Guiding the Future of Rural Health Care

The following article appeared in our 2014 Annual Report.

Gifford volunteers

Back (left to right) Linda Morse, Peter Nowlan, Sheila Jacobs, Paul Kendall, Matt Considine, and Lincoln Clark. Front: Jody Richards, Barbara Rochat, Gus Meyer, Dr. Ellamarie Russo-DeMara, Randy Garner, Sue Sherman, Joe Woodin, Carol Bushey, and Linda Chugkowski. Not pictured: Bill Baumann, Fred Newhall, and Bob Wright.

Volunteer board leads Gifford with vision, passion and energy

2014 was a year of great excitement for Gifford, as several projects moved from the planning stage into actual implementation. Our FQHC status, new senior living community, and the much-needed upgrade for inpatient rooms are all visible signs of Gifford’s readiness for quality community care in a larger landscape of changing healthcare reform.

Each of these accomplishments was built on years of behind-the-scenes planning. None of them would have been possible without the dedicated work of our 16 volunteer board members, who last year alone collectively gave more than 2,500 hours of their time to meetings and subcommittee activities. Board members bring passion and energy to the challenge of balancing the work that translates our mission (providing access to high-quality care to all we serve) with anticipating and planning for future healthcare needs.

“Gifford is woven into the fabric of this community. For more than 100 years generations have had the benefit of local access to quality care,” says board secretary Robert Wright, who was born at Gifford and now lives in Brookfield. “Gifford has been able to maintain that identity and also grow with the times, attracting highly skilled people and successfully investing in the equipment and facilities needed to provide the quality of care that people expect.”

Board members are recruited from across the community and have worked in various businesses and civic organizations. This diverse perspective keeps Gifford’s vision grounded in the community it serves, with a distinctive small town commitment to quality.

Board work is demanding, but members say learning about the hospital and participating in decisions that will shape the future of healthcare in their community is rewarding.

“It is by far the most rewarding volunteer activity that I have ever done,” says Randolph resident Randy Garner. “Gifford has shown me the model of being an actively engaged board member, and seeing the results of the board’s actions is extremely gratifying.”

Others want to give back to their community: “I joined the board because Gifford is community focused, a small town hospital that provides excellent healthcare and uses the latest technology,” says Northfield resident Linda Chugkowski. “I feel proud and privileged to be promoting the hospital during these troubled health care times.”

The job description for a Gifford board member might read: part planner, policy-maker, visionary, realist, promoter, cheerleader, and community advocate. It requires the ability to bring a pragmatist’s eye to sustaining robust primary care and a visionary’s openness to future possibilities. When asked what makes the institution unique, you’ll get the clear answer of a realist:

“Gifford is unique in that they are a small Critical Access Hospital and FQHC facility with niches that they do better than anyone else, like primary care, podiatry and sports medicine,” says Brookfield resident Carol Bushey. “They will never compete with the large hospital, but they will continue to do what they do better than anyone long into the future.”

But new possibilities and future community roles for Gifford are always part of the planning:

“I am excited to see the direction Gifford is going with the senior living community and hope that this continues to all levels so Randolph will have a place where folks can comfortably live out their lives,” says Garner. “Gifford will continue to be on the forefront of quality care with a small town feel.”

2015 Summer Concert Series Seeks Farmers Market Vendors

Sign up now for free vendor space at popular summer community concerts

Gifford Concert Series farmer's marketFree space is being offered to vendors who sign up to sell at the community market held during the 2015 Summer Concert Series on Gifford Park. The summer concerts, now in their 4th year, are a partnership between Gifford Medical Center and the White River Valley Chamber of Commerce.

Starting on Tuesday, July 7th, and continuing for the next six Tuesdays, there will be a different family-friendly concert in Gifford’s park (front lawn) on Route 12 in Randolph. Families bring lawn chairs and picnic blankets for an evening of fun and music starting at 6 p.m. and ending around 7:30 p.m. New this year will be weekly offerings from the grill prepared by a different nonprofit agency during each performance.

There is space for 8-10 vendors per show, so sign up now and reserve a spot to sell produce, flowers, baked treats, crafts, and other farmer’s market items at these popular community gatherings. Contact Jamie Miller, 728-2238; jmiller@giffordmed.org.

The 2015 concert schedule is as follows:

JULY 7: South Royalton Band; Grilling by Potters Angels rescue
JULY 14: Jennings & McComber (Green Mt Indie Folk); Grilling by Orange County Sheriff’s Dept.
JULY 21: Dave Keller Band (Smooth New Jazz); Grilling by Stagecoach
JULY 28: Sol Food (New Orleans Brass Band); Grilling by White River Valley Ambulance
AUG 4: Jeanne & The Hi-Tops (Old Time Rock & Roll); Grilling by Randolph & Bethel Rotarians
AUG 11: Possum Haw (Folk Music/Bluegrass/Country); Grilling by Randolph Center Fire Dept.

The 2015 Summer Concert Series on Gifford Park is brought to you by Chuck Adams Builders, Frankenburg Agency, Gifford Auxiliary, and Gillespie Fuels and Propane.

Gifford Offers ‘Home Alone and Safe’ Course for Kids May 23

home alone courseWellness educator Jude Powers will offer “Home Alone and Safe,” a course for children ages 8-11 on Saturday, May 23, from 9:30 a.m. to noon in Gifford’s Family Center (next to Ob/Gyn and Midwifery).

Designed by chapters of the American Red Cross to meet the needs of children who spend time without adult supervision, this course will help them understand rules and responsibilities, and to anticipate and resolve potential problems.

Participants will learn how to safely respond to a variety of home alone situations, including:

• Internet safety
• Family communications
• Telephone safety
• Sibling care
• Personal safety
• Gun safety
• Basic emergency care

The morning class will include role play, brainstorming, and watching a video on the topic. Each child will take home a workbook and handouts, and earn a certificate upon completion.

“Home Alone and Safe” will be held at Gifford‘s Family Center space at the hospital on Route 12 (South Main Street) in Randolph. The Family Center is beside Gifford Ob/Gyn and Midwifery. Please register with instructor Jude Powers at (802) 649-1841. The cost is $15.

Schulte Exhibit at Gifford Medical Center’s Art Gallery

Lynn Schulte

“Remembrance,” on display in the Gifford Medical Center Gallery, is part of a series artist Lynn Schulte created to celebrate the memory of her mother.

Georgetown, MA artist Lynne Schulte will be exhibiting her paintings in the Gifford Medical Center Art Gallery from May 5th through June 10th, 2015.

The exhibit displays selections from “Remembrance – the Pink Chair Project,” and images inspired by the coastal beauty of New England. Her floral cards and book, Remembrance, will be available in the gift shop.

Schulte has exhibited her work in solo shows in New Hampshire, Vermont, Kansas, Maine, New York, Massachusetts, and Washington DC. Primary among her themes are coastal views and landscapes of Vermont, Maine, and Massachusetts.

Notable series included “A Year in Bloom” when she produced 365 smaller paintings of flowers in oil and watercolor, shown at the AVA gallery in Lebanon, NH. This series was followed by “Fresh Bloom,” consisting of 15 larger floral works, shown at the Latham Library in Thetford, VT. A “Coastal Sunrise” body of work was shown at the Marblehead Arts Association.

“Remembrance – the Pink Chair Project” celebrated the memory of the artist’s mother in moving and beautiful images and was shown in 14 venues over 3 years. Each painting has a story, told in her accompanying book, and these enrich the experience for the viewer. Lynne’s current body of work is a series on the Working Waterfront.

She has taught and has been an art education administrator in Maryland, Vermont, and Massachusetts, and currently teaches private lessons in her studio, specializing in color, painting, and college portfolio development. Schulte holds a BS from Nazareth College of Rochester, NY; an MFA from Antioch University; and a CAGS from Vermont College of the Union Institute and University.

Currently living in Georgetown, MA, Schulte has ties to Vermont from her tenure at as art teacher and Fine Arts Department Chair at Woodstock Union High School. She is married to Thomas LaValley, who was born in Burlington, VT and is a Vermont Distinguished Principal from his many years in educational leadership. Lynne and Tom frequently visit Vermont to be with friends and family.

This exhibit is free and open to the public, and will be displayed through June 10, 2015. The gallery is located just inside the hospital’s main entrance at 44 S, Main St. (Route 12) in Randolph. Call Gifford at (802) 728-7000 for more information.

A Message from the Medical Staff President Dr. Ellamarie Russo-DeMara

The following article appeared in our 2014 Annual Report.

Medical Staff President Dr. Ellamarie Russo-DeMara

Medical Staff President Dr. Ellamarie Russo-DeMara

As president of the Medical Staff I have witnessed firsthand the hard work and dedication not only of our medical team, but of all those behind the scenes who make Gifford a place where patients are a priority.

With economic and healthcare issues front and center in our daily news, it’s reassuring to work for an organization that is fiscally stable without sacrificing quality of care. I know I speak for the entire health care team when I say how fortunate we are to have our new FQHC designation, which will allow us to provide much needed dental and mental health services to our community.

Gifford continues to lead the way in its vision for the future of providing quality care for our community. At the forefront of that vision is the creation of a new Senior Living Community, where our seniors can be cared for in a home-like setting.

As part of this process we are fortunate to be able to “rejuvenate” our existing space into private, more comfortable rooms that will allow us to improve the efficiency and quality of the care we offer our patients.

It has been an exciting year of planning and creating new ways to provide access to the high-quality care we offer through all stages of life—from newborn through to nursing home resident.

A Vision for the Future: Meeting Tomorrow’s Health Care Needs

A message from Development Director Ashley Lincoln

Ashley Lincoln

Above: Ashley Lincoln, Development Director, and Vision for the Future Campaign Committee members Dr. Lou DiNicola (Co-chair), Linda Chugkowski, and Lincoln Clark (Co-chair) at the site of Gifford’s new Morgan Orchards Senior Living Community.

Since outreach began, a little over 18 months ago, many generous donors have stepped up to pledge $3 million for Gifford’s “Vision for the Future” campaign.

This $5 million capital campaign will support patient room upgrades and a new senior living community, improvements that will help us continue to provide the best possible community health care for years to come.

This impressive early support—from members of the business community, Gifford’s volunteer board of Trustees and Directors, former trustees, medical staff, employees, the Gifford Medical Center Auxiliary—is already having an impact.

The beautiful new Menig building that you’ve watched growing in Randolph Center will open in May as an anchor for the new Morgan Orchards Senior Living Community. Soon after, renovation of the vacated hospital wing begins, creating 25 new single-patient rooms that will improve patient privacy, allow state-of-the-art technology to be brought to the bedside, and create an environment that promotes and speeds the healing process.

Humbled and energized by this wonderful start, I can now officially announce that our “silent phase” ended on Saturday, March 7, with the public launch of our “Vision for the Future” campaign at the medical center’s 109th Annual Meeting of Corporators.

Over the years our community has generously supported Gifford through many evolutions. Moving forward we will need everyone’s help to raise the remaining $2 million by the end of 2015. Our goal of $5 million may seem lofty, but this campaign will help us address unprecedented challenges and opportunities in health care.

Providing quality medical care in the hospital and our nine community health centers is central to our mission. We care for patients locally, eliminating the need to travel—sometimes over mountains, often in treacherous winter conditions. Over the years we have invested in state-of-the-art technology, retained high quality staff, and adopted a hospitalist model that helps us care for sicker patients. Modernizing our patient rooms is a next step in improving patient comfort and providing the best care.

A real community concern is a lack of living and care options for our seniors. As our friends and neighbors age and are looking to downsize, we want them to stay where they have grown up, worked, raised their family, and built relationships. Each individual is a piece of our community quilt: when one leaves, it starts to fray.

Your support for this project will help us sustain our community’s health—and protect our “community quilt”—with the very best care, from birth through old age, for another 110 years.

Space that Speeds the Healing Process

One patient per hospital room is good medicine. Here’s why…

The following article appeared in our 2014 Annual Report.

individual hospital rooms

Semi-private rooms offer little privacy or space for patients, their families and
hospital staff. Private patient rooms will alleviate the overcrowding that is typical of shared rooms.

The reality of a shared hospital room is that you don’t get to choose your roommate.

“We do our best to match up personalities and scenarios and illnesses and infection issues,” says Alison White, vice president of the hospital division, “but there are things like having a roommate who is a night owl and you like to be in bed by 7:30. If we need a bed and your room happens to be that one empty bed, you get who you get.”

The new reality at Gifford is that every hospital patient will soon have a room of their own as part of a construction project that received its final okay in October 2013. In spring 2015, when 30-bed Menig Extended Care moves to Randolph Center, the hospital will begin converting the vacated wing. The number of rooms for hospital patients will double while the number of hospital beds—25—remains the same, a ratio that guarantees maximum comfort and safety. The renovations are also an opportunity to open up ceilings, replace old systems, and improve energy efficiency.

“When patients are recovering from surgery or from illness, they want what they want,” says Rebecca O’Berry, vice president of operations and the surgical division.

“Sharing a room with somebody else just doesn’t work for most patients. From the surgeon’s point of view, if I’ve just replaced your total hip, the last thing I want is for you to be in a room with someone who might be brewing an infection.”

White names several other factors, besides the risk of infection, that have helped make private rooms the standard in hospitals today. Among them:

Faster healing: Studies show that patients who are in private rooms need less pain medication because they’re in a more soothing environment. If your roommate has IV pumps that are going off, or the nurse has to check your neighbor every one or two hours—which is very common—the lights go on, the blood pressure machine goes off, the nurse has to speak with the person in the bed next to you. With private rooms, all that is removed.

Ease of movement: Our rooms were built before the current technology existed. IV poles didn’t exist. We now have people with two or three pumps. With today’s technology there’s no room to move around. When you have two of everything—two chairs, two overbed tables, two wastebaskets—it creates an obstacle course.

Better doctor-patient communication: As professionals, we don’t always get the whole story because the patient doesn’t want to be overheard by his neighbor.

Patient satisfaction: Larger rooms, each with a bathroom, will give patients additional privacy and enhance the patient experience. It’s a win-win for everybody.

DeHart Exhibit at Gifford Medical Center’s Art Gallery

“Expressions and Demeanors—Wildlife or Human?”

DeHart art exhibit

“Exuberance,” by Rochester photographer Barb Madsen DeHart

In the year since her last popular exhibit in the Gifford Gallery, Rochester VT photographer Barb Madsen DeHart has collected new photographs while travelling in Africa, The Galapagos, and Wapusk National Park in Manitoba, Canada.

The pieces in the current exhibit, “Expressions and Demeanors—Wildlife or Human?” reflect a change in her objective as a photographer.

“I’m no longer pursuing just ‘photo ops,’ to capture shots of wonderful creatures,” she said. “Rather my focus is on glimpsing how wildlife inadvertently presents itself to the outside world, recognizing their expressions and demeanors as interpreted, in this case, by me.”

The exhibit features 28 portraits—of Polar, Spirit, and Kodiak bears; penguins; fur seals; lions; elephants; and walrus—with a whimsical caption describing what each might be thinking.

One of the photographs, “Polar Bear Mom and Cub,” was selected to be a National Wildlife Federation holiday card for 2015. It is one in a series that shows a mother and her 3-month-old cub emerging from their den in spring.

“The interactions and expressions of new mom and ‘newbie’ made me forget the anxiety I felt as my camera froze, my tripod and camera blew over, and as I vainly tried to de-ice my camera lens, viewfinders, and goggles!” DeHart said.

DeHart has exhibited at the Chandler Art Gallery in Randolph, VT; Compass Arts in Brandon, VT; and at the Annual Photo Show and the Member’s Show, both in Waitsfield, Vermont.

This exhibit is free and open to the public, and will be displayed through May 6, 2015. The gallery is located just inside the hospital’s main entrance at 44 S, Main St. (Route 12) in Randolph. Call Gifford at (802) 728-7000 for more information.

Gifford’s Twin River Health Center Welcomes Susan Tubens, PA-C

Susan Tubens, PA-C

Susan Tubens, PA-C

Susan Tubens, PA-C, has joined Twin River Health Center’s team, adding primary care to their patient-centered urology and OB/Gyn practices.

In 27 years as a physician assistant, Tubens has cared for patients with medical needs ranging from trauma to ongoing primary care. She and her husband, Gifford Obstetrician/ Gynecologist Sean Tubens, moved from Florida to Bethel, Vermont, after searching for a small and friendly community where they could practice medicine and enjoy the outdoors.

Primary care is a special interest of Tubens, who notes that an ongoing relationship with a provider who knows a patient’s health care goals and history can help them stay healthy. A strong believer in preventative medicine, she looks forward to caring for families in the White River community.

Tubens is currently seeing patients at the Twin River Health Center on North Main Street in White River Junction. Call 728-2777 to schedule an appointment today.

Primary Care Gets a Boost

The following article appeared in our 2014 Annual Report.

primary care in Randolph VT

Family nurse practitioner Christina Harlow shares a laugh with Mary Williams of Randolph Center during a recent visit.

A family unable to afford dental care. An uninsured mother-to-be. A loved one suffering from depression. These are some of the people who will be helped by Gifford’s new status as a Federally Qualified Health Center.

The memo to staff was dated November 7, 2013, and sprinkled with exclamation points. It came from administrator Joseph Woodin and was entitled “A Must Read!” The message: Gifford had just been named a Federally Qualified Health Center (FQHC)—an event that Woodin characterized as “some of the biggest news I have ever shared with staff since working at Gifford!”

Gifford's primary care

Christina Harlow consults with family medicine physician Dr. Marcus Coxon.

The FQHC designation is a coveted one, opening the gate to a stream of federal dollars for primary care. The funding comes from the Health Resources and Services Administration (HRSA), the primary federal agency for improving access to health-care services for people who are uninsured, isolated, or medically vulnerable. Of particular interest to Gifford: support for dental care and mental health services for Medicaid patients and the uninsured.

“This assistance from the federal government allows us to develop programs for dentistry, psychiatry, and mental health that are hugely important for the community,” says Medical Director of the Hospital and Medicine Divisions Dr. Martin Johns. “It also allows us to place a bigger focus on primary care. It means we can take better care of our Medicaid patients, offering them services that we couldn’t before because of finances, and that’s huge.

“We’re finding out almost weekly that we can offer things to patients that we didn’t even know about, let alone have the capacity to apply for. The designation was designed to help small groups of physicians serving in rural communities. Our mission has always been that.” Gifford's mission To qualify for FQHC status, a community health center must be open to all, regardless of ability to pay. It must offer a sliding fee scale with discounts based on patient family size and income in accordance with federal poverty guidelines. The federal money is intended to offset these obligations.

Over the past year, Gifford has laid the groundwork necessary to begin drawing on those funds. Among the steps: conducting a search for a psychiatrist to join the medical staff, working out agreements with area dentists to provide care to Medicaid patients, and completing a transition to electronic medical records.

“HRSA is really concerned that they make these health centers as feasible as possible,” says VP of Finance Jeff Hebert, “so there’s a lot of grant opportunity that impacts our financial stability. We get support every year as long as we keep up with the requirements.

“Probably the biggest benefit is that we get bigger reimbursement for our Medicaid patients. Reimbursement is cost-based, and not fee-based, so instead of paying a percentage of the fee for x, y, and z, the government looks at how much it costs to provide those services. It’s a better reimbursement methodology for Medicaid.” Other perks of the designation are: insurance coverage for primary care physicians and relief from staggering medical-school debt, a powerful recruitment incentive.

IF IT WALKS LIKE A DUCK

Dr. Marcus Coxon

The new FQHC designation allows primary care physicians like Dr. Marcus Coxon (left) to offer Gifford patients increased access to mental and dental health services.

The Gifford model is an unusual one: a community health center with satellite clinics and a small hospital at its hub. As such, it provides both primary and critical care to a rural population. It would thus seem eligible for both FQHC funding and the benefits it receives as a Critical Access Hospital, a designation conferred in 2001. But would the feds see it that way?

The FQHC “duck test” was a laborious application process that involved many hospital departments and years of preparation, followed by months of waiting. With acceptance, Gifford the health center became the “parent” of Gifford the hospital—one of only three FQHC/CAHs in the country.

“Our primary-care services—which include internal medicine, family practice, pediatrics, and ob-gyn—are all part of that community health center parent,” explains Woodin.

“The concurrent designation is tremendous for us,” says Johns. “It enables us to provide the most possible benefit to the community while being a small hospital, and it protects us from a lot of the changes going around the state and the region with regard to accountable care: As an FQHC, we cannot be purchased by or absorbed by a larger organization.”

“I look at health-care reform as being primary-care focused,” says Hebert. “It’s that primary-care provider who keeps you healthy and works with you to make sure you as a patient are getting what you need. If you’re prompting that patient to come in for a physical, and to develop healthy behaviors, you’re going to keep that patient a lot healthier at a manageable level than a model that doesn’t focus on primary care. I use myself as an example of what not to do: I only go to a health-care provider when I get to the point when I’m ready to go into the hospital and that’s an extremely expensive proposition. It’s not as efficient, and you as a patient aren’t as satisfied because you’re looking at a long recovery time. By making Gifford Health Care the parent of our organization, we’ve set ourselves up for the future, and I feel we’re in a really good place.”

After eight months of administrative work, Gifford was ready to start drawing on its new funds. The first bill went out in July. “It’s probably going to take most of 2015 to really understand all the levers and dynamics,” says Woodin.

“My thanks and appreciation go out to the staff behind the scenes who made this happen. It was a huge amount of work, and yet strategically, it positions us well, given health-care reform both in the state of Vermont and nationally. It helps us to have the right focus again around primary care, taking care of Medicaid and the uninsured, and looking to build from there.”