Gford pitches ‘Maple Mountain’ residency as a rural workforce pipeline, seeks $4 million bridge funding

Michael Costa, president and chief executive officer of Gford Healthcare, told the Senate Health Committee on March 26 that his organization has secured ACGME accreditation for the Maple Mountain Consortium family medicine residency but still must find bridge funding before it can enroll trainees.

Costa said Gford — a 25‑bed critical access hospital that also operates an FQHC and a retirement community in Randolph and clinics across central Vermont — aims to start cohorts of four residents and expand to about 12 residents at full capacity, producing “over 40 family physicians over 10 years.” He said the program is intended to place trainees in rural health centers so graduates are more likely to remain in Vermont.

Why it matters: Vermont’s primary care workforce is aging and undersupplied, Costa said, and training clinicians in rural settings increases retention. Committee members and witnesses discussed workforce age, panel sizes and the operational steps Gford is taking to increase access to primary care across six clinic sites.

Costa outlined the program’s financing gap: an initial phase‑one grant of roughly $500,000 funded planning and accreditation, but the consortium estimates it will need about $4 million to operate the first four to five years while visit revenue and longer‑term federal support stabilize. He noted that HHS’s (HERSA) teaching health center program typically provides roughly $160,000 per resident per year but the federal program has not been opened to new entrants; Maple Mountain is pursuing state rural health transformation funds, additional federal teaching health center money, and other bridge sources.

Costa said the July start date for residents imposes deadlines: trainees usually begin in July, and a failure to secure funding would likely delay a cohort by 12 months. He identified Loyal Health Partners and the UVM Health Network as key in‑kind partners and named clinical leaders supporting the effort.

Committee members pressed Costa on operational details: how many clinic sites Gford operates (six), how many clinical FTEs (about 48), and a target panel size (Costa described aiming for roughly 1,200 patients per full‑time clinician as an operational starting point). Committee members and Costa discussed recruitment versus retention, physician part‑time trends, use of AI scribes and support staff, and the importance of behavioral‑health capacity in a training program.

Costa also addressed smaller specialty coverage and regional collaboration, describing targeted part‑time hires, telehealth and negotiated arrangements with larger hospitals for radiology or specialty coverage when appropriate.

Costa asked the committee for help unlocking flexible funding: state Medicaid and rural health transformation dollars may be used for some launch costs but several items — housing, certain recruitment costs — may not be covered by particular federal grants. He said Gford will continue discussions with the Agency of Human Services and the federal delegation to explore options and timelines.

What’s next: Costa said Gford has committed to returning reports on several near‑term tasks, including a review of financial assistance and charity‑care policies related to outpatient costs and critical access hospital billing; he said the organization will report back to the Green Mountain Care Board about two‑week deliverables on that front. He cautioned the committee that recruiting and starting a residency on an accelerated timeline will require predictable funding and clear federal or state guidance.

Representative quote: "The car is built, it's been inspected; we need to turn the key," Costa said of the accreditation and the need for bridge funding.

Proper names and authorities mentioned in testimony included ACGME (accrediting body), HERSA/HRSA (federal teaching health center funding), the Agency of Human Services, the Green Mountain Care Board, Loyal Health Partners and the UVM Health Network. Funding figures discussed: a phase‑one grant of about $500,000 and a phase‑two funding need of approximately $4 million to sustain operations until longer‑term federal funding is secured.

Speakers quoted or heavily relied on for this article: Michael Costa (president and CEO, Gford Healthcare); Dr. Ann Morris (residency program director, present in the hearing and referenced by Costa); Leslie (committee member / retired family nurse practitioner). The committee did not take formal action on the residency at the March 26 hearing; next steps are funding discussions and follow‑up reports.