community Building)
Thursday, October 20 from 4 to 7

Canaan (Canaan Hall)
Thursday, October 27 from 4 to 7

What vaccines are being offered?
All of the clinics listed are offering both the regular dose vaccine and the high-dose vaccine, which is recommended for people age 65 and older. All vaccines are preservative-free.

It’s a collaborative effort!
We are grateful to the many volunteers who make these flu clinics happen each year. Thanks to the efforts of MVHI’s Medical Director, Dr. Bill Boyle, Dartmouth-Hitchcock donates the vaccine (well over 1,000 doses) and all the supplies. Students from the Geisel School of Medicine at Dartmouth come to administer the shots. MVHI Board members and community volunteers help us keep things moving. Please contact Alice Ely if you would like to help.