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Hot Meal and a Checkup: Geisel School Students Offer Health Clinic at Claremont Soup Kitchen

  • Tom Chase of Claremont eats his dinner at the Claremont Soup Kitchen as medical students Paula Piedrahita, back left, and Erik Andrews, back right and their advisor Dr. William Boyle, back middle, prepare to give flu shots at the Claremont Soup Kitchen Monday, November 4, 2013. Valley Regional Hospital provided 100 doses of the vaccine for the clinic.<br/>(Valley News - James M. Patterson)

    Tom Chase of Claremont eats his dinner at the Claremont Soup Kitchen as medical students Paula Piedrahita, back left, and Erik Andrews, back right and their advisor Dr. William Boyle, back middle, prepare to give flu shots at the Claremont Soup Kitchen Monday, November 4, 2013. Valley Regional Hospital provided 100 doses of the vaccine for the clinic.
    (Valley News - James M. Patterson)

  • Signs on the doors of the Claremont Soup Kitchen advertise its hours, rules and the flu shot clinic being held by volunteer medical students Monday, November 4, 2013. "We've got approximately 7000 people more coming in and getting (boxed) meals than we had the year before," said Jan Bunnell, the soup kitchen's director. Many of them are uninsured. <br/>(Valley News - James M. Patterson)

    Signs on the doors of the Claremont Soup Kitchen advertise its hours, rules and the flu shot clinic being held by volunteer medical students Monday, November 4, 2013. "We've got approximately 7000 people more coming in and getting (boxed) meals than we had the year before," said Jan Bunnell, the soup kitchen's director. Many of them are uninsured.
    (Valley News - James M. Patterson)

  • Erik Andrews talks with a boy while serving dinner at the Claremont Soup Kitchen Thursday, October 24, 2013. While waiting for the construction and furnishing of the clinic's exam rooms to be finished Geisel Medical School students and Schweitzer Fellows Andrews and Christine Breuer regularly served meals at the soup kitchen to build a rapport with the diners. "The beginning of anything is fragile," said Andrews who, with Breuer, took over the project from two former Schweitzer Fellows. "We wanted to help out and get this thing going." <br/>(Valley News - James M. Patterson)

    Erik Andrews talks with a boy while serving dinner at the Claremont Soup Kitchen Thursday, October 24, 2013. While waiting for the construction and furnishing of the clinic's exam rooms to be finished Geisel Medical School students and Schweitzer Fellows Andrews and Christine Breuer regularly served meals at the soup kitchen to build a rapport with the diners. "The beginning of anything is fragile," said Andrews who, with Breuer, took over the project from two former Schweitzer Fellows. "We wanted to help out and get this thing going."
    (Valley News - James M. Patterson)

  • Christine Breuer talks with soup kitchen volunteer Bruce Howard, of Unity, about his injured shoulder at the Claremont Soup Kitchen clinic Tuesday, November 25, 2013. Breuer suggested that Howard, who has no health insurance, make an appointment to see a doctor at the Good Neighbor Clinic in White River Junction. Two months later he said it is healing slowly, though he has not seen a doctor.<br/>(Valley News - James M. Patterson)

    Christine Breuer talks with soup kitchen volunteer Bruce Howard, of Unity, about his injured shoulder at the Claremont Soup Kitchen clinic Tuesday, November 25, 2013. Breuer suggested that Howard, who has no health insurance, make an appointment to see a doctor at the Good Neighbor Clinic in White River Junction. Two months later he said it is healing slowly, though he has not seen a doctor.
    (Valley News - James M. Patterson)

  • After getting his flu shot Derek Dromgoole, 13, of Claremont, right, with the help of soup kitchen director Jan Bunnell, left, tries to convince his dad, Don Dromgoole, middle, to get a vaccination during a free flu clinic Monday, November 4, 2013. Don, a seasonal worker who stops in at the soup kitchen occasionally when work dries up, decided to forego the shot. <br/>(Valley News - James M. Patterson)

    After getting his flu shot Derek Dromgoole, 13, of Claremont, right, with the help of soup kitchen director Jan Bunnell, left, tries to convince his dad, Don Dromgoole, middle, to get a vaccination during a free flu clinic Monday, November 4, 2013. Don, a seasonal worker who stops in at the soup kitchen occasionally when work dries up, decided to forego the shot.
    (Valley News - James M. Patterson)

  • Erik Andrews, left, and Christine Breuer, right, Geisel Medical School students and Schweitzer Fellows, assemble a scale donated to the Claremont Soup Kitchen clinc by Breuer's father in Claremont, N.H. Tuesday, November 25, 2013. The clinic began with Schweitzer Fellows Samantha Batman and Mazin Abdelghany in 2012 working out of the the soup kitchen office, then two exam rooms were built for privacy. When Andrews and Breuer took over donations of exam tables, cabinetry and other supplies completed the furnishing of the clinic.<br/>(Valley News - James M. Patterson)

    Erik Andrews, left, and Christine Breuer, right, Geisel Medical School students and Schweitzer Fellows, assemble a scale donated to the Claremont Soup Kitchen clinc by Breuer's father in Claremont, N.H. Tuesday, November 25, 2013. The clinic began with Schweitzer Fellows Samantha Batman and Mazin Abdelghany in 2012 working out of the the soup kitchen office, then two exam rooms were built for privacy. When Andrews and Breuer took over donations of exam tables, cabinetry and other supplies completed the furnishing of the clinic.
    (Valley News - James M. Patterson)

  • Tom Chase of Claremont eats his dinner at the Claremont Soup Kitchen as medical students Paula Piedrahita, back left, and Erik Andrews, back right and their advisor Dr. William Boyle, back middle, prepare to give flu shots at the Claremont Soup Kitchen Monday, November 4, 2013. Valley Regional Hospital provided 100 doses of the vaccine for the clinic.<br/>(Valley News - James M. Patterson)
  • Signs on the doors of the Claremont Soup Kitchen advertise its hours, rules and the flu shot clinic being held by volunteer medical students Monday, November 4, 2013. "We've got approximately 7000 people more coming in and getting (boxed) meals than we had the year before," said Jan Bunnell, the soup kitchen's director. Many of them are uninsured. <br/>(Valley News - James M. Patterson)
  • Erik Andrews talks with a boy while serving dinner at the Claremont Soup Kitchen Thursday, October 24, 2013. While waiting for the construction and furnishing of the clinic's exam rooms to be finished Geisel Medical School students and Schweitzer Fellows Andrews and Christine Breuer regularly served meals at the soup kitchen to build a rapport with the diners. "The beginning of anything is fragile," said Andrews who, with Breuer, took over the project from two former Schweitzer Fellows. "We wanted to help out and get this thing going." <br/>(Valley News - James M. Patterson)
  • Christine Breuer talks with soup kitchen volunteer Bruce Howard, of Unity, about his injured shoulder at the Claremont Soup Kitchen clinic Tuesday, November 25, 2013. Breuer suggested that Howard, who has no health insurance, make an appointment to see a doctor at the Good Neighbor Clinic in White River Junction. Two months later he said it is healing slowly, though he has not seen a doctor.<br/>(Valley News - James M. Patterson)
  • After getting his flu shot Derek Dromgoole, 13, of Claremont, right, with the help of soup kitchen director Jan Bunnell, left, tries to convince his dad, Don Dromgoole, middle, to get a vaccination during a free flu clinic Monday, November 4, 2013. Don, a seasonal worker who stops in at the soup kitchen occasionally when work dries up, decided to forego the shot. <br/>(Valley News - James M. Patterson)
  • Erik Andrews, left, and Christine Breuer, right, Geisel Medical School students and Schweitzer Fellows, assemble a scale donated to the Claremont Soup Kitchen clinc by Breuer's father in Claremont, N.H. Tuesday, November 25, 2013. The clinic began with Schweitzer Fellows Samantha Batman and Mazin Abdelghany in 2012 working out of the the soup kitchen office, then two exam rooms were built for privacy. When Andrews and Breuer took over donations of exam tables, cabinetry and other supplies completed the furnishing of the clinic.<br/>(Valley News - James M. Patterson)

Claremont — The Claremont Soup Kitchen has long been a popular destination for people in need of warm clothing, a hot meal or food to bring home. Recently, it’s also offered a free health clinic.

“I’ve dreamed about it,” said Jan Bunnell, the soup kitchen’s director. “Finally, my prayers are answered.”

Bunnell, who founded the Central Street nonprofit in 1983, sees a “drastic need” for medical services among those the soup kitchen serves. Its dinner clients, 117 a night on average, include many lacking health insurance and others whose plans have large deductibles, Bunnell said.

The clinic aims to help people who are under- and uninsured catch medical problems early and avoid costly emergency room visits. Every other Monday, students from the Geisel School of Medicine at Dartmouth offer health screenings during dinner hours, 4-6 p.m. The screenings include blood glucose and blood pressure checks and a questionnaire that asks about other preventative measures, such as vaccines, pap smears and mammograms.

“It’s intended to be the first stop to connect them to where they need to go,” said Christine Breuer, one of the two Schweitzer fellows who is managing the clinic this year. “If somebody comes with an issue beyond our expertise, we would connect them with another care provider,” such as a primary care physician or specialist.

Last Monday, Coreen Price was eating dinner at the soup kitchen with her grandmother and son, 3-year-old Gage Saltonstall. She was worried about Gage, who had a spot under his arm where their cat had scratched him, and stopped into the clinic. It turned out to be impetigo, and Price left with ointment and tips for caring for the skin infection until they could see her primary care physician the next day.

Price’s Medicaid had lapsed when she moved recently, and she hadn’t yet re-signed. The clinic “helps a lot because some people don’t have a lot of money,” she said.

The clinic was started in 2012 by medical students Samantha Batman and Mazin Abdelghany, last year’s Schweitzer fellows at Geisel. Students chosen for the yearlong fellowship, through the New Hampshire-Vermont Schweitzer Fellows Program, volunteer to address unmet health needs in underserved populations.

This year’s fellows, Breuer and Erik Andrews, are building on the project. They have been recruiting first-year students to help and hope to build up to seeing patients every Monday, Breuer said.

The project, modeled on the Good Neighbor Health Clinic in White River Junction, is an evolving collaboration. The Geisel School of Medicine donated exam tables for the clinic, which started off in Bunnell’s office. When patients were being seen, Bunnell took her paperwork into the dining room. Last spring, the soup kitchen installed two soundproof exam rooms off the main dining area and outfitted it with cabinets donated by Crown Point Cabinetry in Claremont.

Good Neighbor has been advising the students on case management and setting up the clinic, which is using a free electronic medical records program, Practice Fusion, to keep track of patients. Good Neighbor, which does not use an electronic medical records system, may eventually adopt the program, said Pam Vernon, Good Neighbor’s volunteer director.

Dr. Bill Boyle, the faculty head of the Geisel Community Service Committee, mentors Breuer and Andrews, as he did last year’s fellows. Dr. Oliver Herfort, chief medical officer and an internist at Valley Regional Hospital, is acting as “preceptor,” or specialized tutor.

“We are trying to work on physician oversight,” Breuer said. “We want to have a physician there when we are with patients, just in case something comes up a doctor needs to see.”

In addition to receiving screenings, patients can also be connected with a tobacco cessation program and receive help accessing other health care programs.

“A lot of people do qualify for Medicaid and just haven’t gone through the paperwork,” Breuer said.

Recently, she and Andrews helped Alan Graves, of Claremont, access the government-funded program. They helped him reschedule appointments and drove him to see a specialist at Dartmouth-Hitchcock Medical Center.

The process was eye-opening, said Andrews, who compared navigating the health care system to connecting the dots. “The dots are confusing, and they move.”

In the future, organizers hope the clinic will be a conduit for other services as well. “We will assess what the needs are and go from there,” Boyle said

Patients requiring follow-up care are referred to local providers, such as Good Neighbor Health Clinic, which includes Claremont in its catchment area, and Valley Regional Hospital, which has a financial aid program for people who can’t pay.

“I see this as filling a need in this community and providing access to a form of health screening that might not otherwise be available readily to this underserved population,” said Rolf Olsen, director of community engagement at Valley Regional Hospital.

That population includes people not covered by Medicaid, such as those with lower-paying jobs who don’t have access to health care through their employers, he said. By law they are obligated to purchase health care or pay the penalty, “though many people, I’m imagining, will opt not to buy the insurance,” and the penalty appears to be difficult to collect.

Bunnell said she’s happy with the clinic so far. Since it opened, clients who “never go to doctors” because they’re uninsured have been diagnosed with serious medical problems, such as diabetes. And the word is spreading. Recently, people who don’t eat at the soup kitchen have also been stopping by in search of medical care, she said. “I’m sure this is going to grow and grow.”

Having the free service nearby is crucial for the many Claremont residents who lack transportation, Bunnell said.

On Monday, 18-year-old Keanu Laferte talked with Breuer about her ongoing upper back pain. “She’s going to help me find a doctor that will look at it,” said Laferte, who has Medicaid.

Laferte, a Claremont resident, receives her medical care in Lebanon. Her grandfather drives her to appointments, but his vehicle is unreliable.

“We usually make it, but we broke down twice,” she said. Seeing Breuer at the soup kitchen was “a whole lot easier.”

Aimee Caruso can be reached at acaruso@vnews.com or 603-727-3210.