The Block Island Times
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Introducing the six candidates for the Block Island medical board

By Gloria S. Redlich | May 12, 2013

Block Island Health Services (BIHS) is holding an election to fill three openings on its 11-member board of directors. The terms for incumbents Cindy Baute, Judith Cyronak and Peter Tweedy are ending in June. While Baute and Tweedy wish to continue on the board, Cyronak is stepping down. In addition to Baute and Tweedy, four community members have stepped up as candidates: Albert Cassaza, Kenneth Maxwell, Bruce Montgomery and Peter Saxon.

Recently The Block Island Times sat down with each of the candidates to learn their views on the medical center and how they might be of service. In addition to providing some personal history, they were asked to discuss any changes they might want to make, what they see as the appropriate relationship between BIHS and the town and what they envision for the future of the medical center.

Only members of the BIHS can vote in this election. To find out whether you are a member, of if you would like to join the BIHS, please call Barbara Baldwin at 466-2125.

The candidates are presented in alphabetical order:

 

•  Cindy Baute  •

Her island connection goes back to the early 1980s, Cindy Baute recalls when she and her husband, physician Peter Baute, began coming out here on day trips; these stays became longer as her husband stepped in as island doctor, which coincided with Cindy Baute’s decision to retire. Purchasing land in 1993, they built their home on island at the end of the decade.

In the late 1980s, she earned a bachelor’s degree in nursing from Rhode Island College, and less than a decade later she again returned to school — this time to Salve Regina University — where she graduated with a Master’s of Science in Health Services Administration. Baute worked at Kent Hospital for 30 years.

Before coming to the island she also worked as a nurse manager in the surgical unit at Pawtucket Memorial Hospital, where she was responsible for 65 employees and staff.

Baute has been a member of the BIHS board since 2009. With her term ending, she said she wished to continue serving because she is “very proud of this medical center” and praised its “outstanding job of meeting the challenges of an isolated location.”

If she is re-elected, Baute’s focus will be on supporting the executive director, Barbara Baldwin, and the staff to “make sure that we are the best that we can be, that we meet the health care needs of an isolated population of full-time residents and visitors alike.”

She believes one of the most difficult challenges takes place during the summer, with visitors coming from many places — some of whom are used to more sophisticated facilities — and she said most are “pretty impressed by what our practitioners have to offer.”

A smooth working relationship

Baute said the Electronic Medical Records (EMR) system will be a critical asset that will enhance efficiency as well as improve communications between island and mainland facilities. Though not directly involved in the process, she says, “I’ll do whatever I can do to help meet the federal mandate.”

She sees the medical center as a private entity, needing the cooperation and support of the town. “We’re providing a very necessary service to the town, and I would like to see a smooth working relationship.” Baute said, “We have made a very good agreement with the town, and what’s most important is to go forward, which I think is doable.”

Health care has been my life

It is gratifying to work with “such a high caliber of people to make the facility be the best it can be,” Baute said, “and I’m very proud of my fellow board members.” Enjoying her role in fundraising, she speaks glowingly of the Lights of Love campaign, which brings in some of the highest revenues, she adds.

While she acknowledges the town’s generosity in increasing its financial support [from $87,000 to $123,000], she strongly feels fundraising must be an ongoing process — both for operations and for the endowment. She added, “I have been blown away by the generosity of people giving their time and money. I just cannot say enough about these donors.”

Her wish to continue on the board is consistent with her deepest convictions: “Health care has been my life,” she said, indicating that her position on the board is her way of serving the Block Island community.

 

•  Dr. Albert Casazza  •

An oncologist looking forward to his 41st summer on the island, Dr. Albert Casazza learned to love the island as a respite from mainland pressures when he and his late wife first rented and then bought land off Corn Neck Road. It was there they built the home he currently occupies. Though still active professionally, he and his companion, Mary Lou Bourque, are spending more and more time here, with his four children and five grandchildren frequently joining them.

Casazza has been involved with the island in several capacities. He served for 10 years on the Physicians’ Advisory Board of BIHS and for six years he was owner of the Water Street Inn. Since 1990, he has served first as treasurer and then president of the Block Island Power Company.

Casazza earned a bachelor’s degree from Princeton University in 1958, and an M.D. from Columbia four years later. In 1988, he earned an M.B.A. from the University of Connecticut.

Among the many positions he has held, Casazza was President of Associated Internists of Danbury, P.C., from 1973 to 1994. He was attending physician and later Chief of Oncology at Danbury Hospital from 1968 to 1999, and was a member of the attending staff at Waterbury Hospital (both in Connecticut) for more than a decade. He has also held positions as Medical Director for Regional Programs and Associate Physician-in-Chief at Memorial Sloan-Kettering Cancer Center in New York, where he is currently attending physician and still sees patients.

Re-imagining the future

Addressing needed changes and the relationship between the town and the medical center, Casazza said it was it important to consider “how much financial support the town wants to give the medical center and for how long.” Depending on whether the town wants “to keep the center small” or more active in billing insurances, “then the town must provide guidance,” he said.

He is convinced the focus should be to increase revenues, the sources of which he feels “haven’t been fully explored.”

Casazza suggested looking at “some new telemedicine initiatives for general medicine, radiology and cardiology.” He feels installing the EMR system is an essential step in the operation of the BIHS.

Acknowledging that many retirees have “established long-standing relationships with mainland physicians,” Casazza said it was unrealistic to suppose that will change. He stressed that the focus of the center should be on follow-up care for island residents.

Because of the difficulty in sustaining two physicians at the local medical center, Casazza said he is “totally supportive of having a nurse practitioner, who is responsible for routine care.” The goal of medical providers should be to make it easy for people to get their services while minimizing disruptions to their lives, he said.

To those ends, he hopes BIHS can offer primary care services, and also suggests exploring pediatric medicine on island. He does not think the size of the board matters, though he feels transparency is important.

Trying new ideas

An example of a new idea that Casazza has championed: “At the power company, we’ve set up a wellness program with the healthcare center.” Through the program, individuals establish goals such as weight loss or smoking cessation. “They receive a cash remuneration if they stay on the program,” he said.

Casazza suggested the BIHS do something similar — offering incentives to town employees and island businesses — that might provide a new source of revenue. In the end, he said, businesses will pay less for health insurance if their employees are healthier.

In a like manner, Casazza advocated working with the school, suggesting seniors write a health column for The Block Island Times on topics such as wearing seat belts, eating healthier, and other topics.

He also sees a role for the medical center in the management of chronic diseases, such as diabetes. He says the professional staff here can tap into a number of existing areas of expertise, implementing tried and tested protocols for treatment. The care of diabetes, for example, “requires a weight and exercise program, tests for visual acuity, care of the feet, assessment of pulses and management of blood sugar levels,” he says. These are straight-forward procedures that most medical staff can follow.

Acknowledging the town must support the medical center, Casazza said changes have to come through developing medical services and raising revenues to sustain the center’s role within the community.

He believes his training and experience have given him a “complete grounding in medical administration” from which to offer his services to the board, particularly at a time the community is discussing “what the facility should be and how do we get there?”

 

•  Ken Maxwell  •

Ken Maxwell has developed very strong personal ties with BIHS. As he remarks unequivocally, he owes his life to the center. Maxwell described a “heart event on July 24, 2000,” during the time he and his wife, Arlene Tunney, were in the process of selling an island home and building the one they currently live in.

On that evening, finding himself  “feeling kind of funny,” Maxwell went to the medical center, where, he said, “they did everything right.” After contacting his off-island physician, the local staff sent him off to Westerly Hospital, accompanied by Registered Nurse Linda Closter.

Recounting the scenario, Maxwell said that while he was in the ambulance, he had an attack “in which I went out of the picture.” Immediately transferred by Life Star helicopter to Yale New Haven, where a cardiac team discovered a blockage in his heart. “They put in two stents and were done by midnight,” he said.

Maxwell is convinced that had island practitioners not acted so effectively and quickly, he “would not be here. There is no doubt about it.”

Keeping options open

Originally from Harrisburg, Penn., Maxwell graduated from Tufts University with a bachelor’s degree in geology. While in school, he joined the Naval Reserve Officers Training Corps (NROTC). After graduation, he served in the Navy as a pilot and, among many posts held, was Main Executive Officer and Instrument Flight Commander. Coming to the island together since the 1980s, the Maxwells settled here full-time in 2007.

He likens his responsibilities in those roles and of his 19 years as a pilot for American Airlines to the decision-making process for a civilian facility like the medical center. In his professional life, Maxwell often found himself deciding whether individuals should be continued in their units or be discharged.

“It’s a part of leadership in adverse situations to keep options open: forget your own feelings and get the best done for both the organization and the individual,” he said. The best results come from balancing those needs, he said. Applying these same values to decisions of the medical board, as an example, Maxwell said “I feel the way that Monty’s dismissal was handled, to put it mildly, regrettable.”

In the interest of the community

Mulling over both sides in the ensuing controversy, he believes board members and island residents must forget their own agendas and act in the best interest of the center and the community.

The catalyst for seeking the board seat, for Maxwell, was reading Article Three of the BIHS Mission Statement, which describes the center’s goals as “providing medical services to year-round and seasonal community members and to make such services financially sustainable.” It is a statement Maxwell identifies with.

Through a number of enterprises and as a trustee of two trusts, Maxwell said he has accrued extensive experience in fiscal management. He has also set up an endowment for the Killingworth Library in Connecticut.

On the issue of growing the endowment, which has come up at BIHS meetings, Maxwell noted a percentage of annual fundraising may be assigned to the endowment, with other funding assigned to operational expenses. He sees raising funds for the medical center as the preeminent need, rather than “simply going to the town” for additional funds. Maxwell said he his experience in fundraising, as well. He believes board members should be required to contribute as much as they are able.

New blood is needed

As to any change he may bring to the medical center, Maxwell said he wants to shift the emphasis “from the negative to the positive.” He added, “Whether we want to or not, people need to work together.” He said the focus should be on two questions: how we preserve the medical center and how to make it better.

Part of necessary change, Maxwell believes is that “some new blood is needed for these positions, and we need to encourage a successful coming together between the BIHS membership and the board.” Strongly indebted to the local medical facility, Maxwell is seeking — by serving on the BIHS board — to give something back to the center and to the town he and his wife call home.

 

•  Bruce Montgomery  •

First coming to Block Island with his wife Peggy on July 4, 1967, Bruce Montgomery staked out what became for them both a love affair with the island. They bought their first home in 1975 and built their current one in 1997. They have three children, one of whom is also an island resident.

Growing up in Forest Hills, New York, Montgomery graduated from Brown University with a bachelor’s degree in Art History in 1961. While at Brown, he simultaneously took courses at Rhode Island School of Design (RISD). During his junior and senior years, Montgomery held summer jobs on Madison Avenue, eventually working there at three different agencies — as an art director, TV producer and creative director — over a period of 37 years.

When he closed his ad agency in June of 1999, he fully expected to retire on the island. However, two weeks into retirement, he says, “I surprised myself when I bought The Block Island Times.”

He published the paper for just over six years, during which time his cartoons, which he clearly loves doing, became a staple of the local weekly. Though he sold the paper to Betty and Fraser Lang, Montgomery continues submitting cartoons. While there are some who take exception to the manner in which he handles his topics, which he says reflect his view of “island issues and personalities,” he hopes to continue expressing himself through this medium.

Escorting out the 900-pound gorilla

“The first thing I want to do, if elected, is to apologize,” Montgomery says. “We have to undo what’s been done, to escort the 900 pound gorilla out of the room — nicely.” Viewing the manner in which Stover was dismissed as “a public relations fiasco, wrought by the current board,” Montgomery believes healing will only begin with a board apology.

“I want to apologize to Monty, to the community and to Mary D,” all of whom he feels were deeply hurt by board actions. Without “acknowledging their [the medical board’s] culpability,” in the handling of Stover’s dismissal, BIHS will be unable to move ahead, Montgomery says. He attributes the recent loss of donations and income to the community’s disappointment with the treatment of the former executive director.

Montgomery said he believed “a dramatic change in the makeup and leadership of the board is needed” and finds it “incomprehensible that there are 11 members who micromanage a staff of four or five.” He suggests a five-member board will be more efficient, though agreeing a member of the Rescue Squad and Town Council should sit in as non-voting members.

He also says the new Executive Director, Barbara Baldwin, “has a wonderful opportunity” to take the medical center in a new direction. He suggests that board members let her do so while offering support. Believing recently the board has been the public face of the medical center, Montgomery feels the director should be.

Bringing something unique

Montgomery said he has been involved in medical center fundraising events since 1998, including Nest Egg, Swing into Spring, Lights of Love, and Art Events at the Atlantic. He offers his advertising and cartooning skills to BIHS in any public relations or educational campaign, on any topic, whether its immunization, family medicine or exposure to the sun.

He said each candidate “brings to the board something unique” and that he brings the benefit of his many years on Madison Avenue, his position as former publisher of the Block Island Times and his time on the board of directors of the Connecticut Association of Children with Learning Disabilities. He is eager to place that experience in the service of the island medical center.

 

•  Peter Saxon  •

Coming to Block Island for approximately 23 years, Peter Saxon has had a home here since 1992 and has, with his wife Kathleen, lived here full-time for the last two years. They frequently enjoy visits from their five children and 14 grandchildren. He is currently Vice President of Block Island Residents Association (BIRA) and a consultant for Block Island Economic Development (BIED).

Saxon earned a bachelor’s degree in chemistry from Adelphi University, and a Ph.D in organic chemistry from the Polytechnic Institute of Brooklyn. He has a law degree from Brooklyn Law School. Saxon still appears before the U. S. Patent Office, but he has, for the most part, retired from active practice. Most recently he has represented former BIHS Executive Director Monty Stover after his dismissal.

Saxon said he believes change at the medical center must take place at the board level and be dramatic. Many islanders have been frustrated by the board’s inaccessibility and have “lost confidence in its decision-making abilities,” he said. Saxon thinks the board needs to change “in personnel, in policy and in numbers.” He sees a seven or nine member board as sufficient.

He said that candidates for any board receive guidelines from the Rhode Island Community Center Boards requiring them to put aside personal interests and to act in the interest of [their facility]. Had incumbent board members followed these guidelines, Saxon says, they would have resigned.

Change through turn-over

Though criticized for circulating a petition in August, 2012 calling for the removal of President Pam Hinthorn and Secretary Kay Lewis while also calling for withholding donations to the Medical Center, Saxon feels it “was the only form of protest possible after the firing of Monty.”

Noting it garnered 175 signatures, Saxon said, it was “a response to the board’s refusal to respond to requests made by the general community.” He attributes the loss of $40,000 in donations in the past year to that refusal.

Had the board recognized “the 16 years Monty had worked for the center,” Saxon said, and “had Hinthorn and Lewis stepped down, they would not have lost contributions.”

With the Town Council approving $123,000 in support for BIHS and with the public donating funds, Saxon sees the center as a public entity. He wants the board to present the community “a clear understanding of the budget,” which he says they have failed to do.

Toward primary care, transparency

As to the future of the medical center, Saxon would like to see it grow as a primary care practice, which would bring in greater income. However, he feels undue pressure is being put on the medical staff to implement an EMR (electronic medical records) system quickly. Believing the system should not be rushed because there are too many opportunities for errors, he suggests the center put the system off for a time or get an exemption from Medicare.

Prominent among Saxon’s wishes is to see more direct and open communication between the board and the community “without lawyers guiding their responses,” he said. According to Saxon, “It took huge efforts to stop their closed meetings” and make changes to their bylaws, which he believes only happened because of pressure exerted by newly elected Town Councilors and the public.

In thinking about “how to resolve the remaining differences between the board’s previous actions and the community’s responses,” Saxon suggested the following: pushing hard to increase membership, renewing fundraising efforts, writing new grants and requesting bequests to the medical center.

If elected, Saxon sees his role as pushing for a completely new board and becoming instrumental in clarifying and simplifying communication between the board and townspeople.

 

•  Peter Tweedy  •

Sailing to the island in 1953 with his grandfather, who built a home here in 1959, Pete Tweedy immediately became attached to island life. Eventually, his mother and his uncle had a home here as well, and he recalls “wonderful times” as a youngster spending summers on island.

Attending Lester Junior College in Worscester, Mass., Tweedy studied accounting, after which he worked for Concord Lumber Corp. for 15 years as chief accountant and comptroller. In 1994, he established his own accounting business in Acton, Mass., which he has continued to run from the island. He has clients both here and Massachusetts. For years he gave thought as to how he might eventually return to live on the island, which he finally did 12 years ago. “It was a dream come true,” he said.

At the time, he wondered whether or not living and working here “would spoil the rarity of it all,” he is clearly relieved to report that it hasn’t.

Heading into the 21st century

Conceding “there are always changes in the medical field,” Tweedy agrees that BIHS needs to change. He sees a part of it as the need to implement EMR. “The government is pushing it; either we do this or we lose money from Medicare,” he said.

With a new executive director, Barbara Baldwin, “who’s bringing good ideas with her,” Tweedy said it is “important to offer staff opportunities for professional development in order to keep up with medical advances.”

As to the future, Tweedy thinks the center must structure itself for the 21st century — at least “in the sense of the product we offer” — bringing itself up-to-date in record-keeping and in financial planning and doing “what is best for the medical center and the island.”

Tweedy would like to see BIHS able to assure islanders they can get comprehensive primary care here and still be referred to specialists as needed. He notes, “We can’t expect people to fully support the island medical center unless it provides them the care they need or want.”

Clear-cut relationship with the town

Stressing the interdependence of the medical center and the town, Tweedy said that the town deals with several independent organizations, such as the Early Learning Center, the Fire Department and the Rescue Squad. He feels it’s important for each to provide services the town needs and expects. At the same time, the town must support these organizations “because it needs them,” he said.

Tweedy sees the relationship between BIHS and the town as clear-cut: “We are contracting with the town in effect; we are providing these services and they have every right to ask, ‘What, where, when and how?’ They should be able to ask whatever they need, and there should be open communication.”

He adds, “The town is really saying to people: ‘We have confidence in this organization.’” However, while people have suggested that the town run the medical center, he feels that “would be a huge mistake.”

As to the makeup of the board, Tweedy feels the medical center “has been good” at finding people with special skills and has “historically done a very good job recruiting qualified board members.”

Being asked to serve (because of his expertise in financial matters) is what drives Tweedy’s desire to continue. “At this juncture,” he says, “we’ve made some significant changes, and I don’t think it fair for me to leave just now, unless there’s someone else to fill that role. I don’t want to abandon them.”

Cindy Baute.
Albert Casazza.
Ken Maxwell.
Bruce Montgomery.
Peter Saxon.
Pete Tweedy.
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