Helps Start Discussions about Substance Misuse

April is Alcohol Awareness Month

Editorial Note: This press release is reposted with permission of the VT Department of Health. For more details of substance misuse prevention and related work in the Upper Valley, please visit Upper Valley All Together. The State of NH also hosts a very effective website, full of information and resources, at DrugFreeNH.

 BURLINGTON – The Vermont Department of Health wants people to know at least two key things about teens, drugs and alcohol: 1) All teens are at risk for substance misuse, and 2) Parents are the number one influence on their kids’ deciding to not misuse drugs and alcohol. To help families start the conversation and keep it going in a way that is meaningful to teens, the Health Department has expanded its web resource to include more interactive tools and how-to guides for parents and caregivers.

“We know kids are at risk for substance misuse, because they told us so,” said Barbara Cimaglio, deputy commissioner with the Vermont Department of Health. “Every two years, our Youth Risk Behavior Survey asks high school students about their risk-related behaviors. What we learned from the students is that in the month before the survey, 30 percent drank alcohol, 16 percent binged on five or more drinks in a row, and 22 percent smoked marijuana,” said Cimaglio.

The good news, she said, is that children who learn about the risks of drugs and alcohol from their parents are significantly less likely to misuse these substances. “Every parent needs to have these conversations with their kids, and it will make a difference,” said Cimaglio. “Solid research shows the number one reason students give for not drinking or using drugs is that they don’t want to disappoint their parents.” helps parents figure out how to have these difficult conversations with their children. “Every family is different, but the common element is that our kids look to us for guidance, whether we know it or not,” said Cimaglio. “The tools, tips and videos will give parents what they need to talk with their teen in a way that they will hear you.”

To view the videos and find all the tools for talking to your kids, visit

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Latest County Health Rankings Released

Grafton County, NH and Windsor County, VT featured in Robert Wood Johnson Foundation’s 8th Annual County Health Rankings

Lebanon, NH and White River Junction, VT– Grafton County and Windsor County ranked favorably in numerous categories according to the eighth annual County Health Rankings, recently released by the Robert Wood Johnson Foundation (RWJF) and the University of  Wisconsin Population Health Institute (UWPHI). Of particular note were Grafton County’s #1 rankings among New Hampshire counties for both clinical care and physical environment. For its part, Windsor County showed strength in its #3 ranking among Vermont counties for health behaviors such as smoking, physical inactivity. The County Health Rankings are available at

The Public Health Council of the Upper Valley is working with regional partners to positively address many of the health outcomes, health factors, policies and programs identified by the Rankings. Specific priorities are defined in the Upper Valley Public Health Region’s Community Health Improvement Plan and include:

  • Preparing for emergencies, including planning and exercising to quickly distribute medications to residents;
  • Impacting substance misuse by implementing evidence-based prevention programs;
  • Promoting healthy weight and relieving food insecurity; and
  • Improving oral health in the Upper Valley

“The information contained in the County Health Rankings report provides critical input to those of us working to effect positive change in population health outcomes.” said Alice Ely, Director of the Public Health Council of the Upper Valley. “Understanding our communities’ health disparities and what is working well allows the many partners of the Public Health Council to make smart choices about where to target efforts to improve health for all of our communities.”

For specific information about the work of the Public Health Council of the Upper Valley, visit their website at or email them at

For More Information: Emergency Preparedness

For more information regarding Emergency Preparedness efforts and how you can get involved through organizations like the Upper Valley Medical Reserve Corps, contact Wesley Miller at

For More Information: National Public Health Week

April 3–9 is 2017 National Public Health week; for more information visit

Transforming Behavioral Health Care Across New Hampshire

On January Region 1 Map25th, about 75 individuals came together from across Region 1 to kick-off the next five months of work to begin transforming behavioral health care for our Medicaid enrolled residents. Through hands-on, small group exercises, teams worked together to discuss opportunities, challenges and goals of our region as we partner in driving integration, improving coordination and expanding capacity. Shared themes emerged across all project team groups including an emphasis on patient-centered care, increased access, improved communication among providers and with patients, enhanced and embedded wraparound services especially housing and transportation, innovative technology solutions, care management roles, peer recovery coaches, and a progressive, proactive and positive culture. Thank you to everyone for their active engagement in this kick-off!

Our work in Region 1 is part of a statewide effort to address costly concerns about how our behavioral health and health care systems respond to our most vulnerable people. Widespread variability currently exists in the availability and accessibility of both general and behavioral health services, including those for substance use disorders, across the state of New Hampshire and especially for the Medicaid population.  Poor coordination among providers further inhibits availability of these needed services and treatments – even in those communities with sufficient resources.  As a result, patients and families struggle to schedule and keep convenient appointments; navigate among providers, offices and agencies; facilitate or ask for communication between providers; or receive all of the care they need in a timely manner.

Providers are often as frustrated as the patients and families; they find that the system makes it increasingly challenging for them to provide patient-centered care and fulfill their missions as care providers.

The State of New Hampshire, responding to a call to action, was awarded federal dollars (the Delivery System Reform Incentive Payment Medicaid 1115 Waiver – also known as the DSRIP Waiver) to improve behavioral health services across the state of New Hampshire for those insured by Medicaid.  The state has created seven regions through which these funds will be invested over the next four years, with some of the funds awarded only if care is improved.

Transforming Behavioral Health Care in Region 1

Region 1 consists of Sullivan County, the Greater Monadnock region, and the Upper Valley. The State intends these funds be used to redesign the delivery of care through the integration of behavioral and general health services, with a specific emphasis on helping patients with substance use disorders and serious mental illness.   Almost 50 agencies, including advocacy groups, public health advisory councils, housing agencies, municipal offices, clinical providers, substance use disorder centers and mental health workers, have united to create innovative solutions to address the systemic problems (both statewide and locally) that lead to poor health outcomes.  We hope the changes we make will, in turn, benefit the whole community, improving health for everyone and not just the Medicaid recipients.

The work is divided into several broad categories:

  • Integration of mental health and substance use treatments into primary care practices to provide one-stop care and comprehensive care plans –  making it easier to coordinate among clinicians and service providers
  • Development of a simple, confidential information system that allows for efficient flow of information among providers
  • Expansion of intensive substance use disorder treatments and services – availability and access
  • Improvement of care during transitions from hospital to community – ensuring patients do not “fall through the cracks” upon discharge
  • Education and training of a new group of mental health workers to help coordinate and manage care
  • Improvement of the care system for people with complex mental and physical disabilities
  • Creation of an alternative payment model to ensure coverage for all integrated services

Our communities currently face a health crisis; this grant provides the necessary support to find solutions.  Working together, as partners, we will meet this challenge by creating innovative paths to ensure all patients receive the right care at the right time in the right place. Together, we are transforming behavioral health care for all.

For more information about this initiative, see this article posted on the DHMC website in November 2016.

To contact initiative staff, you can reach out to Ann H. N. Landry, Executive Director, or Jessica Powell, Project Manager.

Upper Valley Smiles for Life Oral Health Program

Free Oral Health Screening For Adults

Smiles The Public Health Council of the Upper Valley received funding from Dartmouth-Hitchcock Community Health to launch an oral health pilot project. What is unique about this program, and the Ottauquechee Health Foundation’s Smiles Program, upon which it is modeled, is services are provided in community settings. The program is designed to provide a first touch-point for adults who do not have a regular dentist and who may not have a dental plan to help pay for dental care. The program is staffed by a licensed dental hygienist with extensive experience serving lower income clients. The hygienist is supervised by Dr. Christopher D. Baker, DMD. The staff also includes a coordinator who will also serve as a care coordinator, assisting clients who receive referrals to other services.

This project is a partnership between the Public Health Council, the Grafton County Senior Citizens Council, and Dr. Christopher D. Baker, DMD. Working through the Oral Health Working Group of the Public Health Council, this project coordinates with a similar project operated by the Ottauquechee Health Foundation in their region of Vermont and the Upper Valley Smiles school-based program operated by Alice Pack Day Memorial Hospital.

Upper Valley Smiles for Life provides preventative oral health screening, education, and fluoride varnish to adults. Services are provided by a licensed dental hygienist. This pilot program is available to all Upper Valley adults and will provide services at up to four Upper Valley locations between March and August 2017.

United Congregational Church,
Orford, NH

March 2, 2017

May 11, 2017

July 20, 2017

Upper Valley Senior Center,
Lebanon, NH

March 23, 2017

May 22, 2017

August 3, 2017

Mascoma Senior Center,
Canaan, NH

April 6, 2017

June 1, 2017

August 7, 2017

For more information, schedule updates, and to make an appointment, please contact Sally Edson at 603-448-1558 or

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