VNA HOME HEALTH & HOSPICE
50 Foden Road, South Portland
Services: Home health care and hospice
Annual budget: $11 million
People seem to think Colleen Hilton should be more stressed out than she is. As CEO of a health care organization facing major funding cuts and mayor of a city that's seen its share of controversy in the last year, she certainly has reason to be. But for Hilton, making tough decisions comes with the territory.
"If you don't have the mindset that you're confident about what you're doing, you shouldn't be doing it," Hilton says, sitting in her office at VNA Home Health & Hospice, a nonprofit that serves more than 3,000 clients each year. Most of those clients are seniors, making Medicare the organization's primary revenue stream. So when Hilton learned of a forecasted 7.32% cut to VNA's Medicare funding for 2011, she reorganized the company and created new service lines, including LifeStages, a non-medical division funded without insurance that offers seniors companionship and help with everyday tasks such as errands and meal preparation. "That's exceeding our goals," Hilton says.
Despite the cuts, VNA, an affiliate of Mercy Health System of Maine, grew its work force by 15% and was recognized as one of the top 500 home health agencies in the country by HomeCare Elite, which ranks winners by health care outcomes, improvement and financial performance. For 2012, Hilton's staring down another Medicare cut, 5.2% this time, as well as the looming uncertainty of federal health care reforms. "I leave a job when I'm bored," she says. "I've never had an opportunity to be bored in this job."
CEO since 2002, Hilton was drawn to home health care early in her career, fascinated by the challenge of tackling so many medical disciplines — pharmacology, anatomy and more — in a non-hospital setting. "Years ago, people thought we were friendly visitors," she says. "We're doing complex medical procedures."
The work demands employees who can not only handle the clinical tasks, but also establish trust with clients, navigate complicated family dynamics and tend to their own personal safety. "We go into gorgeous houses on the coast of Cape Elizabeth. Sometimes we've seen people in tents," she says matter-of-factly. Hilton credits much of her success at VNA to her 136 employees. "I hire really awesome people to be on my team, and then I give them room to do what they do," she says. "I'm the conductor, they play the instruments, and they play great music."
Last year, a crisis forced Hilton and her employees to adapt to a new tune. The H1N1 virus had emerged as a serious public health threat, but health care providers were scrambling to figure out how to administer the necessary mass immunizations to school children and more. "As people realized it needed to be done, the next question was, 'Who's going to pay for it?'" Hilton says. Building on its expertise vaccinating adults, VNA jumped in to administer 27,000 H1N1 vaccinations, helping Maine to reach a statewide immunization rate that ranked among the best in the country. The effort cost VNA $80,000 in the end. "When you're in a pandemic, you just need to act," Hilton says. "You don't sit around and fight about who's going to pay."
Not that Hilton's any stranger to conflict. Elected as Westbrook's mayor in 2009, Hilton, a Democrat, dismissed six employees in her first week — three of them during her inaugural address. The city recently settled a suit with one of them, the former fire chief, whom Hilton chose not to reappoint in the wake of two female firefighters suing the department over alleged sexual harassment and discrimination. "Sexual harassment, in this day and age?" Hilton says, shaking her head. "Come on."
Soft-spoken with few traces of the hard-charging demeanor you might expect of such a resolute leadership style, Hilton also walked into the middle of a bitter dispute between two of the town's major employers. Pike Industries and Idexx Laboratories had locked horns over Pike's quarrying operations, which Idexx warned could disrupt its plans to expand in Westbrook. Hilton helped negotiate a compromise agreement between the two companies, and Idexx recently announced plans to build a $60 million corporate headquarters in the city.
Not everyone's happy about the deal — Smiling Hill Farm and Artel, a maker of precision measuring instruments, are challenging the agreement in court — but Hilton's proud of the compromise. "I never said we'd get to the end of that and we'd high five," she says. "I think we did the best thing for the most people." Hilton says her family struggles more than she does about criticism of her choices. "I don't personalize it," she says. "Some people are really angry with me."
"Sometimes I think, 'Should I be more worked up?'" Hilton says. She leans forward, an easy grin spreading across her face.
IN HER OWN WORDS
What was the biggest challenge of your career? Heath care reform is, in many ways, payment reform, and I am looking at significant challenges to run an efficient, quality, outcomes-driven organization with continued cuts in funding.
When did you know you'd made it? I am a work in progress and feel there is still much to learn. I believe in the saying that my life is a journey, not a destination.
What advice do you wish you'd gotten early in your career? Take financial analyst courses — it will come in handy for all you do throughout your career.
"I'll relax when... my work is done. Actually, I relax pretty well. I have a wonderful time with my family and close friends. It's important to maintain that balance."
What was your "Haven't we moved beyond this?" moment? When I am asked what's it like to be the first female mayor for the city of Westbrook. Male or female, it just shouldn't matter.