By Mary Alice Murphy

For the safety moment, which usually begins the Gila Regional Medical Center Board of Trustees regular meetings, at the Nov. 30, 2018 session Chief Quality Officer Tanya Caroccio said the hospital is "really keeping an eye out for icy, slippery spots. Let us know about safety issues. We are asking employees and visitors to let us know when they find things that need to be taken care of."

Recognized at this month's meeting was Robert Holguin, who has served 25 years in the imaging department.

"When we had systems falling apart, he took care of them," Chief Executive Officer Taffy Arias said, when giving him the certificate of appreciation. "Last year, he went with (then Interim Chief Financial Officer) JoBeth (Vance) and me when we presented to Prospectors. He could answer the questions better than we could."

Holguin said: "It's amazing how much change has happened in 25 years in imaging. We have a good Board of Trustees. It's good that we kept the hospital community-owned. It's our hospital."

Under public input, Linda Pafford talked about "issues between the hospital and the Detention Center. We of the ACLU are monitoring the Detention Center. We have made IPRA requests that have gone unanswered. We need cooperation among all the agencies, the hospital, the Detention Center, the sheriff and police departments. We need new protocols at the Detention Center for working with the sheriff, the police and Gila Regional. I understand Gila Regional has a mental health ward with 10 beds, but they only ever use five of them. The emergency room often mishandles mental health patients and has to call law enforcement. Does the ER staff need better training? We talked to the mental health ward doctor and he said he is rarely called in to evaluate a patient. Who pays for the treatment beyond issues with Medicaid? It's not necessarily true that once a person is incarcerated, he or she loses Medicaid. Once the person is detained in the jail, the county takes over their care."

She said she assumed the hospital has a social worker to get people to sign up for Medicaid. "If a person needs it, they can get it. It shouldn't be a concern about you not getting paid. If all else fails, the county has an indigent fund. These patients, we're talking about paying customers. There needs to be a discussion among law enforcement, Gila Regional and the Detention Center. As the community has no facility for inpatient mental health care, GRMC must accept the responsibility and has the duty for evaluating those coming into the ER for mental health issues. I ask the Board of Trustees to take this on. It's an issue of liability."

"There is also the difficulty of exchanging medical records," Pafford continued. "The Detention Center has the right to the information. It may be crucial to care by the medical staff at the Detention Center. Someone being booked could be referred back to the hospital. No one is wanting the responsibility for the ones needing intervention. I know of one man in jail who had trouble getting dialysis.

"We demand the situation be addressed," Pafford said. "As a taxpayer, I'm paying for the liability. Family members also need to be informed about the status of their family member. To continue to go as you are doing at present is to invite liability."

Dan Otero, Hidalgo Medical Services chief executive officer, was the second to give public input.

"I wanted to give you updates," Otero said. "I also want to express my gratitude to Taffy Arias and Richard Stokes [GRMC chief financial officer] as we work together." He invited the board members to the opening beginning at 11:30 a.m. at the Tu Casa substance abuse treatment center on Friday, Dec. 7, 2018.

"I also wanted to give you an update on the care coordination with Medicaid CareLink New Mexico," Otero continued. "The program is reimbursing us to identify Medicaid individuals who are not yet enrolled in Medicaid. It allows them access to care anywhere for mental health and co-medical issues. We are working with Gila Regional on this program."

He said HMS had received a SAMHSA grant for non-Medicaid care coordination. "We are relocating 30 employees to a facility on Hudson."

Otero also reported on the status of the Bayard Clinic. "We will set up a temporary clinic near the Santa Clara Senior Center by Feb. 1. We will have a single medical provider there. Thank you for working with us to get another place. If this doesn't work out, we will consider a mobile clinic."

Board Chairman Mike Morones said: "In case anyone was timing the public comment, I try to limit it to five minutes. But if there are not many wanting to give public comment, I will be a little lax."

Board Vice Chairman Dr. Victor Nwachuku said he likes the potential for the hospital to work with the jail. "I hope we can develop a system. We have interactions, why not make them better? I also want to continue to work with HMS."

Chief Nursing Officer Peggy White noted that the hospital does have a team working between Gila Regional and the Detention Center.

Arias echoed that the hospital has been working on the issues. "There have been multiple meetings and a lot of dialogue from the liability issues to patient safety. Evidently the speaker has heard a lot of inaccurate information. Money is not ever an issue when a patient comes here."

Trustee Ed Wilmot said, during board comments, he feels a sense of urgency to get the strategic plan going early next year. "I see more of an urgency on working together. Why don't we invite the community in for part of the strategic plan discussion?"

Trustee Tony Trujillo thanked Otero "for joining us. Getting collaboration among co-health care agencies is important. The effort is there to get the situation taken care of at the jail. We need to get the word out. We need everyone to be aware of it."

Trustee Jeannie Miller said she likes the new signage and logo. She noted that the American Hospital Association would be holding its rural health conference in Phoenix. "I would like to attend."

Trujillo said he attended one of the group's training sessions and it was well worth it to learn and network.

Morones suggested getting a list of trainings for trustees to look at.

"I commend the board chairman for reaching out to the County Commission at their last meeting," Trustee Joel Schram said. "It continues our efforts at transparency with the commissioners."

Morones said he and Arias attended a medical staff leadership meeting. "The doctors wanted a dialogue with the board. I want to continue being a part of all communications available. If this medical staff group proceeds, the members plan to develop a mission and vision. I will try to attend any groups to try to add value to our communications."

"So we can update each other and try to get on the same page as the commissioners, maybe in December or January, we could all get together," Morones suggested. "I want to try to communicate with all stakeholders. When I came on the board, there was a sense of complacency. We need to continue moving forward in the direction of letting the community know what we are doing."

On the consent agenda, Trujillo asked for a correction on the Detention Center administrator's name in the minutes. "His name is Mike Carillo, not Trujillo."

Wilmot asked that the minutes be a bit more specific. "Instead of just saying discussion ensued, maybe add a nugget of information, so the minutes reflect what was talked about."

Morones said typically the discussion is about a certain topic. "Can we try to make the minutes more reader friendly? We can tackle that."

The next article will begin the reports and updates from staff.