Vermont Primary Care Sourcebook Prepared by Bi-State Primary Care Association January 2018 7th Edition

Bi-State Primary Care Association 61 Elm Street, Montpelier, 05602 (802) 229-0002 www.bistatepca.org Printed on January 30, 2018 Table of Contents

Mission and Vision 3 FQHCs Collaborate Across Health Sectors 18

Public Policy Principles, Priorities and Strategies 4 FQHCs Partner to Achieve the Best Care 19

Ten Critical Points to Transform Vermont’s Health System 5 Planned Parenthood of Northern New England 20

Bi-State’s Recruitment Center 6 Rural Health Clinics Overview 21

Bi-State’s Members 8 Grace Cottage Family Health & Hospital 22

Member Map 9 Vermont Area Health Education Centers 23

Member Directory 10 Vermont Coalition of Clinics for the Uninsured 26

FQHCs Strengthen Communities 12 FQHC Federal Requirements 29

FQHCs Ensure Access in Their Communities 13 FQHC Sliding Fee Scale 30

FQHC Patients by Payer 14 Member Site Directory by Organization 31

FQHC Funding and Reimbursement Structure 15 Member Site Directory by County 32

FQHCs Exceed National Average for Quality Measures 16 Vermont Legislative Representative Directory 34

FQHCs Use Data to Drive Improvement 17 Acknowledgement and Contact Information 40

2 Return to Bi-State Primary Care Association Mission and Vision Table of Contents

Mission Vision Promote access to effective and affordable primary care and preventive services for all, with special Healthy individuals and communities with quality emphasis on underserved populations in Vermont health care for all. and New Hampshire.

Who We Are

Bi-State Primary Care Association was established in 1986 to serve Vermont and New Hampshire. Bi-State is a nonprofit, 501(c)(3) charitable organization that promotes access to effective and affordable primary care and preventive services for all, with special emphasis on underserved populations in New Hampshire and Vermont. Bi-State members include federally qualified health centers (FQHCs), community health centers (CHCs), rural health clinics (RHCs), private and hospital-supported primary care practices, community action programs, area health education centers (AHEC), clinics for the uninsured, Planned Parenthood and social service agencies. What We Do

Bi-State works with federal, state, and regional health policy organizations, foundations, and payers to develop strategies, policies, and programs that provide and support community-based primary health care services in medically underserved areas.

Bi-State’s nonprofit recruitment center provides workforce assistance and candidate referrals to FQHCs, RHCs, and private and hospital-sponsored physician practices throughout Vermont and New Hampshire. The recruitment center focuses on recruiting and retaining primary care providers including physicians, dentists, nurse practitioners, and physician assistants.

For more information, please contact: Georgia Maheras, Esq., Director of Vermont Public Policy [email protected], (802) 229-0002 ext. 218

3 Return to Bi-State’s 2018 Vermont Public Policy Principles, Priorities and Strategies Table of Contents

Public Policy Principles Bi-State is committed to improving the health status of Vermonters and ensuring that all individuals have access to affordable and high- quality primary medical, mental health, substance abuse, and oral health care, regardless of insurance status or ability to pay.

We support the state’s efforts to move to a universal and unified health care delivery system and ensure universally available health access and insurance coverage. We support investments in public health and primary and preventive care. Our work aims to preserve, strengthen and expand Vermont’s community-based primary care safety-net providers, recognizing that these organizations are integral to the lives of one in three Vermonters and are the foundation of healthy communities statewide.

Public Policy Priorities Bi-State works through effective partnerships and robust engagement with the Governor and the Administration, State Legislature, Green Mountain Care Board, and other partners to: • Ensure every Vermonter has access to a primary care medical home with particular attention to underserved Vermonters. • Advocate for delivery system and payment models that invest in, build upon, and prioritize community-based primary care, specifically that sustain and enhance the FQHC and RHC models of care delivery and reimbursement. • Build on the successes of Blueprint for Health, ensuring substantial investment in patient-centered medical homes and empowering local care communities. • Close coverage gaps for uninsured Vermonters and affordability gaps for under-insured Vermonters. • Promote population health and well-being through support of public health goals and population health initiatives. • Establish strong community-based partnerships that support patients through transitions across care settings. • Increase investments to integrate mental health/substance abuse and primary care. • Integrate coverage for and expand access to oral health. • Invest in preventive services, early intervention, wellness initiatives, and health education. • Support primary care practitioners in care management and patient engagement for patients with chronic conditions. • Sustain the 340B pharmacy program to ensure continued access to low cost pharmaceuticals. • Increase funding for Vermont Medicaid, and ensure continued investment in primary care. • Invest in comprehensive workforce development strategies including increased federal and state loan repayment for health care professionals and funding for national marketing and outreach. • Increase access to and funding for telemedicine services to improve access to services for Vermont’s rural and underserved populations. • Sustain federal payment “floors” and framework for FQHC and RHC infrastructure, initiatives, and services to improve access to comprehensive primary care for the uninsured and underinsured. • Sustain state funding for the Vermont Coalition of Clinics for the Uninsured. 4 Return to Ten Critical Points to Transform Vermont’s Health System Table of Contents

Vermont’s federally qualified health centers (FQHCs) recognize and value the work of the past year on payment reform. However, Vermonters will be healthier and better off only if the system transforms to address social determinants as a priority, commits to comprehensive primary care, invests in strong community-based care systems, and builds capacity to accomplish these goals. A successfully transformed health system has the following characteristics:

1. Primary care practices are strong and well-supported patient-centered medical homes, with the resources they need to prevent chronic disease, promote wellness, and manage patient care outside the hospital setting. 2. Primary care practitioners have the time they need to address the issues underlying chronic disease and mental health and the resources to maximize primary care practitioner time in direct patient care. 3. Mental health, behavioral health, and primary care work together to provide seamless care to patients. 4. Home health services and primary care practices work together to provide seamless care to patients, and home health is available without regard to Medicare or Medicaid legacy rules around coverage for home health services. 5. Community-based social service agencies are fully-integrated or tightly coordinated with primary care practices, including: • Area Agencies on Aging who serve as the eyes and ears of the system, working to keep vulnerable elders housed and out of impoverished living conditions. • Mental Health Centers who offer integrated services and supports to Vermonters affected by developmental disabilities, mental health conditions and substance use disorders. • The Vermont Food Bank and local food shelves with a pulse on food insecurity in the community, working to feed low-income and underserved Vermonters. • Parent Child Centers, shaping solutions to meet the needs of working families. 6. Primary care practices work with community partners to offer a “health coach” option to help patients in making better health decisions and following a healthy lifestyle. 7. Communities integrate wellness-initiatives with schools, employers, community centers, etc.; i.e. meet people where they are. 8. Hospitals are stable and positioned to meet the acute inpatient and outpatient needs of the community, and participate as equals in the delivery system. 9. Systems of care are focused on the local and regional levels, with resources deployed efficiently to meet the needs of the community, and with local strategic and project plans that roll up to a statewide plan. 10. Vermont’s Blueprint team retains independence and neutrality to lead the transformation effort, using community collaboration boards (e.g. Blueprint UCCs) with broad community representation to shape and drive the transformation at the local level.

Adopted by Bi-State’s Member FQHC CEOs December 2015 5 Return to Bi-State’s Recruitment Center: Addressing Primary Care Workforce Table of Contents

The Recruitment Center is the only nonprofit organization in Vermont that conducts national marketing and outreach to physicians, nurse practitioners, physician assistants, dentists, and mental health and substance use disorder treatment professionals specifically to attract and recruit them to Vermont. Dedicated to recruiting these providers to rural and underserved areas of the state where their services are most needed, the Recruitment Center screens providers to determine which communities and practices will best meet their personal and professional needs to support long-term retention. The Recruitment Center manages the Vermont state page and regularly posts vacancies on the National Rural Recruitment and Retention Network (3RNet).

Due to its familiarity with the health care business, culture, educational, and recreational environment in the state, the Recruitment Center is able to support the transition of newly-recruited providers and their families to Vermont. The Recruitment Center also provides technical assistance on programs that support recruitment such as the National Health Service Corps, which offers loan repayment for clinicians who agree to practice in federally-designated medically underserved areas.

The Recruitment Center regularly collaborates with organizations across Vermont to maximize resources and avoid duplication. The national marketing and outreach complements the pipeline and workforce development activities conducted by Vermont’s Area Health Education Centers and the Vermont Dental and Medical Societies. The Recruitment Center regularly engages with the Vermont Office of Rural Health and the Vermont Department of Health on workforce initiatives in the state.

For information on the Recruitment Center, please contact Stephanie Pagliuca, Director, at [email protected]. For assistance with recruitment, please contact Mandi Gingras, Recruitment and Retention Coordinator, at [email protected].

6 Return to Table of Contents

OUR MEMBERS

7 Return to Bi-State’s Member Health Centers and Clinics Provide Care to 1 in 3 Vermonters Table of Contents

Our Members Our Member Average Coverage Mix

 Federally Qualified Health Centers (FQHCs) 12 Vermont FQHCs encompassing 64 sites in all 14 counties Uninsured 12% Medicare  Planned Parenthood of Northern New England 19% 12 clinics  A Rural Health Clinic (RHC) 1 site  Vermont Area Health Education Center (AHEC) A Network of Partners Third Party  41% Medicaid Vermont Coalition of Clinics for the Uninsured 28% 9 clinics

Vermont’s health centers and clinics have served as medical homes for more than 200,000 patients, with more than 720,000 visits in 2016.

Our members serve:

. 43% of Vermont Medicaid enrollees . 35% of Vermont Medicare enrollees . The majority of uninsured Vermonters

Source(s): FQHC self-reported 2016 UDS data, self-reported data for non-FQHCs, the 2014 DFR Vermont Household Health Insurance Survey 8 Return to Bi-State Primary Care Association Member Map Table of Contents

Our members provide care to Vermonters at 86 sites across every county of the State.

9 Return to Bi-State Primary Care Association’s Vermont Members Table of Contents

Battenkill Valley Health Center Grace Cottage Family Health & Hospital Northern Tier Center for Health 9 Church Street, PO Box 61, Arlington, VT 05250 Douglas F. DiVello, CEO Pamela Parsons, Executive Director (802) 375-6566 185 Grafton Road (Route 35), Townshend, VT 05353 44 Main Street, Richford, VT 05476 www.battenkillvalleyhealthcenter.org 802-365-7357, [email protected] (802) 255-5560, [email protected] www.gracecottage.org www.notchvt.org Community Health Centers of Burlington Alison Calderara, CEO The Health Center Planned Parenthood of Northern New England 617 Riverside Avenue, Burlington, VT 05401 John Matthew, MD, CEO Meagan Gallagher, CEO and President (802) 264-8190, [email protected] 157 Towne Avenue, PO Box 320, Plainfield, VT 05667 784 Hercules Drive, Suite 110, Colchester, VT 05446 www.chcb.org (802) 454-8336, [email protected] (802) 448-9778, [email protected] www.the-health-center.org www.plannedparenthood.org Community Health Centers of the Rutland Region Grant Whitmer, Executive Director Indian Stream Health Center Springfield Medical Care Systems 71 Allen Pond Street, Suite 101, Rutland, VT 05701 Gregory Culley, Interim CEO Timothy Ford, CEO (802) 855-2083, [email protected] 253 Gale Street, Canaan, VT 05903 25 Ridgewood Road, Springfield, VT 05156 www.chcrr.org (603) 388-2473, [email protected] (802) 885-2151, [email protected] www.indianstream.org www.springfieldmed.org Community Health Services of Lamoille Valley Kevin Kelley, President/CEO Little Rivers Health Care UVM Larner College of Medicine 66 Morrisville Plaza, PO Box 749, Morrisville, VT Gail Auclair, CEO Office of Primary Care and AHEC Program 05661 146 Mill Street, PO Box 338, Bradford, VT 05033 Elizabeth Cote, Director (802) 851-8607, [email protected] (802) 222-4637 ext. 104, [email protected] 1 South Prospect Street, Arnold 5, Burlington, VT www.chslv.org www.littlerivers.org 05401 (802) 656-0030, [email protected] Gifford Health Care Mountain Health Center www.med.uvm.edu/ahec Daniel Bennett, CEO Martha Halnon, Executive Director 44 S. Main Street, PO Box 2000, Randolph, VT 05060 74 Munsill Avenue, Suite 100, Bristol, VT 05443 Vermont Coalition of Clinics for the Uninsured (802) 728-2304, [email protected] (802) 453-5028 ext. 7214 Steve Maier, Executive Director www.giffordhealthcare.org [email protected] 122 Green Mountain Place, Middlebury, VT 05753 www.mountainhealthcenter.com (802) 448-4280, [email protected] www.vtccu.org Northern Counties Health Care Shawn Tester, CEO 165 Sherman Drive, St. Johnsbury, VT 05819 (802) 748-9405 ext. 1519, [email protected] www.nchcvt.org 10 Return to Table of Contents

CARING FOR VERMONT’S COMMUNITIES

11 Return to FQHCs Strengthen Communities Table of Contents

Creating sustainable jobs and Making high quality services offering top-tier training available to patients, to their 1,300+ direct regardless of ability to pay. employees.

Through expansions and Communities within federally- community investment, designated medically spurring local economic underserved areas are development, with an provided integrated services. estimated 500+ additional Dr. Anje Van Berckelaer from Battenkill Valley Health Center indirect/induced jobs.*

Responding to the unique Extending hours to include needs of their communities early mornings, evenings with holistic approaches to and weekends. health and wellness.

Meeting patients where Maintaining healthier they are by providing communities makes for interpretation, transportation, a safer places to raise families. and other services.

Dr. Jeffrey Wulfman from Mountain Health Center *Capital Link 2016 Report, “The Economic Impact of Vermont’s Community Health Centers” 12 based on CY2014 data. Return to FQHCs Ensure Access in Their Communities Table of Contents

Federally qualified health centers (FQHCs) offer services to all residents in their service areas and determine charges using a sliding fee scale, which is based upon the resident’s ability to pay.

FQHCs leverage federal dollars to expand services and construct or renovate facilities.

FQHCs are automatically eligible for National Health Service Corps (NHSC) loan repayments and scholarship recipients.*

In many communities, FQHCs are the only comprehensive, patient-centered medical home open to all patients without restrictions, especially underinsured and Medicaid patients.

1 in 3 Medicaid Enrollees

1 in 3 Medicare Enrollees FQHCs provide care to 1 in 4 Vermonters 1 in 5 Commercially Insured Vermonters Over half of Uninsured Vermonters

Source(s): FQHC self-reported 2016 UDS data, self-reported data for non-FQHCs, the 2014 DFR Vermont Household Health Insurance Survey *NHSC loan repayment and scholarships are obtained through a competitive HRSA process. 13 Return to FQHCs Provided Primary Care to Over 170,000 Vermonters in 2016 Table of Contents

Vermont’s FQHCs saw 171,828 individual patients in 2016. Collectively, those patients made 677,293 visits to the FQHCs.

FQHC Patients by Payer in 2016 Types of Health Insurance in Vermont 2014 Uninsured Uninsured 4% 7% 23,231 10,125 Medicare Medicaid 21% 21% 32,669 132,829

Third Party 40% Medicare 62,784 Medicaid 18% Third Party 32% 110,916 57% 50,046 359,655

Source(s): FQHC self-reported 2016 UDS data, self-reported data for non-FQHCs, the 2014 DFR Vermont Household Health Insurance Survey 14 Return to FQHC Funding and Reimbursement Structure Minimizes Cost Shifting Table of Contents

FQHCs are eligible to receive federal appropriations for allowable costs that are not reimbursed by Medicaid, 2016 Sources of Revenue for Vermont FQHCs Medicare, commercial payers, and patient self-pay. Some of these costs may include care provided to uninsured and Other Grants State Grant underinsured low-income patients and enabling services 1% Federal Grant: 3% such as care management, outreach, transportation, and Capital Other interpretation. 1% Revenue 5% • FederalQHC F grants are awarded based upon a very competitive national application process. Patient Revenue: Medicaid • When FQHCs are awarded federal funds, they must Federal Grant: 28% meet strict program, performance, and accountability Operating standards. 13%

• QHCFederal F appropriations are not transferable to any other entity. Patient Revenue: Commercial/ Other Public • Medicare and Medicaid FQHC reimbursement is a Patient Revenue: 19% prospective, capped encounter rate. Medicare Patient 17% • FQHCs bill commercial insurers just like any other Revenue: primary care practice. Uninsured/ Self Pay • No payer reimburses FQHCs for their full costs. 12%

Source(s): FQHC self-reported 2016 UDS data 15 Return to Vermont’s FQHCs Exceed National Average for Many Clinical Quality Measures Table of Contents

Vermont FQHC Average vs. National Health Center Data Average Selected UDS Clinical Quality Measures 100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0% Cervical Cancer Adolescent Weight Colorectal Cancer Childhood Adult Weight Depression Asthma Treatment Hypertension Controlled Screening Screening Screening Immunizations Screening Diabetes

VT FQHC Average National FQHC Average

Source(s): FQHC self-reported 2016 UDS data, HRSA 16 Return to Vermont’s FQHCs Use Data to Drive Improvement Table of Contents

Patients Screened for Depression and Appropriate Follow-up 50%

45%

40%

35%

30%

25%

20%

15%

10%

5%

0% 2014 2015 2016

Source(s): FQHC UDS data 17 Return to FQHCs Collaborate Across Health Sectors Table of Contents

FQHCs collaborate with other health care and social services organizations in their communities to strengthen the health system as a whole.

Mental Health & Substance Use Treatment Centers Integration into Primary Care Vermont ACOs Department of An integrated system Health of care across the state Public Health Initiatives

FQHC Network Collaboration Universities, 340B Pharmacy Technical Schools, Program, Pediatric High Schools Mobile Dental Program, telemedicine, Education & Workforce and transportation Pipeline

Free Clinics for Hospitals the Uninsured ER Diversion & Transitions in Care Outreach to all Vermonters

18 Return to FQHCs Partner to Achieve the Best Care Table of Contents

Each FQHC is unique. They tailor programs and services based on demographics, geography, availability of acute and sub-acute providers, and other needs of their communities. Collaborations with community partners allow them to go above and beyond in delivering high quality primary care.

Initiatives and Partnerships

Northern Tier Center for Health runs an annual free summer day camp for children in Richford.

Little Rivers Health Care sends a dental van to local schools to provide oral health and dental care at least twice a year for over 350 students.

Community Health Centers of Burlington has a physician solely dedicated to running a transgender clinic.

Battenkill Valley Health Center has a partnership with the local food shelf to provide low-cost or free food to patients with financial needs.

Northern Counties Health Care partners with a CSA farm that provides at-risk children with prescriptions for healthy food available for a weekly pick-up at their doctor’s office.

Community Health Services of Lamoille Valley provides bus service to patients in the Stowe mountain area for families who may not have access otherwise.

19 Return to Planned Parenthood of Northern New England (PPNNE) Table of Contents

Founded in 1965, PPNNE serves patients at 21 health centers across Vermont, New Hampshire, and Maine. These health centers provide the highest quality care through a wide range of services for women and men, including cancer screening, birth control, LGBTQ services, well person check-ups, and STD testing and treatment. PPNNE offers a sliding fee scale, making care accessible and affordable to anyone who walks through their doors.

In 2016, PPNNE

• Operated 12 health centers in Vermont • These centers provided care to 18,836 Vermonters • And conducted a total of 28,438 patient visits, including • 2,471 Pap Tests • 3,436 Breast Exams • 34,291 STI Tests

“At the close of 2016, my insurance changed unexpectedly and I learned that my PCP and most local agencies do not accept my new insurance…My husband and I are not in a position to start a family quite yet; I am graduating with my Master's and we are in the middle of purchasing a 'fixer upper' home. I initially thought I had nowhere to turn, until I remembered that Planned Parenthood is accessible, affordable, and completely available to me. I was offered an appointment as a new patient within ONE week of calling, and offered Saturday appointments! The Nurse Practitioner educated me on all of my options, counseled me on proper contraceptive use, and assured me that they would be there for me for whatever needs that arise in the future…The entire staff made for a pleasant and anxiety-free experience, and I could not be more grateful. Even if I found a primary care or gynecology office that will take my insurance, I will still go back for all of my care.” – PPNNE patient

For more information, contact Meagan Gallagher, President & CEO, at (802) 448-9778 or [email protected]. 20 Return to Rural Health Clinics Table of Contents

The Rural Health Clinic Services Act of 1977 (Public Law 95-210) was enacted to address an inadequate supply of physicians serving Medicare patients in rural areas and to increase the use of non-physician practitioners such as nurse practitioners and physician assistants in rural areas.1 Rural health clinics (RHC) can be public, nonprofit, or for-profit health care facilities. They must be located in rural, underserved areas. They are required to use a team approach of physicians working with non-physician practitioners such as nurse practitioners, physician assistants, and certified nurse midwives to provide services. RHCs are required to provide outpatient primary care services and basic laboratory services.2

Vermont’s Nine Rural Health Clinics 1. Grace Cottage Family Health & Hospital* 2. North Country Pediatrics & Adolescent Medicine 3. North Country Primary Care Barton/Orleans 4. North Country Primary Care Newport 5. North Country Obstetrics & Gynecology 6. NVRH Corner Medical 7. NVRH Kingdom Internal Medicine 8. NVRH St. Johnsbury Pediatrics 9. NVRH Women's Wellness Center

*Bi-State PCA Member

1www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/RuralHlthClinfctsht.pdf, as of 1/4/17 2www.ruralhealthinfo.org/topics/rural-health-clinics, as of 1/4/17 21 Return to Grace Cottage Family Health & Hospital Table of Contents

Serving health care needs of its patients since 1949, Grace Cottage Family Health and Hospital provides acute and rehabilitative care in Windham County. Grace Cottage includes a federally certified rural health clinic offering family medicine, pediatrics, geriatrics, podiatry, and mental health services. It is supported by a Community Health Team offering care coordination, nutrition and exercise coaching, resource advocacy, and short-term counseling.

Community Wellness is an important component of Grace Cottage’s outreach to the community. One of Grace Cottage’s buildings houses a Community Wellness Center with a beautiful exercise room built by community volunteers. This room hosts regular yoga classes, as well as four twice-weekly classes of “Strong Bones” exercise for seniors, and two levels of Tai Chi balance classes for seniors each week. In addition, the Community Wellness Center hosts a wide variety of other wellness classes and support groups, as well as providing space for non-profit groups to meet.

For more information, contact Douglas DiVello, CEO, at (802) 365-7357 or [email protected]. 22 Return to Vermont Area Health Education Centers (AHEC) Table of Contents

Vermont AHEC is a network of academic and community partners working together to improve the distribution, diversity, supply, and education of the health workforce in Vermont. Established in 1996, Vermont AHEC has a statewide infrastructure with a program office at the University of Vermont, Larner College of Medicine, and two regional centers. Vermont AHEC focuses on achieving a well-trained workforce so that all Vermonters have access to quality care, especially those who live in Vermont’s most rural and underserved areas. During FY17, the UVM Office of Primary Care and the Vermont AHEC Network

Provided 2,290 Vermont youth with health careers experiences,

Worked with 238 providers precepting health professions students,

Delivered continuing education to 2,088 health professionals, and

Placed 16 physicians in Vermont communities.

23 Return to AHEC Health Care Workforce Development Table of Contents

Education and Career Pipeline

24 Return to AHEC’s Impact on Careers in Health Care Table of Contents

25 For more information, contact Elizabeth Cote, Director at (802) 656-0030 or [email protected]. Return to Vermont Coalition of Clinics for the Uninsured Table of Contents

The Vermont Coalition of Clinics for the Uninsured (VCCU) is an association of nine free clinic programs and four dental programs that provide care (on site or by referral) and assistance free of charge to patients without adequate medical and dental insurance. The clinics are located throughout the state and are supported by the work of volunteers, community hospitals, local fund-raising, and an annual grant from the State of Vermont. All patients are assessed for eligibility in a number of federal, state, and local health care programs. The VCCU provides outreach and enrollment as well as assistance with medical care, prescriptions, dental care, and other health needs, along with providing case management for each patient. Since 1997, VCCU has served over 55,000 Vermonters. Each year approximately 45% of their patients are NEW to the clinic system. The typical VCCU patient is employed, is a high school graduate, and has a wide range of health access needs.

In 2017, VCCU Success story about a patient, “Bridget” Open Door Clinic, Middlebury, Vermont

• Assisted 7,831 Vermonters, which is a 35% Upon her very first visit to the clinic, Bridget did not have increase since 2010. health insurance and her health issues were very time • Provided 4,584 medical and dental visits, worth sensitive. Within 48 hours, Bridget was enrolled in a $610,000. Equivalent ER care would have totaled health insurance plan, had chosen a primary care provider, AND had set up the necessary appointments to more than $3.3 million. help manage her physical and mental health issues going • Provided over 26,000 services overall to forward. Bridget’s referrals, transfer of records, Medicaid Vermonters, an increase of 30% since 2010. eligibility, and treatment plan were all orchestrated by the coalition’s volunteers and staff members.

For more information, contact Steve Maier, Executive Director, at (802) 448-4280 or [email protected]. www.vtccu.org 26 Return to Vermont Coalition of Clinics for the Uninsured Table of Contents

Bennington Free Clinic People’s Health & Wellness Clinic† Sue Andrews Peter Youngbaer 121 Depot Street, Bennington, VT 05201 553 North Main Street, Barre, VT 05641 (802) 447-3700 (802) 479-1229

Good Neighbor Health Clinic & Rutland Free Clinic† Red Logan Dental Clinic† Tony Morgan Dana Michalovis 145 State Street, Rutland, VT 05701 70 North Main Street, (802) 775-1360 White River Junction, VT 05001 (802) 295-1868 Valley Health Connections* Lynn Raymond-Empey Health Assistance Program at UVM* 268 River Street, Springfield, VT 05156 Erin Armstrong (802) 885-1616 128 Lakeside Avenue, Suite 106 Burlington, VT 05401 Windsor Community Clinic at Mt. Ascutney (802) 847-6984 Hospital* Samantha Abrahamsen Health Connections at 289 County Road, Windsor, VT 05089 Gifford Medical Center* (802) 674-7213 Michele Packard 38 South Main Street †Provides on-site dental care Randolph, VT 05060 *Provides referral services only (802) 728-2323

Open Door Clinic† Heidi Sulis 100 Porter Drive, Middlebury, VT 05753 (802) 388-0137

27 Return to Table of Contents

RESOURCES

28 Return to FQHC Federal Requirements Table of Contents

Federally qualified health centers (FQHCs) are health care practices that have a mission to provide high quality, comprehensive primary care and preventive services regardless of their patients' ability to pay or insurance coverage. FQHCs must successfully compete in a national competition for FQHC designation and funding. Additionally, they must be located in federally-designated medically underserved areas and/or serve federally-designated medically underserved populations. Per Federal Requirements, FQHCs must: 1. Demonstrate and document the needs of their target populations, including assuring that any subrecipient(s) meets Health Center Program updating their service areas, when appropriate. Requirements. 2. Provide all required primary, preventive, enabling health services and 11. Make efforts to establish and maintain collaborative relationships with additional health services as appropriate and necessary, either directly or other health care providers, including other health centers in the service through established written arrangements and referrals. area of the health center. 3. Maintain a core staff as necessary to carry out all required primary, 12. Maintain accounting and internal control systems appropriate to the size preventive, enabling, and additional health services as appropriate and and complexity of the organization to safeguard assets and maintain necessary, either directly or through established arrangements and financial stability. referrals. Staff must be appropriately credentialed and licensed. 13. Have systems in place to maximize collections and reimbursement for 4. Provide services at times and locations that assure accessibility and meet costs in providing health services, including written billing, credit, and the needs of the population to be served. collection policies and procedures. 5. Provide professional coverage during hours when the health center is 14. Develop annual budgets that reflect the cost of operations, expenses, and closed. revenues (including the federal grant) necessary to accomplish the service 6. Ensure their physicians have admitting privileges at one or more referral delivery plans. hospitals, or other such arrangement to ensure continuity of care. In 15. Have systems which accurately collect and organize data for program cases where hospital arrangements (including admitting privileges and reporting and which support management decision-making. membership) are not possible, health centers must firmly establish 16. Maintain their funded scope of project (sites, services, service area, target arrangements for hospitalization, discharge planning, and patient population, and providers). tracking. 17. Ensure governing boards maintain appropriate authority to oversee 7. Have a system in place to determine eligibility for patient discounts operations. adjusted on the basis of the patient’s ability to pay. No patient will be 18. Ensure a majority of board members for each health center are patients denied services based on an inability to pay. of the health center. The board, as a whole, must represent the 8. Have an ongoing Quality Improvement/Quality Assurance (QI/QA) individuals being served by the health center in terms of demographic program that includes clinical services and management, and maintains factors such as race, ethnicity, and sex. the confidentiality of patient records. 19. Ensure bylaws and/or policies are in place that prohibit conflict of interest 9. Maintain a fully staffed management team as appropriate for the size and by board members, employees, consultants, and those who furnish goods needs of the center. or services to the health center. 10. Exercise appropriate oversight and authority over all contracted services,

Source: Summary of Health Center Program Requirements. (February 2014) from Bureau of Primary Health Care, Health Resources and Services Administration, http://bphc.hrsa.gov/about/requirements/hcpreqs.pdf 29 Return to FQHC Sliding Fee Scale Table of Contents

FQHCs that receive Health Resources and Services Administration (HRSA) funding must provide access to services without regard for each patient's ability to pay. FQHCs must develop a schedule of fees or payments (often called a sliding fee scale) for the services they provide to ensure that the cost of services not covered by insurance are discounted on the basis of each patient's ability to pay, for incomes below 200% of the Federal Poverty Level (FPL). Ability to pay is determined by a patient's annual income and family size according to the most recent U.S. Department of Health & Human Services Federal Poverty Guidelines.

SAMPLE Vermont FQHC Sliding Fee Scale Annual Family Income Range Below 100% 101 – 125% 126 – 150% 151 – 175% 176 – 200% Over 200% Household Size FPL FPL FPL FPL FPL FPL 80% 20% Discount Applied $5 flat fee 60% discount 40% discount 0% discount discount discount Under $12,061 – $15,076 – $18,091 – $21,106 – Over 1 $12,060 15,075 18,090 21,105 24,120 $24,121 Under $16,240 – $20,301 – $24,361 – $28,421 – Over 2 $16,240 20,300 24,360 28,240 32,480 $32,481 Under $20,421 – $25,526 – $30,631 – $35,736 – Over 3 $20,420 25,525 30,630 35,735 40,840 $40,841 Under $24,601 – $30,751– $36,901 – $43,051 – Over 4 $24,600 30,750 36,900 43,050 49,200 $49,201 Under $28,781 – $35,976 – $43,171 – $50,365– Over 5 $28,780 35,975 43,170 50,365 57,560 $57,561 Under $32,961 – $41,201 – $49,441 – $57,681 – Over 6 $32,960 41,200 49,440 57,680 65,920 $65,921 Under $37,141– $46,426 – $55,711 – $64,996 – Over 7 $37,140 46,425 55,710 64,995 74,280 $74,281 Under $41,321 – $51,651 – $61,981 – $72,311 – Over 8 $41,320 51,650 61,980 72,310 82,640 $82,641 Add $4,180 Add $5,225 Add $6,270 Add $7,315 Add $8,360 Add $8,360 Additional people per person per person per person per person per person per person

Source: Health Resources and Services Administration, http://nhsc.hrsa.gov/downloads/discountfeeschedule.pdf, as of April 2017. 30 Return to Bi-State Primary Care Association’s Vermont Member Sites By Organization Table of Contents

Battenkill Valley Health Center (FQHC) The Health Center (FQHC) Planned Parenthood of Northern New England 1. Battenkill Valley Health Center* 1. Cabot Health Services (school-based) 1. Barre Health Center 2. The Health Center Main Site* 2. Bennington Health Center Community Health Centers of Burlington (FQHC) 3. Ronald McDonald Dental Care Mobile* 3. Brattleboro Health Center 1. Champlain Islands Health Center 4. Burlington Health Center 2. GoodHEALTH Internal Medicine Indian Stream Health Center (FQHC) 5. Hyde Park Health Center 3. Pearl Street Youth Health Center 1. Indian Stream Health Center 6. Middlebury Health Center 4. Riverside Health Center* 7. Newport Health Center (FQHC) 5. Safe Harbor Health Center* Little Rivers Health Care 8. Rutland Health Center 1. Clara Martin Center 6. School -Based Dental Clinic 9. St. Albans Health Center 2. LRHC at Bradford 7. South End Health Center 10. St. Johnsbury Health Center 3. LRHC at East Corinth 8. Winooski Family Health 11. White River Junction 4. LRHC at Wells River 12. Williston Health Center Community Health Centers of the Rutland Region (FQHC) 5. Valley Vista 1. Allen Pond Community Health Center Springfield Medical Care Systems (FQHC) (FQHC) 2. Brandon Medical Center Mountain Health Center 1. Charlestown Family Medicine (NH) 1. Mountain Health Center* 3. Castleton Family Health Center 2. Chester Family Medicine* 2. Mountain Health Center Annex 4. CHCRR Pediatrics 3. The Ludlow Dental Center* 3. Mountain Health Dental Care* 5. Community Dental Clinic* 4. The Ludlow Health Center 6. Mettowee Valley Health Center (FQHC) 5. Mountain Valley Medical Center 7. Rutland Community Health Center Northern Counties Health Care 1. Concord Health Center 6. Rockingham Medical Group 8. Shorewell Community Health Center 2. Danville Health Center 7. Springfield Health Center 8. The Women’s Health Center of Springfield Community Health Services of Lamoille Valley (FQHC) 3. Hardwick Area Health Center 4. Island Pond Health & Dental Center* 1. Appleseed Pediatrics Vermont Coalition of Clinics for the Uninsured 5. Northern Counties Dental Center* 2. Behavioral Health & Wellness Center 1. Bennington Free Health Clinic 6. Orleans Dental Center* 3. Community Dental Clinic* 2. Good Neighbor Health Clinic & Red Logan Dental Clinic* 7. The St. Johnsbury Community Health Center 4. Morrisville Family Health Care 3. Health Assistance Program at UVM Medical Center 5. Stowe Family Practice Northern Tier Center for Health (FQHC) 4. Health Connections at Gifford Medical Center 5. Open Door Clinic* (FQHC) 1. Alburg Health Center Gifford Health Care 6. People’s Health & Wellness Clinic* 1. Bethel Health Center 2. Enosburg Health Center 7. Rutland Free Clinic* 2. Chelsea Health Center 3. Fairfax Health Center 8. Valley Health Connections 3. Gifford Health Center at Berlin 4. Fairfield Street Health Center 9. Windsor Community Clinic at Mt. Ascutney 4. Gifford Primary Care 5. NCSS Health Center 5. Rochester Health Center 6. Richford Health Center 6. Twin River Health Center 7. Richford Dental Clinic* *site provides dental services 8. St. Albans Health Center FQHC – Federally Qualified Health Center Grace Cottage Family Health & Hospital (RHC) 9. Swanton Health Center* RHC – Rural Health Clinic 1. Grace Cottage Family Health & Hospital

31 Return to Bi-State’s Vermont Member Sites by County Table of Contents

Addison County Essex County Orange County • Middlebury Health Center (PPNNE) • Indian Stream Health Center (FQHC) • Gifford Health Care (FQHC) • Mountain Health Center (FQHC)* • Northern Counties Health Care (FQHC) • Chelsea Health Center • Mountain Health Center Annex (FQHC) • Concord Health Center • Gifford Primary Care • Mountain Health Dental Care (FQHC)* • Island Pond Health and Dental Center* • Health Connections at Gifford Health Care (VCCU) • The Open Door Clinic (VCCU) • Little Rivers Health Care (FQHC) Franklin County • Clara Martin Center Bennington County • Northern Tier Center for Health (FQHC) • LRHC at Bradford • Battenkill Valley Health Center (FQHC)* • Alburg Health Center • LRHC at Wells River • Bennington Free Health Clinic (VCCU) • Enosburg Health Center • LRHC at East Corinth • Bennington Health Center (PPNNE) • Fairfax Health Center • Valley Vista • Fairfield Street Health Center Caledonia County • NCSS Health Center Orleans County • Northern Counties Health Care (FQHC) • Richford Dental Clinic* • Newport Health Center (PPNNE) • Danville Health Center • Richford Health Center • Orleans Dental Clinic (FQHC) • Hardwick Area Health Center • St. Albans Health Center • Northern Counties Dental Center* • Swanton Health Center* • St. Johnsbury Community Health Center • St. Albans Health Center (PPNNE) • St. Johnsbury Health Center (PPNNE) Grand Isle County Chittenden County • Community Health Centers of Burlington (FQHC) • Burlington Health Center (PPNNE) • Champlain Islands Health Center • Community Health Centers of Burlington (FQHC) • Northern Tier Center for Health (FQHC) • Riverside Health Center* • Alburg Health Center • Safe Harbor Health Center* • Pearl Street Youth Health Center Lamoille County • H.O. Wheeler School (school-based)* • Community Health Services of Lamoille Valley • South End Health Center (FQHC) • GoodHEALTH Internal Medicine • Appleseed Pediatrics • Health Assistance Program at UVMMC (VCCU) • Behavioral Health & Wellness Center • Williston Health Center (PPNNE) • Community Dental Clinic* Morrisville Family Health Care *site provides dental services • Stowe Family Practice (FQHC) Federally Qualified Health Center • Hyde Park Health Center (PPNNE) (PPNNE) Planned Parenthood of Northern New England (RHC) Rural Health Clinic 32 (VCCU) Vermont Coalition of Clinics for the Uninsured Return to Bi-State’s Vermont Member Sites by County Table of Contents

Rutland County Windsor • Community Health Centers of the Rutland • Gifford Health Care (FQHC) Region (FQHC) • Bethel Health Center • Allen Pond Family Health Center • Rochester Health Center • Brandon Medical Center • Twin River Health Center • Castleton Family Health Center • Good Neighbor Health Clinic & Red Logan • CHCRR Pediatrics Dental Clinic*(VCCU) • Community Dental Clinic* • Springfield Medical Care Systems (FQHC) • Mettowee Valley Health Center • Chester Family Medicine* • Rutland Community Health Center • Mountain Valley Medical Center • Shorewell Community Health Center • The Ludlow Health Center • Rutland Free Clinic* (VCCU) • The Ludlow Dental Center* • Rutland Health Center (PPNNE) • The Women’s Health Center of Springfield Washington • Springfield Health Center • Barre Health Center (PPNNE) • Valley Health Connections (VCCU) • Gifford Health Care (FQHC) • Windsor Community Clinic (VCCU) • Gifford Health Center at Berlin • People’s Health & Wellness Clinic (VCCU) Sullivan County in New Hampshire • The Health Center (FQHC) • Springfield Medical Care Systems (FQHC) • Cabot Health Services (school-based) • Charlestown Family Medicine • Ronald McDonald Dental Care Mobile* • The Health Center Main Site*

Windham • Brattleboro Health Center (PPNNE) • Grace Cottage Family Health & Hospital (RHC) • Springfield Medical Care Systems (FQHC) • Rockingham Medical Group

*site provides dental services (FQHC) Federally Qualified Health Center (PPNNE) Planned Parenthood of Northern New England (RHC) Rural Health Clinic (VCCU) Vermont Coalition of Clinics for the Uninsured 33 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Rep. David Ainsworth (R) Windsor-Orange-1 Rep. Paul Belaski (D) Windsor-1 Sen. Francis Brooks (D) Washington District Gifford Health Care Springfield Medical Care Systems Community Health Centers of Burlington Vermont Coalition of Clinics for the Uninsured Gifford Health Care Rep. Janet Ancel (D) Washington-6 Northern Counties Health Care The Health Center Sen. Joseph Benning (R) Caledonia District The Health Center Little Rivers Health Care Sen. Timothy Ashe (D)/(P) Chittenden District Northern Counties Health Care Rep. (D) Bennington-4 Community Health Centers of Burlington Battenkill Valley Health Center Rep. Steve Beyor (R) Franklin-5 Sen. Claire Ayer (D) Addison District Northern Tier Center for Health Rep. (D) Chittenden-5-2 Community Health Centers of the Rutland Region Community Health Centers of Burlington Mountain Health Center Rep. Clement Bissonnette (D) Chittenden-6-7 Community Health Centers of Burlington Rep. Susan Buckholz (D) Windsor-4-1 Sen. (D) Windham District Gifford Health Care Springfield Medical Care Systems Rep. (D) Windsor-3-1 Grace Cottage Family Health & Hospital Rep. (R) Rutland-2 Rep. (R) Chittenden-8-3 Springfield Medical Care Systems Community Health Centers of the Rutland Region Community Health Centers of Burlington Rep. William Botzow (D) Bennington-1 Rep. (P) Windham-2-2 Rep. John Bartholomew (D) Windsor-1 Battenkill Valley Health Center Grace Cottage Family Health & Hospital Springfield Medical Care Systems Planned Parenthood of Northern New England Vermont Coalition of Clinics for the Uninsured Sen. Carolyn Branagan (R) Franklin District Closest FQHC is Springfield Medical Care Systems Northern Tier Center for Health Sen. (D)/(P) Chittenden District Sen. Brian Campion (D) Bennington District Community Health Centers of Burlington Sen. Christopher Bray (D) Addison District Battenkill Valley Health Center Community Health Centers of the Rutland Region Rep. (R) Addison-4 Mountain Health Center Rep. William Canfield (R) Rutland-3 Mountain Health Center Community Health Centers of the Rutland Region Rep. Patrick Brennan (R) Chittenden-9-2 Rep. Lynn Batchelor (R) Orleans-1 Community Health Centers of Burlington Rep. Stephen Carr (D) Rutland-6 Northern Counties Health Care Community Health Centers of the Rutland Region Rep. (D) Windsor-Orange-2 Rep. (R) Caledonia-3 Gifford Health Care Rep. Robin Chesnut-Tangerman (P) Rutland- Northern Counties Health Care Bennington Planned Parenthood of Northern New England Sen. (R) Franklin District Community Health Centers of the Rutland Region Northern Tier Center for Health 34 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Rep. (D) Windsor-2 Rep. Sarah Copeland Hanzas (D) Orange-2 Rep. (D) Chittenden-8-1 Springfield Medical Care Systems Little Rivers Health Care Community Health Centers of Burlington

Rep. Kevin Christie (D) Windsor-4-2 Rep. Timothy Corcoran (D) Bennington-2-1 Rep. (D) Windsor-3-2 Planned Parenthood of Northern New England Battenkill Valley Health Center Springfield Medical Care Systems Vermont Coalition of Clinics for the Uninsured Vermont Coalition of Clinics for the Uninsured Closest FQHC is Little Rivers Health Care Sen. (D) Washington District Community Health Centers of Burlington Rep. Peter Fagan (R) Rutland-5-1 Rep. (P) Chittenden-6-4 Gifford Health Care Community Health Centers of the Rutland Region Community Health Centers of Burlington Northern Counties Health Care The Health Center Rep. (R) Caledonia-4 Sen. Alison Clarkson (D) Windsor District Northern Counties Health Care Closest FQHC is Springfield Medical Care Systems Rep. Larry Cupoli (R) Rutland-5-2 Community Health Centers of the Rutland Region Rep. (D) Bennington-2-1 Rep. (P) Chittenden-6-4 Planned Parenthood of Northern New England Battenkill Valley Health Center Community Health Centers of Burlington Rep. Maureen Dakin (D) Chittenden-9-2 Sen. Margaret Peg Flory (R) Rutland District Sen. (R) Rutland District Community Health Centers of Burlington Community Health Centers of the Rutland Region Community Health Centers of the Rutland Region Rep. (D) Windham-4 Rep. Robert Forguites (D) Windsor-3-2 Rep. James Condon (D) Chittenden-9-1 Grace Cottage Family Health & Hospital Springfield Medical Care Systems Community Health Centers of Burlington Springfield Medical Care Systems Vermont Coalition of Clinics for the Uninsured Vermont Coalition of Clinics for the Uninsured Rep. (D) Addison-2 Rep. Bob Frenier (R) Orange-1 Community Health Centers of Burlington Rep. Dennis Devereux (R) Rutland-Windsor-2 Gifford Health Care Community Health Centers of the Rutland Region Community Health Centers of the Rutland Region Little Rivers Health Care Gifford Health Care Springfield Medical Care Systems Rep. Douglas Gage (R) Rutland-5-4 Rep. Daniel Connor (D) Franklin-6 Rep. (R) Franklin-3-2 Community Health Centers of the Rutland Region Northern Tier Center for Health Northern Tier Center for Health Rep. (R) Franklin-4 Rep. Charles Conquest (D) Orange-Caledonia Rep. (R) Washington-1 Northern Tier Center for Health Little Rivers Health Care The Health Center Northern Counties Health Care Rep . John Gannon (D) Windham-6 Rep. Johannah Donovan (D) Chittenden-6-5 Closest FQHC is Battenkill Valley Health Center Community Health Centers of Burlington 35 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Rep. Marcia Gardner (D) Chittenden-1 Rep. Matt Hill (D) Lamoille-2 Rep. Bernie Juskiewicz (R) Lamoille-3 Community Health Centers of Burlington Community Health Services of the Lamoille Valley Community Health Services of the Lamoille Valley Planned Parenthood of Northern New England Rep. (D) Chittenden-8-2 Rep. (R) Bennington-4 Community Health Centers of Burlington Rep. (D) Washington-4 Battenkill Valley Health Center The Health Center Rep. (P) Chittenden-6-7 Rep. (D) Franklin-3-1 Community Health Centers of Burlington Rep. (D) Orange-Washington-Addison Northern Tier Center for Health Gifford Health Care Planned Parenthood of Northern New England Rep. (D) Washington-7 Vermont Coalition of Clinics for the Uninsured The Health Center Rep. Charlie Kimbell (D) Windsor-5 Rep. (D) Chittenden-8-2 Closest FQHC is Springfield Medical Care Systems Rep. Rodney Graham (R) Orange-1 Community Health Centers of Burlington Gifford Health Care Sen. (D) Caledonia District Little Rivers Health Care Rep. Mary Howard (D) Rutland-5-3 Little Rivers Health Care Vermont Coalition of Clinics for the Uninsured Northern Counties Health Care Rep. (P) Windsor-Rutland Gifford Health Care Sen. (D) Chittenden District Rep. Warren Kitzmiller (D) Washington-4 Community Health Centers of Burlington The Health Center Rep. James Harrison (R) Rutland-Windsor-1 Community Health Centers of the Rutland Region Rep. (D) Washington-5 Rep. (D) Chittenden-6-3 Community Health Centers of Burlington Community Health Centers of Burlington Rep. (D) Chittenden-7-3 The Health Center Community Health Centers of Burlington Rep. Robert LaClair (R) Washington-2 Rep. (I) Orange-Washington-Addison Community Health Centers of Burlington Rep. (R) Windham-1 Gifford Health Care The Health Center Closest FQHC is Springfield Medical Care Systems Vermont Coalition of Clinics for the Uninsured Rep. Martin LaLonde (D) Chittenden-7-1 Rep. (R) Rutland-3 Rep. Mitzi Johnson (D) Grand Isle-Chittenden Community Health Centers of Burlington Community Health Centers of the Rutland Region Community Health Centers of Burlington Northern Tier Center for Health Rep. (D) Addison-3 Rep. Mark Higley (R) Orleans-Lamoille Community Health Centers of Burlington Community Health Services of the Lamoille Valley Rep. (D) Grand Isle-Chittenden Community Health Centers of the Rutland Region Community Health Centers of Burlington Mountain Health Center Northern Tier Center for Health 36 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Rep. Richard Lawrence (R) Caledonia-4 Rep. Marcia Martel (R) Caledonia-1 Rep. Ruqaiyah Morris (D) Bennington-2-2 Northern Counties Health Care Little Rivers Health Care Battenkill Valley Health Center Northern Counties Health Care Planned Parenthood of Northern New England Rep. Paul Lefebvre (R) Essex-Caledonia-Orleans Vermont Coalition of Clinics for the Uninsured Indian Stream Health Center Rep. James Masland (D) Windsor-Orange-2 Northern Counties Health Care Gifford Health Care Rep. Mary Morrissey (R) Bennington-2-2 Battenkill Valley Health Center Rep. Patti Lewis (R) Washington-1 Rep. Christopher Mattos (R) Chittenden-10 Planned Parenthood of Northern New England The Health Center Community Health Centers of Burlington Vermont Coalition of Clinics for the Uninsured

Rep. William Lippert (D) Chittenden-4-2 Sen. (D) Grand Isle District Rep. Michael Mrowicki (D) Windham-4 Community Health Centers of Burlington Community Health Centers of Burlington Grace Cottage Family Health & Hospital Northern Tier Center for Health Springfield Medical Care Systems Rep. (D) Windham-5 Vermont Coalition of Clinics for the Uninsured Grace Cottage Family Health & Hospital Rep. Curt McCormack (D) Chittenden-6-3 Closest FQHC is Springfield Medical Care Systems Community Health Centers of Burlington Rep. Linda Myers (R) Chittenden-8-1 Community Health Centers of Burlington Rep. (D) Windsor-4-2 Sen. Richard McCormack (D) Windsor District Planned Parenthood of Northern New England Closest FQHC is Springfield Medical Care Systems Sen. (D) Windsor District Vermont Coalition of Clinics for the Uninsured Closest FQHC is Springfield Medical Care Systems Closest FQHC is Little Rivers Health Care Rep. Patricia McCoy (R) Rutland-1 Community Health Centers of the Rutland Region Rep. (R) Lamoille-Washington Sen. Virginia Lyons (D) Chittenden District Community Health Centers of Burlington Community Health Centers of Burlington Rep. James McCullough (D) Chittenden-2 Community Health Services of the Lamoille Valley Community Health Centers of Burlington Community Health Centers of Burlington Northern Counties Health Care Planned Parenthood of Northern New England Rep. Terry Macaig (D) Chittenden-2 Rep. Terry Norris (I) Addison-Rutland Community Health Centers of Burlington Rep. Francis McFaun (R) Washington-2 Community Health Centers of the Rutland Region Planned Parenthood of Northern New England Community Health Centers of Burlington Mountain Health Center The Health Center Sen. Mark MacDonald (D) Orange District Rep. (D) Lamoille-2 Gifford Health Care Rep. Alice Miller (D) Bennington-3 Community Health Services of the Lamoille Valley Little Rivers Health Care Battenkill Valley Health Center Planned Parenthood of Northern New England

Rep. (R) Orleans-2 Rep. (D) Chittenden-6-1 Planned Parenthood of Northern New England Community Health Centers of Burlington 37 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Rep. Jean O'Sullivan (D) Chittenden-6-2 Rep. David Potter (D) Rutland-2 Sen. Richard Sears (D) Bennington District Community Health Centers of Burlington Community Health Centers of the Rutland Region Battenkill Valley Health Center Planned Parenthood of Northern New England Vermont Coalition of Clinics for the Uninsured Rep. (D) Chittenden-7-2 Rep. David Sharpe (D) Addison-4 Community Health Centers of Burlington Mountain Health Center Rep. (I) Windham-Bennington-Windsor Battenkill Valley Health Center Rep. Connie Quimby (R) Essex-Caledonia Rep. (R) Rutland-6 Grace Cottage Family Health & Hospital Northern Counties Health Care Community Health Centers of the Rutland Region Springfield Medical Care Systems Rep. (D) Chittenden-6-6 Rep. (D) Addison-1 Rep. (R) Franklin-3-1 Community Health Centers of Burlington Community Health Centers of Burlington Northern Tier Center for Health Mountain Health Center Planned Parenthood of Northern New England Rep. Edward Read (I) Washington-7 Planned Parenthood of Northern New England The Health Center Vermont Coalition of Clinics for the Uninsured Rep. (D) Windham-3 Grace Cottage Family Health & Hospital Sen. John Rodgers (D) Essex-Orleans District Rep. (I) Windham-Bennington Springfield Medical Care Systems Northern Counties Health Care Battenkill Valley Health Center Grace Cottage Family Health & Hospital Rep. (R) Franklin-5 Rep. (R) Franklin-1 Northern Tier Center for Health Community Health Centers of Burlington Sen. (D) Chittenden District Northern Tier Center for Health Community Health Centers of Burlington Sen. Christopher Pearson (P)/(D) Chittenden District Community Health Centers of Burlington Rep. Brian Savage (R) Franklin-4 Rep. Brian Smith (R) Orleans-1 Northern Tier Center for Health Northern Counties Health Care Rep. Paul Poirier (I) Washington-3 Planned Parenthood of Northern New England Rep. (D) Addison-1 Rep. Harvey Smith (R) Addison-5 Vermont Coalition of Clinics for the Uninsured Community Health Centers of Burlington Mountain Health Center Closest FQHC is The Health Center Mountain Health Center Planned Parenthood of Northern New England Sen. (R) Rutland District Sen. (P)/(D) Washington District Vermont Coalition of Clinics for the Uninsured Community Health Centers of the Rutland Region Community Health Centers of Burlington Gifford Health Care Rep. (R) Lamoille-1 Rep. (D) Chittenden-3 Northern Counties Health Care Community Health Services of the Lamoille Valley Community Health Centers of Burlington The Health Center

38 Return to Bi-State’s Vermont Member Legislative Representation List – Biennium 2017-2018 Table of Contents

Sen. Robert Starr (D) Essex-Orleans District Rep. (D) Chittenden-7-4 Sen. (D) Windham District Northern Counties Health Care Community Health Centers of Burlington Springfield Medical Care Systems

Rep. Thomas Stevens (D) Washington-Chittenden Rep. Matthew Trieber (D) Windham-3 Rep. (R) Caledonia-3 Community Health Centers of Burlington Grace Cottage Family Health & Hospital Northern Counties Health Care The Health Center Springfield Medical Care Systems Planned Parenthood of Northern New England

Rep. (R) Orleans-Caledonia Rep. Joseph Troiano (D) Caledonia-2 Rep. Theresa Wood (D) Washington-Chittenden Northern Counties Health Care Northern Counties Health Care Community Health Centers of Burlington The Health Center Rep. (D) Windham-2-1 Rep. Donald Turner (R) Chittenden-10 Grace Cottage Family Health & Hospital Community Health Centers of Burlington Rep. (R) Chittenden-6-1 Closest FQHC is Springfield Medical Care Systems Community Health Centers of Burlington Rep. (R) Addison-3 Rep. Linda Sullivan (D) Bennington-Rutland Community Health Centers of Burlington Rep. (D) Lamoille-Washington Community Health Centers of the Rutland Region Community Health Centers of the Rutland Region Community Health Centers of Burlington Mountain Health Center Community Health Services of the Lamoille Valley Rep. Mary Sullivan (D) Chittenden-6-5 Northern Counties Health Care Community Health Centers of Burlington Rep. (R) Orleans-2 Planned Parenthood of Northern New England Rep. (D) Chittenden-4-1 Rep. (D) Chittenden-9-1 Community Health Centers of Burlington Community Health Centers of Burlington Rep. (D) Washington-3 Planned Parenthood of Northern New England Rep. Sam Young (D) Orleans-Caledonia Rep. Thomas Terenzini (R) Rutland-4 Vermont Coalition of Clinics for the Uninsured Northern Counties Health Care Community Health Centers of the Rutland Region Closest FQHC is The Health Center

Rep. (D) Chittenden-3 Rep. (D) Chittenden-5-1 Community Health Centers of Burlington Community Health Centers of Burlington

Rep. (D) Windham-2-3 Rep. (P) Franklin-7 Grace Cottage Family Health & Hospital Northern Tier Center for Health Closest FQHC is Springfield Medical Care Systems Sen. Richard Westman (R) Lamoille District Rep. Kitty Toll (D) Caledonia-Washington Community Health Services of the Lamoille Valley Northern Counties Health Care The Health Center 39 Return to Acknowledgements Table of Contents

Special thanks to our Vermont members for providing high quality health care in their communities.

We welcome your questions.

For more information, please contact –

Georgia Maheras, Esq. Director of Vermont Public Policy Bi-State Primary Care Association 61 Elm Street Montpelier, Vermont 05602 (802) 229-0002 ext. 218 [email protected] www.bistatepca.org

40