Lebanon Library Partners for Opioid Overdose Prevention

This article first appeared in the Lebanon Times, Winter/Spring 2023 edition (www.thelebanontimes.com). 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 www.stepupparents.org, call 603-319-4739, or email info@stepupparents.org.

Announcing New Position: Integration Catalyst for GUVIST

March 2023 Update: We are pleased to report we have filled this position. Please read on to learn more about this new role.

The Public Health Council has entered into a Memorandum of Agreement to serve as Fiscal Sponsor for the Greater Upper Valley Integrated Services Team and will be the employer of record for the Integration Catalyst.

What is an Integration Catalyst?

The Greater Upper Valley Integrated Services Team (GUVIST) seeks an Integration Catalyst to guide our efforts to integrate services among our constituent member organizations in the bi-state Upper Valley region. The Integration Catalyst will use Collective Impact principles, network analysis results, and evaluator recommendations to facilitate integration.

The Catalyst will start with a focus on the early childhood sector, facilitating service delivery integration within a network that has already started this work. The Catalyst will use learning from the early childhood sector work to develop an integration model for replication in other sectors. The Catalyst will lead replication with GUVIST guidance.

The position will also support the GUVIST Executive Council and broader network, helping to implement functional growth and development. The Catalyst will work closely with two other regional positions, to ensure GUVIST’s collective decision-making, practice, and accountability are equity- and data-driven.

This position is full time and grant-funded for 3 years, with employment through the Public Health Council of the Upper Valley. This position will be hybrid (remote and in-person) as local presence will be important for certain aspects of the job.

Who are GUVIST and the Public Health Council?

GUVIST is a cohesive and diverse group of health and human services providers serving the communities of the Upper Valley region of Vermont and New Hampshire, with leadership from an Executive Council. GUVIST considers innovative and effective ways of addressing issues of health and wellbeing in our communities. We host monthly meetings to explore holistic and integrative approaches to wellbeing, organize subgroups of members and partners for targeted projects, and promote the use of collaborative work at all levels of decision making and service provision. The Public Health Council of the Upper Valley (PHC) is a broad coalition of community leaders and representatives from many community sectors. These partners work together to create a healthier, safer, more supportive, and vital Upper Valley. PHC members work together to set regional health priorities, provide guidance to regional public health activities, and ensure coordination of health improvement efforts. In the Upper Valley, the PHC leverages and coordinates existing and new resources to address priorities. The Public Health Council has entered into a Memorandum of Agreement to serve as Fiscal Sponsor for this grant and will be the employer of record for the Integration Catalyst.

How does the Integration Catalyst make a difference?

The GUVIST Integration Catalyst will make a difference in our communities by managing all aspects of a Service Delivery Integration workplan, including:

  • Improving client experience
  • Integrating service delivery
  • Building collaborative performance
  • Promoting measurable systems change

The position is funded by a 3-year grant provided by the Couch Family Foundation.

It’s Here! Upper Valley Project Funding to Address Health Inequities

The first round of projects under the Upper Valley Community Health Equity Partnership have been selected.

In October 2022, the Upper Valley Community Health Equity Partnership  (UVCHEP) sought proposals from local entities in the White River Junction District of the VT Department of Health who seek to reduce health disparities the UVCHEP Steering Committee has described in the Problem Statement:

Black, Indigenous, and People of Color (BIPOC) as well as Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual and plus (LGBTQIA+) community members have higher levels of mental health challenges and substance use disorder, diagnosed and undiagnosed. These conditions are both caused by and contribute to isolation, other chronic health conditions, and not feeling safe.

We invited applications for projects that could be completed in the 7-month time frame of this grant period, ending May 31, 2023, and that address the Root Causes of the health disparities mentioned above. We awarded grants ranging from $5,000 to $28,000 and have a total pool of $150,000.

A summary of funded projects will be posted in January 2023.

More Equitable Grantmaking:

Our goal is to reduce the barriers that traditionally prevent groups and organizations most closely connected to the people who experience health disparities from getting funding and other resources to address health disparities in their own communities.

How was this application process more equitable and accessible?

  1. Eligibility requirements have been set to create as few barriers as possible for informal, small, and new entities to apply.
  2. We accept applications in several different formats.
  3. The application was intended to be short and simple. We estimated it would take about 2 to 4 hours to complete once you have developed a clear idea of what you want to propose.
  4. We provided several options to learn more about the application and get your questions answered. This included live Webinars with recordings available online and “Office Hours” with our Equity Facilitator.
  5. If you needed support completing the application, someone from the Steering Committee would help you.
  6. While the grant program is based on reimbursing grantees for actual expenses, and not providing grant funds at the beginning of the award, the Public Health Council (PHC) will provide up to 10% of the total award to grantees at the beginning of the award. PHC will also work with grantees on a case-by-case basis to address cash flow concerns for large grant expenses.

Who was eligible to apply?

Eligible Applicants were those who could demonstrate a clear and convincing plan to address concerns raised in the Problem Statement above, especially with projects that address one or more of the identified Root Causes.

  • Individuals
  • Grassroots Organizations (If you need a Fiscal Sponsor, we will help you find one.)
  • Nonprofit Organizations
  • Businesses
  • Federally (and non-federally) recognized Native American Indian tribes and Alaska Native entities
  • Governmental Entities
  • Funding can support organization(s) not located in VT, as long as they serve people in the White River Junction District of Vermont and can demonstrate ability to address the Problem Statement.

To learn more about how applicants were supported?

RFP Webinar Series:

Tuesday, October 4, 2022                          Health Equity Grant Purpose & Eligibility Requirements
6:30 to 7:30 pm                                            Recording Link: https://youtu.be/HOhbJmtF_4w

Thursday, October 6, 2022                        Health Equity Grant: Completing the Application
6:30 to 7:30 pm                                           Recording Link

Tuesday, October 11, 2022                       Health Equity Grant: Developing a Budget
6:30 to 7:30 pm                                           Recording Link

Questions: Contact Alice Ely

Please note that we may find it necessary or beneficial to post corrections, clarifications, or responses to frequently asked questions. These updates will be posted on this webpage, so please check the page periodically to ensure you have the most up to date information.

2022 Community Flu Vaccine Clinics

Each fall, partner organizations across the Upper Valley come together to provide seasonal flu vaccine to our community members. This year is no exception.

While the COVID-19 pandemic still impacts our communities, protecting people from seasonal flu illness is very important. Many experts predict we will see significant flu transmission this season.

There are numerous options for vaccination. Please use the information below to find the right vaccine option for you and your family.

This list DOES NOT include school-based seasonal flu vaccine clinics offered in many of our New Hampshire schools. This is because these clinics are reserved only for students of those schools. If your child has the opportunity to get a vaccine in one of these school-based clinics, we encourage you to sign them up.

Public Health Council & Dartmouth Hitchcock Hosts Series of Community Flu Clinics

Starting on Saturday, October 1, the Public Health Council, Dartmouth-Hitchcock, Geisel School of Medicine and other partners will host free seasonal flu vaccine clinics in communities around our region. Clinic details are below:

Geisel Medical Students providing flu vaccine in Bradford, VT, October 2021. Photo credits to Bill Secord.

Saturday, October 1
10 am to 1 pm
Plainfield Elementary School, 92 Bonner Road, Meriden, NH
Walk-In, No Reservation Required, Free, See other guidance below.

Thursday, October 13
3 to 6 pm
La Salette Shrine, Rte 4a, Enfield, NH
Drive Thru, No Reservation Required, Free, See other guidance below.

Saturday, October 15
10 am to 1 pm
Orford Congregational Church, 617 NH Rte 10, Orford, NH
Walk-In, No Reservation Required, Free, See other guidance below.

Wednesday, October 19
3:30 to 6 pm
Oxbow High School, 36 Oxbow Drive, Bradford, VT
Drive Thru, No Reservation Required, Free, See other guidance below.

Friday, October 28
4 to 7 pm
Mascoma Community Health Center, 18 Roberts Road, Canaan, NH
Walk-In, No Reservation Required, Free, See other guidance below.

PHC Vaccination Clinic Guidance
  • Offering regular dose vaccine and enhanced vaccine for people 65+. We will NOT be offering COVID-19 vaccines at these clinics.
  • Please practice social distancing for both drive thru and walk-in clinics.
  • Everyone will be required to wear a mask. A mask will be provided for you if you do not have one.
  • Please do not come if you are experiencing symptoms of COVID-19.
  • Please do not arrive more than 15 minutes prior to the start of the clinic.

Other Flu Vaccine Options in the Upper Valley

Dartmouth Health

Dartmouth-Hitchcock will also be offering numerous flu vaccine clinic options for Dartmouth Health patients at various locations at the Medical Center this year. Please go to their Lebanon Flu Clinic Schedule webpage for details. Many of these clinics are drive thru and a few are walk-in. Reservations are required. If you are a DHMC patient and use myD-H.org to make an appointment. If you do not use myD-H, you may call the Flu Hotline at 603-653-3731.

When you schedule your appointment, please have your insurance card ready. If you carry health care insurance, we will bill your carrier at no cost to you. For individuals who do not have any health insurance, we will be providing flu vaccines free of charge. Please contact the Flu Hotline for more information.

Visiting Nurse and Hospice for VT and NH

Tuesday, October 11
9 am to 2 pm
Thompson Senior Center, 99 Senior Lane, Woodstock
Walk-in clinics open to people age 18 and older. Limited number of enhanced doses available.

Tuesday, October 18
9 am to 2 pm
Bugbee Senior Center, 262 N. Main Street, White River Junction
Walk-in clinics open to people age 18 and older. Limited number of enhanced doses available.

Friday, October 28
9 am to 2 pm
Grantham Town Hall, 300 NH Rte 10, Grantham
Walk-in clinics open to people age 18 and older. Limited number of enhanced doses available.

Valley News

Many of these clinics will be posted to the Valley News Calendar, available online and in the print edition.

We wish all our Upper Valley neighbors a healthy and safe fall and winter!