BENNINGTON -- The entire state saw big changes in health care this year, but Bennington County was equally as busy in the health care realm. Here are the four most profound local and statewide health care-related events of 2013.

*Vermont Health Connect, the state's version of the national health care exchange, rolled out on Oct. 1, and with it, the activation of the much anticipated online portal.

Since its inception, there has been no shortage of issues with the website, including two security breaches that were recently addressed by the Department of Vermont Health Access.

As of last week, more than 45,000 Vermonters have signed up for health insurance through the website, according to Gov. Peter Shumlin, who is urging a sign-up deadline of Dec. 23 to ensure coverage to all applicants by the new year.

* Bennington saw the arrival of a locally-based dermatologist this summer after a two-year absence of the specialty in the area. In August, Dr. Lixia Ellis opened her practice within Southwestern Vermont Medical Center's medical office buildings, replacing the former dermatologist Dr. Alan Binnick. Ellis, who earned her medical degree from Harvard Medical School in Boston before going on to complete her residency at the University of Colorado in Denver, was an assistant research professor at UCLA School of Medicine before coming to Bennington.

"I have always enjoyed science," Ellis said in August. "Though it was rewarding to know that by doing research, I was contributing to the development of new therapies to treat human diseases, I wanted the human connection I wasn't getting in the laboratory. Becoming a physician was a natural transition for me."

* State officials investigated SVMC in early October after two emergency room nurses failed to immediately care for a patient showing no signs of life.

The patient in question arrived at the SVMC Emergency Room complaining of back pain shortly before.

Following the state's investigation, it was determined that SVMC staff members failed to follow various hospital policies, including those relating to patient privacy, reporting adverse events, and treatment consent.

The names of the patient and the two nurses involved still have not been released by hospital officials.

At the time of the incident, Hospital Spokesman Kevin Robinson would not confirm whether the nurses continue to be employed by SVMC but did say that both nurses were no longer treating patients. A month following the incident, SVMC passed a follow-up inspection by state officials.

* The Battenkill Valley Health Center in Arlington will operate as a federally qualified health center (FQHC) come January - the only of its kind in Bennington County - after it received a $775,000 federal grant in November.

In addition to the Battenkill Valley Health Center, the Five Town Health Alliance in Bristol and the Gifford Medical Center in Randolph also received federal funding, increasing the number of FQHCs in operation throughout the state from eight to 11.

The local FQHC, as well as the other 10 centers in Vermont are open to everyone and provide patients covered by Medicaid, Medicare, private insurance and no insurance at all with primary care, dental care, and mental health counseling, and also serve as outlets for low-cost prescription drugs.

Sen. Bernie Sanders (I-Vt) said in November that when the three new FQHCs open next year, around 33,000 additional Vermonters will receive care, bringing the total number of Vermonters served under those centers to approximately 163,000.