Mayor David Allaire hopes to have efficiency experts take a look at City Hall.
The General Committee voted 3-1 Thursday to recommend the full board of aldermen approve three firms as vendors for “business process improvement” services. The firms are Regeneration Resources of Brattleboro, CGR Promising Solutions of Rochester, New York, and ALG Consulting of Montpelier.
“We are looking for someone to help us out with streamlining and improving communications,” Allaire said. “The bottom line is, we’re trying to figure out how to do things more efficiently and save the taxpayers some money.”
The administration had not brought a specific proposal to the board, but sought to have qualified consultants pre-approved to be tapped as department heads found specific subjects for them to consult on. Three examples Allaire offered of potential areas the city could use some help streamlining were water billing, the way the city handles workers compensation claims and the appeals process for parking tickets.
City Attorney Matt Bloomer said consultations would likely be paid for out of individual department budgets or the mayor’s contingency fund and that the administration would not come back to the board unless they were looking to fund a project out of the unassigned fund balance. He likened the situation to how his office has a budget to consult with pre-approved outside lawyers and he chooses on what subjects to do so.
Allaire said the city has a list of pre-approved vendors, many it has been doing business with for decades, that the Board of Finance signs off on each year.
Judy Frazier, the mayor’s executive assistant, said the three were narrowed from 13 companies that responded to a request for qualifications that she evaluated for cost, experience working with municipalities and proximity to Rutland.
“All three of these, I found almost the same pattern,” she said. “They do a process map ... rethink the process collaboratively and then do a transition plan.”
Alderman Sam Gorruso, who cast the dissenting vote, said he did not fully grasp the proposal, but suggested that understanding the problems with the water department and what needs to be done about them was as simple as talking to the employees.
“They’re fixable,” he said. “Nobody is listening. ... The people in the departments and City Hall are pretty smart.”
ORWELL — Farming may be an old profession, but there’s plenty about it left to learn. The Northeast Dairy Business Innovation Center, one of three of its kind in the nation, began offering technical support to local farmers this year and plans to kick things up a notch in the coming weeks.
The idea for the Northeast Dairy Business Innovation Center (NE-DBIC), began at a dairy summit held in early 2019, said Vermont Secretary of Agriculture, Food and Markets Anson Tebbetts on Wednesday. Farmers were looking for more technical support. Sen. Patrick Leahy, D-Vt., who is vice chairman of the Senate Appropriations Committee, was contacted about getting some financial backing for this, which he was successful in doing.
Vermont was among three states chosen to host a dairy center, Wisconsin and Tennessee being the other two, said Tebbets. Their work will benefit their respective regions, not just their states.
Laura Ginsburg, center lead at NE-DBIC, said each center got about $6.5 million, with $450,000 to be used in the first round of programs. The second round, which taps the remainder of the funds, got started in the fall.
One of the first efforts the NE-DBIC supported was a “Transition to Grazing” initiative, led by the UVM Extension.
Ginsburg said the UVM Extension selected a group of farmers near enough to each other where they can visit and share information and support.
This group included Scott Cleveland, of Wells; Cindy and Brian Kayhart, of New Haven; Dave Seward, of East Wallingford; Caleb Smith, of Danby; and Brad Thomas, of Orwell.
Thomas said for the past 28 years, he’s run a dairy farm off Route 73 in Orwell. Today he milks 125 cows, give or take a few, on 600 or so acres of land, where he also grows feed such as alfalfa, corn silage and soybeans.
“We graze all our young stock, just trying, working with UVM Extension, trying to stay ahead of things as far as being viable as a dairy farmer, trying to get the most out of our pasture land as we can and trying to save on either harvesting feed or buying grain,” he said.
He and the other farmers met twice in the fall with Cheryl Cesario, UVM Extension grazing specialist. That was after the grazing season was done, but he and the others plan to implement what they learned come spring.
“And they’re teaching us things like rotational grazing. You give the cow so many square feet in an area for one night and then move it to the next section,” he said. “The old-timers used to let the cows chew the grass right down to the ground, and they’re teaching us that we should only let the cows chew the top 6 inches and leave the rest, and put them back there a couple weeks later. It’s like mowing your lawn, you want to clip it down, but you don’t want to make a putting green out of it.”
He said this is much better for the grass; it lets it grow back faster and hot weather won’t damage it as much. Having more for the cows to graze on lowers costs, and feed can be expensive.
Being diverse and open to new things is key to making it as a dairy farmer these days, he said.
“I’m an old farmer, but I can still learn some new techniques or re-emphasize some old ones, I guess,” he said.
Tebbetts said the hope is to expand the grazing initiative, and there are other programs this center will fund, like one that sends technical advisers to farms to troubleshoot any issues they’re having. Also, he noted that in 2020, it helped match some farmers with people who have marketing knowledge, helping them sell their products online in markets they hadn’t tapped before.
“That’s one of the things that farmers have told us repeatedly, is they need more help with technical assistance and this is one way we’ve been able to do that is through this center,” he said. “We think it’s going to make a difference over time, not only to Vermont but to the region, which is important as well to support the dairy industry.”
This year, the Visiting Nurses Association & Hospice of the Southwest Region (VNA&H) marks 75 years of providing the care that helps residents stay out of the hospital by bringing services to the patient’s home.
“When you survey people, ‘where do you want to receive care?’ and 99% of them are going to say, ‘In the home.’ We keep people at home, out of hospitals, out of institutions, out of emergency rooms. We keep them in the comfort of their home with their families and every service is designed around that,” said Ron Cioffi, CEO of the agency.
Cioffi joked that he had announced his retirement and that he’s “up there,” so he hoped VNA&H would take care of his “tired self.”
Incorporated on Jan. 9, 1946, for “promoting health, preventing disease by teaching principles of health, to provide skilled nursing for the care of the sick and to provide other therapeutic services,” the agency started with Mary Stuart, a registered nurse, as the first nurse and director.
The agency now has a team of clinicians with a wide range of skills and certifications including physical, speech and occupational therapists, hi-tech nurses for children and adults, home health aides, personal care attendants, medical social workers, behavioral health nurses, and hospice and palliative care certified staff.
In 1946, the new agency provided about 710 home visits. By 2019, that number was more than 133,000.
Through a number of mergers — starting in 1996 when it merged with the Rutland Area Hospice and continuing by merging with Dorset Nursing Service in 2007, acquiring the VNA & Hospice of Southern Vermont Medical Center in 2014 and merging with Manchester Health Services in 2017 — the agency has grown.
The resulting agency, which Cioffi said had become stronger through joining together with others, became the VNA & Hospice of the Southwest Region.
Sharon Davis, a quality specialist and member of the Rutland Board of Aldermen, said the agency had a motto of “Our family caring for your family.”
“That’s the truth. We work as a family here, and we take that into the field when we deliver those type of services to families out there,” she said.
Bernadette Robin, director of marketing and business development for VNA&H, pointed out that while the agency was marking the anniversary of three-quarters of a century of delivering care, changes in health care methods and technology meant they had “constantly evolved over the years.”
“We’ve used technology so when Ron (who started with VNA&H as a nurse) first joined the agency back in 1980, we had established a little bit before that a home dialysis program — so that enabled people who were sitting at the hospital for hours to receive that treatment in the home,” she said.
Other technology that’s been incorporated to allow care once reserved for hospital-type settings includes intravenous therapy, high-tech wound care, nutritional tube feedings and telemedicine.
Cioffi said he expected the short-term future of home-based health care will be COVID testing and vaccination, but he said further out will be value-based purchasing.
On its website, the Center for Medicare and Medicaid Services defines value-based programs by saying, “We reward hospitals based on the quality of care provided to Medicare patients, not just the quantity of services provided.”
The philosophy is often described as health care providers working to keep patients healthier rather than getting a fee for every service they provide, or fee for service.
Cioffi said the new thinking would be a “game changer.”
Sara King, CFO and COO for the agency, said more than her 20 years at VNA&H, she has been proud of the variety and quality of services it provides.
Also, she shared a personal connection. She said she had a young relative who received services from VNA&H.
“Being able to keep that family member at home through their last days was incredible. The bond that I developed with those nurses, they became part of my family. I can never be more grateful than to be able to say that my family member actually probably outlived his life expectancy because of the care that was provided,” she said.
Cioffi said he doesn’t expect the VNA&H to expand to other sites at this point beyond its officers in Rutland, Bennington, Dorset and Manchester.
“I think we’ve gone as far as we can there,” he said.
Reflecting on what has kept the agency going more than 75 years, Cioffi said he learned when he decided to retire that more than 35 staff members, including himself, King, Davis and Robin, had been there more than 20 years.
“That says something about the organization and the people who work here. … For an agency to be here more than 75 years, you have to have a dedicated staff, and also you have to have a dedicated board of directors,” he said.
He noted all the towns served by the agency provide funding by appropriations voted on at their respective town meetings.
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