Overlap of flu and COVID-19 this winter worries Seacoast medical community

Read the full article here


By Karen Dandurant


PORTSMOUTH – Influenza and COVID-19 resemble each other in symptoms, and it is possible for people to contract both illnesses at the same time, so the medical community is urging everyone to get a flu vaccine to help minimize what could be a terrible season.

While there is no preventive measure yet for COVID-19, doctors say getting a flu shot has taken on an even stronger importance this year.

“We know the season will be bad,” said Dr. Travis Harker, chief medical officer at Appledore Medical Group in Portsmouth, and a family practice physician. “One thing we know for sure is that COVID-19 is most deadly when the system is overwhelmed. If we do not do all we can, our hospitals are going to be filled with cases of both illnesses.”

Dr. Kasra Djalayer, an internist with Greater Seacoast Community Health, which includes Families First and Goodwin Health, said the overlap of coronavirus and flu is concerning to many epidemiologists.

“Both can cause severe epidemic and can cause death,” said Djalayer. “That causes a double burden on the health care system. The risk of co-infections gets higher when two viruses are circulating in the same region. Anybody can get co-infected at the exact same time. Whatever happens, there is one important step people can take that may change the trajectory of either epidemic: Get the flu vaccine.”

“Even before the COVID-19 pandemic, receiving a flu vaccine each flu season has been highly recommended,” said Dr. Irene P. Rupp Hodge, an infectious disease doctor, and the medical director of Frisbie Memorial Hospital’s Center for Wound Care and Hyperbaric Medicine. “This certainly will remain the case for the upcoming flu season. By wearing masks, avoiding contact with people when sick, and utilizing the flu vaccine as recommended, this should reduce the spread of influenza this season, which will be a benefit to the public’s health in general and will free up resources to continue to combat the COVID-19 pandemic.”

Djalayer said influenza occurs in epidemics nearly every year. According to the Centers for Disease Control and Prevention, during the 2017-2018 flu season, 61,000 Americans died.

“Influenza virus is capable of changing its structure and genetic composition in a process called mutation,” said Djalayer. “Due to the high rate of mutation, it compromises our immune system to fight against the new virus. For this reason, new vaccines are produced every year in order to stimulate our immune system to fight against the influenza virus with new genetic composition. We need to vaccinate people every year because the immunity slowly vanishes during the year.”

Harker said the precautions being taken against COVID-19, masking, good hand hygiene and social distancing should help, even in preventing some flu cases, but he said he hopes people take the extra step and get the flu vaccination.

“One thing we know for sure is that the vaccination can help minimize the impact of influenza,” said Harker. “That might also help minimize the COVID impact.”

Martha Wassell, MPH, director of infection prevention at Wentworth-Douglass Hospital, said that even those people who might not have gotten the flu shot in past years should do so now.

“For whatever reason you didn’t in the past, now is the time to change your behavior,” said Wassell. “It’s the right thing to do for you and for those around you, especially if we do encounter the perfect storm of both illnesses striking at once.”

Wassell said to her knowledge a person with both viruses has not yet been seen, but she imagines it will be, and it will be bad.

“I would dread that day,” said Wassell. “I would assume this would overwhelm the person who is host to both illnesses.”

While the two illnesses can look very similar, Harker said testing can determine which illness a person is experiencing.

“We have set up protocols to manage both illnesses and do the testing for diagnosis,” said Harker. “Schools are going to pose a unique challenge this season and will have a low threshold for sending people home during this uncertain time.”

“They will need to use good judgment. It’s challenging, especially with young elementary school-aged children, who may not really understand the need for the precautions that are necessary. I have been impressed in my practice, seeing children as young as two, wearing a mask because they do not want to bring the illness home to grandma.”

Harker said Black and Latino populations are seeing five times the amount of COVID-19 cases as other populations.

“Black people represent four times the death rate, and Latinos, two times the death rate,” said Harker. “I think part of the answer is systemic racism, housing, and education opportunities, but that’s not the only reason. These populations are having a higher risk of comorbidities like diabetes and high blood pressure. COVID-19 is spread through the respiratory system, but it also attacks the blood vessels, so these comorbidities put them at a higher risk.”

Harker said it’s not too early to get the flu shot, and he said the shot is safe. It is too early to gauge the effectiveness of this year’s shot or how bad the season will be, according to Harker.

The CDC’s Advisory Committee on Immunization Practices recommends influenza vaccination for all individuals 6 months of age and older, for all healthy non-pregnant adults less than 65 years of age as well as for individuals over or at the age of 65. Patients with a history of Guillain-Barre Syndrome, who are pregnant or are immunocompromised, or have a history of egg allergy should consult their primary care doctor before getting the flu shot.

Harker said the population who cannot get a flu shot is small, but that if everyone else gets one, herd immunity may protect those people.

Djalayer noted flu shots are offered in many doctors’ offices, pharmacies, clinics, health departments as well as by many employers, and even in some schools.

“We need to be as ready as we can,” said Harker. “If things go south, we may need to lock down again. If we take the right steps up front, we may be able to avoid that and we can get through this upcoming very challenging season. If most people do the right thing, we should be OK.”

One more very important point, raised by Wassell, is people getting the flu shot and doing what they can to protect themselves and others could have an added bonus.

“It could help protect valuable resources we may need to deal with both illnesses,” said Wassell. “It can preserve space, beds, resources and staff we may need soon. If we can directly reduce the percentage of people getting the flu, we will be better able to handle whatever does come down the road.”

Goodwin becomes the first NH Community Health Center to host Family Physician Residents


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August 18, 2020, SOMERSWORTH – Goodwin Community Health has become the first Community Health Center in New Hampshire to serve as a professional outpatient home for a physician residency program.  The program is a result of a new partnership between Goodwin’s parent organization, Greater Seacoast Community Health and Portsmouth Regional Hospital’s (PRH) new Graduate Medical Education (GME) program.  PRH launched its new program on July 1, 2020, as an affiliate member of Tufts University School of Medicine (TUSM).

The program adds four physicians to the team of family medicine providers at Goodwin.  The resident physicians have completed medical school and will spend three years training at Goodwin, PRH and local specialty practices on the seacoast.

Joanne Buonomano, MD, FAAFP, CPE, Chief Medical Officer and Family Physician at Greater Seacoast Community Health, will be the site director and will supervise the residents together with a growing team of outside community physicians, including Dr. Robert Mathes and Dr. Deborah Harrigan.

“We are proud to be the first community Health Center in the state to expand access to patient care through a residency program,” says Dr. Buonomano.  “With a shortage of primary-care physicians in the state and country, we are honored to be selected by these talented new physicians.  We look forward to guiding them through the final step of their training. The announcement is an exciting one for the community and health system, as this residency training program will assist in bringing more doctors to the area, enhance the culture of learning and diversity  at Greater Seacoast Community Health locations, and foster improvements to patient care and the patient experience.’

The launch of the residency program expands Greater Seacoast Community Health’s distinctiveness among community health centers as a teaching environment.   In 2014 The Goodwin Community Health Dental Center began hosting dental students from both Tufts University School of Dental Medicine and University of New England College.

The resident physicians are Matthew Nagelschmidt, MD; Guillermo Obregon, MD; Wesley Phillips, MD; and Nisha Vanmali, MD.



Matthew Nagelschmidt, MD, earned his undergraduate and graduate degrees in Biomedical Engineering from the University of Connecticut, while also working for Medtronic’s Research and Development team (formerly Covidien Surgical Solutions). He then completed his medical training with Saba University, in the Caribbean






Guillermo Obregon, MD, was born and raised in south Texas and Nuevo Laredo, Mexico. He earned a bachelor’s degree in health education and a master’s degree in biomedical science from Texas A&M University. Dr. Obregon completed his medical education at Central Michigan University College of Medicine.






Wesley Phillips, MD, was raised in Southern Ontario Canada. Dr. Phillips attended Trinity School of Medicine in the Caribbean. He enjoys family medicine because of its integral role in community health and wellness.






Nisha Vanmali, MD, was born and raised in Richmond Hill, Ontario. Dr. Vanmali attended the University of Western Ontario in London specializing in Biology. She completed her medical degree at the Medical University of the Americas (Nevis).






About Greater Seacoast Community Health:

Greater Seacoast Community Health is a network of community health centers providing primary care, pediatrics, dental care, prenatal care, behavioral health counseling, substance use disorder treatment, mobile health services, WIC, social work services, a pharmacy, parenting classes, playgroups and home visiting. The network includes Families First Health & Support Center in Portsmouth, Goodwin Community Health in Somersworth, and Lilac City Pediatrics in Rochester. The Strafford County Public Health Network and SOS Recovery Community Organization are also affiliated with Greater Seacoast. Services are open to everyone and aim to be respectful, inclusive, recovery-friendly, LGBTQ-affirming and trauma-informed. For more information, visit GetCommunityHealth.org.

About Portsmouth Regional Hospital:

Portsmouth Regional Hospital is a 220-bed acute care hospital located in Portsmouth, NH. Portsmouth Regional Hospital serves the Seacoast region’s residents in New Hampshire, Maine and Massachusetts and is one of the area’s largest employers. Portsmouth Regional Hospital is the only ACS Verified Level II Trauma Center on New Hampshire’s Seacoast. Portsmouth Regional Hospital is the Seacoast’s only comprehensive heart and vascular program, and its only 24/7 neurosurgical and stroke clot retrieval programs. For more information about Portsmouth’s services and physicians, visit: www.portsmouthhospital.com.

How to ease children into this most unusual school year

Read the full article on Seacoast Online

By Karen Dandurant

PORTSMOUTH – While most school districts are beginning their year with remote learning, or some form of a hybrid model because of COVID-19, kids are searching for ways to deal with their new normal and the specialists say they might need help.

Children of all ages have not been in a classroom since March. They are grieving the loss of socialization, cut off from their friends, from sports and other extra-curricular activities that were a big part of their daily life.

Some are eager to return to school, while others are fearful and cautious. Child experts say the adults in their life need to recognize their feelings, and to learn new ways to talk with them about growing up in an unprecedented time.

Jodie Lubarsky is the Child, Adolescent, and Family Services Director at Seacoast Mental Health Center. She said kids are having a range of emotions, not the least of which are fear and grief, and one way to address this is to have conversations that are transparent and honest.

“Kids have grieved, and a second wave of grief is imminent,” said Lubarsky. “Kids have not been to school under the new guidelines and their classroom will not look like it did before. I think each grade will have its own differences in the ways it has to adapt. I think the process for a kindergarten student will be vastly different than that of a high school senior.”

Lubarsky said the adults should prepare for this second wave of grief. She said it is the caregivers who can help kids feel safe and comfortable.

Lubarsky said the Department of Education released guidelines, leaving the decision to each school district to decide how to structure their school year. She said educators want to teach, but must also learn a new way of doing it.

“There is no one size fits all, no right or wrong answer right now,” said Lubarsky. “What works for a small rural school may not work for a large urban school. Parents need to be comfortable with their own decision and not worry about how others perceive their choices.”

While many children are feeling stressed out, so are their parents, the experts said.

Children thrive on structure and routine but that may prove challenging in a COVID-19 world.

“This is a time of massive uncertainty for kids,” said Kelsey Goodwin, a pediatric rehab therapist at York Hospital. “I have always worked with kids, stressing the need for structure to their day. Well, the pandemic brought that to its knees. I still advocate for structure for kids even if it ends up being a bit non-linear to what they are used to. A lot of the kids I work with say they like coming to see me because it represents a sense of normalcy between their new situation and what they were used to before. I am still here even if other things in their life are not right now. The kids want things to be the same and I want them to understand there will be a new form of structure in their lives, but they can have structure.”

Goodwin said it has been five months since kids stepped inside a traditional classroom.

“Even when they go back, things will not be the way they remember,” said Goodwin. “So many new rules and restrictions will be in place. We need to make sure kids understand this.”

Balok-Searles said she is seeing kids with various symptoms of depression.

“They are showing anxiety at having to home-school,” she said. “They are upset at not being able to socialize. Some are struggling a lot. Parents feel they lost a lot of the education time they should have had by now. I see one child who lost the end of his middle school year. He never got that closure and now he is a freshman in high school. That is a big transition to happen in a bubble. We need to acknowledge this is abnormal.”

“Too much screen time suppresses melatonin,” said Goodwin. “It messes up sleep. We have always advocated for kids to not use devices at least a half hour before bedtime. Parents should try to find a way to break up the time kids spend in front of a screen, into shorter time periods.”

Goodwin said many kids and families are having a difficult time regulating their concerns.

“I see the worry in kids and in their families,” said Goodwin. “Not being able to see their friends is causing kids to grieve; it’s tough. Change is happening. Having structure can help and having parents model calm supportive behaviors is crucial. Parents will help kids navigate this new world.”

“We have to have hope and we have to impart that to our children,” said Lubarsky. “There will be times of anxiety and conflict. We need to hope this will get better and put one foot in front of the other. We need to tap into our resilience and figure out how to come out of this in the end. We need to work together, and we can get through this.”

The Centers for Disease Control (CDC) has good information for parents regarding schools opening, at https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/schools.html.

The Greater Seacoast Community Health 2019 Annual Report is Now Available

The Greater Seacoast Community Health 2019 annual report is now available in digital format. The report outlines the scale and reach of services offered by Greater Seacoast Community Health, which is comprised of Goodwin Community Health, Families First Health and Support Center,  and Lilac City Pediatrics.

The report also reviews the year at a glance, as well as our finances and our response to the COVID19 pandemic.


View the 2019 Annual Report Here


Learn more about Greater Seacoast Community Health 

Tufts Health Plan Foundation Board Approves Additional Funding for Organizations Responding to Coronavirus

Read the Full Article on PR Newswire


Tufts Health Plan Foundation Board Approves Additional Funding for Organizations Responding to Coronavirus

$900,000 will support recovery and rebuilding in communities across the region



Tufts Health Plan Foundation 

Jun 29, 2020, 09:32 ET


WATERTOWN, Mass.June 29, 2020 /PRNewswire/ — Tufts Health Plan Foundation board approved an additional $900,000 to support recovery and rebuilding efforts addressing the effects of the coronavirus pandemic in MassachusettsRhode IslandNew Hampshire and Connecticut. The Foundation’s commitment to COVID-19 response now reaches nearly $2 million.

“Even as we grapple with the effects of the virus, we must consider future implications,” said Tom Croswell, president and CEO of Tufts Health Plan. “This crisis draws attention to deeply rooted systemic health disparities. This additional funding will support nonprofit organizations in their work to address the health and wellbeing of people in communities across the region.”

The Foundation also announced 13 new grants, totaling $1.7 million for support of collaborative community efforts and systems change to advance healthy aging.

“We need to learn from this experience,” said Nora Moreno Cargie, president of Tufts Health Plan Foundation and vice president for corporate citizenship at Tufts Health Plan. “We have an opportunity to think differently about how our systems are addressing community needs and how we can change the conditions that hold problems in place.”


The new grants go to:

  • Cheshire Medical Center (Keene, N.H.)
    Three-year grant for $185,000
    Supports coordination activities for broadband connectivity; aligns COVID-19 responses with Building Resilience Against Climate Effects (BRACE) effort; and supports integration of age-friendly planning with activities around housing, economic opportunity and Alzheimer’s and related dementias. Cheshire Medical Center is the fiscal agent for the Leadership Council for a Healthy Monadnock.
  • Connecticut Community Care (Bristol, Conn.)
    Three-year grant for $150,000
    Supports the creation of a statewide community-driven Age Well Collaborative promoting livable/age-friendly communities, healthy aging, advocacy and age-positive messaging. Connecticut Community Care is serving as the fiscal agent.
  • Ethos (Southwest Boston Senior Services, Inc.) (Jamaica Plain, Mass.)
    Two-year grant for $80,000
    Makes technology and virtual programming accessible for older adults to reduce isolation; provides internet access and training to older people with modest incomes.
  • FSG (Boston, Mass.)
    One-year grant for $100,000
    Examines how service/response adaptations in response to COVID-19 can contribute to more inclusive and equitable age-friendly practices. This research is a collaboration with the Massachusetts Executive Office of Elder Affairs and the Massachusetts Healthy Aging Collaborative.
  • Greater Seacoast Community Health (Somersworth, N.H.)
    Two-year grant for $120,000
    Develops a regional age-friendly plan for all of Strafford County and nearby towns in Rockingham and Carroll Counties.
  • Harvard University Center for Health Law and Policy Innovation (Cambridge, Mass.)
    Two-year grant for $110,000
    Creates a statewide inventory of nutrition programs specifically for older people to make it easier for health care providers, payers and social service agencies to connect eligible patients to Food is Medicine services.
  • Healthy Waltham (Waltham, Mass.)
    Two-year grant for $100,000
    Expands Waltham Connections’ Senior Pantries to additional Housing Authority sites; increases communications around opportunities that address social isolation; and adapts the Waltham Senior Civic Academy curriculum to a virtual format. Healthy Waltham is the lead agency and fiscal sponsor for Waltham Connections.
  • ONE Neighborhood Builders (Providence, R.I.)
    Two-year grant for $100,000
    Develops new design, financing mechanisms and community development options to increase the supply of accessible, affordable housing for diverse older adults.
  • Pioneer Valley Planning Commission  (Springfield, Mass.)
    Three-year grant for $195,000
    Convenes a Pioneer Valley Age-Friendly Collaborative to engage member communities in planning for an aging population. Pioneer Valley Regional Ventures Center supports the Pioneer Valley Planning Commission.
  • The Mental Health Center of Greater Manchester Inc. (Manchester, N.H.)
    Three-year grant for $165,000
    Establishes a citywide collaborative focused on connecting and expanding access to mental health services for older adults.
  • The Open Door (Gloucester, Mass.)
    One-year grant for $85,000
    Supports the rollout of a Medically Tailored Groceries program for low-income older adult clients with chronic health conditions.
  • Trust for America’s Health (Washington, D.C.)
    One-year grant for $50,000
    Engages state public health and aging leaders across the New England region in a practitioners’ community to learn about and grow age-friendly efforts.
  • University of Massachusetts Foundation  (Lowell, Mass.)
    Three-year grant for $300,000
    Creates a citywide age-friendly initiative building community capacity to develop and implement action and evaluation plans that promote health, independence and quality of life for older residents in Lowell. The University of Massachusetts Foundation is the fiscal agent for the University of Massachusetts, Lowell.



The Foundation continues a two-for-one match for donations by Tufts Health Plan employees and board members to organizations addressing the coronavirus pandemic. This match now is expanded and includes donations to nonprofits working on anti-racism and social justice efforts. Since March, more than $245,000 has been contributed to community organizations.



About Tufts Health Plan Foundation
Established in 2008, Tufts Health Plan Foundation supports the health and wellness of the diverse communities we serve. The Foundation has given more than $40 million to ConnecticutMassachusettsNew Hampshire, and Rhode Island nonprofits that promote healthy living with an emphasis on older people and will give more than $5 million to community organizations this year. The Foundation began funding in New Hampshire in 2016 and in Connecticut in 2019. Tufts Health Plan Foundation funds programs that move communities toward implementing age-friendly policies and practices that are relevant, focus on older people, and include them in community solutions. Visit www.tuftshealthplanfoundation.org for grant program information and follow us on TwitterFacebook and YouTube.



About Tufts Health Plan
Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage.  Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.14 million members in MassachusettsRhode IslandNew Hampshire and Connecticut through employer-sponsored plans; Medicare; Medicaid and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. We are continually among the top health plans in the country based on quality and member satisfaction. Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.* Our commercial HMO/POS and Massachusetts PPO plans are rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA).** Our Medicaid plan is rated 4.5 out of a possible 5.***



To learn more about how we’re redefining what a health plan can do, visit www.tuftshealthplan.com/whatwedo.  Connect with us on FacebookTwitterYouTube and LinkedIn.



*Every year, Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract years 2016, 2017, 2018, 2019, 2020.
**NCQA’s Private Health Insurance Plan Ratings 2019–2020
***NCQA’s Medicaid Health Insurance Plan Ratings 2019-2020.



Alrie McNiff Daniels

Kathleen Makela

SOURCE Tufts Health Plan Foundation


Related Links


Telemedicine is here to stay

Read the Full Article on SeacoastOnline

Telemedicine is here to stay

By Karen Dandurant

PORTSMOUTH – Just about every provider who began using telehealth during the COVID-19 pandemic found it to be a safe and efficient way to “see” patients while minimizing exposure to the virus.

State and federal legislators agree and are finding ways to help keep telemedicine services going even after the pandemic.

On March 18, as part of a series of emergency orders issued by Gov. Chris Sununu relative to COVID-19, was an order that temporarily expanded telehealth services in New Hampshire. The order allowed health care providers the right to use telehealth for their patients while still being reimbursed by insurers the same as if the visit were face-to-face.

Doctors who were using telemedicine had one qualm about continuing. They feared that when the governor’s order expired, they might not receive adequate reimbursement for televisits.

HB 1623, which has passed both the New Hampshire House and the Senate, removes that fear. It enables reimbursement parity and allows providers to continue billing Medicaid and commercial insurers the same rate as they would for a face-to-face visit. The bill includes video, audio, or combinations of both and covers all areas on health care, including primary care, dentists, mental health, behavioral health, substance use disorders, dietitians, and home monitoring services.

Gov. Sununu said he will sign the bill when it reaches his desk.

“Expanding telemedicine has been critical during this time of crisis and proven to be a helpful and important tool for providers and patients to have for the long term,” Sununu said. “Expanding these services permanently will help streamline our health care system by breaking down burdensome regulations.”

Jay Couture, Executive Director of Seacoast Mental Health Services, said her organization strongly supported HB 1623.

“We are receiving a grant for technology and we are excited to continue using telehealth visits,” said Couture. “We are pleased that we will be able to continue to bill for this service and that it did not restrict us to licensed counselors. We have a lot clinical staff that we hire right out of school, before they are ready to take the licensing exam. They are overseen by licensed clinician as they learn. We are a good training platform for them. This bill makes a huge difference to us.”

Couture said they use telehealth for day-to-day case management and it is helping greatly to keep in touch with their clients, who might have transportation or childcare issues that would prevent them from keeping their appointments. She said most of their psychiatry staff is doing telehealth visits.

“Telehealth is not a replacement for all services,” said Couture. “But it is making a difference right now and we can see it moving forward, for clients who do not have access, or maybe not enough data for video, they can be reached using the telephone.”

One important feature of telehealth right now is the ability to keep track of kids eligible for SNAP services, providing food for kids not able to access free or reduced lunch programs right now.

“We can help make sure they are fed,” said Couture. “To be able to have the same parity as face-to-face is everything for us. We can show the same value with telehealth as with in-person visits.”

Jeffrey Austin, Vice President of Government Affairs and Communications for the Maine Hospital Association, said they have long recognized the importance of telemedicine in a state with a lot of rural areas, and as a result, the state already has pretty strong telehealth laws on the books.

“We have not had a legislative session since COVID-19 struck, so we were lucky much of this was already in place,” said Austin. “Maine Care Teledata has shown a dramatic spike in usage since the pandemic struck.”

Austin said both the governor and the Maine Bureau of Insurance did take some steps to make sure commercial carriers were allowing telehealth visits, including an order that commercial insurers will reimburse at the same rate as in person visits and clarifying that telephone visits are allowed in addition to video conferences.

“We already have parity in reimbursement for the most part,” said Austin. “We do not see it as a replacement, but as a substitution of services. I think everyone seems happy with telehealth but at times a person still need to see a doctor face-to-face.”

Telemedicine requires the right tools and that means a need for funding.

Last week U.S. Sen. Jeanne Shaheen, D-NH, a senior member of the Senate Appropriations Committee, U.S. Sen. Maggie Hassan, D-NH, and Reps. Annie Kuster, D-NH, and Chris Pappas, D-NH, announced the award of $907,383 to the Community Health Access Network in Newmarket to strengthen and expand telehealth services for Granite Staters in the Seacoast region and across New Hampshire.

The funding, which was awarded through the Federal Communications Commission’s COVID-19 Telehealth Program, was provided by the Coronavirus Aid, Relief, and Economic Security (CARES) Act that was passed by Congress and signed into law. The award will be used to help cover costs associated with remote patient monitoring equipment and software, computer hardware and broadband service.

Joan Tulk, Executive Director of the Community Health Access Network said they are thrilled and cannot wait to put the money to work for New Hampshire residents.

The Community Health Access Network (CHAN) is the only Health Center Controlled Network (HCCN) in New Hampshire. Established in 1995, CHAN has developed and supports an integrated clinical and administrative system infrastructure for its ten Federally Qualified Health Center (FQHC) members which includes three Healthcare for the Homeless Programs.

“The money will serve to help several of our community health centers and their patients,” said Tulk. “We have other partners but some of them chose to apply for grants on their own.”

Centers that will benefit from the technology upgrades are Greater Seacoast Community Health, Lamprey Health Care, Amoskeag Health Center, Health First, and Coos County Family Health Services.

“The purpose of this grant is to help connect the health care provider with the patients for all kinds of telehealth visits,” said Tulk. “It is for COVID-19 patients and for managing chronic health diseases that didn’t go away when COVID hit. We are finding that most people, on both sides, really love telehealth.”

Tulk said telehealth is really important for community health centers since they do a lot of wraparound services including medical, dental, and mental health.

“The primary reason for this FCC grant was COVID-19,” said Tulk. “But we can use the money many ways, including helping to set up access if a patients does not have the capability, if they can’t afford it. We can use it help provide monitoring services between a patient and their doctor. Blood pressure, pulse oximeters and other vital health care signs can be monitored remotely.”

The biggest success Tulk has seen with using telehealth visits in the area of behavioral health.

“Mental health, substance use cases typically have a 30% no-show rate,” said Tulk. “Now that rate is zero. Impediments to the patient coming in have been removed.”

Our Commitment to Inclusivity

The first Community Health Centers in the United States were founded as a result of the 1964 Civil Rights Act, with the mission of providing accessible health care to all. Without the Civil Rights movement, Community Health Centers would not have the institutional strength and federal support needed to offer the health care services necessary to the health of our communities. Greater Seacoast Community Health recognizes that health-equity disparities for people of color continue to this day, and we consider it our obligation to work to address these inequalities and change the institutionalized systems that uphold them.

Racial injustice is a moral and public-health crisis. People of color experience more barriers in their access to health care, and consequently suffer from many chronic health issues at higher levels. From higher infant-mortality rates, to more frequent cases of obesity, heart disease, and lung disease (illnesses that contribute to the higher COVID19 mortality rates among Black Americans), people of color suffer disproportionately, often due to having a harder time receiving care.

Our vision is to provide everyone in our community the opportunity to live a long and healthy life. In order to achieve this, we must first acknowledge the discriminatory practices in our nation that oppress and ignore the needs of people of color. Greater Seacoast Community Health will advocate for changing unjust systems to create fair and just structures that truly respect and represent all.

Father’s Day 5K is now a Father’s Day 5-STAY

Father’s Day 5K is now a Father’s Day 5-STAY

Dover, NH, June 17, 2020 – After Greater Seacoast Community Health canceled its annual Father’s Day 5K due to the coronavirus pandemic, presenting sponsor Novocure and 16 other local companies and organizations agreed that they would still support the fundraiser. Now, the community health centers are asking runners and other members of the public to do the same.

For the past 11 years, this family-friendly race has supported access to quality health care and support services at Goodwin Community Health, Families First Health & Support Center, and Lilac City Pediatrics. Since the Father’s Day 5K is the health centers’ largest annual fundraiser, they are asking for your help.

“If you are in a position to do so, please consider a donation in lieu of race registration,” says Elizabeth Clemence, race director for the Father’s Day 5K. “This will help the three community health centers continue providing essential health care and support services during this emergency. As we pivot to meet the emerging needs of our community during this rapidly evolving crisis, we’re deeply grateful for any amount you can contribute.”

Donations can be made online at GetCommunityHealth.org/donate.

Mike Ambrogi, COO of lead sponsor Novocure, says his company is “very proud to continue to support Families First and Goodwin Community Health and the valuable role they play in our community. The COVID-19 pandemic has highlighted for all of us the importance of continuity of the essential services they provide.”

Greater Seacoast Community Health thanks Novocure and the following other businesses and organizations for their support: Bank of New Hampshire; Digital Prospectors; Eastern Bank; Clark Insurance; Collins Sports Center; D.F. Richard Energy; Homewood Suites by Hilton; Kennebunk Savings; Louis F. Clarizio Oral Surgery & Dental Implant Center; Margaritas Mexican Restaurant; Newburyport Bank; NH Healthy Families; United Way of the Greater Seacoast; Well Sense Health Plan; Wentworth-Douglass Hospital; and ConvenientMD Urgent Care.

Goodwin Community Health and Families First Health & Support Center are community health and family resource centers serving the greater Seacoast region of New Hampshire and Southern Maine. They provide general medical care for people of all ages, dental care, prenatal care, counseling, substance misuse treatment, parenting classes, family programs, home visiting and family programs, and mobile health care for the homeless. Lilac City Pediatrics provides pediatric and behavioral health care to children and adolescents. The three serve almost 20,000 local adults and children, many of them uninsured or lacking access to affordable, quality health care. They operate centers in Somersworth, Portsmouth, and Rochester, as well as mobile health clinics in multiple Seacoast locations. For more information, visit GetCommunityHealth.org.



Photo Cutline:  The organizations pictured have shown their enduring support for Greater Seacoast Community Health by sponsoring the Father’s Day 5-STAY, even though the race is canceled.

Elizabeth Clemence
Greater Seacoast Community Health

The future of health care in a post-pandemic world

The future of health care in a post-pandemic world

Read the Full Article Here on Seacoast Online

PORTSMOUTH – Health care workers have had to make significant changes to the way they deliver services in light of COVID-19 and many of those changes will become the new normal going forward.

While infection control and disinfection have always been mainstays of any health care facility, COVID-19 forced a ramping up of sanitary practices and also resulted in the isolation of patients, both for their own safety, and to keep them from infecting others.

Nursing homes and assisted living facilities have been hard hit because of the proximity of patients to each other. Visitors were quickly banned, except in some end-of-life cases at some facilities.

“I can’t imagine nursing homes and assisted living communities going back to normal any time soon,” said Tom Argue, president and director of Webster at Rye. “As long as COVID-19 is still in the greater community and there are community-acquired infections, seniors with co-morbidities in health care facilities will continue to be at much greater risk. This no doubt means Centers for Disease Control and Centers for Medicare and Medicaid Services will continue to require that residents not dine together or have group activities without social distancing, visitors will continue to be restricted, employees will continue to be screened each time they enter and wear personal protective equipment, and residents and staff will continue to have rolling testing.”

“For assisted living communities where people have more options on whether to move in or wait, people are hesitant to move in knowing they are essentially severing any direct visits with their loved ones other than window visits or meetings via Skype or Zoom for the foreseeable future until such time as the visitation restrictions are lifted,” Argue said. “If this continues for another year or so, and it probably will for senior health care communities, assisted living communities will be significantly hurt by fewer admissions.”

Argue said every admission must be treated as a presumptive positive COVID-19, which requires isolation in a private room for 14 days.

“For most nursing homes set up with primarily semi-private rooms, this creates a bottleneck for admissions and much like assisted living communities, lower census,” he said. “Despite staff’s best efforts, the longer this continues the great potential for feelings of isolation and depression for residents and the more difficulty families will have accepting the restrictions.”

Olivia Korpi, marketing director at Wentworth Senior Living, said they will likely continue using telehealth where appropriate.

“We traditionally had a primary care doctor come in a couple of times a week,” Korpi said. “They are using telehealth and it is working. Obviously, there are times we need a doctor in, but we found not always, and I think that will continue.”

Korpi said the residents isolated to their rooms are actually expanding their circle of friends. The facility handed out a telephone directory of residents and she said patients are using it to call and talk with each other. She said they are taking advantage of things they might not have before, like book club, arts and crafts, and hallway exercise class.

“We are doing activities in small groups, socially distanced,” Korpi said. “We are using headphones with a Bluetooth microphone. They can be sanitized, and our residents can hear what we are doing while staying safely apart. I think that for at least the next 12 to 18 months, this is what things will look like.”

Dr. Joann Buonomano is chief medical officer for Greater Seacoast Community Health, which includes Goodwin Community Health in Somersworth, Families First Health & Support Center in Portsmouth, and Lilac City Pediatrics in Rochester. Buonomano said televisits by phone or video will be one enduring benefit of this pandemic.

“At Greater Seacoast, we now offer telehealth for medical care, behavioral health counseling and even dental care,” she said. “Telemedicine has been on the cutting edge for the past five years. This pandemic has turned it into a mainstay reality. Until recently, health care providers could rarely bill for phone or video visits. As of March, telehealth visits are now covered by Medicare, Medicaid and commercial insurance.”

Buonomano said patients and providers expect telehealth services will continue and Greater Seacoast is making changes in its offices to accommodate it for years to come.

“For patients, telemedicine offers greater convenience, allowing them to maintain a relationship with their primary care provider in their own home, where they are more comfortable,” she said. “It also breaks down transportation barriers and reduces the amount of time the patient has to take from their busy schedule for the visit.”

Buonomano said phone and video visits put the provider and patient on a more equal level, which supports an enduring relationship and more relaxed, open communication. Telemedicine, including tele-behavioral health counseling, can also help patients and their families overcome obstacles to receiving care related to severe social phobias, trauma and anxiety.

“These health problems can often be triggered when entering into a medical office,” she said.

Buonomano said GSCH now offers drive-by pharmacy pickup and an organized respiratory clinic. She said it plans to offer drive-by nursing assessments to assist with quick point-of-care rapid blood testing needed for following the progress of diabetic patients, following a televisit.

Exeter Health Resources’ operating affiliates, Exeter Hospital, Core Physicians and Rockingham VNA & Hospice, have provided care throughout the COVID-19 crisis and adapted programs and services to ensure the safety of patients and staff, said Deb Vasapolli, communications director at Exeter Hospital.

“We will continue to adhere to our social distancing and universal mask policies,” Vasapolli said. “We will ensure we have adequate supplies, including personal protective equipment; clear processes for screening and/or testing patients for the virus; enough space in clinical areas to adhere to social distancing guidelines; and procedures for thorough cleaning and disinfection.

“Telehealth appointments will continue to be offered when appropriate for a patient’s care but as our offices re-open, we are ensuring we are ready and safe to care for patients when they come in.”

Dawn Fernald, director of communications at Wentworth-Douglass, said they are focusing on a new experience for patients and staff as they enter their facilities.

“We are still in the midst of re-opening services, but patients should expect a change with respect to safety and infection prevention protocols,” Fernald said. “This is a new normal for all of us and is ever-evolving. We are adapting services and processes to include infection prevention parameters in both public areas and behind the scenes.”

Dr. Travis Harker, chief medical officer for the Appledore Medical Group, with offices in Portsmouth, Rochester and Derry, said telehealth will likely remain as a patient option when appropriate.

“We need to actively demonstrate to patients that our offices are safe to come to,” Harker said. “We started precautions in August, in anticipation of flu season so we had a jump up when the coronavirus appeared. We were already requiring patients to wear a mask when they came in. We were already diligently wiping down surfaces.”

When COVID-19 emerged, about 80% of patient visits were through telehealth. Harker said once people became more comfortable with the message that the doctors’ offices were safe, that percentage swung the other way.

“Now 80% of visits are in the office, with 20% done through phone or video calls,” he said. “We definitely see a use for it and so do our patients. My only concern with using it in the future is that insurance companies need to maintain reimbursements. If providers lose money, they may not be able to keep using telemedicine.”

Dr. Thomas Wold, chief medical officer at Portsmouth Regional Hospital, said COVID-19 will change things forever.

“The constant unknowns we saw and the constant new information made us all struggle to keep adapting,” Wold said. “In the end, a lot of basic things we already do like good hand hygiene and cleaning common surfaces like doorknobs and counters proved to be most important, for basic infection control.”

Wold said the task moving forward is assuring patients they are coming into a welcoming and safe environment as more services reopen.

Wold said the threat of COVID-19 is not going away anytime soon so universal precautions like screening patients and wearing masks are here to stay.

“We have redesigned the wait room,” he said. “High-touch risks, like vending machines, magazines and toys in the wait rooms are gone. We will continue to do our service desks differently, with barriers between people.”

Wold said telemedicine is here to stay for several reasons.

“We have learned that many visits can be done this way,” he said. “The other perk is that it reduces our need for PPE. My only lament is the loss of patient contact, something we need to balance going forward.”

Baby doctor visits must go on during pandemic

Read the full article on Fosters.com

PORTSMOUTH – In the first two -years of life, a baby sees the pediatrician 11 times, for well-baby visits and scheduled immunizations.

Baby visits are important for the child’s health and should continue even as people navigate the COVID-19 pandemic say Seacoast-region medical professionals, who have taken great pains to make sure the littlest ones, and their parents will be safe.

Dr. Nettie Colella, a pediatrician with Greater Seacoast Community Health sees patients at both Families First in Portsmouth and Lilac City Pediatrics in Rochester. There are also pediatricians seeing children at Goodwin Community Health in Somersworth, the third arm of GSCH.

Colella said pediatricians are worried about the widespread interruption of immunization schedules, possibly happening because parents are afraid to bring kids in because of the risk of infection from the coronavirus.

There are potential outbreaks without immunizations,” said Colella. “Whooping cough, meningitis and measles, can be far more dangerous to children than COVID-19. In 2019, we saw an outbreak pf measles. There were 1,200 cases in the US, with 120 hospitalization and 60 cases with serious complications. In a country where we were declared measles free in 2000, this was a frightening situation.”

Colella said there are procedures in place to keep children needing care safe.

“For example, I am not seeing as many patients in my office as I would have during normal operations,” said Colella. “I use telehealth, but I need to see my most vulnerable populations and that strongly includes infants and young children.

“I worry about losing contact with the children as we might be the only adult beside a parent they are seeing right now. They are not in school and we need to be a second set of eyes on them. They are in social isolation. I have a daughter who is a senior in high school, She has lost athletics. She is not going to have a prom, a graduation. She is already worried about college. I want to be someone my patients can talk to about how they are feeling.”

Colella said GSCH has behavioral health and social workers on staff to help with any mental health or family issues they identify. She said it is important to assure a patient is not neglecting their mental health because of the isolation and is taking their prescribed medication.

Colella said video visits can be used to help manage diabetes, to care for children with ADHD and help with sleep issues. She said that some follow ups for chronic conditions is possible through telehealth.

“But for those first two years, seeing them in person is so important,” said Colella. “During well baby visits, we inspect their growth and development. We talk with the parents about nutrition and sleep patterns. We can talk anticipatory, what to expect as the baby grows. We get the opportunity to check in on the entire family, for issues like postpartum depression. It really does take a village to raise a baby right.”

Most important is keeping the child on a well-organized schedule of childhood immunizations.

“Immunization are given to children at set intervals,” said Colella. “Keeping to the schedule provides the best protection for the child.”

Children are given primary immunizations in the first 30-45 days of their life. They need the measles and chicken pox shot between the age of four and five, and a booster for it at age 11, when they will also get the primary meningitis immunization and HPV vaccine.

“It’s so important to emphasize the importance of getting our patients in,” said Colella. “I am so impressed with how quickly GSCH responded to the COVID-19 needs. We have a really good operations team for all our locations and plans were put into place to make all of our services safe for staff and patients.”

Patients and staff are screened, for temperature, cough, and any signs of respiratory ailment before entering any of the three locations.

“We have a tent set up outside for screening and if you come without a mask, we will give you one,” said Colella. “Patients are sent in one at a time and go directly to a patient room. People should come if they normally would. Do not decide that because Johnny has a cut, you can take care of it. In a week, if it is infected, the care is more difficult. We can look at it, even over the phone and advise you.”

GSCH changed the hours of operations for the clinics, and staggered visits for clinicians and patients, so there are not a lot of people in any office at any time. Colella said they are using telehealth whenever possible. Masks are being used by everyone in the buildings. Colella said they have a high-risk respiratory clinic set up at specific times, and low-risk patients are not scheduled at that time.

“I prefer video visits when I do telehealth,” said Colella. “I find it helpful to be able to see my kids and their parents. I can work with a family where the son is having trouble sleeping. We can talk about nutrition and we can do good quality follow up to previous visits. We can make sure they are keeping up with needed medications. Some people do not have the capability to do live feeds and we can do telephone visits if we need to. Being able to do that frees up protected spaces in the offices to see patients.

“The other important thing I think should be mentioned is that patients without a primary care doctor should not avoid seeking healthcare due to pandemic. GSCH (Families First, Goodwin Community Health and Lilac City Pediatrics) are all accepting new patients and new patient appointments can be via telehealth. It is so important to address all medical and behavioral needs at this time.”

Colella said that recommendations on booking in office appointments are changing rapidly as the state starts to liberalize stay at home orders and patients should call the office, where appointment will be scheduled as appropriate based on the child’s age and medical needs.

To make an appointment, call Families First at 603-422-8208, Lilac City Pediatrics at 603-335-4522, or Goodwin Community Health at 603-749-2346.