Ron first came to Amoskeag Health’s MAT program with a clear mission: he needed heart surgery, and to qualify, he had to stop drinking and using cocaine. Determined to get the surgery, Ron managed to hold onto his sobriety just long enough to make it through the operation. However, once he recovered, he found himself in a tough spot. He couldn't return to his previous job and was struggling with his housing situation. What started as a short-term goal of sobriety for medical reasons turned into a long-term journey. Throughout the summer of 2023, Ron continued to attend his Certified Recovery Support Worker (CRSW) and Medication Assisted Treatment (MAT) provider appointments, but his struggle with sobriety persisted. He intermittently used cocaine and alcohol, feeling ambivalent about the whole process. He now admits he often lied about his substance use and his true intentions during those months. By the end of the summer, Ron found himself homeless and without work. Despite having applied for Social Security Disability Insurance with the help of Case Management back in March 2023, the application hadn't come through yet, leaving him in a precarious position. Ron’s turning point came during a routine meeting with his MAT CRSW. They discussed his motivation for sobriety and his overall quality of life. The CRSW challenged Ron to reflect on his motivations for sobriety and his overall quality of life. They asked him to consider who he truly wanted to be. Did he want to become the gruff, angry old man he was on track to become? Deep down, both Ron and the CRSW knew that wasn't who he was meant to be. That conversation sparked something in Ron. He took a long, hard look in the mirror and decided to make a change. Ron has made a tremendous effort to address his feelings of anger, stress, and frustration. He built a support network and embraced the benefits of meetings, support groups, hobbies, and self-care. The man who had walked into Amoskeag Health a year earlier, ambivalent and unmotivated, is now eight months sober. He's receiving disability benefits, living independently in a rent-controlled apartment in downtown Manchester, and continuing his journey of growth and healing. We are incredibly proud of Ron and can't wait to see what the future holds for him! Ron's story shows how support and care can change lives. Your donations to Amoskeag Health can help more people like Ron find their way to recovery and stability. With your help, we can provide the resources and support they need. Donate today and be a part of changing lives.

Our Family Eye Care Center is dedicated to providing comprehensive vision care for patients of all ages. We ensure that everyone in our community has access to quality eye care. With annual exams for all ages, including infants, we're dedicated to safeguarding vision health and preventing long-term issues. The following is a first-hand account from our Optometrist, Jillian Peabody "I recently saw a pediatric patient for the very first time. Her doctors couldn’t figure out why she’d been struggling with her vision for years. Her mom was especially worried because she had started to fall quite often, and it seemed like she’d lost her peripheral vision. After I examined her, I was able to provide a diagnosis: Retinitis Pigmentosa, a genetic condition with a group of eye problems that affect the retina and cause varying degrees of vision loss. Unfortunately, this is a visually devastating diagnosis. However, she can benefit from low-vision resources that will help her exponentially in school and daily life. I talked to her parents and referred her to Boston Children's Hospital where they’ll likely register her as “vision impaired,” which means that she’ll have more legal and medical options than before. In a few months, she’ll come back to Amoskeag Health, and then I can help connect her family to specific programs in New Hampshire, like Future in Sight. There, they’ll help her better navigate at home and school; provide white cane training; and provide additional resources such as a portable or desktop closed-circuit television (CCTV), which is a video magnifier to enlarge print and images. Although I know the diagnosis was difficult, I also know she wouldn’t have any of these opportunities without an answer. I’m glad I could provide her family with a diagnosis, as well as the connection to resources that will improve her quality of life, enhance her academic performance, and brighten her future." ~Jillian Peabody, Amoskeag Health Optometrist Your support empowers us to uphold this vital mission of ensuring clear sight and bright futures for everyone we serve. We want to continue sharing these impactful stories, and your donation ensures that everyone who seeks help receives it.

The Power of Case Management from an Amoskeag Health Case Manager "One of my patients is a single mom with two daughters who is currently living in a hotel. Her daughters are patients at Amoskeag Health and were on Dr. Lisa DiBrigida’s panel (who has sadly since retired!). During their Health and Family Risk Assessments, Dr. DiBrigida noticed signs that there were economic and mental health challenges at home. She immediately gave me a call to come talk to the family. When I first met the girls’ mother, she expressed that she’s always struggled with her mental health. This snowballed into several huge challenges such as maintaining a steady income, grappling with food insecurity, and trying to take care of her daughters despite a lack of transportation and basic household supplies. I listened to her, I validated her, and I gave her a safe place to shed tears and express her fears. Then, I connected her with the right mental health supports. She was SO grateful. Immediately after that, I put her in contact with the homeless liaison for the school district who began arranging transportation to school and new clothing for her daughters. Once her daughters were properly cared for, her entire body seemed to sigh with relief. She was so overwhelmed and felt like she was failing her daughters before; she needed an advocate. So, that’s who I became! I immediately guided her through re-establishing her benefits through DHHS (cash assistance, food stamps, and Medicaid). Then, we set up appointments to work on reapplying for SSI benefits. As we scheduled these future appointments, we talked about where she wants to go next. I’m so proud of her; now that her daughters are cared for, she’s making her own goals. Next, she plans to establish a reliable job and then find housing with her section 8 voucher. Our work together is still progressing, and it’s wonderful to reflect on the progress we’ve made so far." ~An Amoskeag Health Case Manager Your generosity ensures that families facing economic and mental health challenges receive the holistic support they need to thrive. Join us in making a lasting impact on lives like hers.

Although Case Management is not a billable service to insurance companies, it's vital for Amoskeag Health patients. Case managers are available at each doctor's appointment to help families navigate legal and financial challenges they might face such as domestic violence and food insecurity. The following testimonial was shared anonymously by one of our case managers to protect the family's identity. One of my most impactful stories involves a mother of four from Pakistan whose primary language is Punjabi. Her primary care provider at Amoskeag Health noticed signs of domestic violence and asked her for permission to connect with a case manager. Once I spoke with her, I discovered that her husband harmed her physically, in addition to one of her children. Immediately, I connected her to domestic violence resources and helped her navigate the court system—initiating a divorce and physical protection from her now ex-husband. A little while later, I received a distraught phone call from the mom. She’d received a letter from DHHS notifying her that she was being investigated for fraud—she was terrified that this would jeopardize her ability to remain in the country and care for her children. I was able to calm her down and connect her with NH Legal Assistance where she learned that her ex-husband had put himself down as head of household and was still receiving the benefits even though they were divorced. I helped her work with NH Legal Assistance; together, we restored her Medicaid and SNAP benefits and closed the fraud investigation! Now, I’ve connected her with an employment training program so that she can continue taking steps to self-sufficiency and creating a safe, stable home for her children. The American legal system is challenging for anyone let alone a scared mother of four who speaks English as a second language. I’m honored and grateful that I helped her on the path to a successful future. ~Amoskeag Health Case Manager Your donation covers our case managers' salaries. Every dollar we receive allows us to continue the work that makes a brighter future for someone who is trying to navigate a tough situation, like this family. We want to continue sharing these impactful stories next year, and your donation ensures that everyone who seeks help receives it.

What is the role of a health care coordinator? They get to know our patients and their families, and they become a personal part of their path to health and well-being. This process can be rewarding, heart-breaking, and deeply intimate. Mishelle Sadick, one of our health care coordinators, has spent the last eight years, developing a trusting relationship with Thien, his wife, Oanh, and their three children. Sally, their middle child, is 12 years old and suffers from cerebral palsy, global developmental delay, seizures, and severe scoliosis. Her spinal cord curves in a way that produces excruciating pain and stiffness; she cannot walk; and she has limited verbal communication made possible with a speech device. Mishelle helps Thien navigate insurance; researches equipment to make caring for Sally easier; manages her nursing, physical, and occupational therapy; and most importantly, she keeps their family connected, despite Sally’s physical limitations. But there was one wish above all others. But there was one wish above all others: Thien and Oanh wanted their daughter to meet her family in Vietnam and experience her heritage first-hand–an impossible dream. So, Mishelle advocated for and guided Thien through an application to Make-a-Wish Foundation, which was granted! Sally and her family flew to Vietnam to be embraced by extended family for an entire month. This was a precious gift because, as you can imagine, flying is not a simple ordeal for a wheelchair-bound child. Over the years, Mishelle helped Thien apply for funding to install an elevator in their home; buy a handicapped-accessible van; and build an extensive lift and track system throughout their home that lowers into Sally’s bed, lifts her out, and transports her into different rooms of the house so that she can still spend time with her family, no matter where they are. In June, Sally received extensive surgery at Boston Children's Hospital to correct her spinal cord. The surgery was incredibly complicated, and coordinating recovery during a global pandemic added another layer of difficulty. Mishelle guided the family through each step pre- and post-operation. Although Sally will never walk, this corrective surgery vastly improved her quality of life and helped ease the immense pain that had become this little girl's reality. Since Sally requires extensive, precise medical care, Thien and Oanh cannot have just anyone care for her. Mishelle has coordinated multiple stays for Sally through Cedarcrest Center for Children with Disabilities. These stays provided safe care for Sally in addition to an important reprieve for Thien and Oanh; they were able to attend two weddings, remaining connected with their family. Most importantly, they trusted that Sally was safe. Today, Sally is happily recovered and attending school in-person, with the help of a registered nurse. When Thien was asked what he enjoyed most about working with Mishelle, he gave a huge grin and said, "I love Mishelle. She has done everything for my family. Everything. She is family to us." We often take simple moments with our family for granted. But Thien, Oanh, and their children cherish the magic of shared family time in the living room. For Sally, the equipment to move freely with her family in and out of their home, and the love behind their acquisition, is a lifechanging gift. Mishelle and the Special Medical Programs team here at Amoskeag Health advocate for families, working hard to create and preserve these special moments together. Your contributions help us continue to make wishes come true, not just for Thien and for Sally, but for each and every one of our patients. After all, we consider them our family, too.

Imagine the excitement of a young woman moving to America to begin a life with her new spouse. Imagine her joy and anticipation to create a family. Imagine the opportunities stretched out before her. But then he hits her. He strikes away excitement and joy. And as quickly as the bruises begin to form, so does her anguish and fear. She's all alone. Marta, a young Rwandan immigrant, didn’t have to imagine this incident. Unfortunately, it was her reality. Three years ago, she found herself all alone in a brand-new country with a newborn baby and no work visa. Although the life she imagined was taken away from her, Amoskeag Health helped her to build a new future. Suddenly, she wasn't alone anymore. After placing a restraining order against her husband, Marta sought comfort at a domestic violence shelter through the YWCA. She was also receiving care at Amoskeag Health for her son Adrian. During his appointment, Dr. Keane noticed signs of domestic violence and food insecurity. Because Amoskeag Health has an integrated model of care, we offer much more than a primary care visit. Dr. Keane carefully broached the subject of Marta’s situation and asked Marta if she needed help. Marta agreed and she was connected with Ethan, one of our case managers, that same day. Ethan spent the next few months connecting Marta with state benefits like Medicaid and food stamps; helping her navigate legal assistance to begin her divorce; and writing a letter to the governor’s office to expedite her case to secure a work permit. After Marta secured a full-time job in construction, Ethan talked with her about her career goals. Marta had earned her bachelor’s degree in hospitality when she lived in Rwanda; she speaks English, French, Swahili, and Kinyarwanda. Ethan explained some of her options in the United States and he helped her apply for a scholarship to go to school and receive her interpretation license. As she went to school, worked, and cared for her son, Ethan continued helping Marta move out of the women’s shelter. After securing a temporary apartment through Families in Transition, he worked with Marta to apply for subsidized housing. Today, Marta works as a case manager with stable income and housing. She has full custody of Adrian, and he is attending pre-school next year—hitting all of his milestones along the way! With the help of Amoskeag Health, she built a support system of co-workers and friends. Marta’s strength and motivation gave her possibilities despite the obstacles she faced—now, she lives an independent and happy life in the United States.

"You have to be out by the weekend." Sofia felt her stomach drop. Her landlord was planning to remodel the apartment she’d rented for the last two years. He was going to list it for double what she was currently paying. She’d never missed a payment before. She had nowhere to go. How could this be happening? “Please,” she pleaded, “I just need some time to find a new place.” She kissed her son Gabriel’s head while she blinked back tears and clutched the phone in her hand. “Fine. But you need to be out by Monday. You don’t want me to get a lawyer involved.” Sofia’s heart lurched. She hung up the phone, told Gabriel to go play, and she cried silently in the kitchen. Then, with shaking fingers, she picked up the phone and dialed 603-626-9500, Amoskeag Health’s number. She remembered that her doctor always told her she could call if she needed help. The woman at the front desk assured her that they would have a case manager return her call. Sofia’s mind was a blur. She didn’t know what that meant, but she was desperate for anything. About an hour later, Sofia got a call from a case manager named Ethan. Through her tears, she explained what her landlord said and how she didn’t have any options. Rent was too expensive. She was panicking. Ethan explained that she could not be forced to move out so quickly. The landlord had to provide an Official Notice and she would be granted at least a week before she’d be forced to move. Ethan wanted to doublecheck with NH Legal to find out exactly what Sofia’s timeline could look like. He told her to take some deep breaths and eat some lunch while he consulted with someone. The next time Sofia picked up the phone, her fingers were steady. Ethan had a plan. Sofia and Ethan performed a 3-way call with her landlord. Ethan calmly explained Sofia’s rights, reviewed her rental history as a reliable tenant, and emphasized that housing was incredibly challenging right now. At the end of the phone call, the landlord apologized. He agreed to let Sofia and Gabriel remain on premise until the end of the month at a pro-rated rental rate. And he drew up a written notice to support this conclusion. With some breathing room, Ethan helped Sofia come up with a plan. She connected with a co-worker who agreed to let her stay in a spare room until she could find a new apartment. Then, Ethan worked with his housing connections and started helping her with rental applications. Today, Sofia is happily settled in a new apartment with Gabriel. She knows much more about her rights as a renter, but most importantly, she knows that if she ever has any questions, Ethan, her Amoskeag Health case manager, can answer them.

When 73-year-old Annabelle first began receiving care at Amoskeag Health, she was missing many of her appointments; she was suffering from depression and loneliness; and she was in severe pain. Her provider referred her to a geriatric care coordinator (GCC) for assistance. One phone call set the two on a life changing journey of health and connection. Shortly after facilitating care for Annabelle, her GCC went on vacation. It was 7 PM, just after dinner, when she received a phone call from Annabelle. She picked up, worried that something was wrong. “I just need someone to talk to,” cried Annabelle. Once she found out that her GCC was on vacation, Annabelle apologized and almost hung up, but her GCC stopped her. You see, they share Filipino heritage; family is everything in their culture, and Annabelle’s GCC understood the importance of being there for her. That simple decision to not hang up the phone transformed Amoskeag Health from just another doctor’s office to a place where Annabelle felt genuine care and concern. She gained an integral support system. Over the next two years, her GCC built a trusting relationship with Annabelle. She helped her develop a schedule to maintain necessary appointments and medications; navigate insurance to reduce a $3,000 medical bill to a few hundred dollars; and acquire a rollator, a special walker to help manage her pain and maintain her independence. When Annabelle’s husband was diagnosed with cancer, her GCC explained available mental health services and reduced Annabelle’s stigma about seeking help. She taught her that counseling was a support service that she deserved, not a weakness. In fact, this trusting relationship may very well have saved Annabelle’s life. After an extensive back surgery in the fall of 2020, Annabelle wanted to leave the rehab center against medical advice. She refused to listen to the doctors or nurses. She started to become frantic, worried about her homebound husband. But when Annabelle's GCC volunteered to check on her husband, Annabelle stayed and made a full recovery before returning home. She often expresses her gratitude. “I wish you were my daughter,” she tells her GCC. Those words mean the world to Annabelle’s GCC. It’s her responsibility to fill many different roles for her patients. But at the end of the day, being their family is her favorite role of all. And we know that it’s theirs, too.

Amoskeag Health helps a family navigate insurance and adaptive care in a new country. On a French country road, a three-year-old boy named Devonte rides along with his life stretched out ahead of him. In the blink of an eye, he’s struck by a vehicle and everything changes. He suffered a traumatic brain injury and underwent an emergency hip reconstruction surgery. Devonte’s mother spent 10 years trying to navigate all of the health challenges post-accident. But she lacked support. So, she decided to slowly immigrate her family of six to America to live with family friends in New Hampshire. They wanted a better life. Today, eighteen-year-old Devonte has spastic quadriplegia, an intellectual disability related to his traumatic brain injury, epilepsy, and gastroesophageal reflux disease. These physical challenges cause frequent aspiration pneumonia and made him G-tube and wheelchair dependent. Devonte requires a strict regimen of three different antiepileptic drugs; two nebulizer medications; G-tube formula and supplies; diapers; and consistent doctor’s visits to four different pediatric specialists. Affordable insurance coverage was essential for their family. Thankfully, Devonte became a patient of Dr. DiBrigida’s here at Amoskeag Health back in 2016. His family discovered that we’re so much more than a primary care office. Dr. DiBrigida recognized their challenges and connected the family with a nurse care coordinator named Anne. For the last five years, Anne worked with the family to navigate affordable insurance and overcome the challenge of Devonte’s looming 18th birthday; their immigration statuses made securing Legal Guardianship and Children’s Medicaid tricky. Once NH Guardianship and NH Children’s Medicaid was in place for Devonte, Anne helped the family navigate follow-up appointments and transportation. Although the family speaks English, a French interpreter was often necessary to help explain some of the more complex insurance issues. Anne helped coordinate interpretation services without incurring too many added expenses. Not to mention, now that Devonte is getting heavier, it’s much more difficult to transport him; his father fell recently carrying him down the stairs. Anne helped the family navigate a home modification evaluation, secure a new wheelchair, and secure approval for a ramp in their home. Devonte’s mom said, “we are so thankful for all the services Amoskeag Health helped us with. We really appreciate all the help we received. Thanks to them, Devonte will have a much happier and healthier life. We’re so glad we came here.”

A nurse care coordinator shares her story. I work in the Special Medical Programs department of Amoskeag Health, which means that many of my patients are young children with complex care needs – these children require extensive services that are often not covered by insurance. Many require special accommodations and are at a high risk for falls or seizures. It’s nearly impossible for parents to work and balance these children’s care without help. Thankfully, Amoskeag Health supports these families, helping them learn how to properly care for their children; how to navigate insurance and the health care system; and how to develop mental coping skills to combat the exhausting emotional toll of their reality. I could fill an entire book with pages of the amazing work our organization has done, but one young woman’s journey touches my heart so much that I want to share her story with you today. I want you to take a moment and step into her shoes. Imagine that you’re a single mother of a five-and-a-half-year-old boy with cerebral palsy and seizures. You work 25-30 hours a week as a part-time LNA 25-30 and balance full-time nursing classes at a community college. Your child is nonverbal and must be fed through a G-tube – not just anyone can care for him. Thankfully, your grandmother moved to America with you, so even though she’s a bit older, she can help while you attend classes and work. However, your third-floor apartment is hard to manage. Your son is wheelchair bound and there's no elevator. It’s getting harder and harder to get him up and down the stairs. One day, your son has to be hospitalized and intubated because of a severe respiratory infection. He'd just recovered and come home. Then, you start hearing about COVID-19. You’re terrified. If your son contracts COVID, it would be life threatening. You still have to work, so you try to be as careful as possible, but every single day you’re filled with anxiety and fear. Then, your worst fear is confirmed: You test positive for COVID-19. In addition to losing your only source of income while you recover, you must suddenly quarantine away from your child for his safety. You have to pause college. Your grandmother doesn’t speak English, and your son still has extensive health needs. How on earth will you get through this? Thankfully, you have a support network: Amoskeag Health. You called your nurse coordinator and she helped you make and organize appointments, even connected you with interpreters for your grandmother. She helped provide grocery deliveries, and any time you felt anxious or overwhelmed, you called for moral support. As you focused on recovering, you knew that your son was in capable hands with people who understand his complex needs. After your recovery, Amoskeag Health worked with you to file an application for a housing voucher from NH Housing to secure a first-floor apartment. With your son’s care managed so well, you resumed college courses and are on track to graduate in December. Now, I want you to step back into your own shoes and imagine what might have happened to this single mother without the support and care that Amoskeag Health provided. Take a moment to really visualize how that situation might have played out: A sick, single mother might have found herself homeless, struggling to care for herself, an aging relative, and a wheelchair-bound child with critical medical needs and with whom she could not be near. That jolt of fear and anguish over the “what if” scenario is what keeps me committed to the families I serve. Her success story reminds me every single day that the work I do matters, and I hope that she reminds you that your continued support of Amoskeag Health makes an inexplicable, lifechanging impact. Thank you for allowing me to continue changing lives like hers. ~A.B., Amoskeag Health Nurse Care Coordinator