 Well, good evening. We certainly would like to keep everything running on time. So it's six o'clock Thank you so much for coming out and joining Our community listening tour. Some of you may have been here last year We kicked off our community listening tour events And we hit the four towns last year that we're going to visit again this year And the purpose of these events are to really hear from our community as to What's working and what are suggestions on ways that Gifford and our community partners can improve? Last year we did get a lot of feedback about transportation Some social service programs Access to fresh food. So Gifford went back to the table and we immediately knew That we needed to invite some friends to join us So with us this evening, we have Melanie Guidney from Claire Martin Center We have Mike Reader from Tri Valley Transit and Linda Anderson a local Folk here from Capstone in addition to Dan Bennett. I Gifford CEO. I don't know if I introduced myself I'm Ashley Lincoln. I work in the development and patient relations department at Gifford So I'm going to be moving this event forward tonight calling on different folks Everybody's going to have about 10 minutes to do a quick overview of current programs a status update From each of our partners here at the table and then we would certainly open the floor up to any questions But feel free if you have something that's burning and you need to ask right away I think everybody's very casual and would welcome those questions then So I'm going to begin by turning it over to Linda Anderson from Capstone Capstone community action We were CVCAC Central Board Community Action Council up until about 10 years ago or so we are part of a Network that Consists of five community action agencies in the state of Vermont and a thousand throughout the country We're an anti-poverty organization. We are dedicated to trying to help people alleviate the impacts of poverty and to move out of poverty find ways that they can sustain and Achieve something more so With that in mind, we realize that poverty is not something that has a one-size-fits-all solution People are not cookie cutter. We are all messy and we all have different needs and different barriers So in order to try to address poverty, we come at it from a variety of angles The department that I work with and oversee is family community support services So we are working with folks to try to meet those immediate needs those basic needs those immediate crises So we're working with folks that are literally homeless or about to be we have a housing counseling program They can help people identify What their strengths are what their barriers are? What are the things that are getting out in the way of? Accessing stable affordable housing right now It just doesn't exist So we are working with our communities to try to address that aspect. There's no shelter We're working to try to address that aspect as well We work with individuals to figure out. What is their budget look like? What can they afford? What is it they want and what is it they need? Can we help them look for better employment options? Can we help them? identify Other resources that might be eligible for We try to stabilize that housing situation. We also have the energy and outreach program which looks at How can we help access funds to fill up your tank? So for folks that have received supplemental fuel assistance They are have run out of those funds They get down to a quarter of a tank of fuel or a week's worth of wood and they have no resources poverty is a reason For exigent circumstances. So if they get to that point, they can give us a call and we can provide 125 gallons worth of fuel There are other funds that we can sometimes tap into as well. So Electric disconnects we can help with if it's needed to run their heating source If folks are struggling, it's worth giving us a call to see if there's something we can do The ACP affordable connectivity program has anybody heard of that? So for folks that are income eligible three squares limits We can help them sign up for this benefit, which could give them $30 a month toward their internet bill It might also provide a hundred dollars toward some kind of device the tablet or toward a laptop something like that That's a new program that's come out and we are trying to outreach in our communities and let people know that we can help them access that That's that's a base needs but we go beyond that we want to wrap around people and help them Succeed so other programs we have our head start and early head start Unfortunately, we do not cover Rochester area that's Sefka, but they do have a program for Home visiting I'm not sure if they reach this far That program helps people get ready for school helps them Get their kids vaccinated make sure they're connected to dentists make sure they're getting the primary care They need help them with parenting skills. We also have some head start classrooms in Berry and the moelle The community economic development department works with people on budget coaching credit coaching Do you want to start a small business? They have classes and they can help people figure out business plans and Try to find some self-sustaining capacity there They have the vita program volunteer income tax assistance for folks that are income eligible We will do your taxes for free and if you're really excited to learn how to do taxes. We're always welcoming volunteers Really exciting stuff. So I would love to talk to you about that and connect you with people if you're interested That happens from February through April. We do have clinics in our Randolph office Really exciting program we have is community kitchen Academy that is a workforce development program out of our Berry office And it helps people who are unemployed or underemployed gain the skills For entry into food service. They get their serve safe license liquor license We've got a fairly high placement rate out of that program and the really cool part of that program is that they take food from our Food shelf that's about to turn produce things and they turn it into frozen meals that they can then filter out through our food shelf Keeping it out of the way stream Weatherization, I know we've seen those trucks come through Free weatherization services. They can do energy efficiency testing on your home to see if it's airtight They can work to help you figure out And to put in more insulation work on windows things like that so Ways to avoid spending all of that money that you work hard to earn on your energy bill And it helps save our planet too. So those are just some of the ways that we are trying to support our community members And help address the issue of poverty Yeah, that's great. Thanks Linda. I'd now like to turn it over to Melanie who is here from Clara Martin I'm out to come listen to us tonight. We surely appreciate the support of the towns over here in this area As Ashley said, I'm Melanie Gidney. I'm the executive director at Clara Martin Center I'm here with Christy Everett our director of operations and Melissa Bemis who's a peer support specialist And she's also assisting us with a FEMA grant that we just got as a result of the recent flood this summer It's really an honor to be here with these folks I think we all know that the needs in our community are great And I think in our small rural areas. It really behooves us as a network of community providers to work together To best support each other and build off of our strengths In regards to Clara Martin Center, we are a community mental health center designated by the state of Vermont To provide mental health and substance use services to the residents of the greater Orange County area We serve about 1200 adults children's and families each year And we have about 175 to 200 staff We have offices that are spread out. So our kind of our main hub is in Randolph with several locations there We also have school programs and we're in the schools over here in Rochester We don't have an office over here, but we are connected in as an access point in the schools We go down to Wilder. We also have Outpatient services in Bradford and Chelsea So kind of you know, I think one of the the focuses we've tried to have is how to make it easier people to access services I think sometimes people feel like they you know If they're in Chelsea and they're referred to Bradford or to Randolph it can be like a black hole So how can we bring the services to our local communities? To make it easier on people to access us and get the services that they need We also have you know, our services are office-based, but most of our services are also out in the community We have a 24 7365 day emergency service program and Work closely with a hospital at meeting the needs and providing some services in the ER We recently one of our biggest As I said, we're designated by the state of Vermont. So we are recently certified We went through a pretty rigorous audit and we just were re-designated by the state and had a really positive review Which I think every it's tough times right now and people have a lot of needs So I'm really proud of our organization at a difficult time coming out of COVID to be as strong of an organization as we can be We surely had our workforce challenges I don't think we've been immune to that and that surely impacted our ability to be as accessible as we want But I'm also pleased to report that kind of whatever happened through COVID. We've re-stabilized Kind of our turnover rate. So I'm hoping to turn the turn the corner there In terms of improving our accessibility In terms of our priorities, you know, I think September is is suicide prevention month So I thought it opportune that we're here talking about mental health and substance use and just want to highlight that And remind people that there is 988 is a text number for resources And then our 800 number at Clara Martin Center is 1-800-639-6360 for anybody that may have questions or is in need of crisis counseling As I said coming out of COVID-19, I even think kind of prior to COVID We've surely seen an increase in demand for mental health and substance use services and I feel COVID definitely exploited that so that currently The demand for those services is kind of at an unprecedented level And it's surely been a challenge for us to meet that need. So we've really had to be creative And look at different ways of programming to meet that full need One of the ways that we've gone about that is Christie was instrumental in applying for a SAMHSA a federal grant Called a CCBHC grant and CCBHC the acronym is certified community behavioral health clinic And we were awarded that grant in 2020 and we were the first in the state To be awarded that grant that really allowed us to look at the whole health of of the person and break down Some of those barriers or silos that might have been in place before to get treatment We successfully completed the two-year grant and just recently were awarded another four-year grant to extend some of the gains some of the Enhancements that we were able to make so we're really proud to continue that As well There's two areas of focus of that CCBHC grant I think we're focusing on transition age youth Ages 16 to 23 We found that that's a really high-risk area that some folks fall through the cracks So really trying to boost and enhance our services in that area and then at the other end elder care services From our community needs assessment. It's really clear with our aging population that there's significant mental health and substance use issues that are impacting our elder care and Some of the isolation and lack of community connectedness. I think is a real challenge. So Being able to go out into people's homes to meet them where they're at and maybe hopefully help connect them to the community better So those two areas are an area of focus for us In addition, I do think like Linda. We do try to look at what we call the social determinants of health Really housing is a foundation for anybody's stability. So Working with our local partners, but trying to also Support folks. I think we're all noticing in Vermont an increase in homelessness or people that are at risk of homelessness Surely the lack of housing is a problem both from The stability and for our clients, but it's also been a barrier for recruitment for staff So we've been able to recruit people, but they haven't been able to find housing to move here to work here. So I would say Housing in general from a lot of different lenses is a critical issue for local and state folks to address Like I said, you know, we're dealing with an unprecedented need at our door And one of the things we were are working towards is what we call same-day access. I think our own data We've been working on this for many years Trying different versions and approaches But our own data has proven that the earlier you can serve somebody when they're seeking services The more likely you are to engage them and the more likely they are to be successful in completing treatment If somebody calls and we're not able to get them in for a month The chances of them showing at the door when their appointment is scheduled. It's not gonna happen. They change their mind We've lost our window where they're motivated So we are just doing whatever we can to try to improve meeting people when they're at We are piloting and wilder a same-day access same-day assessment program two days a week We refer somebody right in from 8 30 to 12 30 and that has been proven successful So we are looking to try to replicate that at our other locations So it's exciting But it continues to be a challenge I Reference the workforce challenges You know, I like I said, we aren't immune to the turnover And I think what I've realized or we've realized is that our communities are struggling, but so are our staff You know mental health and substance abuse. We're not immune So really trying to take a focus on beyond salary and benefits. What can we do to support employees in the workforce? support their own wellness To hopefully make it an enjoyable place to work And hopefully retain them So we've really we've had a committee working on this from a lot of different levels And we were just proud to report Awarded the gold level from the governor from the state of Vermont employee wellness program. So I feel like thank you You know, it's just thinking outside the box at what helps people stay in the work It's it's high stress and compassion fatigue and you know, I just think it's unique times right now so Trying to take care of our people. I think our tagline is people. I know our tagline is people helping people But taking care of our staff at the same time On the horizon is an enhancement to our emergency services We are trying to do more mobile crisis outreach When people are in crisis being able to go out to people's homes So there is a grant the state just received some of that's been staffing to have Two people be able to go out to a home and work collaboratively and from a safety perspective So we're working with the state on that as well and hopefully in January can enhance the services that we have Some of that is the recruitment for for those positions, but fingers crossed And Melissa, I don't know if you wanted to say anything about the the FEMA grant or I think Technically this FEMA grant. It's by County itself and Rochester's outside of Orange County so I Think we'll save Melissa for Chelsea But I think we wanted to mention Melissa that she's here and if anybody is dealing with any flood related Issues anxiety needs help connecting with resources. She can assist you in connecting with the local representative so we're here for you and Goodness, I always worry about my ten minutes. There's so much to say and share with you But just really appreciate you folks coming out and and listening to what we have to offer And letting us know what gaps there are from your perspective Great. Thank you, Melanie. We're going to turn the floor over to Dan Bennett Giffords president and CEO Great. Thanks again Those of you who just came in I I can't speak sitting down. So You'll indulge me. I'm just going to stand up as I go through it and I Also want to just note how happy I am To be able to to share the table here with with all the folks up here You know Melanie just said people helping people and I think that really embodies what all these organizations do and who we are we are People who come together who have a passion to help other people And that is the work we're doing and what you're seeing tonight is that the partnerships that that we have in working in our Communities and these are the organizations and the people that we work with So we're very happy to have them here tonight and glad that they joined us This year for our for our community listening tours Before I get into some of my other items on here. I just want to note That COVID is still here some of you may have may have noticed that and one of the things that Gifford will be doing is to Re-engage in some of the communication activities that we had done in 2020 into 2021 Around COVID we had a team of people who actually helped out over here at the park house I don't know if it was 2020 or 2021 at all kind of jumbles together, but We did help out over there and actually actually I think Was here one at least one day preparing dinner over there when There was a shortage of people to help out Hopefully we won't get to the point where we have to where any of us have to jump in to that extent But we will be reaching out to the different congregate care homes in our area and not just here But around Orange County and throughout Windsor County into Washington just reminding Around what protocols organizations and homes should be following if they do have cases that occurred in those settings unlike in 2020 and into 2021 People who do test positive for COVID don't necessarily need to go to the emergency department Don't necessarily need to be hospitalized. We're there for them if they do need that but Peter was just Telling me the story you heard on the way over I heard as well Dr. Levine noted Vermont's head of The Vermont Center for Disease Control. He's the the chief doctor in the state Was saying that somewhere in the neighborhood of 97% of people now have some antibodies whether it's from vaccine or from having Had COVID or some combination thereof so we will be providing those supports, but hopefully You know as we continue to live with this it won't have the same impact that it's had So I want to jump from there into What really is the single biggest project we have going on at Gifford right now? And that is we are in the process of implementing a new electronic health record We're implementing one electronic health record, which is a very good thing because if any of you Do interact with Gifford, whether it's in a practice or set the hospital or the emergency department We have three different electronic health records right now one for the practices one for the emergency department and one for the hospital Not the best situation so on October 9th, we're going to Flip the switch and we're going to be going live with one system to cover all of those areas and We think that is going to be a very good thing We also are going to go from our current situation Where we have two patient portals There's a patient portal if that you access to to have access to your own records in the practice setting And then there's a separate patient portal to access your records in the hospital setting again not the best situation On October 9th, and we're going to go to one single Patient portal so if you want to access your records if you want to communicate with your provider You can do that through one one portal. You don't have to have multiple passwords and multiple ways of accessing that We there are some handouts back there that Ashley brought One is a general information sheet about our new patient portal if you want to grab that on the way out Give you some information about that There's also another information sheet up there to show you how to download Your record out of the old one of the old portals Because all of that information will not be going over to the new portals But you can download that and store that yourself And you're going to be able to do that until until december 31st If you don't do it before december 31st You would need to call our our medical records department and they could Provide you access to it in that manner. So it's still there. It's just that we will be sunsetting The old portals for your access to those old portals. So there is information in the back So please do grab that if if that would be helpful to you There's going to be some significant clinical benefits to going from again three systems to one system I saw a lot of heads nodding when I said we had two portals and that wasn't great Imagine yourself being a Primary care provider or a nurse who's working in some setting They may have to go into anywhere from one to three systems in order to get your information when they're Trying to provide care from you As of october 9th and going forward. They'll have one system that they can do that That should make our ability to provide care to you much more efficient So that will be an improvement for them as well as they're providing care to you It also helps us with one of our other strategic initiatives, which is our investment in population health Were any of you here last year when we did the community listening tour? I think there might be a couple Well in that meeting Dr. White dr. Josh white who's our chief medical officer He asked the question How many of you want to go to the emergency department this year? And of course nobody raised their hands because who wants to go to the emergency department if you don't have to And when we're talking about population health One of the big things we're trying to do with population health We're trying to help you avoid going to the emergency department We're trying to help you avoid Having to have an inpatient stay. We're trying to help you stay healthy And avoid those more costly Settings of care if that's possible One of the initiatives that we have with our new electronic health record system Is having a structure in a way that After you're seen we're able to use the data that's in there About your health to proactively reach out to you to try to help you stay healthier So if someone has has a diagnosis of diabetes We would be able to reach out to them with support with resources and of course with care That they might need that might help them to manage their disease More effectively and stay out of the emergency department or having Having that progressed to the point where they have to go into the hospital We have actually started a population health department at Gifford That's been in place now for about a year So that is going to be as we further develop it. We're going to have health coaches. We're going to have nurses We're going to have community health workers who can reach out to you Who we're going to be able to design more community outreach programs Again that can interact with people proactively and try to help them As they manage their health and for them to stay healthy So there's a lot tied into this electronic health record I know it's at its At its foundation. It's a it's a computer system But it really is a part of our Strategic direction as we go forward in our Efforts to to make care more responsive to help us open up access and to be more efficient as we're providing care We have a number of new providers I have I also have progressive lenses now. So I have to I just found this is that's that's the downfall to standing up when you're When you're talking We have a number of new providers who've joined gifford or will be joining gifford very soon We welcome dr. Andrea Mendelson. She's an ob gyn physician She joined us in may And that's been a position we've been recruiting For some time They'll actually be we'll have a second ob gyn Physician who will be joining us as well In november dr. Howard Last year we welcomed a cardiologist dr. Bruce andress Some of you who've been around for a while Dr. Andress was with us I think he was with us until around 2016. He was he was a dartmouth hitchcock employed Physician at that point. He worked with us on a partial basis And then also worked at dartmouth, but he joined us full-time last year So he belongs to us now not that we're overly possessive, but it's a very good thing And so dr. Andress Is is with us and it's a terrific physician. We're very lucky to have him In november. I'm sorry in october Dr. Doug weiss is going to be joining us. He's an orthopedic surgeon He's coming to us out of the u.s. Navy. He'll be he just recently finished up his His work with the navy and he'll be joining us. So we're very excited to have him He also has ties to the area In around labor day, we welcome two primary care physicians husband and wife team Drs. Jessica and ryan heaney Dr. Jessica heaney works in randolph and dr. Ryan heaney is at our Bethel practice and then Just recently in august we we welcomed nurse practitioner Liz vera good. She is working in our addiction medicine program In randolph as well. So a lot of good additions there. Very excited to have Those people here as you know, we We did add a nurse practitioner here in our Rochester practice bridge it Last year might have been earlier this year. She's And saw a thumbs up back there and we feel the same way We're very lucky to have her here And We've talked about workforce those of you who've Who do go to our practice here? You've noticed that we have had Some issues keeping our staffing levels up to the to where we want and need them over time And that has that has been an issue Just in general with workforce And so at times they've been a little short over there We've been subbing people in whenever we can but if you are patient there I apologize that we haven't been able to have the steady Consistent staffing over there, but we are continuing to try to to make that a priority And again, we are investing in staff and melanie. I think I'm going longer than you did so you don't have to apologize anymore We are continuing to invest in our staff and you all know it's not just health care everywhere There are shortages of people to fill positions We have educational programs that we are That we're invested in at gifford for nursing staffing. We work with It's not vtc anymore of vermont vermont state university But vtc we work with them and their nursing program We have a number of different programs that we do collaborate with them on We have an in-house training program for medical assistance at gifford We also work with the staffer tech center in rutherland on a program to train lna's And like melanie noted for claire marron center We also are our investing in the in the well in the welfare of of our Of our staff as well and we have provided them access to our own Counselors in our in our mental health program And I think we only got a silver in the in the wellness, but we're working to get to the gold over time And that is a goal as well, but we have a lot going on And we're we're very happy that Our transition last year with bridgett coming in the rochester practice went well and Hoping to have that continue as well so Thank you very much for coming out tonight And take questions now or after we finish and thank you very much Great, thank you Um, I would now like to turn it over to our friends at tri valley transit and mike reader Tri valley transit was formed in 2017 with the merger of stage coach and addison county transit resources over in middlebury So if you're familiar with the stage coach name, yep, it's still us We continued operating under our separate names for a few years until 2019 when we rolled out our new tvt branding And changed overall of our buses and buildings This merger has really been wonderful for us. It's it's allowed us to work more efficiently Bring the experience of our of our staff together to really benefit both Both regions of the organization While still maintaining the unique qualities that that each of the regions have in the Terrain and and people that live there So across tvt we now serve addison orange and northern windsor counties Uh Little uh kind of a basics our mission is to enhance the economic social and environmental health of the communities We serve by providing public transportation services that are safe reliable accessible and affordable Looking at those those health aspects. I economic really Help people access employment. We help people access education job training And on the other end of the economic spectrum Do shopping and and contribute to the economy From the environmental perspective more people on a bus means fewer single occupancy vehicles on the road It's better for the environment less emissions less gas being used less other resources as well Shifting to electric cars is wonderful It's less gas less emissions. You still have to build that car So the bus you know more people on the bus even with electric vehicles is is helpful Uh social aspect, uh, we really help people Have more independence Especially people that are dependent on public transit for their for their transportation services Uh really gives them a chance to to be out and not rely on on friends family neighbors to to give them that ride I like to personally add to that one that riding our buses The shock to me When I when I started with tvt four years ago It's actually fun to be on the bus. Uh, is there these are little communities of riders that uh that really enjoy themselves Uh, we deliver these these services. We we strive to reach this mission through two distinct services One is our public bus routes This is familiar and visible to everybody big buses driving around town with our with our logo across them We operate both commuter routes and circulator routes In randolph area and out of bradford In bradford our commuters run from I should say I'll focus on the orange and northern winds their region and uh, and uh, kind of let adison county slip for now, but In uh in bradford, we run down the 90 i 91 corridor for commuter services With circulator services reaching from ferrilli to woodsville new hampshire Uh, and in the randolph area, we have commuters Going down the i 89 corridor To leaven and hathover white river junction These there's seven trips each weekday Going going along those routes We have a couple of spurs that reach out to west leaven and to help people with shopping or to access employment there And over here, we do A nice job of reaching out to the more rural communities as well with Extensions to these routes that come out to rochester chelsea thetford And we've actually just changed some of our routes around to help access south royalton as well Uh, the randolph circulator runs from randolph center to beffel and out to brain tree monday through friday A little bit of a truncated service nine about nine o'clock in the morning to three o'clock in the afternoon three thirty provides a lot of access for people in town to Get to giford to get to shopping Reach the food shelf Go to pharmacies A lot of other other local places in town The other the other side of our should add we added a a shopping trip from From rochester to randolph When max was closing See a lot of familiar faces from those meetings We we were able to put that service on the road, which uh Was an immediate success and actually with the new store opening We've still continued to see people on that on that service, which is uh, which is really nice We know no matter no matter how great that local store is people are still going to have that need to get to a Get to a pharmacy or sometimes need that larger supermarket The other branch of our service we sometimes think of as our invisible service It's a dial a ride or demand response service These are these this programs provide door to door transportation for uh, for people in need to access the services And places that they need to go Uh that dial a ride service breaks down to to several other programs Our largest is our medicaid non emergency medical transportation service This is for uh folks eligible for medicaid that qualify for transportation services Because they don't have a car in the household or don't have access to that transportation I Will provide under that program people can access medical Medical services that's for for doctor visits pharmacy visits Specifically cannot use that for food shopping or other other purposes There's also a sub program under there for folks that do have a vehicle but drive A lot of miles a lot of medical miles more than 50 per week We can help out with some reimbursements there. So if anyone's Experiencing that situation can give us a call and we can work on helping you get enrolled in that program Uh, our other big one is the older adults and people with disabilities program that we shorten down to o and d These offer Unlimited free rides for people to access critical medical care cancer treatment cardiac Rehabilitation dialysis Those are unlimited will provide free whatever is needed for those Uh, in addition we'll do six round trip rides free per month for essentially whatever you need That can be medical. It can be food shopping. It can be uh, it can even be social Those are usually provided by volunteers Most of these demand response trips are provided by volunteers using their own vehicles They volunteer their time. We reimburse them for mileage mileage And uh, and they're able to get into these more uh more remote places that are that our buses just can't can't go In addition under this program we provide a lot of a lot of transportation to congregate meal programs To help folks get to get to those uh those services Uh A couple of lesser used programs under our dial ride recovery and job access If people are recovering from addiction Uh, we can help out accessing different different treatment counseling services, whatever whatever is needed under that while we are able to remove that that disability or age requirement So regardless of somebody's age or level of ability who can help them access those services And also to help people gain employment. Um, that can be rides to job interviews Commuting services job training It's a that's a this is a pilot program from uh from the agency of transportation that we've been working on And frankly it's been a little underused. So hopefully uh, we can get the word out about that one And finally we do have a ride match or private pay program In some cases we can provide you know use our volunteers to provide these trips for folks that That don't qualify for free trips But can pay themselves or if they're working with an insurance company or or something along those lines have a third party providing their their Their fees Frankly our our workforce issue with workforce issues We're not able to get to this level very often We do have a limited number of volunteers that are really staying busy with those Medicaid and and OND trips Uh, but really with all these different programs, we recommend that if you have a Transportation need you give us a call our dispatchers Are the true experts with these programs and can can help If you need a if you need to get somewhere they can try to find the way to the way to make it happen You don't need to you don't need to be aware of all of the programs Uh, and I will say you know with with the workforce concerns and volunteer workforce concerns we have had to Deny more trips than we'd like we've had to work with people to reschedule appointments and And and work around schedules to try to make make those happen More volunteers means more uh more success. So When it comes to the what do we need? portion If you have got a few hours a week and you're able to drive and want to help out You know the our volunteers are the the driving force behind this program We reimburse at 65 and a half cents for every mile driven. That's from your door to Two-year pickup to the destination So so a lot of our volunteers find that very helpful And very rewarding, you know helping people get you know, so many of our volunteers are just so Um Lifted up by by realizing the impact that they have on the community And and helping people out that aren't necessarily seeing you know getting out to see other people So those drivers are our primary contact for them Um other things you can do. I think melanie references support of the towns All all the towns that we go to for for support on town meetings are so generous and so helpful You certainly appreciate Community members that advocate for that whether it's voting. Yes, we're talking to their neighbors about about our programs That's uh, that's a continued need But uh, but I think the biggest thing anyone can do to support public transportation is to use it Everyone thinks public transit is a great idea and a much smaller subset actually get on the bus Uh, so uh, you know, I do encourage folks to to think about that as an option You're trying to get around You know, it it does require planning. It requires a little bit of work But it's certainly be very rewarding if you're if you're able to figure those out and again can always call us for For help with with even figuring out the the easy part of when and where to get on the bus and where we can take you Thank you very much Great. Thanks So we'd love to open the floor up if there are any questions Suggestions ideas Yes We're very concerned about the way that our insurance is Set up because we're an independent facility and we're not connected with any organizations And that means one of the things that came up recently was That if somebody fell down any one of us that none of the staff could be about helping get up Or they could be sued And that was you know, it's but then the concern came to me because I spent years on the rest of the squad Was that there needs to be a program come to the park house That would teach everybody How to be safe How to be careful how if they fell down how they might be able to help themselves up And to see that their rooms are safe That there are things that are going to be You know causing them to fall a trip or anything and that So if having a program come to the park house To do a training with all of the residents and staff Would be very very helpful And I discussed this with the director. She agreed and she couldn't come tonight. So I said that Yeah, so I'm not speaking out of dream personally And that's the aging population Is constantly increasing And that does not mean that we all hear very well And there is not any really any Service about ideology I wish that you could have an It would be so helpful I have been to darkness It's extremely difficult It's because you're short of staff things have been going wrong that Literally, you know, it's been very difficult And I do not want to have to go back there. It's just was a terrible strain My appointment was canceled three times I finally got there. I was waiting three hours for my appointment because things were just getting all big stuff and It's just physically too much to do that It's a large facility for one thing But it's wonderful. I've had great experiences there And when I started off with my problem It was wonderful, but I haven't been able to Sustain that kind of attention that I Would make it easy for me but A number of us at the heart house had hearing problems And they're not being addressed That's my bit I'd love to have everybody's telephone number with the card. Do you have a card with telephone number? So so lolly knows us so if if somebody wants to suggest she reach out about the The safety part or we can we can reach out to her directly about that Happy to talk about I don't I can't promise what or when but but it's definitely a legitimate Need so In terms of the audiology also a legitimate need But a much more difficult thing to solve There you know, there aren't a lot of audiologists around to work in rural communities, which is a Is a the big problem You know and I so I so I can't tell you that that's something that we're going to have anytime soon Um, but we have um We have noted it as as a need and when we do our our strategic planning and Um, we will note that but again, I I can't promise you tonight that that's something we're going to have soon Surely This It's an independent Living situation if Gifford can find a way to Champion this that would be great, but it is not hard It's not their responsibility to To do the training To monitor This is independent living. So we can't go into somebody's Uh situation and say, oh, you're not here. You have to do this Oh In fact, the matter is that we are we are independent um situation That's not an attribute I can find We are So so it would be great actually um Do something in this regard, but um, I don't want I don't want to say that it's Parkhouse's responsibility Well, I made a request Residents that we help somebody come and help You know make sure that we would know how to get up ourselves if we felt good I Father's prevention Yes Yes I'd like to commend you on the Staff that you have recently seen come to town here to take care of various medical needs um people from from live I've had in the direction from the doctor andris and also So Yeah, and a few others and it's all then talk now. It's very very satisfying The one thing I would like to see focus on Is it do something about getting in the comatris? ophthalmologist And now You have to go to barry a very now to the court to Burlington and that's a It's great for the transportation Somehow Laura's Years I So I actually have some hearing problems as well, so I didn't catch all that but The the need for ophthalmology with dr. Sorris having having retired We did work with dr. Sorris For about three or four years as he was trying to get ready to retire to recruit somebody Um, we we worked jointly with him. We were not able to find somebody to come in It's again one of those areas like audio like audiology That it's very difficult to find someone to come into a To a to a rural setting like this that being said it is still on our our list of Services that we do want to add back to the community Um, but again, it's um I I can't promise you that that's going to happen quickly. It is It is a need we recognize when we've come out last year and this year In these discussions that has been something that has come up And um as I noted we did we we have worked With dr. Sorris specifically to try to bring somebody in but um, we were not successful To this point Just congratulations Yeah, that is the the cardiac rehab cardiac pt is A program that um is very beneficial to the community and we are we are lucky to be able to do that here and That's now um under the medical leadership of dr. Andris as well. So that's also a good A good oh great great Well, I'm sorry you had to but I'm glad he was here to be able to I just have I'm sorry. I just have this. I'm sorry Okay Go ahead The choice of which hospitals you can so i'll give you the short version of why i'm asking about What services how that's working? Which is that my father presented at the giford er at three o'clock in the afternoon With what ended up being a gallstone walking his bile duct So it was about six hours from presentation to diagnosis. It happened to be a very busy day And the service we got a giford like no objection to any of that But from the diagnosis at nine p.m. On a wednesday night, it took 17 hours to get him an ambulance transfer Uh Fletcher allen wouldn't take he needed to go to somewhere that had a specific somebody could do a specific procedure Fletcher allen refused him because they didn't have a bed a surgeon or an ambulance Darkness refused him because they had a surgeon but no bed and no ambulance Albany said they would take him because they had a bed and a surgeon but no ambulance So and again your doctors were communicating all of this while we were there but took 17 hours to get him an ambulance They called 14 ambulance companies 10 of them said no outright They did eventually get one when we got to albany. They did not have a bed for him So he spent another 52 hours in an overflow bed in an emergency room Before he was admitted and then he spent another 17 hours after he was admitted until he had surgery So he went four and a half days for presentation to surgery Not because I felt like we got care That was below substandard care at the ER But it also means that now all of his follow-up care is at albany. I have not been able to get it transferred And that's three hours each way for a 30 minute post-op. I have to go back for a stent removal right and the service The emergency room staff were very clear that albany consistently says they have a bed That they don't have But this was a very common occurrence so So but this is to say this is what happened, right? And to say You know Is this is this average of this this normal the ambulance in particular was was the first sticking point But then the hospital choice of where he was referred to also became a problem because fletcher allen said no Dartmouth said no I wasn't allowed a private transport because he was already on an id antibiotic at that point And I actually requested conqueror base state because we have family in that direction And I don't know if there were reasons that wasn't considered but albany Was far away from everybody So that's the background My question is we had this experience with ambulance ambulance services and hospital choice that ended up providing us with We care that means my father won't let me take him back to giffords emergency room under any circumstances Even though he lives here in rochester So that's again your doctors were wonderful. Your nurses were wonderful and they were communicating with me but that was four and a half days for an 85 year old man with a gallstone walking a bile duct So Uh, I I'm sorry I'm sorry that he had that experience. I'm sorry that you had that experience and continue to have that experience Secondary to everything that we experienced we Everybody experienced In the pandemic it was The beginning of those issues that um that you just talked about um Initially The the main issue was that um the hospitals that we would typically transfer to and we first typically Patients would go to uh to darmath darmathish cock medical center or uvm medical center You know often they didn't have beds And then you start having that wider Area that you start to look at and I think the I I think the highest number that was reported to me by our emergency Providers was I think it was 23 or 26. I thought it was 32. It's 32 32 hospitals that they had to call in one case and before they could get a hospital To take somebody who needed that higher level of care that we don't provide at gifford That has now continued Initially it was because beds were full because of coven Now it's because beds are are full With people who can't get discharged to a nursing home or don't have anywhere to go in the community Um, I was with um some people who work at uvm medical center last week And I think they said on any given day at uvm medical center or something in the neighborhood of 75 to 100 patients who are in The hospital beds at uvm medical center who don't belong there because they're not sick enough to need those beds But there's nowhere to send them To that either home or that next level of that nursing home or other level of care So now that is creating an issue for bed availability And then the third issue is workforce with with ambulance services. So even if we find a bed It doesn't guarantee that there's going to be an ambulance service that's going to have a crew Available to transfer them or if they have a crew that's there, they don't want to send that crew to Conquered or base state or wherever because then what happens if there's another call? They don't necessarily have a backup crew So we're seeing just a really um a cascading impact of all these things Um and no individual Organization or person necessarily is doing the wrong thing But the impact is that we don't have always the availability of care and A movement to the right level of care that we expect and you know, we we deserve And uh, so it ends up in that situation. Is it the situation that your father had? It's not typical, but it happens more frequently than it ever did You know, we used to always say that If somebody has a heart attack in there in the emergency department Of course, they're going to get to where they need to get when they need to get there There have been some cases where that's not a possibility so I apologize. I wish that didn't happen. I wish I had more More ability to make it so that you're someone like your dad doesn't have that experience But from time to time we are seeing that and You know and and people are working on it You know from our politicians who are trying to Entice people to get into different medical fields. I talked about some of the things we're doing With education the legislature has appropriated a lot of money to Try to help organizations and individuals get training and education in healthcare fields Try to make it more attractive for them to do that try to make us so they don't have to incur so much debt You know, there are programs to try to support people to get housing so that they can move here and practice in in these fields But it takes a long time and that's a that's a long-term investment and So we are working on it. We are trying to break down some of those barriers And but yes, we've had to send people to albany. We've had to send people to base state to conquer to to boston And it's not a good situation. I think I heard The hospital in beddington Sent somebody as far as philadelphia In the last couple years it's it's horrible for everybody concerned It's horrible for family members who want to be there for the loved one And for the follow-up care that that you talked about so Unfortunately, I don't have anything more for you today other than to apologize Albany said they had a bed and that when we got there they did not and the staff said that that's That's what happened. So in so far as you're referring people to albany If you can have your emergency staff keep that in the back of the head and then the other one was That I requested they consider other hospitals since the ones that they normally would have referred to We're already saying no And I can't say that your doctors did not ask because right like they were busy But um in in so far as your emergency department is considering where to refer people to I don't know the process of how they pick but when they're getting when they're getting turned down by multiple places If there's a way right like if there's a way to consider family choice when you're getting down in so many other places You know, um, again the the care they were communicating with me To the best of their ability, but those two albany doesn't have beds when they say they do lovely people, but no meds And and to consider also going somewhat to the other direction in so far as you can just as options, right? And that's and that's good feedback and we we've we've we've also added in the overnight We've added nursing supervisors Who are on site so they can assist with some of those calls Um, I you know, I I want to think that our provider probably did do that, but I don't know But we have tried to add some resources Who are there and can assist them if they have called that 25 or 30 hospitals and Because that takes a long time and if they're trying to care for people it it is uh, it just extends the the situation for everybody There's a lot of people who should be in the room hearing this that aren't and so I'm wondering how we are how we all are spreading the message because um But I often hear the number In food security, I often hear I didn't know about that. I didn't know this existed and so I know often there's a reliance on digital means of sending information but the majority of people that my organization serves are seniors and we found that non-digital methods of setting out information is More helpful, but I'm just I'm just My ask is that you use your collective leverage to encourage the government to fully fund 211 as we saw during the flooding That didn't work out the way it should have and um, my understanding is a lot of that can be down to a lot of funding and coordination, so Yeah, you could use your your any kind of swaying way you have with the legislative Folks to to really encourage them to fully fund. That's often enough The good things that are happening. I think that one of the things that we at Clara Martin Center have been really grateful for Is to be able to collaborate with Ashley and her department We've been able to use their network with their newsletter To whether it be may as mental health month or to highlight something from a mental health substance use perspective And use their network of getting that out to our residents It is really hard. I think to You know To touch everybody If it's not electronic, they don't see it and then we also know that there's a whole cohort that doesn't use technology And how do we do that? So that is a challenge We've also used front porch forums, but again, that's dependent on internet service. It's depending on having a computer or a phone But trying to bring things to the local level to get that word out We've tried to use updates into the herald For different initiatives that are going on But I think that is a challenge for us and also open to your feedback Of if there's ways that you find successful To let us know as well You know, I think coming this is our best turnout we've had so thank you for all of you It is hard in our busy lives to take time out to come and to listen But your feedback is really important But it also is a sign of even the the energy to do this Some of them aren't well attended. So, you know, we have to get creative And just try multiple different avenues to try to reach people And to let us know we are here You know, I think about mic, you know, the best thing is to use the transportation But it's it's it's shocking to me the level that people don't know who we are And whether it's town meeting trying to get come to to the town and have conversations But really if you have ideas as well, please let us know So I can just follow up here quick I've been working with the most stable jobs fund on the security plan We're just wrapping up the work But in reviewing a lot of the data that we've gotten from across the state There are a lot of the discussion has been about we people where they are Collaboration from service providers And knowledge from service providers of the resources out there I was thinking like, I've learned a bit of flyers about the value of health care So that people know when we're meeting at at the center of the community So that people know why I'm not here to pick up a spar Those sort of things So that you can just catch as many people as possible Connecting with the school, that's been a challenge We try to but there's not It's a volunteer organization It's a time to work organization We don't always have the capacity to do that kind of outreach So the more people can be informed about small efforts like this It would be really helpful to get the word out We try to be able to get the word out for our youth and family Just a great access point But it is a challenge One thing I'd want to just to add to that I think you're absolutely right on with so many of these these statements What what I find to be the most helpful are things like this You know and add in a newspaper or or a You know, you have a french port forum or any of these these Flyers and posters they give you the snapshot that that you know gets you to know about the organization But but it's so easy to think I think I believe it's so easy for people to say oh that That doesn't apply to me or I won't qualify or that's not You know, that's not available to me. So these kind of conversations Really seem to drive our services the best So any anyone affiliated with any organization You know, we're always happy to get somebody out and and having that that conversation and talking about the needs and and how we can help And yeah, this was this was brought up earlier too And I'll I'll say one one thing from from our perspective. We do get a little concerned about our capacity to be able to deliver the services You know Our dispatchers field a couple hundred calls every day Uh, if if that increases, um, you know, we have we have 15 volunteer drivers. We have We have 20 bus drivers. Uh, there's only so much we can do So the as much as we want to provide the service, you know, we get a big influx of calls and it's it's over and over saying Oh, you know, sorry, we don't have someone available. Sorry. We don't have someone available Um, you know, we want to be be cognizant of that and and not be You know coming out and making promises for for something that we're not, you know necessarily going to be able to deliver on Which is is heartbreaking even saying that but But it is part of the challenge I think the most successful things we've found are word of mouth When capstone has money people know They they spread the word that we're really good at networking Um, we are social creatures and when we know that something good is happening. We we share it with our friends So, um, I think really it is about making sure that our partners know what our services are The other piece we found is until you need something it's not going to stick with you I worked for an organization the national lines on mental illness before I came to capstone and We talked to numerous people say I I would drive by your sign every day But until my loved one started experiencing mental health issues I had no reason to look it up No reason to understand what it was about. So I think it's When you get to the point where you're experiencing those things You know if we can get some key people in our communities to know What is out there get to our schools get to our um hospitals and our local officials and just concerned community members who are In the know with the community are well connected. So you can say when your neighbor comes to you and says, oh my gosh Um, I'm gonna lose my house or I'm gonna you know, I'm gonna lose my apartment Or I'm gonna I don't have any fuel You guys hate have you heard about cops capstone? That's probably my help What I would say is messaging. Please they might be able to help Please don't tell them that we have money and we're going to give it to you because it's really disappointing Um when they don't qualify so but they might be able to help give them a call And I would like to see the hospital higher endocrinologist um My husband is a type 2 diabetic And the last day of the wonderful person that was working up at kingwood katie She was his lab. He was her last patient And that was last april and then she moved on to her new position well in the meantime Trying to find another person another doctor to get him into Has been A nightmare to say the least. There's none in randolph. There's none in middlebury Finally was able to find There's three or four of them in ruttland Getting an appointment is another thing We had to transfer the records which Took a while, but they had now been done and so from april 16th, I think was the last appointment He can get in to see the new doctor on march 28 That's almost a whole year that nobody's been paying any attention to his diabetes And he's on medication. He's not on insulin yet But with the price of medication Uh, we would love to see him on insulin But you got to go through the whole process before he didn't even do that So it's it we had been told that There was someone coming in to replace her And that went on all summer Finally in august when I called over there and I said is there a person coming Or isn't there? No, they're not coming. It's a housing issue Okay So I've for the last six weeks. I've been scrambling trying to find him another doctor and now it's going to be next year It's disappointing We are actively recruiting and again, I don't have um That is one we've had more Katie, uh, john you're referring to as a nurse practitioner So we are we are looking um To have another nurse practitioner fill that role and You know, we continue to talk to people and have candidates for that. So You know, I I don't I don't know. I can't tell you when but I'm confident we're going to have somebody in that position. It just it's Like with all the workforce challenges we have it is taking longer than it has in the past That was a big loss. She's she's excellent She's actually stopped practicing To be in uh teaching. Yeah Thank you Carolyn did you have another question? As much as we can to give people public planning another openings So any of you to be able to come and share your Information to be able to pass it out. I think some of you did at the first one. Yeah So anyway, this is that I just happen to have a I Spread the word I think I did the training and I've been in other countries and then what you do Are you what you do when there isn't a job? And I think that's some change Are there any other questions I have a Over the last six months my husband and I have experienced your And I cannot tell you how incredibly accomplished These The staff was the doctors were fantastic. They put every it was just One it was a well-oiled machine. It was fabulous each time. I don't want to come back again I have to say the three were fantastic In our experience of dick at the ER too Same thing just you know if we have to go through something like that. It's nice to know Well, I want to thank you all for Coming out this evening. We always look forward to coming to rochester. It is such an engaged community We always enjoy the feedback that we get and we really do I mean all of us here at the table We we want to hear from you and we want to see what we can always do better That is our goal Often at the end of these meetings. I walk away Learning something new about the partners that we get to work with at gifford I kind of think that I've got it all figured out But on the way home, I'll be like, all right Mike can provide that ride the next time I need help. So Thank you so much and again feel free to reach out to any one of us. I don't have a business card But if you call and ask for ashley at gifford, they're going to direct you to me. So Thanks again, and Hopefully we don't see you in the ER but see you in some other capacity There's some get right here at the back of the room. I can get it for you. Okay Thank you all. Thank you