Editor’s note: This commentary is by Donald Keelan. Keelan writes a bi-weekly column and lives in Arlington.

“Over the last 19 years we have delivered or served three quarters of a million meals and have little awareness as to demographics, social, health or nutritional needs of our clients – until this spring.”

This statement was recently made by Susan P. Fox, the Executive Director for the Bennington County Meals Program, better known as Meals on Wheels (MOW).

The forum where Fox made the statement was at Marlboro College Graduate School’s Nonprofit Management Leadership Master’s Program, in May, 2013, while presenting her Capstone Project to the faculty in Brattleboro.

Fox has had the title of Executive Director of the Bennington County MOW nonprofit, since 2008 and prior to her present role had been, for 5 years, chairwoman of the organization’s board and trustee. However, it was in 2012, when she was planning her Capstone Project that she realized that a rare opportunity had presented itself. In essence it would be a collaboration with the Southwestern Vermont Medical Center, using a grant from the Vermont Community Foundation to find out exactly who MOW was serving with its 50,000 meals per year.

MOW’s involvement with the hospital was beneficial to both nonprofit organizations. The collaboration was also important to the seniors of Bennington County, who represent about 25 percent of the population, the highest in Vermont, and are projected to grow to 35 percent by the year 2015.

SVMC has always been keen on how to better serve the health needs of its constituency, especially upon discharge from the hospital. It is a well-known fact, that if recently discharged seniors could have well-prepared and nutritious meals, while at home, the likelihood of their needing to come back to the hospital could be greatly curtailed. Thus a program was created in conjunction with MOW, whereby discharged seniors were provided with 10 coupons to obtain free meals delivered or served by MOW.

At the same time, it was critical to find out exactly what were the demographic characteristics of the population being served – not only those who receive home-delivered meals but the scores of individuals who frequented the program’s five Bennington County congregate meal sites.

In the spring of 2013, a survey list of questions was provided to the meals-on-wheels clients. The questions asked about their health conditions, if they lived alone, their age, how often did they have visitors, how much in the way of fruits and vegetables they consumed on a daily basis, and what chronic illnesses did they have and were they following their doctor’s advice when it came to good eating habits? Another important question was what other daily meal, if any, did they have other than the one delivered by MOW or served at the congregate meal site? An astounding 83 percent responded to the survey and the data provided was a “watershed” of important information about the individuals MOW was serving. The data from the survey was also helpful to the hospital’s medical personnel.

According to the survey, 67 percent of the respondents consumed only zero to three servings of fruits and vegetables per day – the suggested level is closer to seven

Furthermore, it was noted that 64 percent of those surveyed stated that “their doctors are not recommending changes in their diets.” It was also noted, that “most of the clients want to stay in their homes.” For those who did receive their meals at home, 65 percent were over 80 years old and it was important for them to meet and talk with the person who delivered their daily meal.

Over 50 percent of those who chose to have their meal at a meal site were under 70 years old and for them, the socialization factor was high on their list of what gave them satisfaction. On any given weekday it would not be unusual to see upwards to 35-45 young seniors enjoying a meal and socializing with their neighbors.

MOW is not a welfare program; instead it is a program to bring nutritious meals to the homebound and disabled who are over 60 years old. There is no charge to the client, however, a donation of $3.25 is requested (the per meal cost is about $8). More revealing is the fact that a year’s cost of meals is the equivalent of a 24-hour hospital stay.

Since February, when the joint program with SVMC commenced, 162 new clients were added to the MOW client base – and to date, 62 percent have continued receiving their daily meal from MOW. What is even more significant, no client who had been on the coupon program has had to be readmitted to the hospital.

In years past, MOW may have been perceived as a welfare program. Based on the survey results, the hospital collaboration and the Café experience, it is really an organization bringing “Wellness on Wheels” to an ever-increasing and treasured segment of Bennington County citizens. There are many deserving nonprofit organizations in Bennington County— WOW (MOW) ranks high among them.

Editor’s note: This article is by Keith Whitcomb Jr. of the Bennington Banner, in which a longer version was first published on Feb. 5, 2014.

BENNINGTON — Despite the emergency room being no place to deliver psychiatric care, at times the local hospital’s ER is half-filled with people in need of mental health care, some of whom have been there for weeks awaiting placement in a more appropriate facility.

William Hall, director of engineering at Southwestern Vermont Medical Center, shows the space near the hospital’s emergency room that will be converted into a three-bed area designed to house patients who are having a mental health crisis. Photo by Keith Whitcomb Jr./Bennington Banner

The problem is not expected to go away, said William Hall, director of engineering at Southwestern Vermont Medical Center, and so the hospital plans to renovate existing storage space near the ER into a three-bed area specially designed to house patients suffering a mental health crisis.

Hall expects the renovation will cost between $120,000 and $140,000. Construction is expected to begin the first week of March. The space will have an office for nurses and security staff who can monitor patients via closed-circuit television to allow them solitude. It will be handicapped accessible and there will be a bathroom with a shower.

The Vermont State Hospital in Waterbury, formerly the state’s primary mental health facility, closed in 2011 when it was flooded by Tropical Storm Irene. Its replacement in Berlin is expected to open this summer. But hospitals statewide have been struggling to place their psychiatric patients, and some worry the pressure on their ERs will not be completely alleviated.

The Vermont State Hospital had 54 beds; the new one is expected to have 25.

“We believe that we are building a state mental health facility in Vermont that’s going to be an example for the rest of the country, that’s our plan,” said Gov. Peter Shumlin Monday in an interview. “You have to remember that we lost our state hospital in the middle of the night, we still don’t have it back, and we believe that the additional 25 beds along with the enhanced community-based care, which is what we’re really beefing up, is going to reduce the need for acute care when prevention in the local community works better, is more cost-effective, and better for patients.”

He said the state is still in crisis in the meantime, and hospitals have handled things well.

Locally, there is skepticism the new facility will alleviate the pressure on the ER.

“The long and short of it is that in total by the end of the summer it’s anticipated that they will have increased the capacity of the system by 10 beds, and I don’t think anyone realistically thinks that’s going to fix the problem,” said Dr. Adam Cohen, medical director of SVMC Emergency Department.

Cohen spoke to the Banner in early January and said that during the previous week, seven of the ER’s 16 beds were occupied by patients in need of psychiatric care, two of whom had been there for over a week.

“They are very resource-intensive patients to take care of,” he said. “In many cases we need a sheriff and a full-time one-on-one provider to take care of these patients.”

An emergency room is not a good place for someone in need of psychiatric care, Cohen said.

“It’s bad for them, they’re in a high-stimulus environment that usually makes them worse. It’s bad for the other patients in the ER,” said Cohen. “Imagine you’re next door with your 3-year-old and there’s a violent, out-of-control, psychotic patient in the room next to you screaming profanities the whole time you’re there. That’s not good for anyone else in the ER.”

The new rooms will allow patients in mental health crisis to be away from the noise and hustle of the ER, but they can still be monitored to make sure they do not harm themselves or others.

Hall said the rooms are an extension of the ER, not a new department. No new services will be provided by the hospital, which does not offer psychiatric care.

This problem is not unique to SVMC.

“There is very poor access to psychiatric treatment in the state,” said Cohen. “Again, not a local problem, not a Vermont problem, but a problem nationwide, but if you come to the emergency department there is a likelihood that your wait times will be longer because we are treating a large population of psychiatric patients in a system that is designed, at this point, to offer them no recourse but to go to the emergency department and wait there for a long time for treatment to be available.”

People in need of emergency care cannot be turned away, and when a patient has nowhere to go, Cohen said, emergency rooms end up being a catch-all place to put people.

“We’ve had to develop training programs to handle these kinds of things, and it’s been a lengthy process,” said Cohen. “I feel that we have the training and the policies in place now to help us handle this population as best we can under the circumstances, but this is not the purpose of an emergency department.”

He noted that providers have been assaulted by patients numerous times, which adds to the rate of staff turnover.

Contact Keith Whitcomb Jr. at kwhitcomb@benningtonbanner.com or follow him on Twitter @KWhitcombjr.

News Release — Peter Welch
April 1, 2014

Contact:
Ryan Nickel
202.225.4115

WASHINGTON, DC (April 1st) – Late last night, President Obama signed into law Rep. Peter Welch’s bipartisan legislation to provide funding to hospitals serving disproportionately large numbers of seniors in rural communities. This new law will provide financial relief for one year to the five Vermont hospitals currently receiving federal funding through either the Medicare-Dependent Hospitals program or the Low-Volume Hospitals program. Funding for the two programs was set to expire last night at midnight.

“Vermont’s rural hospitals have a strong reputation for providing high quality health care to seniors in the communities they serve,” Congressman Welch said. “This legislation will make sure our hospitals serving large numbers of seniors are adequately funded.”

Last year, Rep. Welch and Rep. Tom Reed (R-NY) introduced the Rural Hospital Access Act (H.R. 1787) that extends the Medicare-Dependent and Low-Volume Hospitals programs for one year. Reps. Welch and Reed successfully included their bill in the Protecting Access to Medicare Act of 2014 (H.R. 4302) which was signed into law by the President last night.

Vermont has two Medicare-dependent hospitals: Southwestern Vermont Medical Center and Brattleboro Memorial Hospital, and three low-volume hospitals: Brattleboro Memorial Hospital, Northwestern Medical Center and Central Vermont Medical Center.

This article is by the Bennington Banner, in which it was first published Jule 8, 2014.

BENNINGTON — Patients can now see a rheumatologist at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. without having to leave Bennington.

Southwestern Vermont Medical Center announced Monday that since June many patients have been able to see Dr. Daniel Albert, a rheumatologist at Dartmouth-Hitchcock, by teleconferencing. Patients only had to come to SVMC and Albert was able to consult with them while they appeared on a video screen.

Albert also comes to Bennington twice a month to see patients with more complex issues.

“I think this hybrid model of me going to Bennington intermittently and doing telemedicine intermittently is absolutely the right model,” Albert said in a release.

Patients seeing Albert via the Dartmouth-Hitchcock Center for Telehealth enter an examination room as they normally would. A nurse is there to assist them and run diagnostic equipment while the information appears before Albert, sparing both him and the patient the two-hour drive to Lebanon.

“Exactly the same options”

“What we’re learning so far from our telemedicine patients in Bennington is that probably 80 percent of them can be seen in this way to manage their disease,” said Albert. “During their telemedicine visits, some patients will get labs, some will get x-rays, and some patients will be prescribed meds. It runs the gamut of what we do in person. Exactly the same options are available to them as a telemedicine patient as an in-person patient.”

Dr. Trey Dobson, SVMC’s chief medical officer, said in a release that this is being done in part because of the retirement of Dr. Brian Cunningham earlier this year. The hospital has had difficulty in recruiting a new rheumatologist.

Nearly two years ago, all of SVMC’s doctors became Dartmouth-Hitchcock employees. The move benefited both institutions and part of what SVMC was looking for was better access to specialists.

“We have a significant population needing these services,” said Dobson, “And our goal is to provide patients access to Dartmouth-Hitchcock experts here locally. Telemedicine and our close relationship with the D-H Center for Telehealth enable us to do that. Now patients who were faced with traveling out-of-state for care can stay local and receive the high-level of care they’ve always gotten at SVMC.”

Dobson said SVMC will likely explore more ways to utilize the Dartmouth-Hitchcock Center for Telehealth in the future.

News Release — Southwestern Vermont Health Care
Jan. 5, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019
Fax: 802.447.5214
ashley.jowett@svhealthcare.org

BENNINGTON, VT—January 5, 2017—On Friday, February 3, 2017 Bromley Mountain ski resort will hold their 15th Annual “Mom’s Day Off” fundraiser. Moms ski or ride for just $20, which represents more than $50 in savings, when they show the ticket seller a snapshot of their kid or kids. Once again, this year’s event will benefit the Southwestern Vermont Regional Cancer Center in Bennington, part of Southwestern Vermont Medical Center (SVMC). The Cancer Center will receive the entire $20 lift ticket cost as a donation.

“For 15 years, we’ve been raising money and awareness for women’s health in southern Vermont through our Mom’s Day Off event,” says Michael van Eyck, Bromley Mountain’s assistant general manager. “Working with the Southwestern Vermont Medical Center team has given us the local support we need to host this great event and to continue our financial contribution to the Cancer Center.”

Dr. Matthew Vernon, radiation oncologist and medical director of the Cancer Center at SVMC shared, “Receiving donations like this one from Bromley supports our work to provide exceptional care and comfort to our patients. It is inspiring to see this grassroots support from the communities we serve.”

During the day, participants will be able to meet some of the physicians and staff of the Cancer Center, whether on the slopes or in the lodge.

Bromley Mountain is located at 3984 Vermont Route 11, Peru, Vermont, six miles east of Manchester. For more information about Bromley, visit bromley.com.

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The unit would occupy 1,890 square feet of the first floor of the medical building, which is next to the main entrance to Southwestern Vermont Medical Center. The plan has been submitted to the Green Mountain Care Board for the needed approval, called a certificate of need.

A new dental clinic is proposed in the medical building on the Southwestern Vermont Medical Center campus in Bennington. Photo by Jim Therrien/VTDigger

He said plans call for renovating space on the first floor of the three-story structure to create four dental examination and treatment rooms as well as space for offices, a small laboratory and a panoramic dental X-ray machine.

The cost of the project is estimated to be about $804,000 for the renovation work, equipment and dental practice computer software.

In its application, SVHC cites data showing a significant need for more dental services in the area, including that “a significant percentage of the population within SVMC’s service area is afflicted with dental decay.” It also says a state report showed that “Bennington kindergarteners have the highest incidence of tooth decay among peers in Vermont” and says “access to dental services throughout our service area is limited. No dentists in Bennington are accepting new patients with Medicaid’s Dr. Dynasaur insurance coverage.”

In addition, the application says the area has fewer dentists than in 2001 and it has been difficult for practices to recruit dental staff. Many dentists also are aging, and “76 percent of dentists in Bennington are 50 years or older with 47 percent over 60 years of age,” according to the document.

The application says dental professionals in the area have been involved in discussions about the proposed facility and overwhelmingly supported the plan. Dr. Richard Dundas, a local internist who has been active with the Bennington Oral Health Coalition, said of the plan: “We certainly do support that. There certainly is a shortage in our area.”

The coalition has supported adding fluoride to the Bennington water system to reduce the rate of tooth decay and organizing programs in schools, including screenings of students for dental problems and educational efforts to promote dental health.

The new facility would offer oral evaluations and cleanings, diagnostic imaging, restorative services, tooth extractions, endodontics and preventive treatments, such as sealants. Plans call for having two dentists, two hygienists, dental assistants and other staff members when the facility is at full operation.

The SVHC service area is described as Bennington County; western Windham County; eastern areas of Rensselaer and Washington counties in New York; and northern Berkshire County in Massachusetts.

Trimarchi said the space to be renovated has been used by the gastroenterology services and other offices in the medical building. He said a separate $1.2 million project is creating space on the third floor for specialty medical services, including pulmonology, rheumatology, gastroenterology and treatment of infectious diseases.

On the first floor, the medical building also contains primary care offices, the ExpressCare unit and SVMC cancer center offices.

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News Release — Southwestern Vermont Medical Center
Feb. 14, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Southwestern Vermont Medical Center
(802) 447-5019
ashley.jowett@svhealthcare.org
svhealthcare.org

PERU, VT—February 14, 2017—More than 400 mothers skied at Vermont’s Bromley Mountain in Peru on Friday, February 3 to support the Southwestern Vermont Regional Cancer Center in Bennington, part of Southwestern Vermont Health Care (SVHC). Each received a $20 lift ticket when they presented a photo of their children at the resort’s ticket window. SVHC’s President and CEO Thomas A. Dee, FACHE; Vice President for Corporate Development Leslie Keefe; Cancer Center Nurse Manager Jennifer Coutu; and Breast Health Navigator Rebecca Hewson-Steller attended. The first 100 participants received an SVHC gift bag. All ticket revenue, a total of $8,140, was donated to the Cancer Center.

To learn more, visit svhealthcare.org.

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News Release — Southwestern Vermont Medical Center
March 9, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

BENNINGTON, VT—March 9, 2017—Women in Pownal, VT, and nearby Berkshire County, MA, can now schedule gynecologic and prenatal appointments closer to home. Gynecologist Dr. Malcolm Paine has begun seeing patients at SVMC’s Pownal Campus in Pownal, VT.

“Regular visits are so important for women of all ages, especially moms-to-be and their babies. This change allows women who live south of Bennington to travel a lot less to make their appointments,” Paine said.

Dr. Paine offers all of the same services at the Pownal Campus that he currently offers at his office in Bennington, including screenings, prevention, treatment, and prenatal care.
Robert Tarnas, MD, one of three primary care doctors at Pownal Campus, appreciates the opportunity to expand the services the practice provides.

“We see women and children for their routine visits. Having Dr. Paine provide additional gynecologic and obstetrics services makes those appointments more accessible for patients in our community,” said Tarnas. “This convenience makes it easier for patients to get the care that is recommended for them, and that is always a good thing.”

In addition to Dr. Tarnas, Barbara Raskin, MD, and Michael Welther, MD, see patients at SVMC Pownal Campus. The practice opened in October 2015 and is located less than one mile north of the Vermont-Massachusetts border. It includes 5,000 square feet, 10 exam rooms, X-ray, and lab testing. In addition, the space offers many features designed for patient comfort, including a covered drop-off entrance, a comfortable waiting area, and an architectural design that allows for natural light. For information about becoming a patient at SVMC Pownal Campus, call 802-681-2780. Those interested in making a gynecologic or prenatal appointment should call SVMC OB/GYN in Bennington at 802-442-9600 to schedule.

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News Release — Southwestern Vermont Medical Center
March 14, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

Bennington, VT—March 14, 2017—The Cancer Center Community Crusaders (4Cs) hosted their 3rd Annual Cabin Fever Dance at the Elks Lodge in Bennington, VT, on Saturday, February 25. The event welcomed over 250 guests and raised nearly $3,000 for the Southwestern Vermont Regional Cancer Center’s (SVRCC) Patient Resource Fund. Attendees—many of whom wore flannel shirts, the recommended event attire—enjoyed dancing to music supplied by DJ John Woodell, exciting raffles, and great food.

The 4C’s mission is to provide short-term financial, physical, and emotional support to cancer patients who live within the SVRCC service area. The group’s 3-year fundraising total tops $125,000. Financial assistance from the SVRCC Patient Resource Fund is available to those currently undergoing cancer treatment and struggling to make ends meet. Types of assistance available include travel expenses for treatments or second opinions, gas cards, help with utility and fuel expenses, dental care, wellness classes, and more.

In partnership with the SVRCC, the 4Cs invite community members to their Annual Day of Celebration on Saturday, June 3, 2017, at Southwestern Vermont Medical Center. Event activities include the SVRCC Annual Survivors Day luncheon; a large vendor fair; a kids’ play zone, including bouncy houses and a dunk tank; tours of the Cancer Center and the new linear accelerator; live music; and much more. To become part of the Cancer Center Community Crusaders or to support their mission, please email Carson Thurber at carson.thurber@svhealthcare.org or call 802-447-5488.

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The rankings, which are compiled in each state and offer annual statistical comparisons on a county-by-county level, show Bennington County ranked 12th of 14 Vermont counties. Only Grand Isle and Orleans counties are ranked lower, at 13 and 14 respectively.

The healthiest populations in Vermont are living in Addison County, followed by Chittenden, Lamoille and Washington counties.

Nearby Rutland County ranked ninth in the report, while Windham County was 10th.
Bennington County has been ranked between 10th and 12th healthiest in the state over the past five reports, after being ranked sixth statewide in 2011.

Statistics related to drug addiction and overdose were cited by local health care officials as a major reason for the lower rankings. Thomas Dee, the CEO of Southwestern Vermont Health Care, said addiction “stands out [in the annual rankings] as an increasingly important one, and over a pretty short period of time.”

The statistics are packaged in a model designed to gauge the health of a community, while addressing general topics of length of life and quality of life. Stats in a number of health-related categories are included for each state, and the figures are broken down by counties for comparison.

‘Tale of two Vermonts’

Dee said socioeconomic conditions have a direct impact on population health in the region. The four counties ranked highest in terms of health are clustered in the most economically vibrant region of the state, he pointed out.

“I’ve always said that this is a tale of two Vermonts,” he said.

The rankings report cites statistics on the economic health of a county, income levels, the level of education and similar factors. Eighty percent of the health of a community is based on socio-economic or other factors and only 20 percent of the ranking is tied to access to medical care.

As part of an effort to improve the health of county residents, local groups formed the Bennington Community Collaborative. Southwestern Vermont Medical Center, United Counseling Service, Shires Housing and the Council on Aging are spearheading the collaborative.

James Trimarchi, the director of planning at the medical center, said the collaborative works to “break down the silos” in order to better coordinate health care for local residents.

The hospital is also involved in the proposed Putnam Block redevelopment project, which is seen as a tangible way to revitalize the local economy and, by extension, the health of the community, Dee said.

Range of health measurements

The data in the 2017 rankings report contains measurements based on the most recent available statistics on quality of life and health conditions; health behaviors, such as smoking, obesity, physical activity, drinking, teen pregnancy and the rate of sexually transmitted infections; clinical care options, the availability of insurance, dental care, mental health services, diabetes monitoring and mammography screening; social and economic factors, such as employment, having a high school degree or college experience; the number of children living in poverty, exposure to violent crime, the number of single-parent households; and available social associations and income inequality.

The physical environment of each county — including air pollution, drinking water quality, rate of severe housing problems, and the distance residents commute — is also taken into account.

For categories in which the county figure is higher or lower than the state figure, the report highlights areas of concern for possible local efforts to foster improvement, while in categories where the local figure is better than the state figure, that indicates improvement or that the problem is not getting worse.

For instance, 16 percent of adult Vermonters smoke, while 24 percent are considered obese. In Bennington County, those figures are identical.

Bennington County has a rate of physical inactivity of 20 percent among its population, which is nearly identical to 19 percent for the state figure, and 89 percent here have access to exercise opportunities, compared to 72 percent in Vermont.

County statistics also were better than or equal to statewide figures for access to health insurance and mental health providers and mammography screening, and showed greater access to social associations than the statewide average.

However, Bennington County had a lower percentage of high school graduates, 83 percent, than the state as a whole, 88 percent; a higher rate of children in single-parent households, 38 percent, compared with 31 percent statewide, and a higher rate of children living in poverty, 18 percent compared with 14 percent statewide.

An additional figure not included in the ranking calculation but shown in the report found the percentage of local students eligible for free or reduced school lunches was 53 percent, compared to a statewide figure of 39 percent.

In the major health factor sections, Bennington County ranked 12th in health outcomes, 13th in quality of life, 11th in health behaviors, 12th in clinical care options, 12th in social and economic factors affecting health, and sixth in physical environment, which could be affected in future statistics by the PFOA contamination discovered last year in wells around the former ChemFab Corp. factory in North Bennington.

Premature death statistics

Nationally, more people are dying younger, within the ages of 15 to 44.

Premature death is measured in terms of years lost by not living to the national average lifespan of 75 years, based on 100,000 people.

The rate “began to rise steadily in 2012 and then accelerated from 2014 to 2015 (representing a 1 percent increase).”

According to the statistics, during 2015 more than 1.2 million people died prematurely in the U.S., up 39,700 from the prior year, with premature deaths rising across the full range of racial, ethnic groups and community types.

Rural counties had the highest rates of premature deaths, the report states, followed by smaller metro areas.

The Vermont figure was 5,500 years lost per 100,000 residents in Vermont, compared to 6,400 years lost among Bennington County residents and 5,200 years lost for the best performing counties nationally.

Orleans County, which was ranked lowest in the state in overall health, lost 7,000 years to premature death, according to the report. Orleans also had an adult smoking rate of 17 percent and a 29 percent rate for adult obesity.

Addison County, the top ranked county, lost 5,000 years to premature death per 100,000 population, had an adult smoking rate of 13 percent and obesity rate of 23 percent.

The report also contains information on the primary causes for deaths among younger people, which include injury deaths. That category includes vehicle and other accidents, firearm-related deaths and drug overdoses. Overdose was identified as the leading cause of premature death by injury in 2015.

In terms of the “length of life,” or premature death statistics, Bennington County ranked fifth best in the state in 2011 and now ranks 12th.

Also included in the report are references to a number of actions being taken around the country to reduce the number of premature deaths. Information on these initiatives and additional statistical information on the health of counties in each state can be found online at www.countyhealthrankings.org.

A new statistical measurement in the 2017 report counted disconnected youth, or those 16 to 24 who are not in school or working. There are about 4.9 million disconnected youth in the U.S, with the rates highest among minority youth and higher in rural counties — 21.6 percent — than in urban counties, 13.7 percent.

Bennington County showed 11 percent disconnected youth, compared to 9 percent in the state.

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News Release — Southwestern Vermont Medical Center
April 12, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

BENNINGTON, VT—April 12, 2017—Southwestern Vermont Medical Center’s medical staff was recognized at an event last month at the Bennington Museum.

Frank Famiano, MD, was awarded the 2017 Professional Teamwork Award. Famiano has been a hospital medicine specialist with Southwestern Vermont Medical Center since 1994. He received his undergraduate education at Rutgers University in New Jersey and his medical degree at Temple University School of Medicine in Pennsylvania. Dr. Famiano completed his residency at Berkshire Medical Center in Pittsfield, MA, and a fellowship at University of Vermont College of Medicine. In addition, he is certified by the American Board of Internal Medicine

Andrew Shedden, MD, is the 2017 recipient of the Clinical Excellence Award. Shedden has been a radiologist with Southwestern Vermont Medical Center since 2001. He received his undergraduate education at Butler University in Indiana and his medical degree at Indiana University School of Medicine. Dr. Shedden completed both his residency and fellowship training at Medical College of Virginia. He is board certified by the American Board of Radiology.

In addition to the awards, several providers were recognized for their years of service. Among them, Drs. David King and Greg King were recognized for 30 years of service, and Dr. Charles Salem was recognized for 20 years of service.

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News Release — Southwestern Vermont Medical Center
April 18, 2017

Contact:
Cardiac Rehab
802-447-5132

Event Kicks Off 9:30 a.m. June 3 at Bennington Elks Lodge

BENNINGTON, VT—April 18, 2017—For the past 26 years, members of the public have joined past and current participants in the Southwestern Vermont Medical Center (SVMC) Cardiac Rehabilitation program for the Annual Heart Hike and Community Wellness Walk. This year, the Heart Hike has partnered with the Vermont Chapter of the American Heart Association.

“This new partnership relates to growing cooperation between SVMC and Dartmouth-Hitchcock Medical Center. Their Chair of Cardiology Dr. Mark Creager is the immediate past president of the American Heart Association,” said Scott Rogge, MD, SVMC’s medical director of Cardiology. “The American Heart Association conducts important research and provides amazing educational resources. It makes sense for us to join forces and give families here an opportunity to deepen their commitment to this important cause.”

The event starts at 9:30 a.m. Saturday, June 3, 2017 at the Bennington Elks Lodge on Washington Ave. One, two and three mile courses are available. The walk is free and open to all, and no preregistration is required. Pre-walk warm ups will be led by SVMC Cardiac Rehab staff.

Those who would like to start or join a team and fundraise for the American Heart Association may visit www.vermontheartwalk.org. Register using the Burlington Walk link.

“Heart disease is a common struggle. Almost everyone knows someone who has heart disease,” said Patty Ryan, RN, nurse coordinator of SVMC’s Cardiac Rehab program. “Our goal is to increase awareness and get moving, so heart disease affects fewer of our area families.”

Participants interested in more information about the event should contact Cardiac Rehab at 802-447-5132.

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​Robin Lunge and Jessica Holmes, members of the Green Mountain Care Board, speak to representatives of the UVM Health Network earlier this month. File photo by Erin Mansfield/VTDigger

All three current members of the five-seat Green Mountain Care Board voted to have hospitals use half of any unexpected profits they made in fiscal 2016 to offset price increases in fiscal 2018.

The hospital system as a whole took in $60.3 million more from patient care than expected in fiscal 2016. The board disregarded about half of that money as expenses, and ordered action to offset future price increases by roughly $15 million.

The methodology is a shift from years past, when the board has ordered such rate adjustments based on overages in patient care revenue — money from Medicare, Medicaid and insurance companies, before accounting for expenses.

The board has told the University of Vermont Medical Center and Central Vermont Medical Center — which increased their prices 2.45 percent in fiscal year 2017 — not to put together a 2018 budget with a price increase of more than 0.72 percent.

Northeastern Vermont Regional Hospital in St. Johnsbury will be limited to a 3.2 percent price increase, and Southwestern Vermont Medical Center in Bennington will be kept to a 2.85 percent increase.

Northwestern Medical Center in St. Albans will need to reduce prices 1.1 percent.

Leaders of Rutland Regional Medical Center already said at a hearing earlier this month they wanted to reduce prices by $1.1 million starting May 1. The Green Mountain Care Board accepted that proposal and did not use the same methodology as it used with the other five hospitals.

Jessica Holmes, a Green Mountain Care Board member, said requiring the five hospitals to return 50 percent of the unexpected portion of their profit margins sends “a very clear signal” that hospitals should not request to raise their prices by a higher percentage than last year.

“The message is also we have to live within our budgets, and Vermonters cannot afford year after year to have premium increases that are outpacing inflation, and they can’t afford to pay more taxes, so we have to figure out different ways to cut costs and make health care affordable in the state,” Holmes said.

Robin Lunge, another board member, said using half of each hospital’s unexpected profits is a way to account for the individual circumstances at each hospital.

Con Hogan, the third board member, said it might sound reasonable to take 100 percent of the unexpected profit margin, “but that creates a complete disincentive to lower costs.”

Jeff Tieman, the CEO of the Vermont Association of Hospitals and Health Systems, said the board recognized some of the challenges hospitals are facing, such as potential cuts to charity care money the Legislature has been considering, and investments they need to make in health care reform.

“I think the board did a couple of good things here, and acknowledging that it’s most appropriate to look at operating margin” — often called profit — “as opposed to net patient revenue,” Tieman said. “We thought that was good.”

“The board also seemed to acknowledge that hospitals face a series of uncertain and difficult factors that make budgeting a real challenge, and we appreciate that the board understands those various factors and is willing to be in dialogue with our hospitals about them,” he said.

He said hospital budgeting “is sometimes more of an art than a science.”

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The black-legged tick carries Lyme and other diseases. Creative Commons photo

(Editor’s note: This article by Cherise Madigan was first published in the Bennington Banner on April 24, 2017.)

“In 2015 Vermont had the highest incidence of Lyme disease in the United States,” said Bradley Tompkins, an infectious disease epidemiologist at the Vermont Department of Health. “Bennington is the highest incidence county in Vermont not only for Lyme disease, but for anaplasmosis as well.” With such a high rate of infected ticks in Vermont, experts emphasize the importance of recognizing that the majority of tick bites have the potential to transmit an illness.

“There is a very high burden of infected ticks, especially in Bennington County,” said Doctor Marie J. George of the Infectious Disease Department at Southwestern Vermont Medical Center. “In fact, 63 percent of ticks are infected statewide with at least one tick borne illness, with some carrying two at the same time.”

Geography is partially to blame for Bennington’s severe incidence of tick borne illness, according to the Vermont Department of Health.

“I think part of this is that we have seen a northern trend or expansion of a lot of these tick borne illnesses,” said Tompkins. “In the ’70s or ’80s when some of these diseases were first recorded it was in the coastal areas of New England. Bennington County, being the southernmost county in the state, has seen the brunt of these tick borne diseases for the longest amount of time.”

Bennington County finds itself in a perfect storm for the transmission of tick borne illnesses with large swaths of forest, high numbers of individuals working in the outdoors during summer months, and a booming outdoor recreation industry.

“You have to have the presence of the black legged tick, you have to have the pathogen there to infect the ticks, you have to have the proper wildlife like deer and white footed mice to maintain the pathogen cycle in the community, and then you have to have people interacting with the ticks,” said Tompkins. “It’s a very complex issue, and there are a number of factors in play.”

Of the five infections associated with the black legged tick, Lyme is the most common with about half of the 2,000 ticks tested by the Vermont Department of Health infected. Bennington County reported the highest incidence of Lyme in Vermont with over 200 cases per 100,000 in population in 2015 (the most recent year for which data is available).

Though Lyme disease is a serious concern for Bennington County, the steadily rising incidence of anaplasmosis is a troubling trend for health care providers. While the rate of Lyme disease statewide was 394 per 100,000 in population in 2015, anaplasmosis is catching up with a rate of 217 cases per 100,000.

“It’s much easier to transmit anaplasmosis compared to Lyme disease,” said George. “There’s a lot to work out about why anaplasmosis is rising in incidence, and it is more severe.”

Anaplasmosis is a bacterial illness resulting in symptoms like high fever and low white blood cell counts.

“We’ve had two patients with encephalitis [brain inflammation], and we’ve had a couple of patients presenting symptoms similar to septic shock,” said George. “Patients can get much sicker, we see more hospitalized patients with anaplasmosis than we do with Lyme disease because of the severity of illness.”

Statistics show that the rate of anaplasmosis is steadily rising in Vermont, with significant growth in Bennington County specifically. In 2014 there were 69 reported cases of anaplasmosis in Vermont, with 43 percent of cases in Bennington County. In 2015 the number of reported cases rose to 139 statewide, 63 percent of which were in Bennington County. The Vermont Department of Health estimates that approximately 7 percent of all ticks in the state are currently infected with anaplasmosis.

Also rising in incidence is babesiosis, which has become more prevalent in neighboring states including Massachusetts and Connecticut. Because rates of tick borne illness tend to rise from south to north, experts worry that babesiosis may soon become more severe in Bennington County as well.

“More southern states are seeing their numbers increase over the past few years, so we are concerned that Bennington and Windham county may see an increase in the coming years as well,” said Tompkins. “Babesiosis is particularly nasty, and it hospitalizes just about half of the Vermonters that get it. In comparison, about 3 percent of the people that get Lyme are hospitalized, and about a third for anaplasmosis.”

Babesiosis is caused by a parasite which targets the red blood cells, and requires a different treatment than Lyme or anaplasmosis, which can often be treated in conjunction.

Another illness, borrelia miyamotoi, is slowly emerging as well but is particularly difficult to diagnose due to the similarity of symptoms with Lyme and anaplasmosis.

The fifth disease carried by black legged ticks, powassan virus, can cause severe brain inflammation and hospitalization though it has not been recorded in Vermont in recent years.

Tick borne illness can be difficult to diagnose and record as many diseases present similar symptoms, and illnesses can occur (and often be treated) simultaneously. To target this issue, Southwestern Vermont Medical Center is working to maintain the most accurate data on reported cases in the state.

“The laboratory that we use to detect tick borne illness allows us to do a panel where we can find all of them at once, so even though there’s so many crossover symptoms we can truly tell what we have,” said George. “For example, we’re the only ones in the state that are looking for borrelia miyamotoi, and we are finding it.”

The greatest challenge for SVMC so far has been educating the public on the risks associated with tick bites.

“The fact that these diseases don’t often kill a person make it harder to raise awareness,” said George. “We want the information to get out. It’s hard for us to watch people be afraid of going outdoors, and understanding prevention is so important. Pretty soon it’s going to be exploding here.”

Information of how to prevent tick bites and tick borne diseases can be found online through the Vermont Department of Health.

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News Release — Southwestern Vermont Medical Center
April 20, 2017

Media Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

Public is Welcome 10 a.m. – 4 p.m. Saturday, June 3 on Southwestern Vermont Medical Center Campus

BENNINGTON, VT—April 20, 2017—For the last few years, Southwestern Vermont Medical Center (SVMC) has hosted two cancer-related events during the first weekend in June: The Cancer Center Community Crusaders Day of Celebration on Saturday and National Cancer Survivors Day on Sunday. For the first time in 2017, the events will be combined.

“We were hearing, while patients and their families really wanted to attend both events, busy weekend schedules did not allow them to do so, and unfortunately, they had to pick one or the other,” said Wendy Petitt, the Southwestern Vermont Regional Cancer Center (SVRCC) practice manager. “Now they won’t have to choose.”

Both events will be held on Saturday, June 3, 2017. The program schedule begins with an opening ceremony at 10 a.m. Cupcake tasting, raffles, music, and kids’ activities—like inflatable bounce houses and face painting—continue throughout the day.

Attendees are invited to tour the Cancer Center’s newest addition, the linear accelerator, with Matthew Vernon, MD, radiation oncologist, each hour 11 a.m. – 2 p.m. The linear accelerator delivers high doses of radiation to cancer cells in a much more precise and faster manner than allowed by previous technologies, which improves the patient experience through reduced treatment times, fewer side effects, and less damage to neighboring normal organs.

In addition, survivors who received treatment at SVRCC and their families are especially invited to a complimentary lunch buffet 12 – 2 p.m. Food will also be available for purchase.

Community organizations, families and friends of cancer patients, and anyone else who would like to raise funds in support of local cancer patients are invited to volunteer or set up a game booth or activity to benefit the event. No commercial vendors, please. Carnival-type games are especially encouraged. For information on how to participate, or volunteer, please call Carson Thurber at 802-447-5488 or e-mail carson.thurber@svhealthcare.org

The purpose of the Cancer Center Community Crusaders is to provide financial, physical, and emotional support to members of the community and their families as they strive to obtain the best cancer care and treatment possible. All funds raised by the Cancer Center Community Crusaders stay in the communities of Bennington and Windham counties in Vermont and nearby New York and Massachusetts. Patients need not receive treatment at Southwestern Vermont Regional Cancer Center to be eligible for funds.

The purpose of the National Cancer Survivors Day observance at SVRCC is to celebrate life and honor cancer survivors. National Cancer Survivors Day is an annual celebration held in hundreds of communities nationwide in early June.

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News Release — Southwestern Vermont Medical Center
May 3, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

Inaugural talk planned for June 8 at the Taconic Hotel

BENNINGTON, VT—May 3, 2017—Southwestern Vermont Medical Center (SVMC) and Green Mountain Academy for Lifelong Learning (GMALL) are proud to announce a new partnership titled “Medicine Today.” During the series, clinicians from SVMC and Dartmouth-Hitchcock Putnam Physicians will present an intellectual perspective of medicine now and how they anticipate it will change in the future. Often they will be accompanied by physicians and researchers from Dartmouth-Hitchcock.

“Medical information is extraordinarily complex and interconnected with daily life. Understanding it on a deeper level has the potential to enhance our lives as patients, learners, and citizens,” said Thomas A. Dee, FACHE, Southwestern Vermont Health Care (SVHC) president and CEO. “That’s where SVHC’s mission to provide exceptional care and GMALL’s mission to enrich intellectual life intersect.”

The inaugural talk, “Shared Decision-Making Research in the Medical Setting,” will be presented by Dartmouth-Hitchcock Interventional Cardiologist and Researcher Dr. Megan Coylewright 5:30 – 7:30 p.m. Thursday, June 8 at the Taconic Hotel in Manchester. Light refreshments will be served.

A second talk, “Telemedicine: Where We Are and Where We’re Going,” is scheduled for 5:30 – 7 p.m. Monday, August 7 at Burr and Burton Academy’s Hunter Seminar Room. Presenters include Dr. Kevin Curtis, the medical director of the Center for Telehealth at Dartmouth-Hitchcock, and Dr. Trey Dobson, a specialist in emergency medicine, chief medical officer at Southwestern Vermont Medical Center, and medical director of Dartmouth-Hitchcock Putnam Physicians.

“GMALL prides itself on making foremost experts accessible to learners of all ages,” said Gloria Palmer, GMALL’s executive director. “SVMC’s cooperation in bringing medical experts of this caliber to our community is invaluable, and we think our audience will truly appreciate this scientific, behind-the-scenes perspective of health care.”

Both “Medicine Today” presentations are free and open to the public. Visit the science section under programs at www.greenmtnacademy.org to register. Future topics include antibiotic resistance and advanced cancer treatment technologies.

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News Release — Southwestern Vermont Medical Center
May 30, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

Public is Welcome 10 a.m. – 4 p.m. Saturday, June 3 on Southwestern Vermont Medical Center Campus

BENNINGTON, VT—May 30, 2017—For the first time, the Cancer Center Community Crusaders Day of Celebration and National Cancer Survivors Day will be held together on Saturday, June 3 at Southwestern Vermont Medical Center (SVMC). The community is invited to join in this very special event.

The schedule begins with an opening ceremony at 10 a.m. Cupcake tasting, raffles, vendor booths, music, and children’s activities – such as inflatable bounce houses, carnival games, and face painting – will continue throughout the day. A ceremony of remembrance will conclude the day’s activities.

Tours of the Cancer Center’s newest addition, the linear accelerator, will be conducted each hour (from 11 a.m. to 3 p.m.) by Dr. Matthew Vernon, radiation oncologist. The linear accelerator delivers high doses of radiation to cancer cells in a much more precise and faster manner than allowed by previous technologies, improving the patient experience through reduced treatment times, fewer side effects, and less damage to neighboring normal organs.

Survivors who received treatment at SVRCC and their families are invited to enjoy a complimentary lunch buffet from 12 – 2 p.m. provided by the SVMC Nutrition and Dining Department. Food and beverages will also be available for purchase.

For information on how to participate or volunteer, please call Carson Thurber at 802-447-5488 or e-mail carson.thurber@svhealthcare.org.

The purpose of the Cancer Center Community Crusaders is to provide financial, physical, and emotional support to members of the community and their families as they strive to obtain the best cancer care and treatment possible. All funds raised by the Cancer Center Community Crusaders stay in the communities of Bennington and Windham counties in Vermont and nearby New York and Massachusetts. Patients need not receive treatment at Southwestern Vermont Regional Cancer Center to be eligible for funds.

The purpose of the National Cancer Survivors Day observance at SVRCC is to celebrate life and honor cancer survivors. National Cancer Survivors Day is an annual celebration held in hundreds of communities nationwide in early June.

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Encore Renewable Energy has begun work on an array on 3.5 acres off Route 7 in Bennington. The parcel, which will be leased, is owned by Shirley McClenithan, according to the company.

The town will receive net-metering credits through the project, providing a 15 percent discount that is estimated to save Bennington $750,000 over 25 years on electricity bills for the municipal wastewater treatment plant.

The Burlington-based Encore also is constructing an array on a similar size parcel off Murphy Road, on land leased from the Randall family. The project will provide metering credits to Southwestern Vermont Medical Center.

William Hall, director of engineering with Southwestern Vermont Health Care, said the medical center expects to save $25,000 to $26,000 a year on its electric bill over the life of a 25-year agreement.

The hospital’s annual budget for electricity currently is $990,000.

“From our end, this is a way for the hospital to contribute toward the state’s renewable energy goals,” Hall said, “and it gives us a chance to reduce our (electricity bills).”

The state’s goal is to receive 90 percent of Vermont’s energy from renewable sources by 2050.

“We have been working on these projects for some time with the town and other stakeholders, including the Agency of Natural Resources and the Public Service Board,” said Derek Moretz, chief development officer with Encore.

He said work on the two arrays in Bennington is expected to continue through July when they will go online, providing power to Green Mountain Power through the grid.

In March 2016, the Selectboard approved the agreement allowing the Route 7 project, which will supply the town with a discount through net-metering credits over 25 years. Town Manager Stuart Hurd said that, once the array is online, all town facilities will be in net-metering programs.

Power generated at the Vermont Tissue Paper mill dam hydro facility on the Walloomsac River in North Bennington also is supplying discounted electricity for town facilities.

The Route 7 project will include natural screening of the array from the highway, Moretz said.

That facility will be across the highway from a 150-kilowatt array erected earlier this year by Green Lantern Group, of Waterbury. That facility will provide discounted power for at least the next 20 years to the Sheriff’s Department, along with up to $95,000 in lease payments over the contract life.

Green Lantern Group also is developing a 500-kilowatt array on a section of gravel yard off Dean Road in North Pownal. That facility is expected to be sending power to the grid by June.

The credits for the power generated will go to Mount Snow resort, according to the company’s proposal.

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News Release — Southwestern Vermont Medical Center
June 1, 2017

Contact:
Ashley Brenon Jowett
Communications & Marketing Specialist
Phone: 802.447.5019 | Fax: 802.447.5214
ashley.jowett@svhealthcare.org

Bennington, VT—June 1, 2017—Southwestern Vermont Health Care (SVHC) Foundation Northshire Regional Advisory Board welcomes Nancy Kimball.

“We are delighted to have Nancy join our team,” said Vice President for Corporate Development. Leslie Keefe. “She has all of the qualities we look for in a member of the Regional Advisory Board, most of all a deep commitment to this community.”

Kimball worked for NASCAR as both their track services manager and premier touring series’ credentials manager. She has also worked as an administrator of a $1 million training and education grant for women in construction in New Jersey. Since 2004, she has been a full-time mother to her daughter, a senior at Burr and Burton Academy in Manchester, VT, and son, a sophomore at Phillips Exeter Academy in New Hampshire. She enjoys golf and is a member at both the Ekwanok and Manchester Country Clubs.

“I am proud to join the SVHC Foundation Northshire Regional Advisory Board and to serve this hospital and the area that I love,” Kimball said.

The SVHC Foundation Northshire Regional Advisory Board consists of 12 members. Members are nominated by the group or by health system leaders and work to strengthen ties between SVHC and the communities it serves. The SVHC Foundation’s mission is to engage in development and fundraising activities exclusively for the support of the Southwestern Vermont Health Care Corporation.

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Dr. Trey Dobson, a specialist in emergency medicine and chief medical officer at Southwestern Vermont Medical Center, and Alya Reeve, medical director at United Counseling Service, helped launch a new partnership that allows regular psychiatric consultation for patients at the medical center. They are shown in the SVMC emergency department. Photo by Holly Pelczynski/Bennington Banner

Southwestern Vermont Medical Center has worked in the past with United Counseling Service to serve patients having a mental health crisis, said Dr. Trey Dobson, a specialist in emergency medicine and chief medical officer at SVMC. Those mental health professionals were mainly helping with disposition of the case, such as placement in an outpatient program or an inpatient facility.

The collaboration is aimed at addressing the fact that between 30 and 40 percent of patients with a medical issue also have a psychiatric diagnosis, Dobson said.

“The difference now,” Dobson said, “is that not only for these patients in crisis do we have a psychiatric provider available for treatment, but for patients that present to our facility for another, medical reason but have a contaminant psychiatric issue, we have access to psychiatrists and psychiatric practitioners.”

Dobson and Alya Reeve, an advanced practice registered nurse with the counseling service, said the partnership, which began in early May, has allowed earlier and more direct access to mental health consultations at the hospital and has helped in several ways to reduce stress among patients and medical staff.

“The response from medical staff and nursing staff has been overwhelmingly positive,” Dobson said.

Reeve said UCS practitioners come to the hospital during the morning hours, while medical staff members are going through the rounds of the emergency room, intensive care and inpatient units.

“What happens is that there are a few [cases] that come up that they need a consult, or we have already consulted,” she said, “and we are seeing whether medications are working and what the issues are.”

For example, Reeve said, a woman recently admitted for medical reasons also is a patient who is followed by the counseling service, “so we were able to get the case manager who works closely with that person to meet face-to-face with the nurse and the physician, so they know and are working closely on a discharge disposition together.”

In that instance, she said, UCS was able to provide important information about the patient’s ongoing medications, which someone at the medical center would have had to track down.

“That kind of communication that happens, it supports so that the psychiatric issue is not the focus of treatment,” Reeve said. “It allows the medical stabilization to occur.”

With another patient, the psychiatric medication the person was taking may have been a factor in a current medical condition, she said, so UCS practitioners were able to work with medical center staff on a solution.

Cross-practice communication is “how medicine works these days,” Reeve said.
She added, “There is a sign in the hallway that medicine is a team sport, and that’s an example.”

Having mental health providers meeting with medical staff on rounds, “it really gives them an idea of what patients are in the hospital this day, and what is going on with them,” Dobson said. “And the [medical] staff can ask questions and interact.”

The partnership provides for both daily hours of face time in the medical center and for after-hours consultation.

A major area of cooperation comes in working with patients in a mental health crisis and staying in the emergency department for an extended period. Personnel from both organizations consult on treatment to both stabilize the person and to plan a disposition program for the patient.

That includes, “how do we prevent [patients] from getting worse, how do we keep the staff safe, and how do we keep staff from getting burned out,” Reeve said. “So when you talk about consultation psychiatry, it’s not just a consultation about the patient. Patient care is about the staff providing support and assessment of the patient. A lot of our job is also looking at what does it take out of the nursing staff, and mental health workers, or security guards, in order to keep the environment safe for everybody.”

Sometimes, she said, there are several people with major psychiatric problems, with or without medical problems, in the emergency department, and throughout the hospital staff members often deal with stressful situations and have to make difficult decisions. That’s why meeting regularly with the medical staff is a key aspect of supporting the care process, Reeve said.

“You have really talented staff here, and the all work very hard, so being able to support them is very important,” she said.

“The psychiatric providers attend our daily interdisciplinary rounds, and we are able to access consults much more efficiently,” said Laurene Grande, director of Intensive Care Unit and Medical Surgical Nursing. “The dialogues we are having add a new dimension to the care we are able to provide.

“When someone has a medical problem,” Dobson said, “that can make a psychiatric problem worse, and it’s pretty rare that they remain separate.”

Reeve said that after she became medical director at UCS two years ago, she and Dobson began talking about the need to enhance psychiatric care at the hospital, and the partnership took about 18 months to develop.

SVMC once had an in-patient psychiatric unit and later retained consulting psychiatrists, but those positions had been lost over time, she said.

Dobson said the UCS employees, who are contracted to provide services at SVMC, all have significant clinical experience. In addition to consulting on patients, he said, they will assist with policy and guideline development, attend providers from many specialties during rounds, and conduct educational sessions for staff.

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