[Editor's Note: This is part 2 of the Grant County Commission work session on Sept. 10, 2019. More articles to come.]

By Mary Alice Murphy

County reports and public input began the Grant County Commission work session on Sept. 10, 2019, mainly on the wild and scenic river designation, which was up for a decision at the Thursday regular meeting and can be read at http://www.grantcountybeat.com/news/news-articles/53238-grant-county-commission-hears-public-input-at-work-session-091019.

Gila Regional Medical Center Chief Executive Officer Taffy Arias led off the presentations.

"I have several things to share that I'm very excited about. As you know, we have applied for a Level 4 Trauma designation," Arias said. "We have what we call a decontamination area. We recently had an exposure in Lordsburg. We didn't know what the extent of the contamination was, but we received those who had been exposed to chemicals. We treated them all. Because the area is a staging area, no one in the hospital was exposed."

On the Level 4 trauma designation, Arias said they have developed a trauma team. "Everyone on the team is alerted to respond in case of an incident. They complete an immense amount of training, and it involves different departments, such as respiratory, radiation, emergency, EMS, nurses, physicians, and other staff members. We had a gunshot wound come in. Without this training, the young mom might not have made it. Part of the outreach for the trauma designation, which will take about a year of work to complete, is Stop the Bleed. It is an immediate response that a bystander can apply. We will be doing the training out in the community. We had a recent change in our emergency department director, Dr. Stephen J. Kotch. We are working to decrease the wait time in the emergency room. We want to decrease time from the moment the person arrives to when he or she sees a physician to admission. We want to decrease people going out of our hospital."

She also talked about initiatives with the quality program. "We want to better manage our 650 contracts, as well as manage our policies and procedures and to track events in the hospital, so quality can look at them. We begin a employment engagement survey tomorrow (Wednesday, Sept. 11). We are encouraging 100 percent participation to rectify concerns. It will be a year-long process. We will get the results, present them to the board, the commissioners and our employees. We will gather our employees for input to learn what we can do better and to build better relationships. We will celebrate 50 years of the Auxiliary tomorrow and at a reception in October. We have instituted the tele-neurology system in the emergency room and in the operating room. Sept. 27, we will take part in a blood drive, and on Sept. 28, we will participate in the Mimbres Valley Harvest Festival."

On the recruitment side, Arias said they had extended an offer to a general surgeon and are awaiting an answer. "We had an onsite interview with an ENT (ear, nose and throat specialist), and he asked for our proposal. We have also been involved in a process with Dr. James Skee of Silver Health Care and Dan Otero of HMS (Hidalgo Medical Services CEO) to actively look at health care in the community. The most important thing we gained is good dialogue on our issues and the history of health care in the county. I have been listening to dialogue on what worked in the past and we've been talking about what will work in the future. We want to work together not to duplicate efforts. The community needs access to family medicine and internal medicine. We don't want to duplicate specialists. If we see Dr. Skee bringing in a specialist, we bring in a different one, so Dr. Skee doesn't have to. All our entities bring different attributes. HMS is a federally qualified health center and Dr. Skee has clinical knowledge that augments what we have as a hospital. We don't need to look at three different entities. We need to feed on each other's abilities. I appreciate our sorting out how to best serve the community."

GRMC Chief Financial Officer Richard Stokes gave a brief summary of the July financial report. "We had a profit for the month of $7,997. Last year, for the same month, we had a $514,000 loss. Our EBIDA (earnings before interest, depreciation and amortization) for the month was $235,000, which is an approximation of our cash flow. Last year, the EBIDA was a negative $112,000. Cash collections came in at 31 percent at $4.5 million, compared to last year's $4.7 million. August may be a bit tighter. We still have a lot of work left to do. We got down to the foundation last year. This year, we're adding to the wall and adding programs to add to the cash flow. I'm excited about our progress this year."

Commissioner Harry Browne said he was pleased to hear about the collaboration. "Your strategic plan called for opening clinics. Can we have an update on Bayard or are you changing your mind?"

Arias said the hospital is waiting for the financial piece. "We are pleased that HMS opened its new site, which is doing well. Competition brings out the best in all of us. The Bayard community is not as small as you think. It encompasses people from Mimbres, and the entire mining district. We want to provide choice."

"We heard that the hospital lost money with hospice and home health," Arias said. "Yes, but we lose on other necessary services, such as EMS, but they are all needed by the community. Yes, we think it's right to have a choice in Bayard. Our finances when I came were not good. As we dig into the processes of financial management, we have discovered that things weren't handled properly, so we're fixing them. What's important is what we're doing for the community. We know home health is important, and we have to have hospice to go along with the Cancer Center. Our care for the patient doesn't end until the patient is gone. We all share the lack of accessibility. We suffer for having no child or adolescent psychiatric services. Together we can be the best for our community."

Stokes concurred that competition is important. "At our collaborative meeting last Friday, Dan agreed that the three entities are in competition, but where we can cooperate is where we work together. What HMS has resources for, we want to support. We are competitors, but we want to work cooperatively. The conversation continues. We turned the page. We will compete, but we will help where we can."

HMS Chief Executive Officer Dan Otero presented his monthly update. "I have a report we're going to go over. But I want to announce we received a Health Center Quality award for being in the top 20 percent in the nation. We won't be happy until we get in the top 10 percent." He introduced Lt. Gov. Howie Morales.

"It's always good to promote Grant County statewide," Morales said. "Governor Lujan Grisham and Department of Health Secretary (Kathyleen) Kunkel realize that when we look at health care, it is critical to get it right for seniors. I am proud of being from Grant County. We started the First Born program, and the Grant County Community Health Council has been another initiative with statewide impact."

"We have a lot of opportunity in this community," Otero echoed. "Yes, there is competition, but there are a lot of things we can do better together. I appreciate Commissioner (Alicia) Edwards for bringing us together. This report is about a tool to drive change. We applied for a Freeport Community Investment Fund grant for this research and report. Ann Hayes Egan, our core researcher , along with Chris DeBolt, Edith Lee, Dr. Pedro Armendariz and 42 community members are working together on the issue of seniors. We can use this report as a tool for change."

Egan said the advisory group has been meeting for about 8 months and "is deeply engaged. For the process, we wanted community dialogue. We got a tremendous input from the community through a survey. The loss of population in this county is not as great as in others in the state. New Mexico overall was 39th in its population of seniors, but now it is fourth. Grant County has one of the fastest age waves in the state, with the older population permeating all parts of the county. We had 524 responses to our survey, primarily from middle-aged to older adults. We had key interviews with 35 individuals, and had 80 in the key informant groups. We put the responses together in common themes. We held meetings all over the area and got great information from them. You have support for quality of life. We determined priorities and made recommendations."

"There are ways all of us can contribute," Egan said. "you need to encourage your constituents to help with this process. The first phase got to the priorities. I'll let Dan talk about the recommendations.”

Otero listed them:
Improve access to community services. HMS is becoming a benefits enrollment center;
Build quality of life for older adults in the county, between partnership with the county and HMS on senior services and with the Western Institute of Lifelong Learning and includes opportunities for seniors to have paid positions;
Expand and diversify affordable housing options available to older adults in partnership with the state, the governor, the lieutenant governor and the Department of Health, including the greenhouse model for seniors. These are high cost items;
Come together on who will bring in the pediatricians and other specialists. I've been working on having specialists come on a route to Hidalgo County and Grant County; and
Develop more transportation services, especially in the more remote areas.

"HMS will take the initiative to immediately begin the next steps," Otero said. "We will continue to meet and develop ways for the community to help, as well as working on statewide legislation."

Commission Chairman Chris Ponce said he hears concerns about transportation. "I understand we have Corre Caminos, but certain laws get in the way."

Otero said there is also a need to collaborate with Medicare and Medicaid, which have reimbursements for transportation. "It's doable, but we need to sit around that issue specifically."

Edwards declared the efforts: "Amazing work. I feel like the community has needed to do this for a long time. My interest is in the basic needs. How do you define basic needs? I say they are food, housing and transportation. Other entities are working on services, too. We need to support them all."

"This report is not just about health care," Otero said. "It's a holistic report."

Edwards noted that all of it is critically important and will be expensive.

Egan agreed but said so many different agencies can do their jobs and have opportunities to be part of the process. "It will be economic development."

Otero said HMS is extremely proud to take the lead in the efforts. "It's a focus on community."

DeBolt said: "I'm one of those seniors. It occurs to me that it is less than 11 years until the age wave hits us, so we need to start. If not now, then when? If not me, you and us, then who?"

Ponce said he was glad to see that the social aspect was addressed.

The next article will cover the presentations from the Cycling Group and from the Gila National Forest.

 

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