[Editor's Note: This is part one of a multi- part series of articles on almost six hours of Grant County Commission meetings on Feb. 11 and 13, 2025)

By Mary Alice Murphy

Public input at the Grant County Commission work session on Feb. 11, 2025, began with a report from Melissa Green, representing the Gila Back Country Horsemen.

"I just wanted to take a minute to share with you what Gila Back Country Horsemen have been doing to improve the outdoor recreation economy in our county," Green said.

She explained the mission of the group is to ensure continued reasonable use of packing-style stock on public lands and to keep forest trails open for all. "We lead and participate in trail maintenance. We also try to help disperse use and keep solitude high, by maintaining trails in multiple areas throughout the National Forest. Our main projects are March to May and August to October, ranging from one- or two-day projects to pack-in trips for several days."

She said many of the trails they have maintained continue to be worked on and have routine maintenance every few years.

Green noted that New Mexico Outdoor Recreation and the Great American Outdoors Act funding has been a huge funding source to help them get trails ready for the US Centennial last year and into the future. "We also have created and maintained the Gila Trails info website, which provides updated trail information to locals and tourists alike. The information provided includes recommended day hikes, and updated weather conditions and fire and flooding closures, as well as whether and where water is available."

She said the Forest Service regularly shares this website to
the public. and thanks to a New Mexico Outdoor Division marketing grant, "we have a new website that is much prettier."

"We also just received funding to build additional corrals," Green continued. "Thanks to 6,200 volunteer hours, we addressed 60 miles of burn maintenance and 126 miles of routine maintenance last year. We removed 180 logs using crosscuts and chainsaws, in addition to lots of brush, and we built trail markers. Some of the trails we've improved in the past years include a network of trails from Snow Lake and Willow Creek, multiple loop options in Woodland Park and Lily Park, and many out-and-back options on the west side of the Gila Wilderness that was affected by the 2012 Whitewater-Baldy Complex Fire. We have more projects planned for this spring, and we're excited to keep trails open. Thank you
for your continued support."

Next came presentations at the work session.

Dr. Dan Otero, Hidalgo Medical Services chief executive officer, gave the first one. "Thank you once again for the opportunity to provide a brief update regarding developmental services. I do apologize that one of the documents that was provided to you in advance had some data points that needed to be updated. Instead of me going through each of the sections, I'll just provide a brief update. We continue to provide comprehensive services across the two-county area [Hidalgo and Grant], including our 13 clinical sites and, in collaboration and partnerships with the county, our five senior centers.We, too, at HMS, like all health care systems across the state of New Mexico and the country are going through a lot of changes that we are all a part of, including over the last couple weeks, everything from a temporary funding freeze of the federal funding that we receive on the type of services we can provide. We're working with those in collaboration with the National Association of Community Health Centers, with the sole purpose of continuing to serve our communities."

"Our recruitment efforts continue to be a challenge," Otero continued. "We get spurts of applicants, and we continue to work to recruit for all service lines we're actually providing. We have three open positions and we're interviewing for one of them here today, and we have a couple more coming in. With the constant change in staff and professionals in the health care environment, we continue to work closely with our board of directors to do everything we can to provide as many services as possible."

HMS Chief Behavioral Health Officer and Medical Director Dr. Teresa Arizaga presented the next report.

"We continue to provide the array of services as before, with six different divisions, and we employ many different types of behavioral health clinicians and employees. Recently, we've hired a new certified peer support person, who hasn't quite seen clients yet, but will start to soon."

She continued: "We also recently received two federal grants that will help with behavioral health expansion, providing needed services as well, and hopefully more peer support in the schools, the detention centers, hopefully, and senior centers and so on. That's hopeful when we are looking at our numbers."

Arizaga summarized the graph she had sent the commissioners.
"Six months ago, our numbers had decreased at Tu Casa outpatient and also with the MAT (medication-assisted treatment) services. But if you look back at this quarter specifically, we can see them starting to trend up
again, both with the outpatient services at Tu Casa, including
groups and individual therapy, and then also with the MAT services. Our unique number of patients has slowly started to increase over the last two years."

District 3 Commissioner Nancy Stephens said and asked: "Thank you for the update. I know we've talked in the past about expanding services to offer more like crisis or acute care, and I think starting with a maybe a one-day hold, right? Can you give us a kind of an estimate of when you think that would be available and open to the community?"

Arizaga asked if she was talking specifically about the crisis triage center. To a confirmation of that, she replied and said
one of those grants would provide the ability to look at mobile crisis response. "We've advertised some positions for peer support workers to start looking at those services for our center. It's hard for me to give a date, because one of the big things is that we're working with the state to become a certified behavioral health clinic, a community behavioral health clinic, and we need that certification in order to receive a better
reimbursement rate for the CTC (crisis triage center) services. For the process of becoming the CBHC, we have been talking to the state, possibly moving that up to June or October, so that's still a possibility as well. But that's not actually becoming the CBHC; that's just the beginning. We have pretty much everything we need in place for that to happen, and the state has been very good in working with us."

Stephens asked about the mobile crisis units. When will those be up and running?

Arizaga said that's part of the one of the federal grants that "we received as a two-year grant. The first year is the planning and initiation of a program. We just received those funds and started advertising for positions. We have received one applicant. We have advertised for several. We'll be interviewing that applicant next week. I'll just add to this that it is going to take the work of not just a couple of people, because it's going to require an on-call type of model to provide that service 24/7, so we're looking at also working with other people in community."

The next presentation came from Dr. Fred Fox, the chair of the Gila Regional Medical Center Board of Trustees.

"I wanted to start off by just saying that our Board of Trustees, I believe, functions well," Fox said. "We have a variety of experience and opinion, and this results in both good dialogue and decision making. And I'm quite pleased with the recruitment for the hospital.

"Providers are difficult to recruit to rural communities, but we have been successful," Fox continued. "We've been successful in recruiting a pediatrician to join recently. We're doing well in terms of surgical services. We've renewed one contract with an existing physician who has agreed to stay in the community. One other general surgeon has transitioned from private practice to be a hospital employee and another general surgeon has returned to the community."

He noted that the hospital has recruited a family medicine physician who will start this month in the Rural Health Clinic, joining Dr. Stanley there.

"We will continue efforts to recruit needed specialties and have retained services of recruitment firms, and are also establishing relationships with Municipal Health Resources, the state resource to help recruitment. And specifically, we'll try to look at geriatric services and geriatric providers and possibly urological services as well, and we continue to recruit further for primary care."

He said they continue working with re-establishing the family medicine residency program working in conjunction with the Hidalgo Medical Services, and also with UNM. They continue to look for options for first-year residents, where they may spend that year. "Now we're negotiating with UNM for them. We're also looking at other possible locations and also looking at options of funding. The second- and third-year residents would serve here."

The board is working to develop improved metrics to assess the performance of the revenue cycle so that "we can better understand the performance of revenue generation and maximize revenue that comes into the hospital."

District 1 Commissioner and Chair Chris Ponce asked if recruitment of a urologist was ongoing or if it had been put to the wayside.

Fox replied that it's on the agenda and "we're going to try to work with a recruiting firm."

The next article will begin a quarterly report from the Grant County Community Health Council.