SHIRENOMICS: The Healthcare of Tomorrow in Southwestern Vermont

Regional agencies work to retain workforce and promote preventative health care outside the doctor’s office

 By Makayla-Courtney McGeeney in partnership with Southwestern Vermont Chamber of Commerce

In Southwestern Vermont, also known as The Shires of Vermont, residents are never too far without a health clinic of some sort, or knowing someone who is employed by the largest growing industry. Without a 24/7 rescue squad, full-service hospital, and numerous specialty clinics, residents of Bennington County wouldn’t have the quality of health that they do. It’s not just the rolling Green Mountains and maple syrup that keep everyone healthy, it’s on-the-ground and in the community prevention work.

 Southwestern Vermont Health Care (SVHC) plays an enormous role in The Shire’s quality of health with a wealth of partnerships, ongoing projects, and opportunities for employment. The healthcare industry may be the largest growing sector in Vermont, but it’s also relevant to the rest of the country. SVHC is the 12th largest employer in the state with about 1,400 staff. One way the organization retains employees and improves their quality of life has been facilitating homeownership through the Healthy Homes Initiative.

 “If our workforce lives in the community, then it’s a positive thing for retention,” said Kevin Dailey, Chief Human Resources Officer and Vice President of Administration at SVHC. “There are a lot of studies that link homeownership to a healthier lifestyle.”

 The program not only helps SVHC existing employees embark on homeownership, but it also helps recruit new employees and gives the town a bit of a facelift. Healthy Homes partners with local contractors, suppliers, and banks to breathe life back into abandoned buildings. Four homes have been completed in the last three years.

 “If you’re a young family looking around in Bennington and see a lot of abandoned houses boarded up, your excitement will be different than seeing well-maintained homes in the community. If we end up doing 15-20 houses it’ll have a visible impact. It’ll create an appealing area for young families to move into,” Dailey explained.

Bachelor of Science in Nursing Recruitment
The demand for nurses in the next decade was well-documented in a study conducted by the Vermont Business Roundtable, and stems from growing issues across the state: an aging workforce, retirement, finances and a shrinking labor pool. Many communities throughout New England are experiencing similar challenges to filled vacant nursing positions in the immediate future and beyond.

 In an effort to create a pipeline of future nurses for SVHC, Dailey said, the hospital partnered with Castleton University to establish a Bennington campus to deliver its Bachelor of Science in Nursing program. Southwestern Vermont Health Care has made a commitment to offer employment to Castleton students who satisfactorily complete the BSN program, obtain licensure, and meet pre-employment requirements. Additionally, SVHC will pay back (in full) tuition debt to those accepted employees that work six consecutive years within the health system.

“The demand will far exceed the supply in Vermont in the next foreseeable future. It’s not unique to Bennington. This is reloading the existing workforce and there are not that many applicants knocking on doors for nursing jobs,” Dailey said. “We want to tap into the community. If they have ties to the area then there are better odds of them staying.”

In order to ensure the highest quality of care in The Shires, the healthcare workforce pipeline must be supported, and SVHC has economic development strategies in place to do just that.

“There’s always room for more growth and that’s what we’re trying to promote,” said Thomas Dee, President and Chief Executive Officer of SVHC.

The Shires are stretched, latitude, by Manchester (27 miles from Bennington) and Pownal (10 miles from Bennington). While Manchester has been equipped with an SVHC satellite office for more than 25 years, a location in Pownal was erected in 2015, in response to the demand for healthcare in the area.

“It was underserved. It made sense for us. We determined that a certain pocket needed access. We view it as a vital component of the health care system,” Dee said.

Battenkill Valley Health Center (BVHC) in Arlington also has an employee recruitment program in place. In May of 2017, BVHC opened a state of the art dental practice.  In September of that same year, BVHC partnered with the University of New England and has since hosted 8 fourth year dental “externs” for 13 week rotations. One of the externs, a person working in but not living in the area such as a nonresident doctor, eventually relocated to The Shires after graduation and is employed at a private practice in Manchester, according to Kate Bryan, Director of Development and Community Relations at BVHC.

Sylvia Pike, who started as a high school intern, joined the former practice in 2012 as a member of the front desk staff and quickly transitioned to roles including medical assistant and phlebotomist. She currently is the Practice Administrator and Health IT Manager. She also serves as a director on the board of the Southwestern Vermont Chamber of Commerce.

“[It’s about] keeping staff engaged and recognizing strengths that allow for growth; expanding their roles and making sure we’re utilizing people to their fullest potential,” Bryan said. 

BVHC is a nonprofit community health center that has recently expanded its services; dental in 2017 and mental health and substance abuse services in 2018. The center grew from employing 8 to 29 staff serving 1800 to 4000 patients since opening their doors in 2014.

Providers from BVHC frequent Arlington schools to talk about vaping, sex education, relationships, addiction, nutrition, dental hygiene and more. Bryan said this helps familiarize children with their health care providers. 

Preventative Health Care
SVHC is also catering to the growing needs of the public through advanced technology and partnerships, such as the one with Dartmouth-Hitchcock Medical Center in New Hampshire. 

“We have made big strides in ensuring that information flows from one system to the other,” said Trey Dobson, SVHC’s chief medical officer and medical director of Dartmouth-Hitchcock Putnam Physicians.

The two entities share a variety of telecommunication services such as TelePharmacy, TeleMedicine, TeleEmergency, TeleExpressCare, TeleNorthshire ExpressCare, TeleICU, and TeleNeurology. SVMC’s regional cancer center is also made possible through the Dartmouth-Hitchcock affiliation. 

“It’s an exciting time and it’s being driven by how we can provide higher cutting edge care at a much more affordable price,” Dee said. “It allows us to have access to things to help us serve the community better. Having that relationship with Dartmouth-Hitchcock helps make our mission a reality and our vision to become an exceptional health care provider.” 

SVHC is seeking its fifth accreditation from the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program. The hospital is one of 43 organizations worldwide that have been re-designated four times. It’s also one of three Magnet Centers for Nursing Excellence in New England to have held the designation for 16 years running, according to the health care’s website.

“We are fortunate to have SVHC affiliated with Dartmouth as it helps to increase access to care, especially with their telemedicine capabilities, but it can still be tough to establish a relationship with a general doctor. Express Care in Bennington and Manchester, and Manchester Medical Center do offer the ability to be seen when someone is needing care,” said Michael Leake, manager of The Pharmacy. 

The healthcare of tomorrow is outside of the doctor’s office. It’s in the kitchen, in the gym, in the classroom, and on the field. Obesity, tobacco use and food insecurity are other components under the healthcare umbrella. Andrea Malinowski of the statewide nonprofit RiseVT can attest to that. 

“Unhealthy lifestyles are shortening the lifespan of younger people,” Malinowski said. “The more that we show prevention is the key, I think people will grab ahold of it. Most people want to be in charge of their health.”

RiseVT is driven by data that states the current generation has a shorter life expectancy than that of their parents due to unhealthy lifestyles. 

Malinowski has been working with the Southwest Vermont Supervisory Union to put policies in place for wellness procedures, curating show-up events such as a kick-ball game, and including an educational component to the farmer’s market. She wants folks to realize that food and exercise are forms of medicine and becoming healthier may be a complete lifestyle change. 

“Having access to healthier foods and making certain choices can make an impact and little changes do add up. We have to be patient. As a culture we can reverse the trend and our kids can live longer if we make simple changes now,” she said.

Some may consider an annual teeth cleaning as preventative health care while others categorize exercise and the farmers market produce club preventive care. 

Emergency Assistance
Accessing food and resources is extremely important to one’s quality of life. The same goes for physically getting to a hospital or health center to obtain resources, especially in the case of an emergency. 

With a full-time rescue squad in Manchester and Bennington, The Shires is covered for emergency assistance and transportation to emergency services. 

“Bennington is really lucky. It has an exceptional situation with a fully staffed rescue squad,” said Michael Zhuraw, an Emergency Medical Technician (EMT) for the Bennington Rescue Squad. 

A lot of what Zhuraw responds to involves cardiac complications, chest pain, difficulty breathing, seniors who fall and overdoses.

Something Leake of The Pharmacy and Zhuraw have in common is the exposure to the opioid epidemic. While overdoses are something EMT’s respond to, Zhuraw said people are self-administering the overdose reversal drug naloxone or Narcan, more frequently now that it’s free through the state of Vermont. Over the last five years, roughly 50,000 Narcan kits have been distributed, according to the Vermont Department of Health. 

Leake has noticed more unwanted prescriptions being collected by the Drug Enforcement Administration (DEA). National Prescription Drug Take Back Day is another way communities are combating the crisis. Leake said The Pharmacy’s number grows each time they report the total number of medications dropped in the store’s take back box. This year the New England Division collected 92,875 pounds of expired, unused, unwanted prescription drugs and electronic vaping devices and cartridges at 606 collection sites throughout New England – compared to 25,810 pounds nine years ago. Vermont collected 6,734 pounds this year – the most to date. 

“Every eight weeks we ship about 40 pounds of unused medication to be destroyed,” Leake said. “All the pharmacies are trying to become more involved in educating patients on controlled substances.” 

Take back boxes to collect unused prescriptions only formerly used to be at police departments. Now there’s one at SVMC and most pharmacies throughout The Shires, Leake said.  

“If we can remove the drugs that could be abused out of homes and off the street, then there’s less of a risk to abuse them,” Leake said. 

The opioid epidemic plays a large role in The Shires’ health care system involving access to recovery programs, emergency assistance and other resources. Various partners in the community help those who suffer every day. 

Senior Care
As Vermont’s senior population continues to age, organizations that provide relevant care and living accommodations become more important. By 2030 Vermont’s population is expected to gain 88,000 residents – 24 percent will be age 65 and older, according to the Vermont Housing Finance Agency.

Brookdale Fillmore Pond offers three levels of care; independent living, assisted living, and memory care. With 110-115 residents ranging 70 to over 100-years-old, Brookdale typically gets folks who relocated to Florida, Las Vegas or another town within an hour radius of Bennington, but a family member lives in Vermont and wants them to be close by. 

“I had a conversation with a family member recently whose father is from Bennington but lives in Florida. They loved our community in Bennington because of the small town. I think it’s a big reason we have people move here,” said Jennifer Hill, sales manager at Brookdale Fillmore Pond.

While some organizations anticipate a workforce loss, Brookdale embraces the population change. 

Stay To Stay 
The Southwestern Vermont Chamber of Commerce has partnered with regional healthcare partners to attract professionals from around the country to the region through Vermont’s innovative Stay To Stay program. Stay To Stay Weekends, a state initiative which works with regional partners like chambers of commerce, are exploratory vacations for professionals to learn about moving to Vermont. Visiting individuals and families in the program have the opportunity throughout the weekend to connect with employers, realtors, community leaders, entrepreneurs, and potential neighbors all while enjoying a weekend away in the Green Mountains. 

Matt Harrington, executive director of the Southwestern Vermont Chamber, mentions the current success of the program, “In the past two years of the program we’ve seen over 60 individuals come through the program.  People have come from all over including Florida, Maryland, Texas, Mississippi, Colorado and more. We’ve had 8 people decide to move to the region in only the first two years of the program. This is a long game; we’re working with our partners to fill out a pipeline with active, young families that will grow roots in our community.  We know for some they’re ready to move immediately; we also understand others need time to make that change. We’re just excited to provide them a weekend of possibilities and experiences.” The chamber has partnered with regional healthcare partners to offer a July 2020 Weekend with a specific focus on the healthcare industry.  

“Our partners at the state handle the front end of the program attracting professionals through geo-targeting marketing efforts. The ability we now have on LinkedIn, Facebook, Google and other platforms allows us to target health care providers from around the country and encourage them to try out Vermont for a weekend.  That’s our plan with the healthcare industry come this July. We do believe that The Shires of Vermont offer a unique experience for healthcare professionals and we’d love to show that to the world,” reports Harrington.

The Healthcare of Tomorrow
Vermont ranks No. 5 on the list of states with the best healthcare system, according to findings reported on WalletHub regarding cost, access, and overall outcome. It remains in the top five for having a high percentage of residents insured ages 0 to 64. The healthcare system(s) throughout Vermont is shifting to better serve its population. 

When Thomas Dee previously mentioned growth, he referred to the climate of the healthcare system, which is moving from a patient-based to population-based model. The payment structure is changing as well, based on the value of care.

“It’s going through a transformation. We’re moving toward population health and caring for large groups of people and trying to make sure that as a health system, patients receive the highest level of care as possible,” he said. 

This article was produced and published by the Southwestern Vermont Chamber of Commerce and with the generous support and sponsorship of Southwestern Vermont Health Care. The regional Chamber of Commerce promotes, leads and advocates a unified effort, on behalf of its members, to maintain and improve a healthy business climate and rewarding quality of life for the Southwestern Vermont region.