The following article appeared in our 2014 Annual Report.
The first baby of the year is born to Casandra Perry of Bethel. Baby Bryden is welcomed on Jan. 2 at 3:48 a.m.
A “Matters of the Heart” series is offered monthly all year long for heart patients, or anyone looking to improve his or her heart health. Also offered: Chronic Conditions Support Group, Caregiver Support Group, Diabetes Group Education Classes, childbirth classes, and a new Mood Disorder Support Group.
A “Quit In Person” tobacco cessation class helps those addicted to smoking or other tobacco products to quit.
A “Chronic Pain Healthier Living Workshop” is offered at the Randolph House. The six-week free series addresses coping with chronic pain.
Experienced nurse leader Alison White joins Gifford as vice president of patient care services – a role that oversees the Hospital Division, including inpatient care, the Birthing Center, Ob/Gyn and Midwifery, the Emergency Department, Menig nursing home, and Adult Day Program.
After considerable input from providers, staff, and clergy, the Gifford board passes a policy implementing the Patient Choice at End of Life law. The policy allows willing primary care providers to prescribe lethal prescriptions but prohibits use of such prescriptions in the hospital setting.
An educational event shares Gifford’s “Vision for the Future” with Corporators. The vision focuses in part on constructing a senior living community in Randolph
The Gifford Medical Center Auxiliary awards $19,000 to various Gifford departments, including equipment for inpatient units, pulse oximeters for primary care offices, play equipment and furniture for The Robin’s Nest Child Enrichment Center, and a handheld scanning device for Materials Management.
Experienced hospitalist Dr. Robert Cochrane joins Gifford’s hospitalist (inpatient care) team.
An “Infant and Child CPR” class helps new parents and families learn lifesaving techniques.
A “Home Alone and Safe” course teaches children 8-11 how to respond to home alone situations.
A “Babysitter’s Training Course” is held for area pre-teens and teens seeking greater expertise in safe child care.
Chiropractor Dr. Michael Chamberland joins the Sharon Health Center sports medicine team.
A “Healthier Living Workshop” series begins, providing the chronically ill free information on improving their health.
A second “Quit In Person” tobacco cessation class is held, this time at the Gifford Health Center at Berlin.
Gifford’s Health Connections office and Blueprint for Health team partner with Bi-State Primary Care to offer free help signing up for Vermont Health Connect. Help is available each weekday, but on March 6 and March 13 extra “navigators” come to Gifford to help even more people sign-up in advance of a March 15 deadline.
Gifford’s annual Diabetes Education Expo is merged with a Health Fair for all chronically ill and offered on March 14.
Gifford holds its 108th Annual Meeting of its corporators, announcing achievements of 2013, unveiling a new video about Gifford, and hearing a special presentation from Green Mountain Care Board Chairman Al Gobeille. Corporators elected Matt Considine of Randolph to the board and re-elect Lincoln Clark of Royalton. Grants were announced, including $25,000 in William and Mary Markle Community Foundation funds to 10 area towns’ schools to support exercise and healthy eating programs. The Philip D. Levesque Memorial Community Award, in memory of Gifford’s late president, is awarded to the Orange County Parent Child Center.
Gifford staff raise $520 for the March of Dimes by wearing “Blue Jeans for Babies”.
Gifford’s mammography and nuclear medicine departments earn three-year, national re-accreditations from the American College of Radiology.
Certified nurse-midwife and women’s health nurse practitioner April Vanderveer joins Gifford’s 24-hour midwifery team.
Steven S. Mustoe, D.C. has joined the Sports Medicine clinic at the Sharon Health Center. A board-certified chiropractor, he has practiced for the last 18 years in Brattleboro, VT and Charlottesville, VA.
Mustoe became a chiropractor because of his own experience with an injured back. “The only relief doctors could offer was through medication. When I went off drugs, the pain returned,” he said. “I eventually found a chiropractor who helped me heal. To be able to relieve someone’s pain like that is an amazing thing!”
Originally from London, England, he received a Doctor of Chiropractic degree at Life Chiropractic West in California after relocating to the States to be with his wife, Gail. The two met 25 years ago when Mustoe was a tour guide on a seven-week bus tour through Europe. They’ve been together ever since, and now have two children.
After years in private practice, Mustoe looks forward to collaborating with a multidisciplinary sports medicine team that includes podiatry, general sports medicine, and physical therapists. He is also excited about the equipment and technology at the Sharon center—a physical therapy gym space; x-ray technology and mounted flat screens for reviewing radiological exams; physical therapy treatment rooms; and a state-of- the-art gait analysis system.
His special interest is in helping people regain the ability to enjoy their life: as an athlete, an injured veteran, or someone unable to perform daily tasks.
“I tend to work gently, to listen to people and then help with function as well as pain,” he said. “You don’t have to be an athlete—maybe what’s important to you is to be able to play with the grandchildren in the back yard.”
Dr. Mustoe is now seeing patients at the Sharon Health Center. Call 763-8000 to schedule an appointment.
When Christina DiNicola, MD, FAAP started practicing in Gifford’s Pediatrics department this spring, she returned to work next to the mentor she had “job shadowed” before heading off to Stanford University in the fall of 1994. Today that mentor, Dr. Lou DiNicola, is not only her colleague but her father-in-law.
“I always knew I wanted to practice medicine, but that long-ago summer with Lou confirmed that I wanted to work in Pediatrics,” she said. “Last fall, I was about to sign into a partnership that would mean committing to living in Philadelphia when the Gifford position opened up, but we knew this was the right move for our family. I felt like I was coming home!”
DiNicola has worked in a range of communities (including suburban New Jersey, inner city Philadelphia, rural Appalachia, and on a Navajo reservation in Arizona), and with several national organizations including the National Multiple Sclerosis Society and Families USA. She was director of the Integrative Pediatrics program at the Thomas Jefferson University and Hospital in Philadelphia, and founder and medical coordinator of the Reach Out and Read Program at South Philadelphia Pediatrics.
After that summer internship in Randolph, she attended Stanford University and graduated with a BA in human biology (concentration in Children, Family & Public Policy). She received a certificate of completion in the Children & Society Curriculum from the Stanford Center on Adolescence, and earned her medical doctorate degree at the University of Medicine and Dentistry-Robert Wood Johnson Medical School. Her residency training in pediatrics was at The Children’s Hospital of Philadelphia, and she is board certified in pediatrics.
DiNicola says she brings a personalized, yet evidence-based approach to her practice, and stresses building healthy habits early on to prevent disease and mental health issues later in life. She especially enjoys helping families understand the direct connection between mental and physical wellbeing, and to use self-relaxation techniques like deep breathing, yoga, progressive muscle relaxation, or other mind/body techniques that can help with anxiety, depression, or sleep issues. She prefers using a team oriented approach in partnership with families to create the best health outcomes for her patients.
When the DiNicola family’s moving van arrived in Randolph on April 1, 2015, the “meant-to-be” nature of her new position was highlighted by the fact that the chance encounter that connected her to Gifford and her subsequent career in Pediatrics had occurred on April 1st exactly 21 years ago.
Christina DiNicola was visiting a friend when she met Damian DiNicola on April Fool’s Day in the Randolph High School parking lot in 1994. She returned home to New Jersey with a prom date, and the two have been together ever since.
Dr. Andrew Erickson has joined Gifford Medical Center, adding a fourth provider to the hospital’s general surgery team.
He most recently worked as a surgeon at a Mid Valley Hospital, a rural community hospital in Omak, Washington; and as a general and acute care surgeon at the Franklin Square Medical Center in Baltimore, MD.
Born and raised in Seattle, Erickson earned a BS in physics at the University of Washington, where he also competed in national collegiate cycling championships. Before moving on to graduate school, he took a year off to work as a bike messenger in Boston. A physician from one of the city’s larger hospitals was among the avid cyclists he met that year, and he began to consider a career in medicine.
“I felt more social than most physics majors, and I knew I wanted to interact more with people than with particle detectors and telescopes,” he said. “Being a surgeon seemed like a good fit. I enjoy people and the problem-solving involved in fixing bikes and machines—a surgeon helps people by solving problems and fixing things in the body.”
Erickson returned to Seattle, took premed courses, and received a Doctor of Medicine at the University of Pittsburgh School of Medicine. He completed his general surgery residency was at the Washington Hospital Center in Washington, DC, where he gained experience in emergency general surgery, transplantation, and cardiovascular surgery.
Erickson and his wife, Gifford Ob/Gyn Elizabeth Nigrini, have been looking for a small community where they could raise their two young daughters and easily access the hiking, biking, and skiing that the family enjoys. They were drawn to Gifford because they felt the hospital was responding to changing healthcare needs in a thoughtful and proactive way, and offered opportunities to provide service to central Vermont.
Dr. Erickson brings to his work an enthusiasm for minimally invasive (laparoscopic) surgery. He likes to partner with his patients, clearly explaining the problem and available options, so that together they can find an approach that works for the patient. To learn more about Gifford’s General Surgery program, visit www.giffordmed.org or call the General Surgery office at 802-728-2430.
The following article appeared in our 2014 Annual Report.
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.
Roger Clapp and JoEllen Calderara from March of Dimes in Vermont, receive check from Ellen Fox, RN, and Kim Summers, Birthing Center assistant nurse manager. The check was for $505 in employee donations to Blue Jeans for Babies day, and Gifford’s sponsorship of the CVT March for Babies in May.
More than 100 Gifford Medical Center employees raised $505 for the March of Dimes by wearing “Blue Jeans for Babies” to work on Friday, March 20, 2015.
Each March the Randolph medical center and its outlying health clinics participate in the fund-raiser, which allows employees who donate $5 to the March of Dimes to wear jeans to work for the day. The March of Dimes is the nation’s leading non-profit organization for pregnancy and baby health. It raises funds through a variety of events to help prevent birth defects, premature births, and infant mortality.
Roger Clapp, executive director of the March of Dimes in Vermont, thanked hospital employees for their participation in the fund-raiser and – as a medical center with a renowned Birthing Center – for their work toward healthy births.
“The March of Dimes recognizes the care and commitment to excellence among the Gifford team that contributes to Vermont’s national lead in preventing premature birth. We’re particularly thankful to be able to reinvest the staff’s fund-raising proceeds to give every baby in Vermont a healthier start,” Clapp said.
Gifford Birthing Center Assistant Nurse Manager Karen Summers and RN Ellen Fox presented the check to Clapp and Jo Ellen Calderara of March of Dimes in Vermont.
Gifford is also a sponsor of the Central Vermont March for Babies walk on Sunday, May 3, 2015 at Montpelier High School. Sign-up online at www.marchforbabies.org or by calling 802-560-3239.
The following article appeared in our 2014 Annual Report.
Members of our Gifford family were recognized at the Employee Awards Banquet on October 18 at Vermont Technical College for their years of service. (Employees are recognized in five-year increments.)
Congratulations to these individuals and thank you to all for your dedication and service.
Rebecca Jo Ward
Dr. Elisabeth Nigrini has joined Gifford Health Care, expanding the comprehensive women’s health care team to three Ob/Gyn doctors and four certified nurse midwives.
A native of Pittsburgh, PA, Nigrini discovered early in life that she enjoyed teaching, working with people, and that she had a particular interest in women’s issues. She mentored adolescent girls as an undergraduate at Swarthmore College, was awarded a graduate fellowship in public affairs, and has volunteered with counseling hotlines and in women’s shelters.
In the field of women’s health she found a career that combined her driving interests. “In my third year of medical school I did a rotation in obstetrics and it was so rewarding,” she said. “I found a way to combine medicine with my commitment to public service, mentoring, and working with women.”
Nigrini has worked with underserved women in Tanzania and the United States, and had additional training in maternal-fetal medicine at Johns Hopkins University. She likes helping women through their labor and delivery experience, and most enjoys establishing continuing care relationships with her Ob/Gyn patients.
“Working with women’s health has an educational component that I enjoy because I feel I can have an impact,” said Nigrini. “People are willing to make changes when facing transitional periods. A woman may quit smoking when pregnant, or be more open to information about lifestyle changes—these things can impact an entire family.”
The move to Randolph is an especially good fit for Nigrini and her family. Her husband, Andy Erickson, MD, is also working at Gifford and they both wanted to practice medicine in a hospital where they could establish ongoing relationships with their patients. They also wanted to raise their two young daughters in a small community where they could enjoy the outdoors.
Board-certified by the American Board of Obstetrics and Gynecology, Nigrini brings a set of skills and experience that enhance the comprehensive approach of Gifford’s women’s care services, particularly for women with complicated or higher risk pregnancies. She is currently accepting new patients. Call her at Gifford Ob/Gyn & Midwifery at (802) 728-2401.
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.
The following article appeared in our 2014 Annual Report.
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!”
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.” 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
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.”