Gifford 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.
The 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.
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.
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.
Born in New Jersey, Dr. Lou DiNicola moved to Randolph in June of 1976 to become a local pediatrician. Passing up job offers in much larger areas then and since, he chose to stay in Randolph because he’s been able to able to practice medicine as he always envisioned. He has been able to affect change on a state level; create unique, trend-setting models of health care; and demonstrate his love of the community through his work.
Married to his wife Joann for 43 years, the couple has two grown children, two grandchildren, and a third on the way. Dr. DiNicola is an outdoor enthusiast, enjoying hiking, snowshoeing, walking, and gardening. He’s also a photographer and works with his artist wife, framing her paintings.
Dr. DiNicola has spent his entire career in Randolph while also working in Rochester from 1977-1992 with internal medicine physicians Drs. Mark Jewett and Milt Fowler.
Below is his story as told in his own words, as featured in our 2012 Annual Report.
Thirty-six years ago I was fresh out of residency and looking for job opportunities when I saw an ad in a magazine for a pediatrician in rural Vermont. Vermont was where I wanted to work, so I sent in my curriculum vitae, the medical equivalent of a resume, but never heard a word back. I called but the response was less than enthusiastic. I was basically told “thanks, but no thanks.”
I had three job offers in Pittsburgh and was literally sitting down to take a job at Children’s Hospital of Pittsburgh where I’d just completed my internship and residency when my pager went off. It was Gifford President Phil Levesque’s secretary, wondering if I could come up in a couple of weeks for an interview. “I’ll come this weekend, or I’m not coming at all” was my response. The secretary covered the phone, relaying my message to Phil. “Hell, let him come” was his reply.
Needless to say, I came, and stayed.
More than three decades later I hope I have made a positive impact on the community and my patients, and know they have made a remarkable impact on me – teaching me how to communicate care, respect, and love.
It’s amazing how much you can love your patients. Also amazing is the window being a pediatrician gives you to see the love between a parent and a child. No more clearly is that demonstrated than in the unconditional love between a parent and a special needs child. More than once, parents of special needs children have amazed me and inspired me, as have the children themselves. I’ve seen parents of special needs children go on to adopt more children with special needs. Those are the moments that touch you most; those, and loss.
Dr. DiNicola thumb wrestles with patient Troy Daniels.
There is no greater loss than the loss of a child. Throughout my career, there have been car accidents, disease, malignancies, and newborn deaths. I think of two patients I lost to cancer, both of whom I visited at their bedsides at home as they were dying. As I reflect on my career, I think of them not with tears but fondness because of the relationships I have had with their families.
At Gifford, we are small enough to have that closeness with our patients and courageous enough to get up the next day and reflect on what we did or didn’t do, what we could have done differently, and how we can improve care. This ability to affect change is one of the things that has kept me practicing – happily – in this community and state for so many years.
One of the biggest changes Gifford has been able to enact in health care is around childbirth. When I first came to Gifford, I kept hearing about this guy Thurmond Knight, a local physician who was delivering babies in people’s homes. I met Thurmond at a Medical Staff meeting. He was knitting. I asked him what it would take for him to deliver babies at the hospital. He answered “a Birthing Center”. We opened the Birthing Center (the first in the state of Vermont) 35 years ago in 1977.
I’ve also been fortunate to be part of and help form organizations that were decades ahead of their time, in many ways laying the foundation for today’s medical home and Vermont Blueprint for Health models as well as utilizing computers for communication at the advent of the computer revolution. Additionally, Vermont has provided me with the opportunity to work on important legislation, such as child abuse laws, outlawing corporal punishment in schools, mandatory kindergarten, and the recent immunization law. These opportunities along with the privilege of making a difference in kids’ and families’ lives keep me going.
One of the things I find incredibly rewarding is living and working in the same town. I don’t mind if I run into someone downtown and they ask me a question. And I feel it’s so important that we recognize and talk to kids. One way I have been able to successfully converse and care for kids for so long is through humor. I try to infuse that in my appointments with children and often am treated – sometimes at unexpected moments – to humor in return.
One such humorous moment came from a 5-year-old. I try to end all my appointments by asking if patients have any questions for me. This 5-year-old’s question: “Why do frogs jump so high?” Should I ever write a book, I think this will be the title.
~ Lou DiNicola, M.D.
Above left – Dr. DiNicola in 1979. Above right – Dr. DiNicola with Kim Daniels of Berlin and her adopted son Troy. Troy along with his siblings, Maggie, Ben, and Alex, were patients of Dr. DiNicola’s for years. Dr. DiNicola credits Kim, who had a special needs child and then adopted two more, with showing him the true meaning of love and parenting. Troy credits Dr. DiNicola with seeing him as a person.
Our 2012 Annual Report included a month-by-month “Year in Review” section. Here is the second quarter excerpt.
To support patient needs, the Blueprint team grows to include a behavioral health specialist (social worker) and a second care coordinator.
Gynecologist Dr. Ellamarie Russo-DeMara of the Bethel and Twin River health centers leads a free women’s health talk at the Montshire Museum on menopause and genetic testing for breast and ovarian cancers.
Gov. Peter Shumlin visits the Menig Extended Care Facility to offer thanks to the state’s top nursing home, calling it a “tribute to the community”. “We’re proud of you. Thank you from the bottom of our hearts,” the governor said to residents, families, and staff members. The governor’s visit came in the wake of the U.S. News Report “2012 Honor Roll” listing.
Joining Gov. Shumlin are Vermont Disabilities, Aging and Independent Living Commissioner Dr. Susan Wehry, Vermont Health Care Association Executive Director Laura Pelosi, Division of Licensing and Protection Director Suzanne Leavitt, and Assistant Director Fran Keeler.
Gifford provides free assistance with advance directives in conjunction with National Healthcare Decisions Day.
Gifford’s more than 200 volunteers are honored with a luncheon served by hospital managers, prize awards, musical performances, and more.
Dr. Sandy Craig joins the hospitalist team, having previously practiced at The Health Center in Plainfield for many years.
Employees raise $455 for the March of Dimes by donning “Blue Jeans for Babies”. At the same time, the Vermont Chapter of the March of Dimes recognizes Gifford with a Leadership Legacy award for its commitment to prenatal, birth, and newborn care, and its support of the non-profit organization working to prevent birth defects, premature births, and infant mortality.
Long-time pediatrician Dr. Lou DiNicola receives a national award for his work around childhood immunizations.
Dr. DiNicola is recognized by the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases and the CDC Foundation as the first ever “CDC Childhood Immunization Champion” for the state of Vermont.
Ob/gyn Dr. Anne Galante joins the women’s health team full-time. She had worked as a locum tenens, or part-time contracted, provider at Gifford since 2009.
Menig residents celebrate a “Day of Play” with representatives of the Vermont Department of Disabilities, Aging and Independent Living. The day celebrated Older American’s Month and included a scavenger hunt.
The Robin’s Nest Child Enrichment Center holds its annual preschool graduation, complete with caps and gowns.
Gifford and Valley Rescue Squad Inc. move forward with the formation of a new non-profit aimed at stabilizing ambulance costs and maintaining or improving quality through a new non-profit to be called Supporting Ambulances for Vermont Emergencies (SAVE).
A free men’s health talk by general surgeon Dr. Ovleto Ciccarelli and urologist Dr. Richard Graham address colorectal health, prostate cancer, and erectile dysfunction.
For an eighth consecutive year, the Menig Extended Care Facility receives a Nursing Home Quality Recognition from the Vermont Department of Disabilities, Aging, and Independent Living.
A free talk on Medicare insurance, why it’s important, why participating in Medicare Part B is beneficial, and what one’s choices are under Medicare Part D is offered.
The Commission on Cancer of the American College of Surgeons grants accreditation with commendation to the cancer program at Gifford. Gifford’s cancer program, which includes outpatient chemotherapy, has been accredited since 1965.
Family nurse practitioner Emily LeVan joins the Bethel Health Center.
Gifford is awarded a Hospital of Choice Award from The American Alliance of Healthcare Providers for “courteous, compassionate, and caring services for patients, family, and the community.” The ranking places Gifford among “America’s most customer-friendly hospitals”.
Our 2012 Annual Report included a month-by-month “Year in Review” section. Here is the first quarter excerpt.
Urologist Dr. Richard Graham and menopause practitioner Dr. Ellamarie Russo-DeMara of the Twin River Health Center offer a free talk at the Montshire Museum on urinary incontinence.
Gifford is once again awarded a grant from the Avon Breast Health Outreach Program. For the 11th year, Gifford is the only entity in Vermont to receive the $35,000 grant for breast cancer awareness education and outreach.
Pediatrics and adolescent medicine moves from the main medical center building to Dr. Chris Soares’ former space at the corner of South Main and Maple streets. Joining the practice on the first floor of the renovated, spacious Victorian home is pediatric physical, occupational, and speech therapies.
A free three-week series on heart health includes talks from cardiologist Dr. Bruce Andrus and registered dietitian Stacy Pelletier as well as a heart-healthy cooking demonstration from Gifford’s chefs.
As part of Gifford’s expanded efforts under the Vermont Blueprint for Health, a chronic illness support group – Chronic HealthShare Consortium – is launched and begins meeting monthly.
Dr. Ovleto Ciccarelli strives to bring colon health to the forefront with a free health talk, “Everyone’s Got One: A Discussion on the Colon and How to Keep It Healthy”.
Pacemaker surgeries return to Gifford after a quarter century hiatus.
The Menig Extended Care Facility is named among nation’s top 39 nursing homes by U.S. News and World Report, which released a list of “2012 Honor Roll” nursing homes. Menig was the only nursing home chosen in Vermont and neighboring New Hampshire.
The 106th Annual Corporators Meeting is held at the medical center and features Steve Kimbell, commissioner of what was then the Vermont Department of Banking, Insurance, Securities and Health Care Administration. Leo Connolly, Fred Newhall, and Peter Nowlan are elected to the Board of Trustees.
A Vermont House of Representatives resolution recognizes “the outstanding health care services provided by Gifford Medical Center”. The resolution is in honor of Gifford’s more than 100 years of service to the Randolph area and for its many recent awards.
The Diabetes Education Expo focuses on teeth and feet and how diabetes can keep both healthy. It is the 7th annual exposition organized by the Diabetes Clinic especially for the growing diabetes population.
An open house is held for pediatrics’ new space at 40 South Main Street. Children attending enjoy face painting, balloons, snacks, tours of their new doctor’s office, bike helmet fittings, and painting tiles that have become part of the clinic’s permanent decor.
The following is an excerpt from our 2011 Annual Report. Our 2012 Annual Report will be out soon.
Blueprint Care Coordinator Keith Marino meets in Gifford primary care with patient Cheryl Abbey of Randolph.
The Vermont Blueprint for Health is a state-led initiative aimed at improving care coordination, especially for the chronically ill. The goals of the initiative are to improve health, enhance the patient experience and reduce, or at least control, health care costs.
This is accomplished through what the Blueprint is calling “advanced primary care” that seamlessly coordinates a broad range of health and human services for patients and their families.
In 2011, the Vermont Blueprint for Health came to life at Gifford. Each of the medical center’s primary care practices was recognized as a Patient-Centered Medical Home and a huge care coordination effort got under way to meet patients’ diverse needs.
The care coordination effort, which is supported in part by grant dollars, is twofold. First, Gifford formed its own small care coordination team made up of three core employees; Blueprint Care Coordinator Keith Marino, Gifford Diabetes Educator Jennifer Stratton and
Health Connections Caseworker Michele Packard. Second, a larger Community Health Team consisting of a diverse group of state and regional community housing, aging and disability agencies as well as eye care professionals, a pharmacy, insurers and more, was formed.
Blueprint core team members – Health Connections caseworker Michele Packard and diabetes educator Jennifer Stratton – meet weekly with Blueprint Care Coordinator Keith Marino at the Bethel Health Center to discuss individual patients and how to better serve them.
The Community Health Team meets quarterly while a care coordination team meets weekly. More importantly, referrals are bouncing back and forth between the agencies and teams ensuring patients are getting the services they need to maintain and improve their health. Keith coordinates this work, meeting directly with patients, spending time in each
of Gifford’s Patient-Centered Medical Homes, conferring with health care providers and helping patients access needed services.
Patients and community members are referred to Keith for a huge variety of reasons. They may need help managing chronic conditions, be struggling socio-economically, need mental health assistance, be disabled or elderly, have housing or transportation needs or just need help navigating the health system.
The Blueprint provides that help directly or refers them to an appropriate community agency. The help comes in the form of one-on-one meetings with Keith and outreach on his part to get the patient connected with needed resources.
“My role is to make sure patients are getting access to proper services, which enables them to self-manage their chronic condition,” Keith says.
Medicine Division Vice President Teresa Voci gives the example of a chronically ill patient who, because of financial pressures, has to choose between food and medication. Without medication, their health suffers. With the Blueprint services, their health care provider has a central resource to offer the patient for those issues that fall outside the health care setting but are barriers to care, like help with finding resources to buy food and medications.
Kim Flood of Barre is a real life example.
All three of Kim’s sons were diagnosed with asthma. The younger two, ages 4 and 1, were especially sick, including being hospitalized. Kim thought she knew the problem – mold in her Barre apartment.
Pediatric hospitalist Dr. Lou DiNicola referred Kim to the Blueprint. “Keith helped us find someone to do mold testing, help us with legal aid,” Kim says, “and he got city officials to come to the apartment. I had tried for months to get the housing inspector and building inspector to our house. I just got the runaround from everyone.”
With the mold verified and the help of legal aid, Kim settled with the landlord and in October moved into a home she bought in Barre Town on nine acres.
The kids haven’t been sick since.
Kim is one of 230 referrals Gifford’s Blueprint team has received since Keith was hired and the program got under way in February, notes Blueprint Project Coordinator LaRae Francis. Most of the referrals are from primary care providers, like Dr. Terry Cantlin of the Bethel Health Center.
“He’s been invaluable,” says Dr. Cantlin of Keith, who does the work primary care physicians simply do not have time to do in their busy practices.
Now if a patient is not taking their medication due to financial pressures, is missing needed appointments because of transportation issues or struggling with social issues – all scenarios Dr. Cantlin sees – he now has a one-stop resource for the patient.
It also prevents patients unaware of available community resources from “falling through the cracks,” says Mary Ellen Otis, executive director of the Orange County Parent Child Center in Chelsea.
That center, which provides a vast array of family services from new baby visits to parenting education, is part of the Community Health Team and refers clients to Gifford as well as gets referrals from the hospital. Under the new coordinated effort, Mary Ellen says, referrals are now far more efficient.
Maryette Withington can attest to that.
The Barnard resident has a relative with Alzheimer’s disease. Dr. Cantlin referred Maryette to Keith for help learning more about the disease. He met with her at the Bethel Health Center and connected her with the Randolph Area Senior Center and the Vermont Chapter of the Alzheimer’s Association. Within 24 hours Maryette had information in her hands about the disease that she says has changed everything in her life.
“You’re totally responsible for that person. I just needed to know what to expect.”
She will have an ongoing relationship with the association and also continues to receive help from Keith, Dr. Cantlin and her Gifford health care team. It’s help she appreciates. “I have the best health care team in the world,” she says.
Need help yourself? Call the Blueprint Care Coordinator at (802) 728-2499.
The following is an excerpt from our 2011 Annual Report.
Information Systems Director Sean Patrick sits amid the old way of keeping patient records – paper files – and the new way to come – electronic medical records updated by providers via new laptops or even iPads.
As lawmakers embark on an ambitious schedule to create a health care exchange required under the federal Patient Protection and Affordable Care Act by 2014 and a Vermont single-payer system by 2017, Gifford is mindful of its role as a community care provider.
The laws seek to bend the health care cost curve, in part through information technology, advanced primary care and payment reform.
Through the implementation of Vermont Blueprint for Health initiatives, Gifford is embarking on reform initiatives including care coordination for the chronically ill and recognition of Gifford’s five primary care practices as Patient-Centered Medical Homes.
The medical center has chosen an electronic medical record (EMR) vendor and is progressing toward both the installation of an EMR system and meeting federal requirements for “meaningful use” of electronic health records (EHRs). EMRs are internal electronic medical records. EHRs can be viewed by appropriate outside entities, including specialists and providers from other hospitals.
Gifford’s modest budget requests and responsible spending also align with reform, notes Trustee Paul Kendall, who actively follows reform legislation.
But the non-profit community medical center is by choice not at the forefront of reform efforts.
Gifford Administrator Joe Woodin likens health care reform to a passing ship. Where others might be quick to jump on – appropriately, the region’s larger health care providers – Gifford is waiting to ensure the medical center commits to the best choice for
Gifford’s size, patients and rural area.
“Gifford is more inclined to stay on the dock and wait for the boat to come around on health care reform,” Joe says. “It takes a lot of fortitude to humbly wait for the boat to make a reiteration.”
“We continue to be watchful of what’s going on and gradually position ourselves to do
what is right and appropriate,” agrees Paul, noting some initiatives like information
technology upgrades can require huge investments of time and financial resources.
Gifford also strives to be a voice in discussions leading up to reform legislation. Leadership is suggesting cost-saving ideas the state could pursue now. They continue to set a standard
for financial stability and maintaining strong relationships with other hospitals, state and federal lawmakers, and health care organizations, like Bi-State Primary Care and the Vermont Association (VAHHS).
VAHHS represents the state’s nonprofit hospitals before lawmakers and the Green Mountain Care Board, which was created by the Legislature in 2011 to oversee the creation of a single payer Vermont system. Bea Grause, VAHHS president and chief executive officer, sees small hospitals’ role in health care reform as one of preserving local access to high-quality care.
“Hospitals are seeking to create reform opportunities by working with the Green Mountain Care Board and federal lawmakers that will balance the need to contain costs with the need to ensure sufficient revenue that will help hospitals meet their local missions,” she says. “Issues such as recruitment and retention of physicians and other health professionals, improving quality, ensuring access and long-term financial sustainability are just a few of the challenges small hospitals will face as Vermont and the entire industry prepare for a decade of continued change on all levels.”
Gifford’s work with Bi-State Primary Care in part addresses the recruitment piece.
Bi-State Primary Care is a nonprofit membership organization of Vermont and New Hampshire rural health care providers working to support primary care practices in medically under-served areas. Its members represent more than 175,000 Vermonters. This equates to one in four residents, or 46 percent of Medicaid enrollees and 52 percent of the state’s uninsured.
The organization is working on Gifford and small, rural primary care practices’ behalf to improve access by recruiting providers to underserved areas. They are also working on health information exchanges and quality improvement initiatives.
The ultimate challenge the state – and likely hospitals by default – will face for successful health care reform, however, will be answering the question: “What can we afford?”
“There are a lot of uncomfortable issues with health care reform that we don’t talk about. The most common issue is ‘what can we afford,’” Joe says, hoping lawmakers will address that question. If they don’t, it will fall on hospitals, which will be given limited funds to provide care. They will have to make tough choices on what care they can afford to
RANDOLPH – Gifford Medical Center is launching a Caregiver Support Group this November.
Open to anyone caring for a family member or loved one, the group meets on the second Tuesday of each month from 11 a.m. to noon in the Randolph hospital’s Conference Center.
The group is participant-driven with members deciding how the meetings will be designed, choosing a facilitator and picking discussion topics. Samantha Medved, a licensed social worker and behavioral health specialist at Gifford, will also work with the group, providing ongoing support.
“Caregivers invest so much of themselves – both physically and mentally – into caring for others. This group is an opportunity to have time away to deal with the normal range of emotions all caregivers experience, by gaining support from peers experiencing similar issues,” Medved said.
The group is offered as part of Gifford’s efforts through the Vermont Blueprint for Health. No registration is required. Medved and the Blueprint team can be reached at 728-7100, ext. 6, with any questions.
The Gifford Conference Center is in the main medical center at 44 S. Main St. (Route 12) in Randolph. From patient parking, the Conference Center entrance is marked with a green awning. For handicapped accessibility, take the elevator from the main lobby to the first floor and follow signs to the Conference Center.
The following is an excerpt from our 2011 Annual Report.
What is a Medical Home?
A medical home is an approach to providing comprehensive primary care that builds partnerships between patients, their physicians and, when appropriate, their families.
The American Academy of Pediatrics was at the forefront of the medical home movement, detailing decades ago that every child needed a place where care was accessible, ongoing, patient and family-centered, of high quality, coordinated, and compassionate.
Today, those philosophies have been expanded to adults as they’ve been adopted by family practice and other health care associations.
In fact, the National Committee for Quality Assurance, a non-profit dedicated to improving health care quality, is now recognizing qualifying medical practices as Patient-Centered Medical Homes.
Bethel Health Center family physician Dr. Terry Cantlin talks with patient Eileen Strickland-Holtham of South Royalton during a routine exam. The Bethel Health Center is one of five Gifford practices recognized as a Patient-Centered Medical Home.
Patient-Centered Medical Homes
Achieving the Patient-Centered Medical Home recognition is part of the Vermont Blueprint for Health’s goals for all primary care providers in the state.
The hope is to improve primary care so patients are getting regular needed care and other supports to maintain their health before facing more costly emergency or inpatient care.
“The medical home adopts a ‘whole person’ approach to primary care, encompassing medical, behavioral and self-management support,” says Gifford Blueprint Project Coordinator LaRae Francis. “It’s the entire health care team wrapping its arms around the patient to provide the support and resources he or she needs to manage his or her health
“It aims to keep people healthier, enhance their quality of life and benefit them financially, both through reduced health care costs and secondary costs such as missed work.”
In 2011, each of Gifford’s primary care practices – the Gifford Health Center at Berlin’s pediatrics practice, the Bethel Health Center, the Chelsea Health Center, Gifford primary care in Randolph and the Rochester Health Center – was recognized as a Patient-Centered Medical Home following inspections by the National Committee for Quality Assurance.
The health centers, which serve a total 21,540 patients, each formed quality improvement teams to address expectations for a Patient-Centered Medical Home, primarily through honing and streamlining systems. Among those expectations, or standards, were access to care, communication, such as through timely callbacks to patients and tracking referrals and tests, such as lab results to ensure they are communicated back to the patient.
The process, says Vice President of Medicine Teresa Voci, allowed the health centers to identify and correct problems. It’s all work done behind the scenes, but also all work that makes care more timely for patients.
Labs, X-rays and referrals to specialists are all now better tracked to ensure the patient and the primary care provider know the results of those exams, notes Chelsea Health Center site manager and nurse Travis Worthen. Providers are also more often meeting with patients to go over results.
And the patient is increasingly a bigger part of the health care team.
“Historically, medicine has always told patients what to do and now medicine is really turning toward engaging the patient in a partnership for health outcomes,” Teresa explains.
Blueprint Project Coordinator LaRae Francis has headed up efforts to implement the Vermont Blueprint for Health at Gifford and in the larger Randolph Health Service Area.
The work doesn’t stop with Gifford.
With the medical center’s primary care locations now all recognized, LaRae, as Blueprint coordinator for the Randolph Health Service Area (a Blueprint-defined area spanning from Randolph to White River Junction), is now looking outside of Gifford. She’s reaching out to White River Family Practice in Wilder and the South Royalton Health Center.
She hopes to help these private health centers also earn the recognition, further improving patient care in our region.