Local health board seeks answers
Three thousand-plus Mad River Family Practice patients, as well as over 600 patients on the waiting list, will lose their local access to health care next spring after the state’s largest health care provider announced plans to close that Waitsfield clinic along with the nearby physical therapy clinic.
Local leaders, including the Mad River Valley Health Center board, which manages the building that houses the family practice and other health services, requested concrete information from the University of Vermont Medical Center (UVMMC) and its subsidiary Central Vermont Medical Center (CVMC) about exact savings from closing these local health care centers.
Jay Ericson, media spokesperson for CVMC, said that no specific budget or savings numbers would be provided. He said financial details cannot be disclosed publicly due to privacy policies.
NOT ANSWERED
“Mad River Family Medicine is the smallest CVMC family medicine site. As a result, it loses more money per patient visit than all the other sites,” Ericson said.
He said that the physical therapy clinic saw the fewest number of patients in CVMC’s network, accounting for less than 5% of all rehab patients.
Further, specific requests for details about money lost per patient were not answered.
The Mad River Valley Health Center board met on Tuesday, November 19, to discuss its response.
MRVHC BOARD
“The board of directors of the Mad River Valley Health Center, Inc. (MRVHC) are as upset and disappointed with the decision to close the CVMC clinics here as most of The Valley residents are. Board members are all residents themselves, many of whom are also patients at the clinic. To be clear, the board was never notified in advance of this decision and only learned of the closure on the same day as the announcement was made public,” health center board president Don Murray said.
Murray said the local board reached out to CVMC and UVM to request additional concrete information on the financial decisions that led to the closure. If and when that information is provided, the board will share that with the public.
“The board is attempting to compile as much concrete information as possible that will enable us to make as strong a case as is possible against the planned closure. Today’s health care environment is incredibly complex and there is no one simple ‘fix’ that is going to solve this problem,” Murray added.
CVMC currently rents about 3,300 square feet of the building and has been a tenant since 2016, with the current lease auto-renewed on October 1, 2024, for two years, according to Murray, who did not provide the amount of rent.
STAFF REACT
Most of the 3,000 or so patients on the roster at Mad River Family Medicine live locally, but many travel from other regions where primary care settings may be less accessible, according to Barry Bolio, operations specialist, and support specialist at the clinic.
He said the CVMC Family Medicine practice in Waterbury, where CVMC said staff and patients can transfer, currently has six providers and a wait list of 500 people.
Bolio described how Mad River Family Medicine staff were told about the closures early last Thursday morning, shortly before taking the first patients of the day. He said they felt a great deal of shock, fear, and frustration.
“There has been zero transparency,” Ryan Gauvin, clinical coordinator of nursing at Mad River Family Medicine said. “The last thing, as a nurse, I would ever expect is for a rural clinic like this one to be on the chopping block.”
POTENTIAL CLOSURES
The health network did not host public meetings to discuss the potential closures with the community at any point.
Gauvin said that having a local primary care practice is critical, since some patients don’t have access to transportation make their way to the clinic on foot. Currently, there is no public transportation from The Valley to Waterbury where the nearest CVMC family medicine practice is located.
He said the practice also treats local people with acute injuries and needs, at times functioning like an urgent care center. He said staff triaged several life-threatening emergencies for people without appointments in the recent past.
Mad River Family Practice also has a mental health clinician on staff – a nurse practitioner who worked previously at CVMC Family Psychiatry in Barre, which closed earlier this year.
STAFF RELOCATED
There are 14 or 15 staffers at Mad River Valley Practice and at least two providers at the nearby physical therapy clinic. Ericsen and CMVC president Anna Noonan have stated that the goal is to retain all staff and move them to other clinics. The proposed reductions and closures will affect about 200 employees across the network, including 100 staff members who will be relocated and 100 traveling staff members who will not see renewed contracts. 50 CVMC staff will be cut, according to administrators.
Ericson said on behalf of CVMC, “we know that this transition will mean that some of our patients in the Mad River Valley will need to travel further for their care. Over the past several years, we have added new options to receive care through telemedicine or to receive medications through mail order pharmacy programs, and we’ll continue to grow these resources.”
TRANSPORTATION
Free Wheelin’ a locally funded and managed volunteer ride service that helps local seniors and others get to medical and other appointments outside of The Valley is already operating at peak capacity and The Valley no longer has any public transit options for local folks trying to get to Waterbury for primary care or Barre for physical therapy.
That fact is not lost on local leaders or on the leadership at the Mad River Valley Chamber of Commerce where executive director Eric Friedman raised the issue of how these closures impact the business community and patients of the clinic.
“Many residents rely on the local health center due to its accessibility. Traveling to the next nearest clinic in Waterbury (12 miles away) is impractical for those without reliable transportation or those who cannot afford to take time off from work,” Friedman wrote in an email to state legislators.
CAN’T TAKE TIME OFF
Friedman said he saw economic impacts from the potential loss of health care access which may exacerbate workforce challenges, as employees face increased time away from work to attend appointments further away.
Most importantly, he said transparency in decision making was lacking here.
“The community lacks clear information about the specific cost savings expected from these closures. Such transparency is critical to understanding the justification for such a significant decision,” he pointed out.
Friedman noted that the health center’s mission of providing perpetual access to facilities for health care is critical and said that closing these facilities directly contradicts this mission and threatens the sustainability of the community.
EXPLORE SOLUTIONS
“We respectfully request a meeting with you to explore solutions and discuss how we can work together to preserve essential health services for the Mad River Valley. Our community is willing to collaborate with you, UVMMC, and other stakeholders to identify viable alternatives to closure, including:
- Exploring potential funding sources or grants to address the financial challenges faced by CVMC.
- Advocating for state-level interventions to support rural health care facilities.
- Engaging with the Green Mountain Care Board to reassess budgetary decisions impacting local care,” Friedman wrote in his letter.
MERGER PLANS
Per last week’s announcement CVMC plans to consolidate the family medicine practice in Waitsfield with its Waterbury practice 12 miles away. It also plans to merge its Waitsfield physical therapy practice with one in Barre. There are currently two CVMC physical therapy practices in Barre – both between a 50- to 60-mile round trip from The Valley.
The University of Vermont Health Network said the closures are part of the organization’s efforts to close a $16.2 million budget deficit for CVMC, after regulators with the Green Mountain Care Board denied the networks’ requests to increase patient revenue and the prices it charges commercially insured Vermonters. It said that consolidating clinic locations will increase efficiency and reduce the costs of providing care. UVMMC – the parent organization that includes CVMC – is facing $122 million in cuts overall.
“The primary focus of the Mad River Valley Health Center, Inc. is ‘To provide a quality facility to insure the availability of local health care to residents of the Mad River Valley, neighboring communities and visitors.’ The Board of Directors is not in a position to provide health care services nor is that its mandate. The primary role of the Board is to maintain the facility housing those entities that provide the health care services. The Board has no control over the decisions made by UVM and/or CVMC as to the operation of the clinic here,” Murray added.
