2009 was hectic year for local health care


BENNINGTON -- The year 2009 was a pivotal year for health care on the national stage and no less so for our area.

For one thing, it was a turbulent year at Southwestern Vermont Medical Center and its parent, Southwestern Vermont Health Care. In January, Chief FinancialOfficerThomas Lenkowski announced that he would be leaving for a post on Martha’s Vineyard after 22 years at the hospital.

Yorke left in March

In mid-March, Chief Executive Officer Harvey Yorke announced his retirement after nearly 18 years as leader of the health system. As a reason he cited "accounting errors" in the previous year’s budget that also impacted the 2009 budget.

Administrators had revealed that the health system was facing a dramatic $6.1 million swing in its budget projection. A $4.8 million projected surplus had become a $1.3 million projected deficit. In April, interim CFO George Brisson, hired through an agency, was let go because he did not have the requisite experience to deal with the financial situation, officials said.

Dr. Mark Novotny, chief medical officer at the hospital, was named interim CEO.

On May 1, three more hospital executives were laid off and their positions consolidated as a cost-saving measure. That lowered the total number of senior executives from 12 to 9.

After an internal audit, the projected deficit was found to be much larger, possibly totaling $22 million, with the operating deficit $12 million and the pension fund taking an unrealized loss of $10 million. Those figures were later revised downward.

More cuts came when 60 non-clinical staff were laid off, and the hours of 30 employees were cut. Other measures included trimming vacation time, eliminating travel and employee-recognition events and other actions.

By November, hospital officials said that the cost-cutting actions reduced the projected year-end deficit to $7.5 million and had put the hospital on track for a modest profit in 2010.

In news that had the area buzzing, Yorke filed a lawsuit in U.S. District Court on Aug. 4 naming the health system, the medical center, the state and others, claiming the state’s Department of Banking, Insurance, Securities, Health Care and Administration required the health system not to honor a contract that he signed with SVHC in 2008 that guaranteed him $27,000 each month for 22 months if he were terminated.

By early September, a hospital official announced that Yorke would be paid. On Aug. 28, BISHCA changed its order against "significant payments or expenditures," apparently freeing the hospital to meet its end of Yorke’s contract.

The effort to find a permanent replacement for Yorke began in June, when SVHC announced that it had hired the firm of Witt/Kieffer to identify and screen qualified candidates. On Nov. 4, the health system presented Thomas A. Dee as the new CEO. Dee was most recently president and CEO of Benedictine Hospital in Kingston, N.Y., where he led the planning and implementation of a wide range of new services, including a breast cancer unit, a cardiac diagnostic testing and primary care centers. During his tenure, Benedictine built a $12 million state-of-the-art cancer center and medical office building.

At Benedictine he also engineered a $10 million financial turnaround and led the institution to profitability for 12 consecutive years. Dee began in his position at the SVHC at the beginning of December.

Another of the year’s big health stories, internationally, nationally and locally, was the H1N1 -- aka swine -- flu. This virus is unusual both in that it is an off-season flu and in that it has had a more adverse effect on the young than on the elderly. Pregnant women also are very at risk from this flu.

Vermont’s response to the swine flu outbreak was among the best in the nation, according to a recent report that looked at how the states organized their efforts to vaccinate the public against the H1N1 flu.

Vermont was one of only eight states that received nine points out of 10 on the seventh annual report, which was published this month by the Trust for America’s Health and the Robert Wood Johnson Foundation.

In early November, SVMC -- as did other area hospitals -- made temporary changes to its visiting policy, including a prohibition of children under 18.

Despite expectations from hospital officials of great demand for the newly available H1N1 vaccines, a clinic for those at highest risk on Nov. 16 only had 200 people show up for the 300 doses of vaccine available. The H1N1 vaccines are now available for anyone in Vermont six months of age or older.

Important health news, however, was not confined to SVMC and SVHC. Crescent Manor Care Center in Bennington in 2009 set up the state’s only specialized care unit for Huntington’s Disease patients. Before this, Vermonters suffering from this condition needing nursing home care had to receive it at facilities out of state.

In a major development, on Jan. 15, the Bennington Free Clinic began seeing patients, the day after a gala ceremony celebrating its opening attended by about 200 people. The clinic is located in the Nichols Education Building of the First Baptist Church at 601 Main St.

The idea originated with Dr. Richard Dundas, an internist who has practiced medicine in Bennington for more than three decades. The not-for-profit free clinic is a program of the Bennington Interfaith Community Services Inc., an entity of the Greater Bennington Interfaith Council. Dundas, the clinic’s medical director, said at the gala opening that his dream was not to open a free clinic but that "to the contrary, it has been my dream that I would never have to open a free clinic, because we would all have health insurance."

Organizers say the clinic has been in high demand, and it has expanded from one examining room when it first opened to three. Dozens of area health professionals have volunteered their services to the clinic, which routinely sees patients on Thursday evenings.

On April 15, U.S. Sen. Bernie Sanders, I-Vt., visited the clinic and made his case for why the clinic should become a Federally Qualified Health Center. Reasons to do so include the availability of hundreds of thousands of dollars in federal funding, higher Medicare and Medicaid reimbursement rates, low-cast prescription drugs and federally covered malpractice insurance. There are already eight such health centers in Vermont.

Usually, community members form a FQHC as a separate entity from the local hospital, and the center’s board must have a majority membership of people served by the center.

Earlier this month, Sanders announced that the that the U.S. Department of Health and Human Services has designated Arlington, Sandgate and Sunderland as under-served in terms of access to health care. The designation is "an important milestone" toward establishing the first qualified center in Bennington County, Sanders said.


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