Porter eyes affiliation with medical partner

MIDDLEBURY — Porter Medical Center is inviting the public to help shape what officials called one of the biggest decisions in the 91-year history of the county’s hospital: Whether to continue on an independent path or seek more financial stability and new services through an affiliation with a larger medical institution.
The Porter administration has dubbed the conversation, “Our Legacy — Creating a Vision for Porter’s Future.”
It’s a discussion that will include at least three community forums next month and will also involve staff, nurses, physicians and administrators from throughout Porter Medical Center (PMC), which includes the hospital, Helen Porter Healthcare & Rehabilitation Center and 12 physicians’ offices throughout Addison County and Brandon.
Twenty-six Addison County residents have agreed to serve on a PMC Citizens Advisory Committee that will help gather public input and assist Porter leaders in making a decision that Porter Interim CEO Dr. Fred Kniffin acknowledged will have ramifications for generations of future patients.
“What I am pitching here is, let’s all come together and talk about what we want Porter to be going forward,” Kniffin said during an interview on Monday. “We are at a fork in the road and we need to either go it alone, or do it with a partner. It’s a big decision.”
Kniffin and Porter spokesman Ron Hallman said the community dialogue this summer will be fairly far ranging. Participants will be asked to share their views on the concept of affiliation. They will also be asked to identify the most important medical services that PMC should continue to provide or acquire. And they will be invited to weigh in on PMC’s independent status — whether it should retain that status and try to persevere through what have been some weighty budget challenges.
Porter officials have drafted a fiscal year 2016 spending plan of roughly $89,990,000 that reflects 83 days of cash on hand (savings), which is an improvement but still substantially below the industry standard of 120 days of cash on hand to be deemed a healthy/sustainable organization.
Porter last February cut 17.5 full-time equivalent positions, including 8.5 in the nursing category. Former Porter CEO Lynn Boggs resigned soon after.
Assisting PMC in its exploration of potential affiliation — which began in 2014 — is the consulting firm Stroudwater. Workers from that firm interviewed 40 PMC employees this past winter on the topic, which was also featured at a Jan. 13 organizational retreat that included more than 20 medical staff leaders, according to Kniffin.
Stroudwater is now soliciting information from potential affiliation partners, according to Kniffin. PMC officials declined to divulge the names of the potential suitors on the advice of Stroudwater, which has argued that premature disclosure of those would-be partners could hurt PMC’s bargaining power. A large part of affiliation, according to Kniffin and Hallman, is negotiating the best possible deal for Porter. Recent budget challenges have kept PMC from investing in capital projects on its campus, and affiliation could leverage — among other things — some amenities. For example, PMC officials have long imagined the addition of a modern, on-site medical office building that could consolidate some of the county’s physicians’ practices and accommodate visiting specialists.
A sophisticated electronic medical records system compatible with PMC’s new, bigger sibling would also be on the list of things an affiliation might bring.
“We would like the best terms from any potential partner,” Kniffin said of a negotiation process that he noted is somewhat akin to high-stakes poker.
Hallman said “several” potential partners have emerged. He said identification of a lead suitor — and a new round of public engagement — would likely occur late this summer.
Surveying the state’s health care industry landscape, it’s not difficult to reasonably surmise the identities of two logical players in a Porter courtship.
The University of Vermont Medical Center is by far the largest hospital in Vermont and has already consummated affiliations with such previously independent institutions as Fannie Allen in Colchester and the Central Vermont Medical Center in Berlin.
Dartmouth-Hitchcock Medical Center, in Lebanon, N.H., is affiliated with the Mt. Ascutney Hospital and Health Center in Windsor.
If PMC officials, employees and the community decide affiliation is the way to go, the resulting partnership could take several forms, according to Kniffin. It could range from the casual to a full-on merger. The depth of that commitment would in large part be predicated on the level of investment a partner would be willing to make, officials said.
“The focus is to get terms from the partner so we can improve clinically and financially,” Kniffin said.
“It may also mean we would have to give up some local control.”
PMC officials have drawn up a list of pros and cons on affiliation.
The pros, according to PMC administrators, include clinical integration, enhanced local specialty care, access to capital, and long-term financial stability.
Cons include potential loss of autonomy, independence, identity, culture — and less job security. A larger entity could consolidate some Porter Medical Center functions that could result in local job cuts, Kniffin conceded.
“Change can be tough and scary,” Hallman said. “People want to know, ‘What would the change mean for me?’ That’s the toughest question for us to be able to answer articulately right now.”
For now, Porter officials will focus on the “Legacy” public information campaign. Hallman said the organization will send forum-reminder postcards to 1,000 patients, and reach others through social media and ads. The three forums, which will all meet from 4-5:30 p.m, are slated for:
•  Tuesday, July 12, at the Middlebury Regional EMS headquarters at 55 Collins Drive.
•  Wednesday, July 20, at the Bixby Library in Vergennes.
•  Tuesday, July 26, at Holley Hall in Bristol.
Members of the PMC Community Advisory Committee include United Way of Addison County Executive Director Kate McGowan; Addison County Chamber of Commerce Director Sue Hoxie; Rep. Fred Baser, R-Bristol; former legislator and Porter board member Gerry Gossens of Salisbury; Sen. Claire Ayer, D-Addison; Vergennes Mayor Bill Benton; and Vermont Book Shop owner Becky Dayton.
An online survey on the question of PMC affiliation is in the works and is expected to be ready for respondents by early July, according to Hallman.
Officials hope to hear from a lot of people during the next few months on this important topic for Porter Medical Center. The organization drew fire at its annual meeting this past April for a recent lapse in communication on the announcement of family practice physicians leaving the PMC network.
“It is vitally important that this community feels its input is being heard,” Hallman said.
Reporter John Flowers is at [email protected].

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