Introduction

The Franklin/Bristol Public Health Network is managed by the Caring Community Network of the Twin Rivers (CCNTR). CCNTR integrates the energies and ideas of the many small town health officers, police,fire and school departments, with the private non-profit health and social service agencies in a new public/private partnership to address needs, plan, and implement community health activities on the regional level.

Service Area

The Caring Community Network of the Twin Rivers is a community collaborative that serves the Twin Rivers area. This area includes the towns of Alexandria, Andover, Bridgewater, Bristol, Danbury, Franklin, Groton, Hebron, Hill, New Hampton, Northfield, Salisbury, Sanbornton and Tilton.

The service area has a population of just over 30,000 people with towns ranging in size from the smallest of 600 to largest of 8600, with 13% of the population being medically uninsured. In addition to the diverse population of elder and uninsured or underinsured, there is also small refugee population.

Partners

CCNTR partner agencies include the Twin Rivers Clergy Association, three public school districts serving the Twin Rivers area, health care providers, area businesses, municipal agents involved in public health in each of the participating towns, health and human service agencies in the area, community centers, faith based organizations, and community members.

Objectives

CCNTR understands its role to assure the delivery of the ten essential public health services in the region. CCNTR and its partner organizations are most actively involved in monitoring health status at the local level, diagnosing and investigating health problems and hazards, informing and educating the public about health issues, mobilizing a community response, linking people to needed services and ensuring a competent workforce.

Activities

CCNTR has been developing a local public health function in the region since 1997. Key activities during this period have included establishing a organizational structure which engages broad stakeholders; regularly conducting a comprehensive community needs assessment identifying local priority health needs; setting priorities and developing a public health improvement plan which addresses priority needs; and facilitating implementation of strategies and interventions designed to improve the health and wellbeing of area residents.

CCNTR has hired a full-time public health professional who is available to provide technical assistance and support to Health Officers and towns in the participating communities. Inter-municipal agreements have been signed with nine of the twelve towns defining services to be provided to the town by the public health professional. Towns vary in terms of how they use the professional ranging from seeking information to contracting for the individual to serve as the town's Health Officer or Deputy Health Officer. The Public Health Professional has been deputized in four towns and is retained as the official Health Officer in one community. The individual serves as a key resource to communities in identifying and disseminating answers to public health questions by tracking down information from RSAs and state agencies on a broad range of public health issues including water, septic, garbage, health, etc.

CCNTR serves as the parent organization for a number of Project Task Teams that target specific issues identified as priorities for health improvement. As such, CCNTR provides technical and administrative support to these coalitions including assisting with grant writing, facilitation, organizational support, research, etc. Examples of coalitions include:

• Development: responsible for seeking new funds to support initiatives and interventions;
• Alcohol and Drug Abuse Prevention Team: addressing issues impact the health and well-being of youth;
• Various Basic Needs coalitions targeting transportation, child care, housing, etc.;
• Care Coordination and Access Team: addressing the need to assure access to care.

This structure permits many individuals to be involved with CCNTR on issues which are important to them. This is essential for retaining participants in a volunteer role. Through this structure, CCNTR has engaged in a broad range of community health improvement initiatives targeting water quality, lead abatement, health promotion, cleanup, emergency preparedness exercises, establishment of a common sliding fee for all participating health care organizations, and development of public green spaces. In addition, CCNTR produces a regularly featured column in the local paper, Public and Community Health Up-Date.

CCNTR leads the effort to conduct a regular community needs assessment defining health concerns and issues impacting the community. 14,000 surveys were distributed and 10 community forums were conducted in the most recent assessment to solicit input from community members. This needs assessment is widely distributed to municipal town managers, selectmen, Health Officers, and community agencies. CCNTR has developed a Powerpoint presentation to inform interested parties about key findings of the assessment and is available to do presentations.

The results of the community needs assessment are distributed to all members of the coalition. Coalition members and members of the Development Committee review the results to identify priorities for health improvement. With this information, each coalition is encouraged to reassess what they are currently doing and to make appropriate modifications to focus activities/interventions to address identified priorities. Coalitions are then encouraged to draft a work plan. These work plans are aggregated into a broader public health improvement plan or community care plan. The plan states the problem, goals and objectives, activities, responsible person and timeframe for action as well as the intended outcomes. The Development Committee sets priorities for fund raising based on the findings of the needs assessment and works to seek funds to support initiatives and interventions which target priority issues.