Healthcare Heroes Greater New Haven 2014

HEROE

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CONGRATULATIONS A healthy community starts with a healthy commitment.

That’s why we applaud Business New Haven’s 2009 Healthcare Heroes.

Their vision and leadership improve the quality of life in our community.

Dr. David Rosenblum on being named a Healthcare Hero.

After all, a healthy community is everyone’s responsibility. We believe all of us working together can help to make our community stronger … better … healthier.

And we’re just committed to doing our part.

February/March 2014

With Support From Gaylord Hospital | Gaylord Outpatient Services | www.gaylord.org

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Heroes for Life M

eet the Health-Care Heroes Class of 2014. They are doctors, nurses, educators, researchers, administrators, volunteers. They come from many different places and backgrounds, and their work is performed in venues ranging from community health clinics to corporate boardrooms.

Publisher Mitchell Young Editor Michael C. Bingham Advertising Manager Mary W. Beard Senior Publisher’s Representative Roberta Harris Publisher’s Representative Gina Gazvoda Robin Ungaro Gordon Weingarth Contributors Felicia Hunter, John Mordecai Karen Singer, Tom Violante Photography Dominick Cenotti, Tom Violante Healthcare Heroes: Publshed February 2014 in Business New Haven and March New Haven magazine. and at www. conntact.com Business New Haven and New Haven magazine are publications of Second Wind Media, Ltd., with offices at 20 Grand Avenue, New Haven, CT 06513. Telephone (203) 7813480. Fax (203) 781-3482. Second Wind Media, Ltd., d/b/a Business New Haven, New Haven magazine shall not be liable for failure to publish an ad or for typographical errors or errors in publication. email: support@conntact.com

What they have in common is a deep respect for the value of human life, and have devoted not only their careers but their lives to preserving and enhancing it.

One of these is Steven Wolfson, the cardiologist and public-health advocate who was instrumental in establishing Project Access-New Haven in his home city. Established in 2010, PA-NH provides quality care to uninsured patients and undocumented workers who otherwise would have to rely solely on hospital emergency-room care in times of medical crisis. In addition PA-NH staff help clients — many of whom have low medical literacy and/or poor grasp of English — to navigate a complex health-care bureaucracy.

Speaking of those in need, the Weigh To Live program, a collaboration of Chapel Haven and the Cornell Scott-Hill Health Center in New Haven, helps adults with developmental and/or social disabilities to make better diet and lifestyle choices and thereby lead healthier lives.

Also doing important work on the education front is Michael Corjulo, coordinator of school health services for Area Cooperative Educational Services (ACES), who has been instrumental in helping to bring skilled, compassionate nursing care into area public schools.

With this issue, we also say goodbye to a remarkable doctor who passed away recently, and whose like we may not see again. The premature passing of obstetrician Joel Silidker last July has left a whole in the hearts of his many patients who came to rely on his compassionate care, as well as the countless residents and medical students he taught and mentored, earning well-deserved teaching awards literally too numerous to mention.

He will be missed.

We hoping you enjoy reading the stories of all the 2014 Health-Care Heroes in the pages that follow.

— Michael C. Bingham Editor

CONGRATULATIONS

Dr. David Rosenblum on being named a Healthcare Hero.

Gaylord Hospital | Gaylord Outpatient Services | www.gaylord.org 2

HEALTHCARE HEROES 2014

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CORPORATE ACHIEVEMENT Visiting Nurse Association of SouthCentral Connecticut John Quinn, CEO

A Core Mission of Caring The Visiting Nurse Association marks a milestone in community service

I

t’s the kind of community service that could easily be taken for granted. But if the Visiting Nurse Association of South Central Connecticut did not exist, a significant number of people might be left without adequate health care.

“The next level after that is hospice.

We are not a hospice,” says Quinn.

“But we do provide a lot of services for a person going through a lot of pain management.” Collaborations with some area hospices are a future possibility, he adds.

“I think the need has always been there for home health care,” says John Quinn, CEO of VNASCC. The organization celebrates its 110th anniversary this year. There’s a definite reason for its longevity, says Quinn.

The total VNASCC staff numbers about 170, including some per-diem workers.

Included in the total staff are about 50 nurses, 20 home health aides, seven physical therapists and three social workers.

“It’s flourished because it’s kept to its mission, and that’s to serve the community at large,” he explains.

Simply, “We provide care of the ill.”

Quinn touts VNASCC’s board of directors, also, as an invaluable resource for the organization.

“It’s a good mix of people, and they really understand [VNASCC’s challenges],” he says, “so I’m really appreciative to the board of directors.”

But sometimes it hasn’t been so simple. Take for example when grants are lost or other revenue streams dry up. That happened recently when the United Way of Greater New Haven dropped funding that helped pay for subsidized care, a major VNASCC need, says Quinn.

When such incidents occur, some shifting and redistribution of resources have to take place. In the case of funding for subsidized care, the United Way of Milford and the Valley United Way were able to offer support for their respective residents.

Many of those subsidized-care dollars are used for senior-care services.

“That’s one of our big, big needs, for those 65 and over,” says Quinn.

The possible loss of grant funding isn’t the only financial hurdle that VNASCC sometimes must face. There are also systemic impediments with programs such as Medicare, when lowered reimbursement payments or increased senior copays are proposed.

A former legislator (he was a Connecticut state representative from 1974 to 1983) Quinn is fully aware of the reasons behind such potential actions.

“I can see why. There’s a lot of fraud,” he notes, adding that the jury is still out on what impact the Affordable Care Act will have on the quality, consistency and duration of care for VNASCC’s home-based clients. For example, 4

In addition to providing health care directly to clients, VNASCC staff members contribute to the community in other ways, says Quinn. One nurse, for example, started a grocery-donation program, Pam’s Pantry, after learning that VNASCC staff discovered bare cupboards when visiting patients.

John Quinn, VNA CEO

questions about if and how ACA would offset changes in Medicare have yet to be answered.

VNASCC, a client’s average hospital stay would likely be much longer, Quinn says.

Quinn employs his political experience to advocate for VNASCC and its clients regarding such issues; he is a registered lobbyist on behalf of the agency.

“The first thing we do, for everybody, is to have a very significant needs assessment.” For example, on an initial visit a nurse would evaluate all of the medications a patient is taking and review them for necessity, among other duties.

Founded in 1904, the organization provides home health care to patients who otherwise might have to be admitted to the hospital and/or would suffer from lack of care or post-hospital follow-up. VNASCC’s largest referral source is Yale-New Haven Hospital.

VNASCC nurses are skilled to care for clients with needs stemming from cancer, cardiac recovery, IV infusion, wounds, behavioral disorders, chronic illnesses and more.

“The big goal of Medicare, and all health care, is to reduce the 30-day readmission [rate],” Quinn says, explaining the process to receive VNA services.

“Sometimes people with diabetes, we have to help them give themselves insulin,” say Quinn. Nurses also assist mothers who recently gave birth to care for themselves and their newborns.

“There has to be a doctor’s order through a referral,” he says. Without home health-care services such as

Additional specialized programs include palliative care for advanced illnesses.

“We find a lot of patients don’t have food,” notes Quinn. Over the past year 95 food baskets were given out. Pam’s Pantry also supports a Christmas gift-giving program. Staff members selected a present off of a tree and the gift was delivered to a patient.

The relationship between patients and VNASCC staff is such that patients actually become protective of their caregivers — urging them not to come for a scheduled visit in inclement weather, for example.

But that is part of the inherent nature of VNASCC, and one of the reasons the organization is so effective, says Quinn.

“Our field staff goes out in every weather condition. Snowstorm, hurricane, they go out to their patients,” he notes. “They’re professional, they respect the patient, and they worry about the patient’s pain.

These are the truest heroes.”

— Felicia Hunter

HEALTHCARE HEROES 2014

The Visiting Nurse Association of South Central Connecticut, Inc. 1904—2014

Happy 110th Anniversary We are honored to receive the Health Care Hero’s Corporate Achievement Award for 2014. We thank our community partners for putting their trust in the professional home care service of the Visiting Nurse Association of South Central CT, Inc. We celebrate with all our current and past patients who receive the best care everyday in everyway!

Ask for us by name Not all VNA’s are the same!

Have your doctor call the VNA/SCC when you or a loved one needs home care.

Robert H. Motley Board Chair

Home Health Care Experts

www.VNASCC.org

John R. Quinn

President & CEO

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INDIVIDUAL OF MERIT David I. Scheer Scheer & Co. Inc.

Man in the Middle Investor/entrepreneur Scheer helps Achillion Pharmaceuticals navigate the brave new world of commercialization

Chairman, Achillion Pharmaceuticals

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Theatre for the past 12 years, founded the theater’s Global Health and the Arts series with Yale University.

avid I. Scheer may not be someone with whom many people are familiar. In fact, he has largely (and consciously) avoided the limelight, working behind the scenes to found, co-found, acquire funding for and build some of the region’s biggest and most famous contributors to the Northeast’s bioscience industry.

He is president of Scheer & Co. Inc., a firm founded in 1981, with activities in venture capital, corporate strategy and transactional advisory services focused on the life sciences. That’s a modest opener for him because his list of accomplishments is dizzying, to say the least. Scheer is a founder and past member of the boards of directors of ViroPharma Inc., OraPharma Inc. (acquired by Johnson & Johnson in 2003), Esperion Therapeutics Inc. (acquired in 2004 by Pfizer), Aegerion Pharmaceuticals, Tengion Inc., Axerion Therapeutics and Optherion Inc., all of which he is or has chaired.

From 1991 through 1999 Scheer was affiliated with the health-care investing team at Oak Investment Partners and has also led or played significant roles in a series of transactions involving corporate alliances, licensing arrangements, divestitures, acquisitions and mergers in the life sciences. He has served as a member of the Leadership Council of the Harvard School of Public Health and the Advisory Committee to the Harvard Malaria Initiative. He has helped to launch and served as chairman of the Executive Committee for “The Unfinished Agenda in Infectious Diseases,” an initiative at the Harvard School of Public Health focusing on neglected diseases.

Scheer has also been a member of the Global Advisory Council for AIDS@30 and an advisor for the Global Task Force for Expanding Cancer Care and Control in the Developing World, both of which are Harvard-affiliated initiatives. He also serves as an advisor to the Rett Syndrome Research Trust.

In 2007, he was awarded the Atlas Award for Venture Capital from Connecticut United for Research Excellence (CURE), representing the 6

“What we do each year with Global Health and the Arts is identify a topic in public or global health and convene a high-level symposium at the theater in collaboration with Yale,” Scheer explains. “We bring an array of academic and industrial thought leaders together to discuss the nature of these challenges and some avenues for innovation and solutions.” Previous symposia have covered HIV, cancer, Alzheimer’s disease, mental illness and obesity. The 2014 event will focus on tobacco and addiction.

“New Haven has something that is extremely important,” says Scheer.

“It has a university of great renown in terms of science, engineering, medicine, public health, translational research, business and law. This is an exceptional place to live .”

Photo:Tom Violante

state’s bioscience industry, of which Scheer also serves as a member of the board of directors and its executive committee. In 2009, he received the Venture Capital Leadership Award from the Connecticut Venture Group.

In 2013, he received the Yale Science and Engineering Association Award for Distinguished Service to Industry, Commerce and Education.

But in New Haven he is best known for his role as non-executive chairman and co-founder of Achillion Pharmaceuticals, located at 300 George Street, one of the original life-sciences firms at the tip of the spear of the Elm City’s entry into the biotechnology industry.

“We named it ‘Achillion’ because we wanted to pick up on the notion of the Achilles heel,” explains Scheer, who earned an AB in biochemical sciences from Harvard College, and an MS in cell, molecular and developmental biology from Yale. “We were trying to find the Achilles heel of either bacteria or viruses to develop drugs to treat conditions that resulted from these infectious agents. Find the Achilles heel and, if you can, you can come up with the next generation of really good drugs, in order to get beyond drug resistance in these classes of drugs.”

In 2000, Achillion partnered with the Yale School of Medicine, which had identified assets related to treating viral diseases including HIV, Hepatitis B and Epstein-Barr, among others. He essentially restarted the company with the newly acquired compounds to fight HIV with a drug called Elvucitabine.

The drug made it through Phase II testing but got to the market late and will be commercialized by a company in China.

After startup chief executive William Rice left Achillion, Michael Kishbauch, who had worked with Scheer as CEO of another company, OraPharma, was recruited as CEO. Although he retired last year, he continues to serve on the company’s board. Milind Deshpande, who had been in charge of the company’s research and development, was recruited from within the company and is its current president and CEO. “Achillion, as a New Haven-based company, has generated high-quality jobs in the area and we’re proud of that,” says Scheer. “Drug development is a very tough field to be in. Even though we’ve had some great success, in some ways, we are still navigating through some interesting challenges.

Scheer, who has served as vice chairman of the board of Long Wharf

Scheer describes New Haven as a tractable, accessible community.

“You can get to know the right people and, if you want to make a difference, you can — whether it’s in terms of access to people at Yale or in terms of not-for-profit work. There is a cadre of people here [who are] incredibly committed to helping others and keeping our artistic and cultural institutions alive. From a healthcare perspective, we have amazing resources in terms of Yale-New Haven Hospital and Yale Medical School.”

Scheer notes that New Haven’s biotech industry may not have the same critical mass as some other cities, but will continue to advance with the continued success of its companies, including Achillion, Alexion.

“Because, at the end of the day, what any of us aspire to do is to help people, to have the fruits of our work be measured — not necessarily in terms of dollars, but in terms of how we can positively change the lives of people in whatever dimension, whether it’s cultural environment, health care, science or education,” says Scheer.

“That’s the legacy that any of us who work as entrepreneurs should aspire to achieve.”

– Thomas R. Violante HEALTHCARE HEROES 2014

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EDUCATOR OF THE YEAR Michael Corjulo Area Cooperative Educational Services (ACES), North Haven .

A Breath of Fresh Air Bringing skilled, compassionate nursing care into public schools

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ducation and health care do not necessarily go hand in hand, says Michael Corjulo. There are clinical protocols to consider, not to mention state health-care regulations and individual school guidelines.

“I said, yeah, I think I can do this,” he recalls of the experience.

Corjulo studied nursing at Southern Connecticut State University, earning a bachelor’s degree in 1983. ACES maintains a mutual-benefit relationship with Corjulo’s alma mater. Nursing students are part of the rotation one day each week for up to eight weeks.

Corjulo should know. As coordinator of school health services for Area Cooperative Educational Services (ACES), Corjulo is responsible for anticipating and addressing the health needs of students on a daily basis.

“We’re a clinical site, a clinical partner with SCSU, so we have a partnership regarding the nursing students,” he notes.

“One of the big challenges is, we’re trying to implement safe and effective health care in an educational model,” Corjulo explains. It could be an uncomfortable fit, he says, noting that “[Health care] is not inherent in an educational model.”

Several years after graduating from SCSU, Corjulo returned to school, this time at Yale, where he earned a master’s degree in nursing in 1998.

That decision opened a number of career doors, he says.

However, good health is an important prerequisite for academic success, says Corjulo.

“Health affects a student’s ability to learn,” he says. “If you’re trying to look at the big picture, if you’re trying to focus and concentrate,” heath plays a major role.

Corjulo supervises a team of nurses that tend to the health needs of students in ACES schools.

“We’re a private organization that runs a public school district,” says Corjulo about the collection of magnet and special-education schools that fall under the ACES umbrella. They are located in New Haven, Meriden, Hamden, North Haven and Northford.

All ACES schools are staffed by at least one registered nurse during the school day. In delivering nursing care, they adhere to guidelines established

by ACES, the National Association of School Nurses, the National League for Nurses and the American Academy of Pediatrics.

Sometimes going strictly by the book isn’t enough, however. Corjulo discovered that when he observed the number of children who were asthmatic, but for whom the ACES schools did not have plans from a student’s primary care physician for in-school care. He wanted to increase 8

Photo: Tom Violante

the number of so-called Asthma Action Plans that the school maintained.

At the outset of his quest, “We had 12 action plans for 300 kids” from eight physicians, notes Corjulo, explaining why an Asthma Action Plan is important.

“By having that, it really empowers the school nurse to be a much more effective member of the student’s school asthma team,” he says. “Then the school nurse has an actual, intelligent health-care plan. You don’t just learn from [only] the student.”

By reaching out to the physician, he says, “We’re facilitating health care.”

Corjulo made increasing the number of Asthma Action Plans maintained

by ACES a priority. He wrote a letter to every provider in the area.

Six weeks into the following school year the district had improved from a 3.8 percent Asthma Action Plan participation rate to between 58 and

60 percent. He’s especially proud of Wintergreen School, a K-8 interdistrict magnet school with 640 students, located in Hamden.

“There are 90 kids there with asthma.

Out of that, we [ended up with] 88 Asthma Action Plans,” he notes.

The development demonstrates the need for a strong school-physician partnership, says Corjulo, adding that it lets physicians know that “We’re not just putting on Band-Aids. We’re an extension of your practice.”

Coincidentally, Corjulo suffers from asthma himself. But that’s not why he chose health care as a career.

Growing up in Rockland County, N.Y., he enjoyed studying the sciences in school.

“I did really well in biology,” he recalls.

“I was more interested in that type of subject than math.” He later took a part-time job as an orderly at a hospital.

In addition to his work at ACES, Corjulo is a lecturer at the Yale School of Nursing and a clinical educator at Yale-New Haven Hospital. On the legislative level he’s involved with the state’s Person-Centered Medical Home Committee. In addition, he is a primary-care pediatric nurse practitioner for the Children’s Medical Group in Hamden (his subspecialty is asthma education and management) and site director for Community Asthma Integrated Resources.

“You can make a case that a lot of kinds spend as much time in school as they do in any other areas of their lives,” Corjulo says. “Some have a chronic condition — asthma, for example — and you need to know that your asthma is well controlled,” he adds regarding the need for good school-based health care. He says it is incumbent upon the nurse to be as aware, direct and efficient as possible when providing health care.

“All of that time getting assessed and treated is time that they’re not in the classroom,” Corjulo notes. “That’s a big part [of the situation] that we appreciate from a health-care perspective.”

– Felicia Hunter HEALTHCARE HEROES 2014

CONGRATULATIONS MICHAEL CORJULO FROM ALL OF US AT CMG

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• Over 30 years of providing the highest-quality pediatric care to infants, children, and adolescents • Comprehensive asthma management and education • Certified lactation counseling • Cutting-edge technology in concussion management • Adolescent transition (life coach consultations) • Endocrine services on site • Evening and weekend hours for well and sick visits Interested in learning more?

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Maria DeLucia, DO, FAAP Laleh Ardeshirpour, MD, FAAP Michael Corjulo, APRN Jennifer Searles, APRN

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area cooperative Educational services Proudly congratulates

Michael corjulo, cPnP, aE-c

For receiving the Healthcare Heroes Education Award and salutes all of the Business New Haven Healthcare Heroes

I n n ovat or s I n E d u c at Io n

w w w.aces.org 9

COMMUNITY SERVICE Veterans Administration Hospital

Caring for Wounded Warriors VA Hospital’s community-care center helps veterans whose injuries go beyond the physical

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he Errera Community Care Center located at the Veterans Administration Hospital in West Haven, part of VA Connecticut, is an oasis of relative calm in the eye of the storm for veterans returning from the wars in Iraq and Afghanistan as well for as for older veterans who fought in Vietnam and Korea.

Photo:Tom Violante

The hospital provides a full range of patient-care services with state-of-theart technology and a renowned training and research program, according to Pamela R. Redmond, the center’s public-affairs director. VA Connecticut Healthcare System provides primary, secondary and tertiary care in medicine, geriatrics, neurology and psychiatry with an operating bed capacity of 216.

The system also provides services for mentally ill veterans, geriatrics rehabilitation and extended care, women’s health care, hospice and respite care, pharmacy services, dental care, psychological treatments, pastoral counseling, psychosocial support services, podiatry, prosthetics, same-day surgery, alcohol and substance abuse treatment, chiropractic treatment, dialysis and specialized services for diabetics.

Errera Center Director Laurie Harkness sees the faces of veterans young and old as they struggle to reclaim what most would consider “normal” lives following tours of duty.

“We are a community-based recovery center for people who have been struggling with mental illness and substance abuse with homelessness and with other significant psychosocial issues,” explains Harkness.

“These issues are caused either by their time in the military or life before or after their military experience.”

VA Connecticut provides services at nine locations, with campuses in West Haven and Newington, as well as six clinics in Danbury, New London, Stamford, Waterbury, Willimantic and Winsted. The U.S. Department of Veterans Affairs also offers combat-readjustment counseling at Vet Centers in Danbury, Rocky Hill, Norwich and West Haven. For 2013 in Connecticut, the medical care budget was $494,529,295. There were 59,023 10

“In December, we opened another 74 units of permanent housing,” adds Harkness. “We’re always looking to give people their own key for their own lease, and therefore their own life. We do outreach with our local universities and colleges to help soldiers be more successful when they try to go to school. The political support that we receive from our Connecticut legislative delegation, who frequently visit the center, is unbelievable. They are great advocates, both for veterans and also to make sure that we get the resources that we need. One of our clients just got a Habitat for Heroes house in Bridgeport, the first time since 2001. She and her three children can now live under the same roof.”

Harkness says that the center attracts patients from all over the country and the world seeking recovery-oriented services.

Errera Center Director, Laurie Harkness

unique patients, 2,909 female patients, 727,222 outpatient visits, and 5,430 total admissions with a 75-percent occupancy rate. In 2013, the center treated 4,785 veterans for mental health issues but has only 16 inpatient beds for mental-health patients.

“The majority of our veterans are still mostly over 55 and come from the wars in Vietnam and Korea, but a growing percentage are coming from the [1991] Gulf War and the Iraq and Afghanistan wars,” explains Harkness, who is also a clinical professor at the Yale School of Medicine. “We’re up to about 15 percent of young soldiers [from Iraq and Afghanistan], more and more of them each day. Our young returning soldiers don’t want to be patients — they want to be living their lives.”

Harkness adds that younger veterans, including some in their early 20s, are too proud to ask for help and are simply trying to get on with their lives, including going to school and and/or getting jobs.

“We provide all sorts of recoveryoriented services that include counseling, teaching life skills, housing searches, vocational services and case-management services,” says Harkness. The center, which opened

in 1994, is in the process of adding 20,000 additional square feet of space. A recent $10 million grant from the Department of Veterans Affairs will help to pay for augmenting the center’s services for homeless veterans, as well as expanding medical services, vocational services, employment services and life-skills services.

“We have 150 on staff, of which over half are veterans themselves,” Harkness explains. “This is very important because, in our country, there is no stronger bond than veteran to veteran.”

She adds that in 2013 more than 1,000 homeless veterans came into the center for the first time, including almost 200 who were heads of families as well as 100 young female veterans.

“Our job is to get them housed as soon as possible and back to living their dreams, working and going to school,” Harkness explains. “We place our staff social workers out in the courts to work with judges, prosecutors and public defenders so that our young soldiers coming home and getting into trouble can take advantage of our services to get treated rather than incarcerated.”

“We couldn’t do this without volunteers and without community partners,” she says. “They include Columbus House, Homes for the Brave, the Women’s Institute, the New Haven Community Loan Fund, AT&T and Connecticut Heroes Project, which is developing our statewide strategic plan to end homelessness.”

“We have some veterans who are 20 and 21,” says Harkness. “When they’re that young, they don’t want to admit that they have a mental illness or Post-Traumatic Stress Disorder [PTSD].

We teach people how to live with their mental illness. We teach them that, in spite of having PTSD or being depressed, you can still live a rich full life like the rest of us. They carry the motivation and we provide the support.

Our fleet of 63 vehicles goes out into the community every day to work with veterans where they live, because we want to teach them how to live in their community, not in an institution.”

She is proud of the fact that the center is a national model and has been recognized by Congress as a exemplar for the rehabilitation of war-weary veterans. It’s the first time a mentalhealth facility has been so honored.

“I love my job,” adds Harkness. “Can you tell?”

— Thomas R. Violante

HEALTHCARE HEROES 2014

DESIGN BUILDERS • GENERAL CONTRACTORS • CONSTRUCTION MANAGERS

Connecticut Health Care Construction Specialists CT Ortho Medical Facility, Branford 16,000 Square Feet, $2,000,000

PDS served in the role as General Contractor for this new multi-story outpatient surgery center. PDS met all department of health & safety standards. The project entailed 3 surgical rooms, recovery rooms, extensive medical gas, plumbing & equipment, complex interior finishes, secured regulatory approvals, and was a fast track completion.

Veterans Health Care Facility, Rocky Hill 90,000 Square Feet, $ 27,000,000

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PHYSICIAN OF THE YEAR David S. Rosenblum, MD

A Doctor Who Has Your Back Spinal-cord injury specialist David Rosenblum stops at nothing to improve the lives of his patients

Gaylord Specialty Healthcare Wallingford

P

inned to the bulletin board in the Niantic nursing home room where Cynthia Fiora lives is a photograph of a man who has played a central role in her life.

In 2012, Gaylord became one of 20 facilities in the world where patients can use the exoskeleton.

Research is one of Rosenblum’s priorities.

“He been heading up our effort to try to make sure that patient care is the latest and the best,” explains Alan Jette, MD, director of the New England Regional Spinal Cord Center. Rosenblum is a co-principal investigator with the center.

“If I point to the picture or ask Cynthia, ‘Who is that guy at Gaylord we love so much?’ she can’t speak but she will smile,” says Cynthia’s mother, Gloria Litsky.

The “guy” is David S. Rosenblum, MD, medical director of physical medicine and rehabilitation at Gaylord Specialty Healthcare in Wallingford, and director of its spinal-cord injury program. He’s a physiatrist, or medical doctor specializing in physical medicine, rehabilitation medicine and spinalcord injury medicine.

As director the Health & Disability Research Institute at the Boston University School of Public Health, Jette oversees a research program that spans nearly three decades.

“We’ve looked at things like pressure ulcers and ways to reduce depression,” Jette says. “Now we’re focused on advocacy, using a computer- based program to help people become stronger advocates with their primary care doctors.”

Fiora, 62, has multiple sclerosis.

She met Rosenblum more than two decades ago, when she was a Gaylord outpatient. Over the years he has helped her — and countless others.

The research is federally funded in five-year cycles.

Rosenblum, 52, was an early advocate for the baclofen pump, an implanted device used to deliver medicine to relieve spasticity.

“Cynthia got her first baclofen pump in 2000 to help keep her legs from becoming stiff,” Litsky says.

In 2006 Gaylord, in collaboration with Boston (University) Medical Center, affiliated with the New England Regional Spinal Cord Center, one of 14 model spinal-cord systems in the U.S. Its research is funded by the federal government. The achievement was the culmination of years of effort by Rosenblum.

His pursuit of excellence began early.

While growing up in Woodstock, N.Y., Rosenblum had twin passions: medicine and music. His family physician, a family friend, often took him on rounds at a local community hospital. The budding doctor also devoted himself to the flute, which he began playing as a child.

When considering colleges, Rosenblum chose the University of 12

Photo:Dominick Cenotti

Albany (N.Y.) as much for its music program as its science curriculum.

“I wanted to be able to take lessons and play in chamber ensembles,” he recalls. “Then [following graduation] I went to medical school at the University of Buffalo, and there wasn’t time for music.”

A sub-internship in rehabilitation during his final year of medical school set the stage for Rosenblum’s career.

“That was it,” he says. “I never looked back.

After completing med school in 1987, Rosenblum did an internship in internal medicine at Millard Fillmore Hospital in Buffalo, N.Y. and a residency in physical medicine and rehabilitation at ColumbiaPresbyterian Medical Center in New York City.

He began working at Gaylord in the early 1990s, where he assumed a proactive approach to finding the best care for his patients.

“As soon as the baclofen pump was approved [in 1994 by the U.S. Food & Drug Administration], I went to Boston and spent a lot of time with one of the lead investigators,” says Rosenblum. “Gaylord was one of the first centers to offer it.”

Rosenblum also was an early adopter of using botulinum toxin (trade name Botox) to treat spasticity.

One of the latest innovations Gaylord has helped to pioneer is the Ekso Bionic Exoskeleton, a robotic suit enabling individuals confined to wheelchairs to stand and learn to walk.

During Gaylord’s first grant cycle, Rosenblum explains, “We worked to create a reliable and valuable measurement tool for spinal-cord injury that may be better than the functional independence measure [on disability and rehabilitation outcomes], which was never designed for use with spinal cord injury. Now in our second cycle, we’re working on computer technology allowing the choice of questions to be narrowed.”

Jette says he has “really enjoyed collaborating with Dr. Rosenblum” since 2006.

“His compassion as a physician and dedication to the patients is very genuine,” Jette says, “and he’s the kind of person I’d like to work with if I had a spinal-cord injury.”

Brian Marshall is glad he did.

“His dedication is just unbelievable,” says Marshall, who first met Rosenblum in the intensive care unit at Yale-New Haven Hospital last September, following surgery for an accident that left him paralyzed from the chest down. “I was in a coma for HEALTHCARE HEROES 2014

most of two weeks but I did know that he was going to be my physician.”

move around in a wheelchair. He now lives with his mother in Massachusetts.

Marshall was transferred to Gaylord on October 1, 2013. “As I started to gain consciousness and cognitive abilities, that’s when I realized that Dr. Rosenblum is truly one of a kind,” he says. “He answered all my questions, and he would check on me in the morning, and in the evening, depending on what issues arose.”

“I can’t believe how much better and stronger I got so quickly, thanks to PT [physical therapy] and OT [occupational therapy],” Marshall says.

“Dr. Rosenblum got me going as quickly as I could, and I would not be where I am without his care.”

Litsky characterizes Rosenblum as “very remarkable” in the way he listens to patients, looks at them and talks to them “in this quiet voice.

Even more important to the patient was Rosenblum’s demeanor. “He smiles,” Marshall says. “He’s confident.

“After all these years we’ve never lost He exudes enthusiasm, which sets the touch,” she says. “He’s such a gem, tone for his whole team.” and the people who have him are so That enthusiasm was contagious. fortunate.”

“I immediately made the decision I was going to work as hard as I can,” says the 50-year-old Marshall, a former sales specialist for Hesco, a Rocky Hillheadquartered industrial-automation solution provider. “I’m paralyzed, but I’m adapting to my spinal-cord injury.

“It’s a case of just moving forward.

When I woke up and found out my back was broken, I figured I would be in on a ventilator and in rehab for a year,” Marshall adds. Instead, he left Gaylord shortly before Thanksgiving.

He was strong enough to sit up and

Looking ahead, Rosenblum envisions further improvements on an ambulatory system for patients with spinal-cord injuries, including home units within the next five years.

“Then there’s search for the cure,” he says. “There’s so much going on with research in stem cells and chemicals to inhibit factors that inhibit the growth of nerves. There really isn’t anything practical now, but perhaps in the next decade well be able to capitalize on the fruits of all that research.”

– Karen Singer

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PROGRAM Weigh To Live A joint program of Chapel Haven and the Cornell Scott Hill Health Center

Shedding Pounds of Flesh A new collaborative program helps adults with disabilities make healthier lifestyle choices

L

iving an independent life means more than having the ability to put a roof over one’s head or clothes on one’s back. It also means being able to make intelligent day-to-day decisions that affect a person’s life and well-being.

That’s what Chapel Haven President Michael Storz had in mind when he introduced “Weigh To Live” to residents. The program teaches good eating choices to help maintain a healthy overall lifestyle.

Chapel Haven is a residential facility for adults with developmental and/or social disabilities.

“Our goal is to teach adults how to live truly independent lives,” Storz explains. “Within two years a student will graduate and learn how to bank, grocery-shop, live with roommates” and other necessities, he says.

“Health and wellness is just as important,” says Storz. “It’s really critical that we each our individuals how to live and maintain an independent lifestyle.”

Weigh To Live was developed through a partnership with the Cornell ScottHill Health Center. Jill Meyerhoff, the center’s community-health promotion specialist, designed the program with Storz’ goals in mind. It includes a range of aids and incentives, from weight-loss tips to choosing healthy snacks to weekly weigh-ins.

“I wanted to create a program to help Chapel Haven residents maintain healthy weight and healthy lifestyles,” Meyerhoff explains.

It worked, according to both Meyerhoff and Storz. “[The program] is showing pretty significant benefits,” Storz says.

For example, one student’s triglyceride levels dropped more than 150 points, from 337 to 159, says Storz.

Other students experienced notable reductions with triglycerides as well as improvement in other health areas.

“Of the 50 students [monitored during the program], 12 lost [a total of ] 52 pounds, 11 had lower blood-pressure readings, six had lowered cholesterol and six lost inches in their waist and hips,” says Meyerhoff.

14

Photo:Dominick Cenotti

From left to right, Margit Comway a student at Chapel Haven, Einera Beauvaif from Chapel Haven. Christine Solimini-Swift from Cornell Scott, Michael Storz from Chapel Haven, Adam Macleod, Jill Meyerhoff and Brianna Foshay from Cornell Scott.

“Pretty much all students in this program have seen significant reductions,” Storz says.

The students achieved these health gains largely by making better food choices, Meyerhoff says.

“They ate more fruits and vegetables, more [low-fat foods such as] nonfat yogurt.”

A continuum labeled Go-Slow-Low aided their choices. Foods in the “Go” category, such as yogurt, were to be generously consumed. Those in the “Slow” category, such as potato chips, were to be eaten only occasionally.

And those in the “Low” category, such as fried foods, were to be consumed only occasionally.

Chapel Haven was established in 1972 on Chapel Street with the mission of helping people with special needs lead independent and fulfilling lives.

The facility moved to Whalley Avenue in 1976, with expanded programs.

Today, programs focus on residential education; supported living, community life, employment and

community-centered initiatives; and recreation. Chapel Haven has a sister facility in Tucson, Az., Chapel Haven West. A Weigh To Live program has been established there too..

Storz wanted to incorporate an emphasis on healthy eating into the Chapel Haven independent-living goals. There is, he notes, a correlation between obesity and being disabled.

Weigh To Live was initiated at Chapel Haven after Storz decided to confront his own weight-loss challenge. He joined Weight Watchers to address it.

For example, “Many of our individuals are on medication, and there’s a lot of medication weight gain,” he explains.

“I was a person certainly struggling with weight issues,” Storz recalls.

And, he notes, “I was a guy who thought the last thing I would do was enter a Weight Watchers program.

[But] when I went there, I felt surprisingly comfortable.”

He learned a lot, he says.

“I thought I knew what eating healthy was, but I was making poor choices,” he says. “When I saw how easy it was if you followed [the Weight Watchers Program] like a science,” he was convinced of its effectiveness.

Storz lost 50 pounds on the program, and has kept the weight off.

The program has had an extended effect, Storz says.

“It’s not only teaching students to maintain a healthy lifestyle, but it’s changed the entire culture of the staff,” he notes.

“It’s truly been an amazing partnership with Cornell Scott and incredible things are happening,” says Storz.

Chapel Haven is located at 1040 Whalley Avenue. It will host an open house from 10 a.m. to noon February 28. During that time visitors may find out more about Weigh To Live as well as other Chapel Haven programs. To learn more visit the Chapel Haven website at chapelhaven.org.

— Felicia Hunter HEALTHCARE HEROES 2014

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ADVANCEMENT IN HEALTH CARE Cobalt Therapeutics New Haven

“M

an can alter his life by altering his thinking.”

That observation by philosopher and psychologist William James expresses the fundamental principle of cognitive behavioral therapy (CBT), a therapy that helps patients understand the processes underlying their behaviors.

Many regard CBT as especially helpful in the treatment of insomnia, depression, anxiety and addiction.

Change the behavior, solve the problem — in contrast to the alltoo-common tactic of throwing prescription pills at any and every disorder.

Seth Feuerstein and Benjamin Steve Bunney are keenly aware of these issues.

“Treatment guidelines for some of these conditions actually say CBT should be your first option,” says Feuerstein. “If you talk to the sleep experts they will tell you almost universally that if you can get CBT for insomnia you should do it first, because the meds come with all kinds of baggage.

“But have you ever met anyone who has had CBT?” he asks rhetorically.

A major problem, Feuerstein says, is that there simply aren’t enough CBT practitioners to satisfy the demand.

There is virtually a “bottomless” need for them, he explains, even in cities like New Haven that are home to generous medical resources, let alone more remote areas where even fewer resources are available.

This is where Cobalt Therapeutics comes in, making Computerized Cognitive Behavioral Therapy (CCBT) available via the Internet.

Both Feuerstein, 41, and Bunney, 75, co-founded Cobalt in 2009 to provide another resource for the rise of CCBT in the United States, following its better established application overseas.

The pair became acquainted while Feuerstein was completing his training in psychiatry at Yale; Bunney was chairman of the psychiatry department there for 20 years up to 2007.

At Yale Feuerstein observed patients with mild symptoms being given prescription drugs when CBT might 16

Filling a Treatment Void Cobalt makes CBT treatment available to patients online

have been a superior option.

“It was really hard, if not impossible, to get them an appointment with a CBT clinician, even though I know a lot of them,” Feuerstein recalls. “There were long waits and a shortage of clinicians.”

Photo: John Mordecai

So the two ultimately researched and traveled the globe in search of programs that addressed some of the most common disorders, assembling a portfolio of programs to address insomnia, depression, anxiety, addiction and obsessive compulsive disorder (OCD).

“Our criteria being that these had to have been developed at academic institutions that had carried out randomized control trials and worked, and had been published in leading journals,” Bunney says. “The data is the difference.”

The software is provided to qualified patients through gatekeepers such as insurance companies and clinics, including the Connecticut Mental Health Center in New Haven, the West Haven VA Hospital, St. Mary’s Hospital in Waterbury and MidState Medical Center in Meriden.

Cobalt does not offer its software directly to consumers yet, stressing that it ultimately is more important to have a clinician (e.g. a doctor, mental health or social worker, nurse) at the helm to coach and assist as necessary.

“Maybe we’re overprotective, but what if it’s not working? [The patients] need someone to be in contact with,” Feuerstein says. “It’s human nature.

There is data to suggest that if they have someone to reach out to, they’re more likely to stick with” the therapy.

The Mental Health Association (MHA) of New York City, which operates the National Suicide Prevention Lifeline, offers Cobalt software as an extension of its mental health services, and makes available to patients round-theclock chat online or by phone if needed.

Cobalt Vice President and COO Joshua Rubin says the speed of access provided by CCBT programs is key.

“This absolutely reduces the barriers to care,” explains Rubin. “You don’t have to take the time off work or tell your boss you’re going to therapy. You

Seth Feuerstein (l) and Benjamin Steve Bunney

don’t have to walk into the clinic in your neighborhood that says ‘Mental Health.’ [CCBT] makes it possible for people who would never have been willing to get help to get help.”

Kathryn Salisbury, vice president of programs for the MHA, says CCBT costs one-third to one-quarter as much as a face-to-face visit to a provider. The fact that it can be used in primary care and easily accessed by all is a major selling point as well.

“There aren’t enough providers to send people who need behavioral health services,” she says. “This way we can identify people earlier and provide immediate access to care without the long waits or even having to gain access to a clinic.”

The MHA recently was awarded a grant from the state of New York to provide CCBT to victims experiencing long-term mental-health effects from Hurricane Sandy.

his or her convenience (it takes only a few minutes per week), without paying for regular doctor visits or time off work. The physicians are able to offload a majority of their face-to-face patients to focus on the most serious cases.

The Affordable Care Act mandates mental health coverage. Feuerstein stresses that placing mental health on a par with medical benefits — represents an advancement.

“Medical versus behavioral are artificial distinctions to begin with,” Feuerstein asserts, citing the co-morbid conditions that often accompany things like high cholesterol and other behavioral disorders. “The health-care industry splits the two, but one of the things that has helped accelerate our success over the last few months is mental-health parity.”

— John Mordecai

One of the principal benefits of CCBT for patient and clinician alike is time and cost. The patient accesses the treatment immediately from home at HEALTHCARE HEROES 2014

RESEARCHER OF THE YEAR Anil R. Diwan NanoViricides Inc. West Haven, Shelton

In Search of Silver Bullets How NanoViricides’ Anil Diwan kept alive a dream that at last nears commercialization

A

nil Diwan may be the least likely bioscience researcher and entrepreneur in greater New Haven today.

Diwan illustrating his polymer designs on a napkin. Seymour initially held back, telling Diwan he was perhaps too far out “on the edge” (recalling Diwan’s “out of range ideas” at IBI).

But Seymour kept researching the approach, as Diwan’s says of Seymour “his curiosity built an interest” as did the potential in attaching desease if Diwan’s approach worked.

Diwan grew up in the small Indian town of Kolhapur, then attended the India Institute of Technology in Bombay (now named Mumbai).

He would add to his academic résumé in chemical engineering at Rice University in Houston before accepting a teaching position at the University of Connecticut in the late 1980s. A position at IBI International Biotechnologies Inc. (now a subsidiary of Kodak) brought him to New Haven and Science Park.

By 2005 interest in the type of targeted therapies that Diwan had been pursuing was gaining traction, and Seymour came onboard as CEO. “He [Seymour] had confidence he could raise money,” Diwan explains. “We formed NanoViricides in 2005 and went public by a reverse public shell and merged into it.”

Ideas and simple explanations of complex bioscience concepts flow quickly from Diwan, and a visiting reporter has all he can do to keep up with a flood of scientific lessons and terms. So it’s not surprising that a younger Diwan might have encountered some early resistance, as he did when pitching an idea at IBI. “My boss thought [Diwan’s ideas] were way out of the range and shouldn’t be pursued,” he recalls.

For the indefatigable Diwan that disappointment was merely a blip, as he was determined to put his own theories to the test.

So in 1992 he formed his own company, Applied Biotech Concepts (ABC), but absent a university affiliation Diwan discovered that financing was not easy to come by.

He eventually connected with the University of Massachusetts at Lowell, known for its advanced chemistry department, and was able to garner support for his “proof of concept.”

Diwan’s idea was for a way to use a polymer (a large molecule with many repeating parts) to surround and attack viruses or cancer cells within the body.

With this institutional support he was able to attract Small Business Innovation Research (SBIR) and other grants to pursue “his ‘out of range ideas, that shouldn’t be pursued.’”

Progress was made and a patent obtained, but along the way Diwan

With Seymour came new business and scientific skills, as well as a network of financial and medical contacts.

NanoViricides began to grow, adding employees and lab space in the pursuit of developing and testing its molecules and their efficacy.

learned another important lesson: with major institutions comes major bureaucracy and thorny internal politics. It was not Diwan’s ability to develop polymer chains that can connect to viruses, but a lack of skill at politics that proved to be the undoing of the relationship with UMass.

Eventually the breakup would prove to be a blessing in disguise, but not before what looked like the end of his dream. “By 1999, I was completely disheartened and decided I have to do something else and started doing software engineering,” he recounts.

The lab continued, however, with just a single employee.

“I was making money [from the software] and I would write up my concepts and had an employee whose salary I could pay from that money,” Diwan says. He spent “six months there, six months in the lab” to try to keep his dream alive.

Without the work from his collaboration with UMass/Lowell, he

had to reevaluate and chart a path toward a more sustainable approach.

The company was located in a large warehouse space in West Haven, hardly a sexy location for today’s high-flying biotechs. But it would be characteristic of the frugal style Diwan has taken, initially designing and often building the company’s own equipment to conserve precious financial resources.

After several years of very slow progress, the effort finally began to accelerate in 2004 when he made a business contact who became interested in the company and its technology, and as a result introduced Diwan to Eugene Seymour. Seymour was a physician who had established an HIV-testing laboratory in Los Angeles in 1986 and had been a consultant to the UN on AIDS research and was himself a bioscience entrepreneur.

In what was planned as a brief introductory meeting turned into an intense hours-long discussion, with

Today company remains low key in West Haven in a sprawling set of offices and labs , but that is all about to change. The company is building a new facility in Shelton to be able to build and test in volume the polymers it needs to advance to more testing and clinical trials.

To be sure there are still doubters of Diwan and whether his effort will yield results. Failure, of course, is the life’s blood of bioscience, but as of now that does not look like the future of either Diwan or NanoViricides. In early February the company filed with the SEC that it “now has approximately $38 million of current assets plus restricted cash in hand,” having raised an additional $20 million this January.

The company added that it “estimates that this funding is sufficient to enable [it] to perform initial human clinical trials of our injectable FluCide drug candidate, as well as possibly to advance our DengueCide orphan drug candidate toward initial human clinical trials.”

– Mitchell Young

17

VOLUNTEER(S) Kacey Rose Foundation Glen and Kristina Mitchell Wallingford

Honoring a Brave Little Girl Wallingford’s Kacey Rose Foundation helps families of children with cancer and blood disorders

I

t’s often seen as sound advice to take whatever negative circumstances life throws our way and turn them into positives.

Sometimes that’s all the more important the more severe the circumstances. And Kristina and Glen Mitchell know a thing or two about severe circumstances.

Photo: Dominick Cenotti

The foundation is acutely sensitive to those whose cancers require transplants of bone marrow and stems cells, and promotes the donation of the stem cell-rich umbilical cord blood.

The foundation’s website links donors with Florida-based Lifeforce Cryobanks, and thanks to initiatives from State Sen. Len Fasano (R-34), health-care providers in Connecticut must inform patients about public and private cord blood banks.

It was within a week after giving birth to their son Max in January 2007 that the Mitchells’ year-old daughter Kacey Rose was handed a diagnosis of acute myeloid leukemia (AML), type M7 — a rare and fast-spreading disease that starts in the bone marrow and disrupts the production of blood cells. In young children it typically is mortal.

Cord blood was particularly important in the Mitchells’ case. The family had first sought a bone marrow transplant for Kacey while she was in the hospital, but were shocked to find their daughter had no matches in the national bone-marrow registry.

The stem cells in cord blood, however, provide another option for those in similar condition.

The year and a half that followed saw Kacey enduring five rounds of chemotherapy — she went into remission after the first round, but relapsed shortly after the fifth — a stem-cell transplant from donated umbilical cord blood, and a second relapse before ultimately succumbing.

But the story didn’t end there. The Mitchells used their experience to help the families of others affected by childhood cancers and blood disorders. The Kacey Rose Foundation was created while Kacey was still in the hospital and friends of the Mitchells would pitch in or raise money to help the family with everyday costs.

After Kacey’s passing in May 2008, and at the urging of Kristina’s friends, the charity was launched and fundraising events were already being planned. It was as much a means to help others as it was for the family to distract itself from the pain.

“Kacey passed away in May, and in June I was already planning our first event, and really we just branched from there to help other people experiencing the hardships we felt when our daughter was sick,” Kristina Mitchell says.

“Everybody needs help when they have a sick child, regardless of what their salary is.”

The Kacey Rose Foundation raises money through donations and fundraising events throughout the year to help offset all kinds of financial 18

the hospitals and the families are very grateful, so even if it stays this way, it’s still a great success.”

burdens – whether it’s for relatively simple things like gas, groceries or utility bills, to mortgage payments, rent or insurance bills. Kristina Mitchell says they’ve even provided payment of a week’s salary so a parent can spend time with their child in the hospital. In some cases the foundation has helped with the costs of funerals.

“I want people to know that they’re not alone in the fight and there are others who understand the burdens — emotional and financial — that come with having a child who is sick,” she says. “I know that when my daughter was sick, I didn’t care about anything around me; who helped or who gave what. But even if it’s just $500 in gas cards, those little things go a long way.”

The foundation holds an annual golf outing, a wine-tasting, 5K road race, a motorcycle ride and other events through the year, raising between $50,000 to $100,000 per year. Last year it raised $45,000, which went

to help 44 families. The first event of 2014 is an April 3 wine-tasting at Anthony’s Ocean View in New Haven.

Families are referred to the foundation mainly through social workers at area hospitals, primarily Yale-New Haven Hospital (YNHH) and the Connecticut Children’s Medical Center.

The foundation takes in donations from the public, some come from former Kacey Rose recipients. She says the donations that come in usually depend on the economy, and the foundation. While Kristina Mitchell would love for the foundation to grow, she’s also more than happy to be helping out in any capacity.

“We’re a grassroots organization; we have great supporters and we look to the local community” she says. “I would love to see this grow into something bigger than it is, but I’m extremely proud of myself and everyone who is a part of it. I know

“If you have a loved one with cancer or anemia or sickle cell and their only chance of survival is a bone marrow transplant, and then you find out you don’t have a match, you need another option,” she says. “We make it part of our mission to spread awareness that this umbilical cord is going to be discarded, when it could actually save someone’s life. That’s huge.”

Among the other initiatives the foundation has undertaken is Kacey’s Korner, a library of children’s books in the pediatric clinic of the Smilow Cancer Hospital. In addition to public donations, last year the Barnes & Noble bookstore in North Haven made Kacey’s Korner the recipient of its holiday book drive. There is also Kacey’s Kart, a mobile library for the inpatient unit at YNHH and at Yale’s Pediatric Oncology office in Guilford.

“When I started the foundation it was to help with the grieving process, but now I don’t envision being able to discontinue the work. I don’t need to do this anymore to help me get through what I’ve been through. I do it because I want to now.”

— John Mordecai HEALTHCARE HEROES 2014

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COMMUNITY SERVICE Steven Wolfson, MD YNHH Heart and Vascular Center

A

Caring for the Neediest Cardiologist and public-health advocate Wolfson has been instrumental in bringing quality health care to the uninsured

Sometimes real change begins with just a single person saying yes.

It was health-care policy and patient contact that became more important to Wolfson than teaching, so he founded a practice, Cardiology Associates of New Haven, which has grown to 16 physicians in five offices region-wide, (recently sold to YNHH).

It also provided training to medical students and housed a research facility for drug trials.

When New Haven physician Suzanne Lagarde learned from Peter Ellis, MD, an assistant professor at the Yale School of Medicine, about Project Access, a Waterbury program that provided free medical care to uninsured patients, she got into gear.

Having a successful private practice allowed Wolfson to spend time on health-care policy and what he describes as “protecting physicians’ ability to deliver individualized and compassionate care.”

Lagarde became chief executive of the Fair Haven Community Health Center (FHCHC) last July after longtime CEO Katrina Clark retired. But well before assuming the helm at FHCHC, Lagarde was already an experienced do-gooder and public-health advocate.

As a physician she traveled to Biloxi, Miss. to help out in the wake of Hurricane Katrina in 2005 and had been returning returning regularly to provide medical care.

Lagarde brought the idea that New Haven needed its own Project Access to the then-president of the Connecticut State Medical Society, Steven Wolfson, MD, a cardiologist and public-health advocate.

Wolfson observed an immediate need f in New Haven, with its large population of working poor as well as undocumented immigrants lacking health insurance. Wolfson knew that care was available at both Yale-New Haven and St. Raphael’s hospitals, but it was expensive for the institutions and insufficient for the patients.

Wolfson was enthusiastic about Lagarde’s proposal, and he agreed to spearhead Project Access in 2008 — at a time of the recession — to ask doctors and other health-care providers to provide free care and to help finance the effort.

Eventually a core group of physicians; Wolfson, Lagarde, Ellis and Stephanie Arlis-Mayor, current president of the Project Access-New Haven board, would craft a program that has bound New Haven’s medical community together and provide more than $5 million in specialty care, tests, equipment, hospital services — all completely free to its clients.

What makes Project Access-New Haven unique is participation by as many as 300 specialists and 20

Rhonda Hawes of the Connecticut State Medical Society says of past CSMS president Wolfson, “He is an extraordinary, passionate physician who believes we have a moral obligation to care for one another through our daily lives as well as through medicine.” other health-care providers across disciplines and across the region.

Wolfson explains why his group’s efforts have been met with such widespread support. Project Access, he explains, “liberates the good will in the medical community.

“Ordinarily if an uninsured person comes to [me], I’m going to spend some time, we identify the problem and then we use a medical tool called ‘begging’ for tests and specialist visits and treatment in the hospital.”

“But you have to be pretty sick to be admitted,” Wolfson adds.

With the Hill Health Center, FHCHC and Yale-affiliated clinics, quality primary care was relatively available in New Haven. Specialist care, was not.

Explains Wolfson, “The problem was once the patient needed specialty care, the wait lists were enormous.”

Wolfson’s contacts and understanding of the issues made for rapid progress.

Paul Fortgang, MD, then president of New Haven County Medical Association, immediately said, “We have to back this,” recalls Wolfson.

“They gave us some staff and some financial backing.”

The effort moved on to the hospitals and what some might call enlightened

self-interest brought support from both Yale-New Haven and St. Raphael’s, with both institutions agreeing to provide PA-NH patients free hospital care as needed. Project Access-New Haven opened its doors in autumn 2010.

Says Lagarde of Wolfson: “He was likely to be an ally [in helping to get Project Access established]. He already had a reputation for being very sympathetic to the plight of the underserved and had a track record of getting things done.”

Wolfson grew up in Brooklyn, N.Y., attended Columbia College and the New York University School of Medicine was a fellow at Boston’s Peter Bent Brigham Hospital and a senior resident in medicine at Massachusetts General Hospital and two-year hitch as staff cardiologist at the U.S. Air Force’s premier medical facility, Wilford Hall Medical Center at Lackland AFB in San Antonio, Tex. He would eventually come to New Haven to teach at the Yale School of Medicine, as director of the Cardiac Catheterization Laboratory at the YaleNew Haven Hospital for seven years and served as president of the YNHH medical staff.

For any patient, negotiating the health care-delivery system during a medical crisis can be a difficult challenge.

Making the system work for Project Access patients of limited resources includes helping them “navigate” the health-care system, stay on track, communicate, keep appointments and more. Project Access navigators are now a core part of that effort.

Initially, Wolfson and his colleagues worked weekly to train navigators and other staff. PA-NH then reached out to Gateway Community College, which responded by developing a certificate program for navigators, who now can find employment in clinics and medical practices.

With the expansion of Medicaid through the Affordable Care Act, Project Access is helping many of its patients sign up for Medicaid, but undocumented immigrants remain uninsured and will continue to require free medical care.

Wolfson sees the changes brought by health reform as providing more coverage for many PA-NH clients, but he expect a role particularly for Project Access’ navigators because, he says, “Health insurance does not guarantee health care.”

— Mitchell Young HEALTHCARE HEROES 2014

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ADVANCEMENT OF HEALTH CARE: INDIVIDUAL Alvin Greenberg, MD North Haven

Medicine’s Master Builder The visionary physician whose career has been spent anticipating patients’ needs — and then meeting them

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lvin Greenberg, MD has played a pivotal role in the evolution of health care in greater New Haven ever since he arrived here in the early 1960s. Born in 1935 in the Bronx, NY, Greenberg graduated with a bachelor’s degree from Johns Hopkins University in 1956 and earned his MD from the University of Rochester Medical School in 1960.

Haven Hospital Shoreline Medical Center, located at 111 Goose Lane in Guilford, in 2003.

“I went to [then-hospital president] Joe Zaccagnino at Yale-New Haven Hospital and [told him] that he needed a presence out on the shoreline,” says Greenberg. “We went back and forth on the idea and finally agreed it was the right thing to do.”

Before founding his own practice, Neurosurgical Associates of New Haven, he was a resident in neurosurgery at Yale-New Haven Hospital (YNHH). A board-certified neurosurgeon, Greenberg is a past president of the Connecticut Neurological Society, the New Haven Medical Association and the New Haven Jewish Federation. He is also a 2006 recipient of the Anti-Defamation League’s Torch of Liberty.

The center began small, with plans for a 40,000-square-foot building, but along the way hospital officials decided to add other services including a full emergency room, which increased the size of the facility to 80,000 square feet.

Greenberg believes that the proliferation of hospital satellite centers located between large cities is part of a community outreach trend that will only accelerate because it fills a need for immediate, local care.

Once he had completed his residency, Greenberg was ready for private practice and thought the Elm City was a good place to start. He’s been here ever since.

The need for a better way to handle the complicated and time-consuming medical workups that patients had to undergo leading up to surgery had been something Greenberg was analyzing in his mind for some time before he arrived at a conclusion.

“I got the idea when I was first here,” he recalls. “Back then, you have to understand that people who needed a diagnostic workup were admitted to the hospital [for the necessary tests].

You could stay up to two weeks in the hospital for this because they had to schedule all your tests. Sometimes you could schedule them the same day and sometimes you couldn’t. Then, after the workup, which was a couple of weeks, they would decide you didn’t need any surgery and they would discharge you. Or if they decided you did need surgery, they would book you for it in the hospital. Maybe two or three days would go by until you were on the schedule for surgery. I thought this was ridiculous.”

Instead, Greenberg decided that doctors could work up their patients in an outpatient setting in a centralized location and pool their resources, 22

Photo: Tom Violante

getting the different test and labs done under one roof.

“We could buy the finest, state-of-theart equipment, work these patients up as outpatients, save them a fortune because they don’t have to go into the hospital, and, if they do have to go into the hospital, the blood work was already done in our lab and the pre-op X-rays were done,” says Greenberg.

“How many times does someone go into the hospital the night before and the doctors find a problem and cancel the case? So we decided we’ll get the diagnostics done before admission and make sure everything is okay.”

Greenberg’s idea took physical shape in 1978 in the form of Temple Medical Center at 40 Temple Street. But the human components — in the form of physicians — remained to be determined.

“There was a group of specialists in New Haven, whom I respected medically,” Greenberg recalls. “I said, ‘Hey guys, we’re building an outpatient surgicenter.’ And they asked, ‘What’s that?’ Then I explained the whole thing to them and they asked, ‘How much

does it cost?’ I said, ‘Nothing. The bank is going to fund it 100 percent.’

So they said, ‘That’s fine.’”

“We all agreed on my concept,” says Greenberg. “We got together and got a general partner [Edmund Fusco of Fusco Construction in New Haven], we didn’t know anything about finances, and we built Temple Medical Center.

It was a great boon to greater New Haven. Now it’s been replicated all over the country and it’s routine to work up patients as outpatients.

“There were no full-service radiology departments as an outpatient facility in the country back then,” Greenberg adds. “We were the first to do that.

We had the first MRI in Connecticut, where patients came by ambulance from all over the state.”

Not content with just one project under his belt, Greenberg realized that there was a need to reach out into the surrounding community and establish a hospital satellite along the fast-growing shoreline communities stretching east from New Haven. He conceived the idea and played a key role in establishing the Yale-New

His last project, forming the Recovery Care Center in the New Haven Hotel, grew out of a need to create a continuum of care keeping patients out of the hospital following ambulatory surgery or getting them out of the hospital after surgery there.

It is located on the third floor of the New Haven Hotel and is connected by a pedestrian bridge to Temple Medical Center, allowing the transfer of patients from one building to another without the need for an ambulance or even stepping outdoors.

“The hotel center is licensed by the state and has its own staff including a doctor as the director,” Greenberg explains. “We have two types of admissions. If we had a place for the patient to sleep overnight, we could do bigger surgeries in the surgicenter that might require 24 to 48 hours of observation [before the patient returns] home.”

He says the other admission is as a step-down unit for patients from the hospital, those with more serious conditions, whether surgical or medical, who then became stable but still weren’t ready for discharge.

— Thomas R. Violante

HEALTHCARE HEROES 2014

FALLEN HERO Joel Silidker, MD (1953-2013)

‘One in a Million’ The passing of a beloved obstetrician leaves a hole in the hearts of all who knew him

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o matter whom you talk to among those who knew him, the mere mention of Joel Silidker’s name evokes an array of emotions that let you know he was truly loved by all and that his passing deeply affected their lives.

make sure they were all right. He was an excellent surgeon, he loved teaching and he was excellent at that.

He was a motivator.”

Fletcher notes that Silidker received an award for teaching medical students just prior to his death.

Silidker, a physician in practice with Obstetrics-Gynecology and Infertility Group, PC, with offices located in greater New Haven, died suddenly last July 6 at age 60. He was en route to the hospital in a car driven by Tina, his wife of nearly 37 years, after he experienced chest pains at home. He left behind a legacy that few feel will ever be duplicated.

Born in Newark, N.J., Silidker was graduated from George Washington University with a BA in 1974 and the George Washington University Medical School with an MD in 1979.

He completed an internship in internal medicine and a residency in obstetrics and gynecology at Yale-New Haven Hospital (YNHH), where he was awarded the Irving Friedman Award as chief resident, an honor bestowed for his outstanding clinical and humanistic skills. He was a clinical professor in the obstetrics, gynecology and reproductive sciences department at the Yale School of Medicine.

He was offered fellowship positions in both reproductive endocrinology and maternal fetal medicine, but turned both down to enter private practice in obstetrics and gynecology.

Silidker was one of the first to train and practice advanced operative laparoscopic surgery, pelvic floor and urinary incontinence repairs, as well as robotic-assisted gynecologic surgeries.

Silidker was renowned as a teacher and a mentor to countless residents and medical students, garnering virtually every teaching award offered by the department. He served YNHH on its medical board and obstetric practice committee, and authored the departmental newsletter.

“When I came to New Haven in 1982 as a young attending [physician in training], Joel, who was chief resident

“He didn’t expect it,” says Fletcher. “He was proud of it. I don’t know anybody who had anything negative to say about him. It was very much a shock when he passed away. He was one of my best friends and he was wellrespected in the community. [Following his death] the patients called here and people were crying. For several months, patients who came in to the office were still devastated by his loss. He was one in a million. I don’t know anybody like him and I don’t think I’ll ever meet any other doctors like him.”

at Yale-New Haven Hospital, took me under his wing and introduced me to everybody and brought me into his circle where I was immediately accepted because of the esteem in which he was held by others,” recalls Norman Ravski, MD of County Obstetrics and Gynecology Group, PC. “Joel and I became friends — but we were really more like brothers and spoke three times a day.”

Ravski explains that for 30 years Silidker provided compassionate, evidence-based, care to New Havenarea women. “As a partner in his practice he made everyone he knew feel as if they were his best friend. He offered sage advice to residents and opened his heart and home so that people could feel like a part of his family”, Ravski adds.

“He had a presence, an aura about him and he was just fun to be with. And he made sure that every minute you were with him was a fun, memorable moment.”

Silidker established his own tradition for incoming classes of residents at Yale-New Haven.

“He would buy them a case of wine with the proviso that they could only drink a bottle of it if at least three out of the six of them were having dinner together,” says Ravski. “He actually did it for them this year because the residents start in June, so it was before he passed away. I intend to continue that tradition for him. He wanted people to enjoy life. His message was, ‘Yes, you work very hard but you also have to enjoy life’.”

“Joel was one of the most sincere people I’ve known,” says Kim Fletcher, MD, who was in the same practice as Silidker. “He was someone who not only took care of patients but cared about the patients he took care of.

“He would go out of his way in ways that I can’t even imagine how he kept up,” Fletcher adds. “He’d call patients when they had family problems that had nothing to do with their medical issues. He’d check up on them and

“He was such a special person,” says Diane Prunier, office manager of Silidker’s practice. “I’ve worked here for 32 years and he came in here six months after me, so we had a real special relationship. He just made everybody feel so special, whether it was his patients or his staff. Every day he would thank us. He would call me every morning and ask, ‘What can I do for you?’”

Prunier says that, even half a year after the fact, Silidker’s patients remain devastated by his loss.

“I can’t tell you what we’ve gone through here in the past six months,” says Prunier. “I feel so bad for my staff because they were upset about him passing suddenly. And then, to have to come in here the day after his funeral and pick up the phone and tell the patient that he’s gone, one after another. And the physicians and the midwife who are seeing his patients have a hole in their heart and the patients are crying. He made everyone feel like they were his only patient.

We’ll never be the same here. There will never be another Joel.”

— Thomas R. Violante

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