Michael Costa on Community, Courage, and the Road Ahead
This community knows how to do hard work. People shouldn’t undervalue what a source of strength love for their community and showing up for their community is. Gifford, CEO, Michael Costa
I spent nearly two hours chatting with Gifford’s newish CEO, Michael Costa, and it was clear from the start that he carries both the weight of the organization’s past struggles and the determination to move it forward. The questions that once surrounded the hospital – whether it could endure, whether it could adapt – still linger, but Costa’s story is one of resolve and growing optimism.
Costa, who grew up in northeastern Massachusetts and now lives in Norwich, has been at the helm for just over a year. In that time, he has faced tough financial and reputational headwinds, including the strain of a less-than-perfect electronic health record rollout and persistent doubts about Gifford’s future. His response has been transparent and deeply personal.
He was quick to share stories that reveal his high moral character. He laughs about his childhood dream of playing hockey – derailed when his father put up a basketball hoop in the driveway instead – and about his two sons who became goalies. Because goalies are always in demand, his boys are often asked to step in for other teams that find themselves short.
“For them, at 10 or 11 years old, to show up in a locker room where you don’t know anybody, and you have to fit in and do your job – that has a lot of applicability,” he said. “It teaches hard work, teamwork, and determination. You have to keep showing up.” That lesson, he added, is at the heart of his leadership style. “Leadership is action, not position. Whether you’re at our front desk or on the senior leadership team, you’ve got to own your role in Gifford’s success.”
Costa has also been getting to know Randolph in the way many residents do – through its food and small-town gathering spots. He brings Wee Bird Café bagels home to his kids, who joke they’re the size of a toboggan. He sometimes tucks himself upstairs at Chef’s Market with a sandwich and his laptop, and he’s quick to note that Randolph Village Pizza is a reliable favorite, even for board meetings. “These little rituals matter,” he said. “They’re part of how you get to know a place.”
Not every CEO tests acoustics, but Costa couldn’t resist. One quiet afternoon, he wandered into the 750-seat main hall at Chandler Center for the Arts, stepped onto the stage, and let a few notes fly – before quickly admitting his singing voice is now mostly reserved for the shower. The sound, he added, was terrific.
As a Chandler board member, it struck me as a pleasant surprise to hear he’d sung in the hall – a small but telling gesture of how he connects with the community around him. It also revealed a willingness to step outside his comfort zone, a trait that mirrors the kind of leadership he brings to Gifford.
That willingness to step outside his comfort zone also shapes how Costa thinks about governance. In our conversation, I shared with him something his predecessor, Dan Bennett, told me in an earlier interview before he retired: “Everybody has a boss, and the person sitting in the CEO’s chair reports to our board, and our board represents our community.”
Costa agreed with that sentiment but noted that today’s directors have pushed themselves further. In recent months, they have launched a recruitment drive to bring in new voices and perspectives, working to ensure Gifford reflects the full spectrum of ages, demographics, and lived experiences in the region. For Costa, that inclusivity isn’t optional - it’s what keeps leadership grounded. Directors, he said, are there to ask the hard questions: How would a patient really see this? To him, serving on Gifford’s board goes well beyond governance; it’s a chance to strengthen the hospital and create opportunities for neighbors to “do good” for their community.
One of the most challenging moments for Costa arose with the release of the Oliver Wyman Report, a statewide hospital sustainability study commissioned by the Green Mountain Care Board and the Vermont Legislature. The report bluntly suggested that small rural hospitals like Gifford might not survive in their current form. Costa acknowledges that it left a scar. “It still reverberates through the community,” he said. “There’s this fear of the unknown and Gifford’s future. But what I can say is this: the idea of ‘Will Gifford close?’ – the answer is no.”
He called the report “a difficult gift,” one that forced Gifford to confront its challenges head-on, but also gave the organization a head start on the transformation all Vermont hospitals must face.
And there are signs of real progress. When Costa arrived, Gifford’s inpatient census averaged about eight patients a day. Over the past year, that number has more than doubled, with recent weeks averaging nearly 20 and even a day at 22 – nearly full capacity. For the first time in years, the number of unique patients served is also climbing again, reversing a long decline. “That’s a really heartening fact for us,” Costa said. “It means people are choosing Gifford again.”
Access has improved as well. Gifford has eliminated its primary care waitlist, which once numbered in the hundreds, ensuring that new patients can now be seen without delay.
Financially, Gifford has made strides. “In the last six months, we’ve gone from 59 days cash on hand to 79 days cash on hand through better operations,” Costa explained. That improvement reflects stronger management and day-to-day discipline.
Separately, a recent $8 million ARPA tax settlement has provided an additional boost. “It does not solve all of our problems,” Costa said. “But it gives us such a better platform to engage with the future.”
He is also clear-eyed about deferred assets. “Our physical plant is in very good shape – it’s been lovingly maintained – but deferred investments are always a risk. Like any household, if something breaks, we have to find efficiencies to fix it. And we need to do better at grant funding to support those long-term needs.”
But Costa is quick to point out that Gifford’s future isn’t just measured in balance sheets – it’s measured in people. One of the programs he’s most proud of is the nurse residency initiative, which welcomed eight new graduate nurses who are now about to become full-fledged nurses. That “grow your own” model, he believes, is key to Gifford’s future. It enables experienced nurses to transition into specialized areas while new graduates establish their footing.
“As those new nurses gain confidence on the medical-surgical floor, our seasoned staff can move into critical service lines like the birthing center and the emergency department,” Costa explained. “That reduces our reliance on traveling staff and ensures continuity of care in the hospital’s most essential units.”
He envisions Gifford becoming known as a place where people can train and grow. “We take care of people through every phase of life,” he said. “I do not think there’s another place in America that has a critical access hospital, a federally qualified health center, and a retirement community with independent living, a nursing home, and adult daycare.”
Gifford’s stability is inseparable from Randolph’s future, and the hospital’s progress mirrors the broader work the town is doing to strengthen its economy and community life.
Building a Stronger Local Economy
Gifford’s stability matters not just for health care, but for Randolph’s economy. As the largest employer in Orange County, Gifford provides hundreds of jobs and anchors the local economy alongside Vermont State University’s Randolph campus and a strong manufacturing sector. Their presence draws people into town each day, supporting downtown businesses and sustaining Randolph’s role as the county’s hub.
According to the Vermont Department of Labor, Orange County’s unemployment rate has remained among the lowest in the state, hovering at around 2.5 percent in mid-2025. Yet despite that strength, household incomes continue to trail the statewide average, underscoring the challenge of not just creating jobs, but ensuring they are quality positions that support a good standard of living.
At the same time, Orange County’s demographics and land-use trends point to deeper shifts. Residents aged 65 and older now represent nearly 23 percent of the population – the fastest-growing segment by far. Meanwhile, the number of farms has fallen to its lowest point in 30 years. Although total acreage has increased slightly in recent years, the long-term trend remains downward as farmers continue to sell land to cover their living costs. These changes highlight both the opportunities and vulnerabilities facing the region: an aging population with growing needs, and a farming base under pressure even as agriculture remains central to the county’s identity. That demographic shift also underscores why Gifford’s services are so vital – meeting the health needs of a rapidly aging population while remaining rooted in the rural economy that defines Orange County.
Recognizing these pressures, Randolph is working to build on its strengths. The Town has been strengthening relationships with regional and statewide partners, including a new collaboration with Rethink Local and consultant Alex Torpey, to help align local initiatives with broader economic trends. At the same time, the Town is rebuilding its Town Plan, a process designed to reflect current realities and future opportunities. The plan will guide decisions on land use, housing, infrastructure, and economic development for years to come. A key component of that work is the Walk, Bike Master Plan, which is taking a comprehensive inventory of Randolph’s assets – sidewalks, trails, crossings, and bike routes—and identifying areas where improvements can make the community safer, healthier, and more connected.
Building on that momentum, the Town of Randolph, in partnership with Chandler Center for the Arts, has secured a $107,000 grant through Think Vermont’s GROW program – a statewide initiative funded by the Vermont Legislature via the Department of Tourism and Marketing. The program is designed to help communities attract and retain residents, strengthening both the local economy and cultural life.
As part of that effort, the Town has also launched a downtown tree-planting initiative in partnership with Walk, Bike, Roll, Randolph – a committee of local residents dedicated to improving walking and biking infrastructure. Trees will be planted along Main Street, Merchant’s Row, and other downtown streets. The new trees will be a visible step toward making the village center more welcoming and shaded, with the project set to commence this spring.
Still, challenges persist. Housing remains a pressing issue, with limited options for families and workers. Child care, even with new capacity scheduled to open this November, faces a hiring crisis that may make it difficult to operate at full strength. Job quality remains a hurdle. Randolph has openings, but not enough positions that provide the wages and benefits needed for a good quality of life. Public safety is also a growing concern. Having already begun building a community-based police force, the Town must now focus on making that model sustainable and reliable for the long term.
Looking Ahead
As the largest town in Orange County, Randolph carries a responsibility that extends beyond its borders. With nearly 5,000 residents and a concentration of employers, services, and downtown businesses, Randolph is the county’s civic and economic hub. That position brings both opportunity and obligation. “We can’t just think about Randolph in isolation,” Town leaders have noted. “Our success is tied to the success of Brookfield, Braintree, Bethel, and every other community around us.”
Randolph is stepping into that role with intention. By strengthening partnerships with neighboring towns, regional organizations, and statewide initiatives, the Town is working to ensure that growth in this area benefits the entire county. Randolph’s challenges – housing, child care, job quality, and public safety – are not unique. But as the county’s largest town, Randolph is positioned to lead in finding solutions. That means advocating for more housing options, supporting the rollout of new childcare capacity this fall, pushing for higher-quality jobs, and ensuring that its already strong, community-based police department has the long-term resources and structure it needs to remain effective and sustainable.
The pressures of an aging population, the decline in farms, and the need for stronger job quality are real. Yet Randolph is showing that it is willing to face these challenges directly and creatively. From planting trees downtown to rewriting the Town Plan, from strengthening partnerships to investing in culture, the message is clear: Randolph is building for the long term. The community’s resilience, combined with the determination of its leaders and residents, is laying the groundwork for a future that people can be proud of—a future rooted in health, strengthened by culture, and committed to being a place where people want to live, work, and play. Oh, and yes, Mr. Costa, to sing!