A New Home for All Rehabilitation, Billing

occupational therapist Ann Brunelle

This article was featured in our Spring 2014 Update Community Newsletter.

The Kingwood Health Center in Randolph underwent an expansion in the fall that both improved the Route 66 health center and freed up needed space at Gifford’s downtown campus.

The addition was completed in November and over the winter several Gifford departments made the move to the impressive, new space. Those departments included:

  • Occupational and speech therapies, which joined outpatient physical therapy on the ground floor of Kingwood
  • Billing
  • Accounting

The move of occupational and speech therapies creates a full-spectrum, multidisciplinary rehabilitation center at Kingwood. Added is some gym space, six new exam rooms and improved staff areas.

“Everyone loves the new building,” notes Megan Sault, the rehabilitation department’s operations coordinator.

Having all rehabilitation services in one, convenient location has reduced confusion among patients as to where they should go for their appointment and allows for a collaborative approach to care.

“It’s really great to be so close to team members and share this beautiful facility,” says speech therapist Kathy Carver, who on the day we visited was meeting with patient Terry White of Randolph Center. Terry, who had a stroke, had also seen physical therapy that day, allowing him to make just one trip to Kingwood, and allowing collaboration on Terry’s care.

For others the new location near Interstate 89 is just convenient.

Occupational therapy patient Michael Dempsey of Brookfield was recovering from a broken arm that had left him with shoulder pain. “It’s nice, got a lot of room and is closer to my house. It’s convenient,” Michael remarked.

On the top floor is new office space for accounting as well as billing, or what the medical center calls patient financial services. This is where patients can go to pay their bills or make billing inquiries.

To find the billing office, park in the upper drive and use the door on the left. There are signs inside.

Gifford first bought the Kingwood building in 2007 as an opportunity to expand services. Initially the flat-roofed, dark structure underwent renovations. The new addition seamlessly expanded the structure toward the wood-line.

Also located at the health center are Gifford’s Blueprint Community Health Team, mental health practitioner Cory Gould, the Diabetes Clinic and a private practice dentist, Dr. John Westbrook – all on the top floor.

Call the health center at 728-7100 and listen for options for reaching the various departments.

Health Connections caseworker Michele Packard remains at the main medical center. Michele provides patients help accessing insurance and free care options. (Go in the main entrance at Gifford’s main campus and look for signs to find Michele.)

Gifford Named a Top 100 Critical Access Hospital in the Nation

Gifford facadeGifford Medical Center in Randolph has been named among the nation’s top 100 performing Critical Access Hospitals by iVantage Health Analytics.

iVantage has developed what it calls a Hospital Strength INDEX and for 2014 measured 1,246 Critical Access Hospitals across the nation on 66 different performance metrics, including quality, patient outcomes and satisfaction, affordability, population health and hospital financial strength.

After weighing all of those factors, Gifford for 2014 has been named among the Top 100 Critical Access Hospitals in the nation – meaning it does well in a variety of areas as compared to its peers.

“Rural health care …. plays a vital role for communities across America, serving nearly 80 million people. The services provided in rural America are similar to those needed in any major metropolitan area, yet the volumes and economic resources provide little economies of scale, making for little benefit from scale. These Top 100 Critical Access Hospitals exhibit a focused concern for their community benefits and needs, regardless of scale, reimbursement and people’s ability to pay,” said John Morrow, executive vice president of iVantage.

Gifford was founded in 1903 and is part of Vermont’s non-profit health system. A 25-bed hospital in Randolph, it has eight outlying health centers meeting community members’ health needs where they live and work.

For the last 14 consecutive years, Gifford has met its state-approved budget and operating margin – a unique feat amid challenging economic times. At the same time, Gifford has embraced community health improvement initiatives that benefit patients, such the Vermont Blueprint for Health and by achieving Federally Qualified Health Center status.

A Critical Access Hospital is a hospital certified to receive cost-based reimbursement from Medicare. This program is intended to reduce hospital closures in rural areas, promotes a process for improving rural health care and focuses on community needs. Federally Qualified Health Centers are also nationally designated, but rather than inpatient care support outpatient primary care, including mental and dental health.

“What is interesting about this evaluation is that it looks at so many different indicators, all publicly available data, and combines them into a comprehensive evaluation. This year factors also grew to include the health of our community – a vital area where Gifford as a Critical Access Hospital and a Federally Qualified Health Center excels,” said Ashley Lincoln, Gifford director of development and public relations.

“These findings tell our community that we not only have a strong, high-quality local health care provider but that Gifford is well positioned for health care reform,” Lincoln added.

Springfield and Copley hospitals in Vermont also made the list.

A Message from the Administrator

The following is an excerpt from our 2013 Annual Report: A Recipe for Success.

Joe Woodin

Joe Woodin

This has been another successful year for Gifford, and it is due to our continued ability to take care of so many different patients, from so many different communities. Ultimately that is our mission and focus, and for me constitutes our Recipe for Success. We continue to offer treatment and services over a wide geography, and “how” we do that is as important as “what” we do. We strive to bring personal attention into the clinical delivery system through relationships and flexibility. Sometimes we do these things very well, and sometimes we learn and grow from our experiences and shortcomings. In all instances we are indebted to the many communities and friends who utilize us and give us feedback and support.

A Gallon of Leadership

A Gallon of Leadership

This has also been a year marked with stress over health care reform and the roll-out of both a national and state-wide insurance product (i.e. Vermont Health Connect). Although the state has done a better job than the federal government in implementing the insurance exchange, there is still much uncertainly about these new programs, with people looking for answers and assurance that this is the “right direction.” That uncertainty, however, does not find its way into our planning for the future. Gifford has always relied upon a simple understanding that if we focus on patient care, quality and insuring access to everyone, regardless of their ability to pay, we will be successful. Maybe it’s that three-ingredient recipe that has helped sustain us over these past 110 years (since our founding in 1903). While others are employing sophisticated forecasting techniques and prediction models, we are just trying our best to be your medical home and guide.

I hope you enjoy this report, and the many stories that highlight our efforts this past year. We are grateful for the legacy we have inherited, and continue to build upon that
success each and every year.

Joseph Woodin

Gifford 108th Annual Meeting Paints Strong Picture of Uniquely Successful Small Hospital

Gifford Administrator Joe Woodin

Joseph Woodin, Gifford’s administrator, speaks at Saturday’s Annual Meeting of the medical center’s corporators. Woodin outlined a year of success.

If there was any doubt that Randolph’s local hospital – Gifford – stands above when it comes to commitment to community and financial stability, it was wholly erased Saturday as the medical center held its 108th Annual Meeting of its corporators.

The evening gathering at Gifford featured an overview of the hospital’s successful past year, news of spectacular community outreach efforts, a video detailing employees’ commitment to caring for their neighbors and a ringing endorsement from Al Gobeille, chairman of the Green Mountain Care Board and the evening’s guest speaker.

Diane and William Brigham, corporators, arrive at Gifford’s 108th Annual Meeting

Diane and William Brigham, corporators, arrive at Gifford’s 108th Annual Meeting.

For Gifford, 2013 brought a 14th consecutive year “making” budget and operating margin, new providers, expanded services including urology and wound care, expanded facilities in Sharon and Randolph, a designation as a Federally Qualified Health Center and all permits needed to move forward on the construction of a senior living community in Randolph Center and private inpatient rooms at Gifford.

The Randolph medical center also collected a ranking as the state’s most energy efficient hospital, an award for pediatrician Dr. Lou DiNicola, national recognition for Outstanding Senior Volunteer Major Melvin McLaughlin of Randolph and, noted Board Chairman Gus Meyer, continued national accolades for the Menig Extended Care Facility nursing home.

Al Gobeille

Al Gobeille, chairman of the Green Mountain Care Board, speaks at Gifford’s 108th annual corporators meeting on Saturday evening at the Randolph hospital.

“In the meantime, we’re faced with an ever-changing health care landscape,” said Meyer, listing accountable care organizations, payment reform initiatives and a burgeoning number of small hospitals forming relationships with the region’s two large tertiary care centers.

For some small hospitals, these shifts cause “angst.” “We like to think it brings us possibility,” said Meyer. “As both a Critical Access Hospital and now a Federally Qualified Health Center, Gifford is particularly well positioned to sustain our health as an organization and continue to fulfill our vital role in enhancing the health of the communities we serve.”

Joan Granter and Irene Schaefer

Joan Granter, left, and Irene Schaefer, corporators, arrive at Gifford’s 108th Annual Meeting.

The FQHC designation brings an increased emphasis on preventative care and will allow Gifford to invest in needed dental and mental health care in the community, Administrator Joseph Woodin said.

Gifford is but one of only three hospitals in the country to now be both a Critical Access Hospital and Federally Qualified Health Center.

“Congratulations! You’re a visionary,” said Gobeille in addressing Gifford’s new FQHC status. “It’s a brilliant move. It’s a great way to do the right thing.”

And Gifford is doing the right thing.

Gobeille was clear in his praise for Gifford’s management team and its commitment to stable budgets, without layoffs or compromising patient care.

Community investment

Marjorie and Dick Drysdale

Marjorie and Dick Drysdale, corporators, arrive at Gifford’s 108th Annual Meeting.

Gifford’s commitment also extends to the community.

In a major announcement, Woodin shared that thanks to the William and Mary Markle Community Foundation, Gifford will grant a total of $25,000 to schools in 10 area towns to support exercise and healthy eating programs.

Gifford annually at this time of year also hands out a grant and scholarship. The 2014 Philip Levesque grant in the amount of $1,000 was awarded to the Orange County Parent Child Center. The 2014 Richard J. Barrett, M.D., scholarship was awarded to Genia Schumacher, a mother of seven and breast cancer survivor who is in her second year of the radiology program at Champlain College.

The continued use of “Gifford Gift Certificates,” encouraging local spending during the holiday, invested about $40,000 in the regional economy in December. “These small stores appreciate it. It really does make a difference,” noted Woodin, who also detailed Gifford’s buy local approach and many community outreach activities in 2013, including free health fairs and classes.

The community in turn has invested in Gifford. The medical center’s 120 volunteers gave 16,678 hours in 2013, or 2,085 eight-hour workdays. Thrift Shop volunteers gave another 6,489 hours, or 811 workdays. And the Auxiliary, which operates the popular Thrift Shop, has both invested in equipment for various Gifford departments and made a major contribution toward the planned senior living community that will begin construction in May.

Elections

David and Peggy Ainsworth

Outgoing Gifford board member David Ainsworth arrives with wife Peggy to Saturday’s 108th Annual Meeting of the Corporators.

The night also brought new members to the Gifford family.

Corporators elected two new of their own: Matt Considine of Randolph and Jody Richards of Bethel. Considine, the director of investments for the State of Vermont, was also elected to the Board of Trustees and Lincoln Clark of Royalton was re-elected.

Leaving the board after six years was Sharon Dimmick of Randolph Center, a past chairwoman, and David Ainsworth of South Royalton after nine years.

‘Recipe for Success’

“Recipe for Success” was the night’s theme and built around a fresh-off-the-press 2013 Annual Report sharing patient accounts of Gifford staff members going above and beyond. The report, now available on www.giffordmed.org, credits employees’ strong commitment to patient-care as helping the medical center succeed.

Taking the message one step further, Gifford unveiled a new video with staff members talking about the privilege of providing local care and the medical center’s diverse services, particularly its emphasis on primary care. The video is also on the hospital’s Web site.

David Ainsworth and Sharon Dimmick

Gus Meyer, chairman of Gifford’s board, honors retiring board members David Ainsworth and Sharon Dimmick.

Health care reform
Shifting resources to primary and preventative care is a key to health care reform initiatives, said a personable and humorous Gobeille, who emphasized affordability.

“We all want care. We just have to be able to afford care,” he said. “In the two-and-a-half years I’ve been on the board, I’ve grown an optimism that Vermont could do something profound.”

Gobeille described what he called “two Vermonts” – one where large companies providing their employees more affordable insurance and one where small businesses and individuals struggle to pay high costs. “The Affordable Care Act tries to fix that,” he said.

The role his board is playing in the initiatives in Vermont is one of a regulator over hospital budgets and the certificate of need process, one as innovator of pilot projects aimed at redefining how health care is delivered, and paid for, and as an evaluator of the success of these initiatives as well as the administration and legislators’ efforts to move toward a single-payer system.

Audience members asked questions about when a financing plan for a single-payer system would be forthcoming (after the election, Gobeille said), about how costs can be reduced without personal accountability from individuals for their health (personal accountability absolutely matters, he said) and how small hospitals can keep the doors open.

Gobeille pointed to Gifford’s record of financial success and working for the best interests of patients and communities as keys. “I don’t think Gifford’s future is in peril as long as you have a great management team, and you do,” Gobeille said.

Get Help ‘Creating a Healthy Lifestyle’ March 14 at Gifford

Free health fair and diabetes expo focuses on chronic illness

Gifford chefs Ed Striebe and Steve Morgan

Gifford chefs Ed Striebe, left, and Steve Morgan present at a past Diabetes Education Expo. The annual, free event is expanded this year to all with chronic illnesses and includes a health fair as well as presentations, including a cooking demonstration by Morgan.

Gifford Medical Center will hold a free Health Fair and Diabetes Education Expo on Friday, March 14 from 10 a.m. to 2 p.m. in the Randolph hospital’s Conference Center and visitors’ entrance.

The fair, redesigned from past years, is open to anyone with a chronic condition, not just those with diabetes. It does not require registration, and puts a strong emphasis on “Creating a Healthy Lifestyle” – the fair’s theme.

Gifford has held a Diabetes Education Expo for eight prior years. While the diabetes epidemic remains, organizers from Gifford’s Blueprint for Health team decided to expand the event this year to other conditions because so much of what is being discussed is applicable, explained Jennifer Stratton, Gifford certified diabetes educator.

“Most people who have chronic conditions have something in common,” Stratton said. “I also wanted to open it up to those with pre-diabetes to help prevent diabetes from actually happening.”

The day includes vendor booths and a health fair open throughout the 10 a.m. to 2 p.m. event. Vendor booths are located in the hospital’s visitors’ entrance south of the hospital near the Gift Shop. Vendors this year are local community resource agencies and organizations talking about services and help available locally.

Health fair booths are in one of the hospital’s conference rooms and include blood pressure checks, foot checks, glucose monitoring, goal-setting guidance and guidance on healthy lifestyle choices, physical therapy exercises, tobacco cessation help, diabetes education, information on support groups, and more. The booths are operated by experts from Gifford as well as local dentist Dr. John Westbook and local optometrist Dr. Dean Barelow.

Special presentations will also be offered in a second conference room, including a 10-10:45 a.m. talk by Stratton on “Advances in Diabetes Management;” an 11-11:30 a.m. talk on “Using Herbs to Complement Your Diabetes Wellness Plan” by Sylvia Gaboriault, a registered dietitian and certified diabetes educator; and a 1-1:30 p.m. cooking demonstration on “Sugar ‘Less’ Baking” with Gifford chef Steve Morgan.

Participants may drop in or stay all day. A couple of raffle drawings will be offered and the hospitals’ cafeteria will be open for those wishing to buy lunch.

Learn more by calling Gifford’s Blueprint team at (802) 728-7710. Gifford Medical Center is located at 44 S. Main St. (Route 12) in Randolph. Drive past the hospital, south on Route 12, and take the entrance just after the medical center to access the visitors’ entrance. The Conference Center is marked with a green awning. For handicapped accessibility, go in the main entrance marked “Registration” and take the elevator to the first floor.

Sign-Up for Health Insurance March 6, 13 at Gifford

Vermont Health ConnectThe deadline to sign-up for health insurance through the state’s new online marketplace – Vermont Health Connect – is March 15.

To help more of this region’s residents meet the deadline, Gifford Medical Center has organized two special days – March 6 and March 13 from 9 a.m. to 4 p.m. – when extra “navigators” will be available to help people sign-up for insurance.

On hand will be navigators from Gifford’s Blueprint for Health team, Gifford’s Health Connections office (which is part of the Vermont Coalition of Clinics for the Uninsured), and from Bi-State Primary Care.

“For those who haven’t already signed up, the deadline is looming, meaning people must act now. We have been signing people up for months and will continue to do so until the deadline, but wanted to make this extra push to help those who haven’t yet chosen an insurance plan,” said Health Connections caseworker Michele Packard.

For Vermonters not offered insurance through their employer, Vermont Health Connect is how insurance is now sold in the state. This includes Vermonters who:

  • do not have health insurance;
  • currently purchase insurance for themselves;
  • have Catamount or Vermont Health Access Program; or
  • are offered “unaffordable” coverage by their employers.

Signing up for health insurance is a requirement under federal health care reform efforts. Those who do not sign up may face a federal tax penalty.

Appointments at Gifford’s special March 6 and 13 events are preferred, but walk-ins are welcome. Call the Health Connections office 728-2323 to sign up for an appointment. On the day of your appointment or when walking in, use the main entrance. Private one-on-one discussions are being held in the primary care doctor’s office area. Look for signs and ask for directions.

Responding to Community Needs

Vermont Blueprint for Health

Gifford’s Blueprint for Health Team has expanded to include additional mental health and addiction counselors offering one-on-one care at all Gifford primary care locations. In this file photo, from left, care coordinator Keith Marino, Health Connections (financial assistance) case worker Michele Packard and certified diabetes educator Jennifer Stratton discuss a patient at the Bethel Health Center.

In 2012 as part of the federal Patient Protection and Affordable Care Act, Gifford Medical Center completed a Community Needs Assessment.

Less than two years later, the Randolph-based medical center has already made huge strides addressing many of the needs found in that study.

In a survey of Town Meeting attendees in nine communities in 2012 plus feedback from other groups, community members’ described their priorities for a healthy community, perceived health problems and risky behaviors in the community, and their health needs or lacking services.

Among factors for a healthy community were good jobs and a healthy economy, access to health care, good schools, and healthy behaviors and lifestyles. Top health problems listed by survey respondents included addiction, obesity, and unhealthy lifestyle choices. Top health needs, or services community members have tried unsuccessfully to access, within the community were assisted living and nursing home care, alcohol and drug counseling, and dental care.

Today, Gifford is preparing to break ground in the spring on a senior living community in Randolph Center that will, over time, provide a full spectrum of housing options including the relocation of its award-winning nursing home and newly created assisted and independent living. Gifford has earned the coveted Federally Qualified Health Center (FQHC) designation, making it one of only three hospitals in the country to be both a Critical Access Hospital and an FQHC. This means expanded access to care, including dental and mental health care. And the medical center’s Vermont Blueprint for Health Team has greatly expanded over the past year to include more mental health and addiction counselors, providing services at all Gifford primary care locations.

chronic illness support group

Among Gifford’s free community services is a chronic illness support group. Here Gifford pharmacist Jane McConnell provides medication advice to past participants.

“Each of these major initiatives, which have taken substantial work, targets an identified community health need. Meeting these needs and addressing the community’s feedback defines the future of Gifford and its expanding role,” says Ashley Lincoln, director of development and public relations at Gifford.

The Community Needs Assessment process is required every three years, but Gifford’s efforts are ongoing. The medical center continually provides community outreach initiatives to meet care needs, many of which are offered for free. These include classes, support groups, and health fairs. Additionally, many initiatives support local economic health, including a buy local approach.

The medical center also continues community outreach daily through a boots-on-the-ground approach that has Blueprint Community Health Team working directly with individuals and community organizations to address health and socioeconomic needs, particularly for the chronically ill.

“The Blueprint for Health is a statewide initiative. Gifford has placed extra focus on meeting community members’ needs so they can successfully manage their health,” says Blueprint Project Manager LaRae Francis. “This approach means not waiting months or years for needs to be determined, but matching resources and needs today to create an ongoing healthier community for all.”

A grant from through the Vermont Department of Health helped support the costs of the 2012 report. The full report is available on Gifford’s website in the “About Us” section under Community Reports.

A Message from the Medical Directors

The following was published in our 2012 Annual Report.

medical directorsReflections on the past remind us of our roots and of how health care has changed in the past decades. Chief among those is the increasing role mid-level providers, such as nurse-midwives, nurse practitioners, and physician assistants, play in health care. Today, we have diverse physician-led health care teams in every area of medicine to encourage and support wellness.

Mid-level providers are extremely instrumental at birth, during hospital stays, in the primary care setting, specialty clinics, and even for our surgical patients. This team approach to care improves provider access and quality of care.

At Gifford, we are transitioning with great success to a team-based approach and are taking steps to ensure continued access to high-quality health care.

In 2012, some of those steps included new radiology services and technology, such as more interventional offerings, an upgraded 64-slice CT scanner, and a fluoroscopy room.

The midwifery team has expanded to the Twin River Health Center in White River Junction. Gifford’s approach to obstetrics and gynecology has grown to include more complicated cases.

The Blueprint Community Health Team has expanded and behavioral health is increasingly a part of Gifford’s offerings. Thanks to a generous gift from the Auxiliary, new CarePoint EKG transmission technology is available between our Emergency Department and ambulance services to identify heart attacks in the field and determine the best and fastest course of treatment.

Urology offerings have also grown and the Cancer Committee continues to expand. The Sharon Health Center sports medicine team has welcomed a nurse practitioner and second chiropractor.

These improvements are examples of the changes and quality upgrades we, as part of the health care team, can affect in an institution of the size and mindset of Gifford for the betterment of the community. Meld these improvements with Gifford’s foundation of patient care and advocacy, and we have a formula for success for decades to come.

Ovleto Ciccarelli, MD, Surgery Division
Martin Johns, MD, Hospital Division
Joshua Plavin, MD, MPH, Medicine Division

Get Help Signing Up for an Insurance Plan from ‘Navigators’

Vermont Health Connect

Beginning Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty. Gifford has specially-trained staff called “navigators” available to help you sign-up for a health plan.

This information appeared in our
Fall 2013 Update Community Newsletter.

Beginning on Jan. 1, federal law requires all Americans to have health insurance or face a tax penalty.

In the Green Mountain State, Vermont Health Connect is the new online marketplace where individuals, families and businesses with 50 or fewer employees can shop for, compare and purchase insurance plans.

Open enrollment for these plans began this October. Vermonters can determine their eligibility and enroll online. For those without computer access or needing in-person support, Gifford has resources to help.

Across the state, “navigators” have been trained and taken rigorous exams to provide one-on-one assistance with the Vermont Health Connect marketplace.

Gifford has three navigators through its Health Connections office, a part of the Vermont Coalition of Clinics for the Uninsured, as well as the medical center’s Blueprint for Health team.

If you’re:

  • A Vermonter without health insurance,
  • A Vermonter who currently purchases insurance yourself,
  • A Vermonter with Medicaid or Dr. Dynasaur,
  • A Vermonter with Catamount or the Vermont Health Access Program,
  • A Vermonter with “unaffordable” coverage provided by your employer, or
  • A small business with 50 or fewer people

and you need help understanding the exchange, get help by calling Gifford Health Connections at 728-2323.

Individuals who are fully enrolled by Dec. 16 will have health coverage starting Jan. 1.

Under Vermont Health Connect, an employer-sponsored plan is considered “unaffordable” if your premium for yourself is more than 9.5 percent of your household income. To learn more, call (855) 899-9600 or visit www.healthconnect.vermont.gov.

A Message from the Medical Staff President

The following was featured in our 2012 Annual Report.

Marcus Coxon

Marcus Coxon

Our effectiveness as a medical home has grown this year with the expansion of health care teams and our collaboration with the Vermont Blueprint for Health. But at the heart of these teams are Gifford’s long-established primary care practices. In each of our health team locations, we have providers and support staff whose relationships with the community run deep.

Take Starr Strong, for example. For 19 years, Starr has committed herself to the people of Chelsea – first under the mentorship of Dr. Brewster Martin and now as a mentor in her own right.

With humility and compassion, family physician Dr. Ken Borie has cared for the people of Randolph for 32 years. The humanity he brings to medicine is an example for all, including the many medical students who he guides through the family medicine portion of their clinical studies.

And Dr. Lou DiNicola, a local pediatrician for 36 years, has been among the foremost leaders in this state when it comes to children, advocating at every turn for their health, safety, and welfare.

Those of us enjoying long-standing relationships with Gifford and with our central Vermont community consider ourselves fortunate to know and work with these practitioners and their support teams. Such stability, and depth, builds our medical homes into more effective tools for helping our patients.

~ Marcus Coxon
Medical Staff President & family physician