BRATTLEBORO—The story of Windham County’s response to the COVID-19 pandemic has one of collaboration, improvisation, and cooperation.
That story was told to U.S. Rep. Peter Welch, D-Vt., during a June 4 visit to Brattleboro Memorial Hospital.
It was told, in the room where BMH has vaccinated more than 20,000 people since last December, by some of the people who led the response, such as Josh Davis, executive director of Groundworks Collaborative; Drew Hazelton, chief of operations at Rescue Inc.; Brattleboro Retreat CEO Louis Josephson; and Wichie Artu, the vice president of the Windham County chapter of the NAACP.
They were joined by key BMH personnel such as Chief Operating Officer Eilidh Pederson; Dr. Jennifer Funaioli-Sheehan, director of acute care for nursing homes and assisted living facilities; and Matt Dove, a psychiatric nurse practitioner in the emergency department.
As the pandemic winds down in Vermont, Welch’s visit marked both an opportunity to review the remarkable achievements of local service providers as well as a chance for some of those same providers to remind the federal lawmaker how much is needed to maintain services to the most vulnerable populations in the post-pandemic era.
A temporary end to homelessness
The pandemic inadvertently gave Groundworks and other agencies an opportunity to do something that Davis called “unprecedented.”
“For a brief moment, we accomplished something that we as advocates have been working toward for years,” Davis said. “Everybody in the state had access to shelter.”
The state paid motel owners to house people without shelter during the pandemic, but Davis said funding for the program ends July 1, putting people back on the streets.
The Windham & Windsor Housing Trust recently turned the former Dalem’s Chalet in West Brattleboro into supportive transitional housing, similar to what the Housing Trust did in converting the former Lamplighter Inn Motel into Great River Terrace.
Providing stable housing to those who don’t have it is a good start, Davis said, but more help is needed in the Brattleboro area.
“Despite unprecedented resources designed to support people exiting the motel program to housing — including subsidies, support services, and move-in resources — there simply are not available places for people to rent,” he said.
Dealing with people in crisis during a crisis
In normal times, getting help to people with mental health issues or substance abuse problems is challenging. The pandemic made it even harder.
Groundworks, together with BMH, the Retreat, and Health Care and Rehabilitation Services, a nonprofit community mental health and developmental services center, collaborated on a new program, Healthworks, to serve people who needed help the most.
Dove, who was a key member of that initiative, said that “it wasn’t about how patients access care, it was about how care can access patients. We are moving the dial on improving the health of the most vulnerable and marginalized.”
People who had gone years without seeing a doctor were finally getting the medical attention they needed through Healthworks, and Dove told Welch that additional aid from the federal government would ensure that the program can continue after the pandemic.
Dove said that “for less than the cost of one [emergency department] visit, we could fund an entire month of services that includes doctors, nurses, social workers, and case managers.”
Josephson said the Retreat — which has lost approximately 125 staffers since March 2020 — managed to get through the pandemic but fears that “a tsunami of mental health needs [will be] headed our way” and that the psychiatric hospital will not be able to handle it.
Right now, he said, the Retreat is operating at about half of its usual inpatient levels.
“We’ve got the [physical] capacity; I need the people,” Josephson said, adding that inpatient care during the pandemic “went way down.”
“People were staying home, suffering from home, not getting care,” he said.
Avoiding the worst in long-term-care facilities
Funaioli-Sheehan said that of all the Vermonters who were at risk for COVID-19, the most vulnerable were the residents of nursing homes and long-term-care facilities.
“Almost every day during the pandemic, we would be hearing on the news about nursing homes and the death tolls,” she said, adding that the facilities in Windham County “recognized immediately” the threat and came up with an action plan to deal with it.
“We got all the area nursing homes, assisted living facilities, and residential facilities together and met on a twice-weekly basis for pretty much an entire year,” Funaioli-Sheehan said.
She said the goal of those meetings were for key staffers to get together, support one another, and mobilize and share resources to keep the patients and residents in these facilities safe.
With state and federal rules and regulations changing “almost daily,” she said that pooling the collective expertise of local facilities was critical.
Long-term-care facilities in Windham County were under lockdown for most of the past year, Funaioli-Sheehan said, and rigorous testing programs for staff were put in place.
As a result, she said, no big outbreaks of the virus erupted locally. Only one facility, Holton Home in Brattleboro, had multiple cases of Covid, which led to the death of one resident in January — the only fatality inside a Windham County facility during the pandemic, she said.
Funaioli-Sheehan said the pandemic has led to closer alliances between BMH and local long-term-care facilities, “so if we are ever faced with something of this nature again, we know all of us can come together and have a plan of attack when it comes to keeping these patients safe.”
Getting the shots where they’re needed
Vermont has been one of the top states in the country for vaccinations. One reason is the work of emergency medical services (EMS) personnel.
Hazelton said Rescue Inc. and other EMS agencies around Vermont were enlisted to deliver vaccines to vulnerable populations unable to go to central vaccination sites. He estimates that Rescue personnel traveled 50,000 miles to bring vaccines to 5,000 people in southern Vermont and southwest New Hampshire.
Rescue also joined other EMS agencies to set up clinics for what Hazelton called “hard to reach people” in settings across the state, including mobile home parks, nursing homes, probation and parole offices, homeless shelters, highway rest areas and state parks.
All this was done, Hazelton said, while EMS agencies statewide lost 20 percent of their workforce in 2020.
“Unfortunately, all EMS education was stopped during the pandemic,” he said. “There’s nobody coming in to EMS in Vermont right now.” [Editor’s note: Grafton Rescue Squad delivered first responders’ training to 15 area personnel despite the pandemic, for which the squad’s president, Keith Hermiz, was honored by the Vermont Department of Health.]
Artu said it took time for the state to see there were disparities in case counts and access to care for Vermont’s BIPOC (Black, Indigenous, and people of color) community. One way of bridging that gap came when the NAACP and other organizations, working with the Vermont Department of Health, arranged for vaccination clinics for BIPOC residents and their families in southern Vermont.
He said these clinics vaccinated 1,145 people, with 86 percent of recipients and their families identifying as BIPOC. “The biggest thing that I have found for people being able to have access to vaccines is breaking down barriers,” Artu said.
From providing rides to clinics to having someone to talk to one-to one about vaccine concerns, Artu said everyone involved in the vaccine effort played a part in getting out the vaccine and building trust among those who were going to get their shot.
He said it is also helpful that the vaccines are being delivered free, without recipients having to deal with insurance companies.
Artu credited the collaboration among all the service providers for getting Windham County through the pandemic, and he told Welch that giving the local agencies the freedom to collaborate and help those in need is the most important thing, next to providing more funding, that the federal government can do.
“We are on the ground, and we know their needs and can talk to them,” he said.
The power of community
Speaking to the agency heads, Welch said that “it’s truly humbling to listen to you and hear what you did. There was no roadmap.”
“Everybody had to find a way, and you had to do it when you were getting the same warnings about how contagious and how fatal this disease was,” he continued. “You had a lot of responsibility for the people who were depending on you.”
Welch said the biggest lesson from the pandemic was that “we need community and we need institutions that are going to be there in an emergency to help folks get through.”
While he admitted that the fractious political atmosphere in Washington has made governing difficult, Welch told the agency heads that “our job is not as tough as your job.”
He said the work of the Vermont congressional delegation is simple — “to get the [federal] resources back to the state” and to give local institutions the flexibility to use those resources where they can do the most good with the least amount of hassle.
“We have a lot more work to do,” Welch said, “but what’s inspiring is how the people in this room took the resources that were available and figured out how to execute a plan. It really has saved lives and has reinforced the importance of community.”