Gifford Welcomes Certified Nurse-Midwife Julia Cook

Certified nurse-midwife Julia Cook

RANDOLPH – Certified nurse-midwife Julia Cook has joined Gifford’s team of midwives, and is now seeing patients in our Randolph and Berlin clinics.

Cook received a Master of Science in Nursing from Frontier Nursing University in Hyden, KY. Her clinical interests include adolescent care, patient education, and helping women to be active participants in their ob/gyn care.

Born in rural Louisiana, she moved to a suburb of Atlanta while in High School, and went on to get an associate of Science in Nursing from Georgia Perimeter College. She was first attracted to ob/gyn care after the birth of her first child 16 years ago.

“The midwives who cared for me were amazing—they empowered me as a woman and as a new mother,” she said. “I was intrigued by what they did, and asked them what I needed to do to start on that career path.”

When Cook finished her training she began to look for work in a smaller community, and was drawn by the story of Gifford’s Birthing Center and its pioneering efforts in family centered birth. She also appreciates that her work will include opportunities for well-women and adolescent care.

“I feel that education is so important when it comes to women’s health,” she said. “I especially enjoy working with adolescents because they are at a time in life when information about how to be healthy is taken with them as they transition into adulthood.”

Cook says her husband and four children are also excited about moving to New England, and the family looks forward to living in a smaller community and exploring all the new things Vermont offers.

To schedule an appointment, or to learn more about Gifford’s Birthing Center, please call 802-728-2401.

Rochester Welcomes Dr. Erwin Lange to Community’s Health Center

Gifford Medical Center

Photo: Dr. Erwin Lange (right) with Rochester Health Center Office Manager Dawn Beriau (left) and Registered Nurse Gail Proctor.

Dr. Erwin Lange has joined Gifford’s Primary Care team and is seeing patients at the Rochester Health Center. He started in Rochester as a locum in November, 2015 and has now settled in full-time as the community’s primary care provider. Lange brings many years of medical experience to his patients. He received a BA from Dartmouth College, a MD from the Brown Alpert Medical School in Providence RI, and completed a three year residency in family practice at the St. Joseph Hospital Health Center in Syracuse, NY.

Board certified in Family Practice, he began his career as a family practitioner in a rural community in New York State before moving into practice as an emergency physician in several NH and Vermont hospitals. When he decided to return to family medicine he was looking for a rural community like Rochester, where he could care for a variety of conditions but also establish ongoing relationships with patients.

Office Manager Dawn Beriau and Registered Nurse Gail Proctor have worked at the clinic for more than 30 years and are introducing him to local families, many who have been receiving primary care at the Health Center for generations. Lange says he really has appreciated how welcoming the Rochester community has been during his first months here. “Rochester really is an amazing community,” he said. “Sometimes people have stopped in just to introduce themselves and visit, and that has been great!”

The Rochester Health Center opened in 1976 and provides family and internal (adult) medicine in a convenient location at 235 Main Street. Dr. Lange sees patients at the center from 8:30 a.m. to 4:30 p.m., Monday through Thursday, and Physician Assistant Tammy Gerdes sees patients on Fridays. Services include: annual physicals, blood work, sick visits, EKGs, chronic disease management, care coordination, and emergency procedures. To schedule an appointment call 802-767-3704.

Gifford Primary Care Team Welcomes Dr. Kasra Djalayer

Gifford Medica Center

Dr. Kasra Djalayer

Dr. Kasra Djalayer has joined Gifford Health Care’s primary care team and is now seeing patients in the Berlin and Randolph clinics. He also sees Gifford patients at the Rowan Court Nursing Home in Barre, where he is the Medical Director.

Board-certified in internal medicine, Dr. Djalayer received his license of Medicine and Surgery at the University of Complutenese (Madrid, Spain). He completed his residency at the Yale-Griffin Hospital Prevention Research Center and did post graduate training in Obesity at Harvard University and in Rheumatology and Clinical Immunology at the University of Vermont. His clinical interests include dementia-related behavioral disorders, geriatric medicine, and rheumatology.

Most recently he has worked at Franklin Regional Hospital (Franklin, NH) and as a hospitalist at the New London Hospital (New London, NH), and the Brattleboro Memorial Hospital (Brattleboro, VT).  “Dr. DJ,” as he is known to his patients, has received both the Patients Choice Award and the Compassionate Doctor recognition for five consecutive years (2000-2014).

“I like to use humor in my conversations, and find it energizing to build ongoing relationships with patients,” he said. “We talk about the details of their medical problem but also about their situation in general—any family issues or other concerns. It’s an important part of good care.”

When not working, Dr. Djalayer enjoys cycling, tennis, swimming, and reading to keep up with current events and new medical developments.

Gifford’s Free Medical and Dental Health Access Day June 11

Oral exams, medical screenings, and wellness and health access resources

No insurance, high deductibles, or lack of a primary care provider keeps many from getting medical care until they find themselves in an emergency room with a serious problem.

Gifford Health Care in Randolph is sponsoring a free Dental and Medical Health Access Day on Thursday, June 11, 2015 from 8 a.m. to 4 p.m., with free medical and dental health screenings and information about community resources that can help with access to care.

We know that regular primary care can help people manage many chronic conditions, and that dealing with health issues before they become serious can prevent expensive hospital visits. Research has linked gum disease and poor dental health to increased rates of heart disease, premature birth and low birth weights, osteoporosis, and other health problems.

On Dental and Medical Health Access Day, two local dentists (Dr. John Lansky and Dr. Chris Wilson) will give free oral exams, and Gifford primary care providers and pediatricians will provide free health screenings for registered participants. (Call 728-2781 to schedule an appointment.)

A day-long wellness fair, open to the general public, will offer information on preventative health programs and resources to help with access to medical and dental care, including:

  • Diabetes and diet
  • Smoking cessation
  • Vermont Blueprint for Health
  • Healthier Living Workshops
  • Health Connections
  • Other community resources

Refreshments will be served, and there will be a raffle for registered participants.

For more information, or to register for a free medical screening and oral exam, call Casey Booth at 802-728-2781.

Dental & Health Access Day

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.

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.

For the Love of Patients, Families, and the Community – Dr. Lou DiNicola

Dr. Lou DiNicolaBorn 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. Lou DiNicola

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.
Gifford pediatrician

Dr. Lou DiNicola

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.

Year in Review – Part 2

Our 2012 Annual Report included a month-by-month “Year in Review” section. Here is the second quarter excerpt.

APRIL

Blueprint teamTo 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.

Gov. Peter ShumlinJoining 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.

March of DimesEmployees 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.

MAY

Ob/gyn Dr. Anne Galante joins the women’s health team full-time. She had worked as a Menig celebrationlocum 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.

JUNE

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”.

Year in Review – Part 1

Our 2012 Annual Report included a month-by-month “Year in Review” section. Here is the first quarter excerpt.

JANUARY

pediatrics' open houseUrologist 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.

FEBRUARY

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.

MARCH

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.