Grace Cottage Family Health & Hospital Board chair and president Martha Dale.
Randolph T. Holhut/The Commons
Grace Cottage Family Health & Hospital Board chair and president Martha Dale.

State’s smallest hospital makes big economic impact

With a $33 million budget, Grace Cottage Family Health & Hospital works to keep as much of that money as possible in its underserved, rural economy

TOWNSHEND-The people of the West River Valley love Grace Cottage Family Health & Hospital for its role in providing health care to this underserved rural area, but they might not realize the economic contribution it makes to the region.

While Grace Cottage - by numerous metrics, the smallest hospital in Vermont - relies on philanthropy to continue providing its services, it also pours a significant amount of money back into Windham County.

Founded in 1949, Grace Cottage offers a small, 19-bed hospital; a recently updated 24-hour emergency room; a laboratory; a pharmacy; a rural health clinic with 13 primary care providers who provide more than 30,000 patient visits per year; in-patient and out-patient physical and occupational therapy; and a hospice room.

"As the largest employer in Windham County outside of Brattleboro, we currently employ 229 individuals," said CEO and president Doug DiVello. "Most of these employees live within a short distance of Grace Cottage, shop locally, and have a significant impact on the region's economy."

Of those employees, 169 are full-time, 17 are part-time, and 43 are per diem.

All together, Grace Cottage, Brattleboro Memorial Hospital, and the Brattleboro Retreat employ the largest percentage of employees in any single sector - in this case health care - in Windham County.

The staff has a strong sense of devotion to the hospital. For the second year in a row, it was named Vermont's Best Place to Work in the medium-sized business category by Vermont Business Magazine and the Vermont Chamber of Commerce.

Approximately 75% of the hospital's $33 million budget will be spent on salaries. That ought to mean a significant amount of money for those 229 employees to put into the many local businesses of Windham County, New Hampshire, or wherever they live.

But where they live might not be where they want to live, because Windham County has a serious housing shortage at the moment.

"The number one question that somebody who's considering a job has is, 'Can I find housing nearby?'" said Grace Cottage Board Chair and President Martha Dale.

"And it is a challenge," she continued. "I don't know the geographic distribution of our staff, but I know a fair number travel over from New Hampshire. They come from all around."

Dale is sure that some Grace Cottage people commute as long as an hour "because either that's where they wanted to live or where they found housing or whatever. So, yes, it's a major issue."

The issue has become even more critical because Grace Cottage is now recruiting for a new president and CEO to replace DiVello, who will retire on Sept. 30.

"Right now we're doing a search, and housing and relocation is a major factor for anybody we're going to attract to that position," Dale said, explaining that "you can sell a position and the challenges and the vision of the organization as best as you can."

"But somebody who's making a choice to to throw their hat in the ring to be considered as a candidate is also going to going to want to know what the likelihood is that they're going to find a house in their price range," she continued.

Prospective employees, Dale added, "also want to know if they're going to find a house where their kids can go to school and where their spouses can work."

"All of these tend to factor in," she said.

A new clinic

Grace Cottage's current health clinic is crammed into two old houses built in the 1840s and is bursting at the seams. In 2018, it had 21,000 individual patient visits, which grew to 31,000 visits in 2022.

The hospital is trying to raise $20 million to build a new primary care clinic and broaden its services.

It hopes to submit its Act 250 application in June for a proposed 23,000-square-foot accessible building, with improved parking and easier access to the hospital's lab and diagnostic services. If things go well, the hospital hopes to break ground in spring 2025.

At the beginning of April, U.S. Rep. Becca Balint, D-Vt., was able to secure an additional $1.5 million in federal funding for the project, which has now raised $7.8 million.

"As long as we have targeted congressional spending like this in the appropriations process, it enables us in Congress to work together as Democrats and Republicans," Balint said when she made the announcement.

"So much has fallen apart in Congress, so many things have made it so difficult for us to work together, and having this congressional spending going directly to people's communities is a signal that, first of all, we are remembering that the most important people are the people back home," she continued. "And secondly, that government can actually work for people."

In constructing the new clinic, Grace Cottage will try to spend as much of the $20 million as it can in Windham County; this is also part of its ability to be an important economic driver in the West River Valley.

"My hope is that we can employ local contractors and workers in the building of this, that we can purchase products locally, or as locally as we can," Dale said. "With the engineers and regulatory specialists that we hire for this project, we're trying to find the best qualified as near geographically to our service area as we can."

Buy local

For the 25% of the annual budget not committed to salaries, the hospital tries to spend locally when it can.

It uses Brunelle & Son Construction, based in Brattleboro; DeCamp Plumbing and Heating, of Putney; and Lawrence & Lober Electric, of Rockingham - "just off the top of my head, all local vendors," said Andrea Seaton, senior director of development, marketing, and community relations.

"We'd be happy to buy more, but there's not much that we can buy locally - not sheets and pillows, medicines, computer networks, or TVs," she said.

The hospital also procures building materials from WW Building Supply in Newfane and Wilmington (whose owner, Ed Druke, also serves on the Grace Cottage board of trustees as vice president). It source food from Townshend-based River Bend Farm Market, although it uses US Foods, based in New York, "for most of our food for patients and employees," Seaton said.

In all, Grace Cottage spends money with 60 local businesses.

Over the past year, Grace Cottage has contracted locally for rubbish removal, new construction, advertising, and tent rentals with local vendors, and the hospital contributes to the Townshend Cemetery Commission. It purchased mulch from the Vermont Mulch Company, services from the Richards Group, and paint from Sherwin Williams, all in Brattleboro.

KitKat's Embroidery is a sole-proprietor shop in Chester; the owner makes flags and silkscreens T-shirts and hats for events such as the hospital's Health Golf Tournament and its Fair Day.

"We could send the jobs out to some big multinational corporation, but we don't," said Charma Bonanno, the hospital's associate director of development, marketing, and community relations. "We want to keep it local when we can."

Grace Cottage pays for membership in the Windham Solid Waste Management District, which is also in Brattleboro. It is a sponsor of the golf tournaments of both Brattleboro Memorial Hospital and the Winston L. Prouty Center for Child and Family Development, which, in turn, sponsor Grace Cottage's golf tournament at the Haystack Golf Club in Wilmington.

Green Mountain Power is another vendor from the region, as are Best Septic, Miller Milk, and Abatem Exterminating.

An economic challenge to the community

Dale considers Grace Cottage's very existence to be an economic driver. But in a larger sense, Grace Cottage challenges its community, especially Townshend, to think about its infrastructure.

"Whenever you engage in community infrastructure projects, or buildings, or whatever, you are ultimately going to enhance the grand list," Dale said.

"But in a more demonstrable way, you're going to enhance the development potential in your community," she noted. "And I think whatever Grace Cottage engages in that, it encourages the towns that it serves to think about their infrastructure-building."

Such a project, Dale added, is "ultimately going to have a positive impact on those communities themselves."

"It increases the potential for other developments and the like," she said.

This News item by Joyce Marcel was written for The Commons.

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