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.

Student Interns Get Real-World Public Health Training

Emma Hartswick '17,

For the past 18 months, Emma Hartswick, one of the student interns profiled in this article, has worked with the Public Health Council as an Upper Valley Social Entrepreneurship Fellow from the Dartmouth Center for Service. She has been a real asset to our work and we look forward to having her back on staff after what sounds like a wonderful summer in Boston. — Alice Ely

Article Written By Charlotte Albright (Used with Permission)

Twelve students spent the summer in Boston on the front lines of public health. As participants in a 10-week program sponsored by Dartmouth Center for Service in partnership with Dartmouth Partners in Community Service, they interned in community health centers and other nonprofit organizations, serving the city’s most vulnerable populations—people living on the streets or in shelters, refugees, and low-income families.

“All of our internship programs seek to develop leaders capable of meeting social challenges in either the public or private sector,” says Tracy Dustin-Eichler, the assistant director for nonprofit careers at the Center for Service. “Boston is a hotbed for innovative solutions to pressing health care problems.”

Learning How to Help

Intern Emma Hartswick ’17 began most workday mornings at a foot clinic run by Boston Health Care for the Homeless in St. Francis House, a daytime shelter that offers a wide range of social services. Interns and local nursing students do triage, caring for tired and damaged feet, which can flag more serious health problems that might otherwise go undiagnosed—especially in homeless people.

In a small, windowless room with a few chairs, soaking basins, and a supply cabinet, Hartswick greeted clients and posed a few basic questions—names, ages, health issues—before offering socks, anti-fungal foot powders, and soothing  creams.

A middle-aged man limped in, sat down, took off his shoes, and soaked his feet in a basin as Hartswick rummaged in a drawer for white cotton socks. He said it was exhausting, walking the streets of Boston in all kinds of weather, using a cane.

“They help take care of my feet here,” he explained. “They take my blood pressure, too, and I appreciate the kind words they have to say.”

Hartswick also worked in two other community health clinics, doing intake assessments and providing child care for patients.  A sociology and biology major, she’s thinking of attending medical school and is considering a master’s degree in public health.

“I am really interested in the social determinants of health, in the intersection of somebody’s life circumstances and their overall wellbeing,” Hartswick says. She often chats with homeless people as she walks through Boston Common to St. Francis House. “People assume they are unemployed, but a lot of them are working—they just can’t afford housing,” she says.

Connecting Students and Alumni

In addition to placing students in clinics, the Center for Service connects them with Dartmouth alumni working in medicine. Each intern is paired with an alumni mentor. Once a week, the 12 interns, who lived in dorms rented from Boston University, gathered for a dinner seminar, either to make presentations and share stories about the places where they are working, or to listen to a talk by a leader in health care or public policy.

“Local alumni are key co-educators with us in this program,” says Dustin-Eichler. A larger alumni group, called Dartmouth Partners in Community Service, provides funding and mentoring connections for this and other internship programs.

In a downtown office building one warm night, the interns met Joshua Greenberg ’86, vice president of government relations at Children’s Hospital, and Jay Gonzalez ’93, the CEO of CeltiCare Health Plan. Both men have been forceful advocates for broadening access to affordable health care in Boston.  Gonzalez served as budget chief for Massachusetts during the governorship of Deval Patrick, chairing the board of Health Connector, which was a model for the Affordable Care Act. He traces twists and turns in his career path, advising interns to consider public service.

“If you have the chance to work in government,” he advised the students, “do it. And if you can prove you can take on any responsibility, you will get it, and then some. The opportunity to really have an impact on people in the public sector is unlike anywhere else.”

Seeing Policy in Practice

Some of the interns are more interested in health policy than in hands-on care. For example, at DotHouse Health, in Dorchester, Arvind Suresh ’19 and Yingna Wang ’17 updated patient and provider lists. They also worked on an app to help patients find social services.

The interns shadowed doctors, which, for Wang, was eye opening, especially regarding the impact electronic medical records are having on medical practice.

“I think it’s really important for policy people to understand what doctors do on a daily basis, and I will take that understanding with me as I pursue a career in public health,” Wang said.

Suresh gathered data about a device being used on a trial basis to determine an infant’s height. As each baby lay on a tabletop measuring board, Suresh watched a nurse use sliders to mark the head and feet. He was trying to learn whether this method is more accurate than the clinic’s current practice of using markers and paper to measure babies.

“I am learning so much about public health from different perspectives. We’re also seeing what are the most important issues that we can take on in the future,” Suresh says.

That future will present challenges as public health care workers try to meet the needs of an increasingly diverse population. About one-third of the clients at DotHouse are of Vietnamese descent. There are also many Spanish speakers.

“Providers here are very aware of language and cultural barriers to health care,” said Wang. She and Suresh made sure that the practical tips about health and wellness they post on waiting room bulletin boards get translated into several languages.

For Suresh, managing that flow of multi-lingual information has deepened his understanding of the challenges patients in this clinic face—not just health problems, but other issues, like housing and employment, which affect their wellbeing.

“It’s extremely interesting to see how everyone here needs to think about all the things that other people need and prepare for that every day,” Suresh says.

The full list of summer community health interns:

  • Yingna Wang ’17, DotHouse Health
  • Aneeq Chaudhry ’19, Health Resources in Action
  • Daniel Finch ’17, East Boston Neighborhood Health Center
  • Emma Hartswick ’17
  • Arvind Suresh ’19, DotHouse Health
  • Wafaa Ahmed ’17, Codman Square Health Center
  • Angela Liu ’17, Baraka Community Wellness
  • Allessandra Ledoux ’17, Codman Square Health Center
  • Noah Manning ’17, Health Leads
  • Allyson Block ’19, East Boston Neighborhood Health Center
  • Amrit Ahluwalia ’19, The Boston Living Center
  • Margo Putnam ’19, The Women’s Lunch Place

Editor’s Note: Charlotte Albright is a writer in the Dartmouth College Office of Communications. This story was originally published on Dartmouth News, the college’s news website. The photograph is by Robert Gill, who also works in the Communications Office.