In cash-strapped Colorado, consensus building for more school-based health care

This is an excerpt from an article in the Colorado Independent.  To access the article in its entirety, click here.

State Rep. Daniel Kagan, D-Denver, let the fleeting pleasant experience wash over him: His bill to make school-based health care more accessible, HB 11-1019, passed out of committee on a unanimous vote.

Currently, health clinics located in schools treat uninsured children for free but have to charge insured children the appropriate co-pays. If you thought it was hard to make sure every first-grader had 30 cents in his pocket every morning for breakfast, imagine making sure your kid has $30 in her pocket in case she gets the sniffles.

Kagan said even the insurance companies support his bill, because, he says, they know their overall costs are reduced if kids get preventative treatment when they need it rather than a trip to the emergency room a day later.

Kagan said that in his district the clinics would have stopped treating insured kids in July, but that if the bill passes there will be no disruption in service.

“When kids can’t get the care they need, entire families are disrupted. This bill keeps our most vulnerable children healthy and focused on their education,” said Rep. Kagan. “Insurance and medical providers both agree that preventative care drives insurance costs down system-wide, by keeping kids out of the emergency room and receiving the care they need when they need it.”

Clinics provide a variety of services, including well child exams, immunizations, diagnosis of illness and injury, lab tests, management of chronic issues such as asthma and diabetes, treatment for substance abuse and mental health issues. Some of the clinics even include dental services.  Access to such clinics improves attendance and even reduces drop-out rates as healthy kids are more likely to thrive in school.

To access the rest the full article, click here.

Celebrating 20 Years of CRHC: Your Perspectives, Part II

These reflections on the past twenty years are part of our ongoing series for 2011 encouraging our members to share their thoughts with us. If you have memories, stories of why you love working rural Colorado, or thoughts on what "rural" means to you, please send them to sm@coruralhealth.org.

"There are just of few of us who remember working in rural healthcare in Colorado before the Rural Health Center even existed.  I remember meeting with family members of patients who had been transferred to more advanced facilities and having to try to explain why the doctors on the receiving end had told them that the care we provided was substandard. I remember when patients with possible head injuries had to be transferred 120 miles to have there heads cleared by a CT scan and were back in town the same afternoon describing the inferior services our rural hospital provided. Those were not the “good old days”.

Today, the auto licensing fees provide support for EMS equipment and RETACs work diligently to provide education and coordination of system members. The Trauma program has made the transfer and quality of care dialogue vastly better and has fulfilled its promise to improve trauma care throughout the State. Our improved funding enabled us to purchase or lease CT scanners and other advanced technologies and, now, we can send those images instantaneous to our partners at larger facilities. Our community recognizes this as being able to support their care, no matter what and make good treatment decisions.

Through all of this the Rural Health Center has been there; providing education, providing grant funding, providing technical assistance, advocating for us with payers and regulators, and, frankly, holding our hand during tough situations. I remember vividly my first Critical Access survey conducted by the State of Colorado and Lou Ann Wilroy [CRHC's CEO] being right there with me at the hospital guiding us through the process. Thanks for being a positive force for change in rural Colorado."

--Randy Phelps, Gunnison Valley Health

More than Half of Hickenlooper’s Appointees are from Rural CO

This is an excerpt from an article published in the Pueblo Chieftan.  To access the full article, click here.


Gov. John Hickenlooper’s no hick, but he’s not shy about rubbing elbows with rural folk. Most of his senior staff comes from outlying areas of the state.

“More than half the people we’ve appointed are from rural Colorado,” Hickenlooper said Thursday.

Geographic diversity wasn’t what landed them the jobs, Hickenlooper said, but it’s an advantageous coincidence.  Hickenlooper has lauded his senior staff for walking away from more lucrative opportunities to join his administration in hopes of making a difference for the entire state.

“It is really difficult to get really talented people to take significant pay cuts,” Hickenlooper said.


Click here to read the full article.

Pagosa Mountain Hospital expands Wellness Center work through generous contributions from local businesses

Pagosa Mountain Hospital staff recently received a check from a local dentist to support and expand the work of The Wellness Center.  The Wellness Center works throughout the Pagosa Springs community  to provide self-management support for cardiovascular disease patients.  Matt Guy, CRHC's Quality Improvement Coach, is second from the left, and he helped bring the Heart Healthy Solutions program to Pagosa originally.

Webinar Series: 2011 AgriSafe Network

February 24, 2011
Falls and Aging Farmers: Prevalence and Prevention - Session Link

March 23, 2011
Pesticides and Farm Worker Health - Session Link

April 6, 2011
The National Pesticide Information Center (NPIC): Practical Resources for You and the People You Serve - Session Link

For the most up-to-date information on the webinars and directions to log in, please click here.

Udall visits MCC, WTA on economy tour

Photo by Dan Barker

This is an excerpt from an article by Dan Barker at the Fort Morgan Times.  Click here to access the article in its entirety.

Health occupations and broadband Internet access are a growing part of the economy, which were among the reasons U.S. Sen. Mark Udall visited Morgan Community College and the Wiggins Telephone Association Friday.  Udall stopped in Wiggins, Fort Morgan, Sterling and Akron Friday on a tour meant to give him a look at progress in Northeast Colorado and to listen to people about what they need -- particularly about getting local economies up and running, he said.

Health occupations are a growing part of the overall economy, he said.  Not only are these professions vital in improving health care, but these kinds of training programs fill the need for jobs, Udall said.

Udall said he helped push through the Rural Physicians Pipeline Act as a portion of the Patient Protection and Affordable Care Act. The pipeline provides incentives to draw young people from rural communities into health care professions of all kinds and to return to their communities.

The idea is to promote "home-grown" physicians and other health care providers such as nurses and medical technicians, Udall said.

Udall went on to Sterling to talk with regional officials about workforce issues, and to Akron to a public meeting to talk about bringing good-paying jobs to rural Colorado.

 

Click here to access the full article.

Celebrating 20 Years of CRHC: Your Perspectives

These reflections on the past twenty years are part of our ongoing series for 2011 encouraging our members to share their thoughts with us.  If you have memories, stories of why you love working rural Colorado, or thoughts on what "rural" means to you, please send them to sm@coruralhealth.org.

"In 1991, we moved into our own “new” 3,600 sq ft medical clinic after operating out of a small store front in downtown Lake City.  On Jan 10, 2011, we opened for business in our new 7,000 sq ft clinic.  Twenty years has been very good for medical care in Lake City.  The old clinic is being remodeled into an EMS, Wellness and Conference Center and should be completed by the end of March."

--contributed by Ray Blaum, Board of Directors, Lake City Area Medical Center



"Why we love rural Colorado: It’s all about the “relationships” for me. Building friendships and relationships is important to me and working in rural Colorado affords me the opportunity to do this, and do this I have! Also…..it’s where the mountains are! There are no mountains in the cities so therefore, if I lived in the city I could not take as much advantage of our gorgeous mountains as I have been able to in Gunnison, Fort Collins and Estes Park."

--contributed by Robert Austin, Estes Park Medical Center

Gov. Hickenlooper to tour Colorado to promote bottom-up economic development plan

Governor Hickenlooper
Photo from Westword.com

Governor Hickenlooper begins a statewide economic development tour today, Friday, January 14. We would like to urge you and your colleagues to attend the meeting in your community, and help articulate the importance of healthcare as an economic driver in rural Colorado:

• A rural hospital is often one the largest employers that offers one of the largest payrolls in rural Colorado counties
• A single rural Family Physician generally directly creates 3 jobs and indirectly creates 18 additional jobs
• “Leakage” of healthcare dollars to larger towns and across state lines hurts local economies
• Companies take access to healthcare for their workers into account when considering whether or not to relocate to rural Colorado

Friday, Jan. 14, 2011

• 10:00 a.m., Singletree Community Center
  1010 Berry Creek Road, Edwards, CO
• 3:00 p.m., Fruita Community Center
  324 North Coulson St., Fruita, CO

Saturday, Jan. 15, 2011

• 10:00 a.m., Strater Hotel, Pullman Room
  699 Main Ave., Durango, CO
• 3:00 p.m., Rio Grande Annex Community Room
  965 6th St., Del Norte, CO

Sunday, Jan. 16, 2011

• 1:00 p.m., Spradley Community Center, Pueblo County Conference Room
  1001 N. Santa Fe Ave., Pueblo, CO
• 4:00 p.m., Cheyenne Mountain Resort
  3225 Broadmoor Valley Road, Colorado Springs, CO

Monday, Jan. 17, 2011

• 10:00 a.m., Limon Community Center
  477 D Ave., Limon, CO
• 3:00 p.m., The Ranch, McKee Community Building
  5280 Arena Circle, Loveland, CO

Letter from the CEO: What Were You Doing In 1991? CRHC Was Just Getting Started

Lou Ann Wilroy, CEO

2011 is a very special year for the Colorado Rural Health Center. It’s our 20th Anniversary! Can you remember what you were doing back in 1991 when CRHC was established?

To jog your memory some, here are some 20 year-old facts: the Soviet Union broke apart in 1991 after President Gorbachev resigned. Professor Anita Hill accused Judge Clarence Thomas of sexual harassment that year. Dances with Wolves won Best Picture (Just Googled it and can’t believe how young Kevin Costner looked). The Song of the Year was “From a Distance” by Bette Midler and the album of the year was Phil Collins’ “Another Day in Paradise.”

Did that help? Do you remember 1991 now?

Okay, I’ll admit it’s still a bit fuzzy for me too, so I’ll give you an easier assignment.

To celebrate our 20th we’re asking rural providers to tell us why they love working in rural Colorado, what the word “rural” means to them and, finally, any interesting or especially helpful contact you’ve had with CRHC staffers over the past two decades.

We plan to feature your memories and observations throughout 2011 through our website and other communications tools we utilize.

CRHC is proud to have had the opportunity to serve rural providers and rural Colorado citizens for 20 years, and I am extremely proud to be able to lead this organization into the next 20 years.

Please send your observations and anecdotes (and questions) to Sarah Mapes at sm@coruralhealth.org. And thank you in advance!

Guest Commentary: The challenges of health care reform at a Rocky Ford clinic

Doug Miller, FNP

This is an opinion piece written by Doug Miller, a Family Nurse Practitioner who owns the Rocky Ford Family Health Center, and published in the Denver Post.  To access the full article, click here.

I need to start this column by saying I am so grateful for my job. I am a nurse practitioner in Rocky Ford. I own my own medical practice. I am honored to be a part of the lives of my patients, their parents and grandparents, and sometimes even their great grandparents.

I needed to start out with that positive statement, because a clinic in rural Colorado often feels to its owner like a small ship in a big ocean, an ocean with some pretty nasty waves.

I'll start with the challenge of getting help. Not only is it hard to attract medical professionals to rural spots like ours, finding enough funds to pay them competitive salaries is difficult too. The Colorado Rural Health Center (CRHC) has done much to help on this front; the two physician medical directors I've recruited since opening the practice in 2003 have come due to CRHC recruitment.

Part of our challenge out here is getting the government and insurance companies to really understand that care in rural areas is often delivered via advanced practice nurses like me.

I'll close with a word about health care reform. While much debated and criticized, much in the health care reform law approved by Congress is good, especially when it comes to pre-existing conditions and allowing parents to continue to insure their children to age 26. The issue that worries me about reform is the number of newly covered patients it creates. Don't get me wrong; more covered people is definitely a good thing, I just worry about my, and our, capacity to care for significant numbers of new patients. Also, I worry about how the state, which is required to pay for half of all Medicaid charges, is going to find the funds to accommodate the increased cost of thousands of new patients?

Since I started on a positive note, I'll end on one. We're an innovative and generous state and country. I'm confident we can address these challenges, but also appreciate the time to get to work on them is now!

To access the complete article, click here.

Yuma Clinic Links Patients, Resources through Close Community Connections

Article provided by Colorado Community Health Network.

Providers at Yuma Clinic in rural Yuma, Colorado treat about 1,000 patients per month on average. Serving a patient population that is about 40% Hispanic with a significant number of elderly, the Yuma clinic has close ties to its small community and the local hospital which helps for prioritizing care coordination.

Teri Mekelburg, R.N., says successful follow up and coordination of treatment after receiving care at the clinic is easier in a small community. The provider and nurse work together to make sure referrals are done to home health care, or other community resources with the help of a Community Health Worker who is employed by the hospital.

“Our community health worker does local outreach, and working through a grant for heart healthy solutions, she offers weight management classes and glucose and lipid screenings as a free service. Last year she conducted screenings on 300-400 patients,” says Mekelburg.

Mekelburg adds that when patients are discharged from the Yuma hospital, located in the same building, the hospital discharge planner coordinates with community resources and with the clinic so that a patient’s care team is notified of any emergency department use, for example.

“It’s nice because there is no dropping the ball between the hospitalist and primary care provider as happens in larger facilities. The provider that is seeing them in the hospital is the same one who normally will see them in the clinic,” she says. “The discharge planner would make a plan for patients to follow up with their PCP here. The same thing goes for the ED. If a doctor wants to see a patient again, then they will make an appointment at the time of discharge.”

A county-employed ombudsman is also available to assist patients with resources for care. “If we have someone who needs help with insurance or Medicare Part D sign up, our ombudsman conducts referrals to special services, including help with long term care options,” says Mekelburg.

Mekelburg adds, “We also have very low nurse turnover; so our nurses, who know the resources well, and the community health worker can work together to coordinate care between clinic, hospital, and home for the best patient outcome.”