Neal Dwelley of the Sanofi Pasteur Vaccines

Role: Account Manager

Organization: Sanofi Pasteur Vaccines

State: ME, NH, and VT

Can you please tell us a little about yourself and your work in rural health?

I have been working 33 years for Sanofi covering Northern New England. I have enjoyed seeing the passion and commitment from the providers who I have known for many years working in the FQHC setting.

Why rural?

I have seen the challenges first hand in patients being able to afford quality Health Care. Camp Carefree is a two week Diabetes camp for kids located in New Hampshire. I started volunteering there in 1987. Many of the 220 campers came from rural Maine and New Hampshire on grants. I still remember the 7-year old girl at dinner time reading her meal card as she became so excited that she could have one tablespoon of peanut butter with her meal. Another girl looked up at me when I was teaching her how to read a compass and she said “Do you have diabetes too?” I replied “No”. She looked up at me and said, “Oh, you know we are very special people” 

It is also the first time that many parents can sleep through the night knowing their children are in a safe environment.

I wish more families had the economic means to send their children to Diabetic Camps to help them learn the best ways to manage lifelong diabetes.

 What does being a member of the New England Rural Health Association mean for you?

The association allows me the opportunity to better understand the challenges that FQHC’s have in meeting the needs of patients. I then can share issues with my company to help address. The following is an example of the benefit in attending the yearly Fall Meeting.

 FQHC’s can not bill Medicare for Influenza vaccines given daily. They can only submit yearly spend reports which makes it a challenge with cash flow. 

I took advantage and met with John McGough Regional Director for HHS in Boston after his talk and explained the problem. He said this is the type of issue that Secretary Azar wants to correct. 

Meetings have taken place to address this issue with Sec Azar. Nothing in Government moves fast.

What does rural health mean to you?

Access to health care is challenging due to many factors including where patients live and the long travel times to work and heath care facilities. Many times, home is in a different direction to work and healthcare. I also appreciate and love the passion that health care workers have for providing high quality health care for patients in rural New England.


If you’d like to be considered for a member spotlight, please let us know!


Keri Dostie of the AMD Global Telemedicine

Role: Director of Marketing
Organization: AMD Global Telemedicine
State: MA

Can you please tell us a little about yourself and your work in rural health?

I am the Director of Marketing for AMD Global Telemedicine, a telemedicine technology and solutions company that focus on helping healthcare organizations deliver care to patients in rural communities. 

I feel passionate about understanding rural healthcare organizations’ specific telemedicine needs, so I can share their success stories with the rest of industry. My role here at AMD has allowed me to engage with the rural healthcare community to help them increase access to care through the use of digital technologies.

Why rural?

The rural population is such a gem to our population because they bring a sense of community to our nation.  But unfortunately their remote locations make it difficult for them to receive proper healthcare in times of need and to manage their chronic conditions.  Rural patients have the most to gain from telemedicine because it removes the very common barriers of travel and expense in going to see a healthcare provider or specialist far away. Telemedicine brings the specialist and healthcare directly to the patient instead of the patient having to see the provider.

What does being a member of the New England Rural Health Association mean for you?

Being a member of New England Rural Health Association is important to me as an individual to feel part of making a difference in how rural communities can receive quality care. As a member, I look forward to networking with healthcare organizations to find out their challenges in the delivery of care to rural patients.  

What does rural health mean to you?

Rural health means making sure patients in remote areas have access to the care they need.


If you’d like to be considered for a member spotlight, please let us know!


Andy Lowe, Chief Strategy Officer at Outer Cape Health ServicesAndy Lowe

Why rural?

I have lived in rural New England my entire life, growing up in grown-over farm country in Connecticut, then living in Vermont in college and after, and most recently in outer Cape Cod. People who live in rural places have a connection to the land and nature that you just don’t get even in suburban environments, let alone urban spaces, and that connection binds us together in a way that used to be universal but which is rapidly—and unfortunately—becoming antique. I find the challenges faced in rural environments, particularly those related to health, to be stimulating and thought-provoking. Solutions to rural challenges require thinking around corners, often by adapting solutions from urban/suburban spaces to fit the unique challenges of low-density environments. I wouldn’t—probably couldn’t—live anywhere else.

What does being a member of the RoundTable mean for you? 
The Association provides a focal point for raising awareness about rural health challenges and solutions and a forum for conversation, networking, and best-practice sharing. In terms of tangible benefits, I have had several funding and research opportunities sent my way by RoundTable colleagues. I also love the fact that the folks from the “rural nooks and crannies” in southern New England can contribute to and learn from their more “classically” rural northern New England colleagues. TheAssociation is ultimately a validation of the fact that we’re all in this together!

What does rural healthcare mean to you?

Rural healthcare means identifying and overcoming challenges that most of the country doesn’t even recognize. Many folks see rural landscapes and think of beautiful scenery, vacations, and getaways. I see places where invisible, underserved populations have been created by the forces of tourism and second home-driven economies. I see people who are living on subsistence-level incomes from two, three, or four jobs—snowplowing, commercial fishing, handiwork, snowmaking—while dealing with a variety of social determinant issues that their urban counterpoints couldn’t even fathom. These are people with an innate dignity, but for whom access to healthcare can require lengthy trips by car, if they are fortunate enough to own one, or ridiculously lengthy trips by public transportation, which is frequently inadequate to non-existent. Let’s not forget that limited cell coverage and broadband that can make rural places feel more like the 19th than the 21st century (OK, so that’s an attraction for some of us as well). We have essentially created a rural underclass that faces serious health disparities, and I find the challenge of reversing this trend to be stimulating and rewarding. 

Marty Milkovic, Connecticut Dental Health Partnership Marty Milkovic

Why rural? 

Most people don't think of rural and Connecticut together. While our state is small, there are significant areas that are rural and they have all the associated challenges: fewer services, transportation issues, isolation, cows, etc. I live in a small town on the edge of Connecticut's 'Quiet Corner', the northeast portion of the state. Farming is still an important business and we have one of the largest farmers markets in New England which hosts up to 5,000 people on a peak summer Sunday. I grew up in another rural Connecticut town with a chicken farm for a neighbor and I lived in a very rural area of Ohio for five years. So you can say I've had plenty of exposure to rural. 

What does being a member of the RoundTable mean for you?

The RoundTable has been a good forum for rural health issues and rural oral health issues in particular.  I got involved originally with the old 'Rural Oral Health' conference almost ten years ago and have stayed involved ever since.  It has been important to meet other folks from across New England, hear about their work and see how oral health fits in the overall picture.

What does rural healthcare mean to you?

Of course, for me, oral health care in rural settings is important.  Our data shows that dental utilization for clients in HUSKY Health (Connecticut Medicaid/CHIP) is lowest in the rural areas of our state, even though the American Dental Association's Health Policy Institute's analysis shows that physical access to dentists is very good throughout Connecticut.  Our hypothesis is that rural areas have unique problems that limit utilization: weaker social service networks, more isolation, and transportation issues.  There may even be cultural barriers, in our words, Yankee stubbornness. Our work is to figure out how we can overcome these obstacles.  It's a meaningful task.


The New Hampshire Office of Rural Health

What is your organization's mission and/or purpose of your organization/department/program? How do your efforts support healthy rural communities?

The mission and function of the Rural Health and Primary Care section is to support communities and stakeholders that provide innovative and effective access to quality healthcare services with a focus on the low income, uninsured, and Medicaid populations of New Hampshire.

How does being a member of the RoundTable help you and your colleagues in your work? What resources/opportunities do you find valuable?

Being a member allows us to easily collaborate with and support similar programs in rural New England. It directly supports our responsibility as a State Office of Rural Health to offer technical assistance to rural health care providers and organizations, provide healthcare-related information to rural healthcare stakeholders, and serve as a liaison between rural healthcare organizations and many New Hampshire Department of Health and Human Services programs. We also maintain a clearinghouse for collecting and disseminating information on rural health care issues and innovative approaches to the delivery of healthcare in rural areas. 

Can you share an example of a project that you are working on that may be a valuable model/resource for other members of the RoundTable?

For the past three years we have been supporting a Rural Health Clinic Technical Assistance network for all of the RHCs in New Hampshire. The main purpose of this initiative is to directly benefit rural communities by equipping Rural Health Clinics with the tools and resources necessary to effectively and efficiently serve their rural populations. In addition to an annual needs assessment, the network has three main functions: technical assistance webinars, diabetes learning collaborative, and clinical measure data collection and reporting for both diabetes and hypertension.

New Hampshire Rural Health


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