Editor's Note: This is Part 10 of a multi-part series on the Prospectors' forum, which was held on Dec. 9. Then the holidays happened, and the rest of the articles did not get written.
Brian Cunningham, chief executive officer of Gila Regional Medical Center spoke on behalf of the hospital. Chief Financial Officer Elizabeth Allred also answered questions.
"We have been through the transition," Cunningham said. "I'm proud of what we've done in a short time. We replaced all the C-level leadership with internal candidates. We are aligning to meet the needs of the hospital and the community.
"We are a county-owned not-for-profit 68-bed hospital," he explained. "We serve 63,000 people from an area of 17,000 square miles, larger than Massachusetts and Connecticut.
"We serve with the Cancer Center," Cunninham continued. "The hospital does not receive county subsidizing, but relies on public funding, with a high level of Medicaid.
"We offer patient-centered care, with 700 caregivers and medical providers," he said. "Quality care in the right amount at the right time every time."
He pointed out that everything is changing in health care. "The whole reimbursement structure is a challenge to us and all hospitals. It requires working better with the physicians and caregivers."
One of the challenges is a workforce shortage of health care workers. "We also have a significant challenges in infrastructure needs with a major shift from inpatient care to outpatient care," Cunningham said. "We have a $30 million payroll, with an additional $8.5 million in benefits."
"In fiscal year 2013, we had a $9 million shortfall," Cunningham said. "It has been a challenge to turn it around. We have had a $2.5 million decrease in expenses for the first four months of the fiscal year. We are insuring that everything is value-added.
"We are doing more with less and are better than ever before," he opined. "We are focused on customers, patients, the community and medical providers. With funding from House Bill 580, we are purchasing and installing a new linear accelerator for cancer care. We are halfway through the project.
"We provide 400 deliveries a year, 4,000 surgeries and 18,000 outpatient procedures," he said.
"I'm glad to see a new cardiologist in town," Rep. Dianne Hamilton said. "When my husband saw his cardiologist in Albuquerque, he said to talk to our new one."
"I appreciate the direction you're taking with GRMC," Rep. Rodolpho "Rudy" Martinez said. "Grant County appreciates it. Gila Regional is one of our most important operations here in the county. I thank you and the staff."
"It's a team effort," Cunningham said.
"For true quality of life, the hospital has to be a part," Sen. Howie Morales said. "Do you have a quick update on HSD and the sole community provider funding?"
"We jokingly say, there's lot of action, but no progress," Allred said. "The state wants to intercept 1/8 percentage of the county's gross receipts tax to run Centennial Care to get the three-to-one federal match. We have no real information on the issue. The state said it would raise the Medicaid rate, but the sides are ever more firmly entrenched."
She said the counties are united and feel the money won't be divided appropriately to rural hospitals. The county still has the responsibility for health care to its citizens.
"I think it will happen in the session," Allred said. "We're available to answer questions."
Morales said the concerns are there in all the rural communities. "Help us make the argument. We need to know the possible solutions."
"If the funding doesn't come from the counties, we miss the federal match," Allred said. "Without the $250 million to $300 million, all the hospitals will suffer. I've never seen it in writing, but without the funding to get the match, it severely impacts the counties. I think if the counties could get something written, something sure, it would help. They feel jerked around.
"HSD got in trouble with CMS and the current indigent program ends Dec. 31," Allred pointed out.
"If you can help clarify with HSD, whether if the money goes to HSD, if it also comes back to the counties, that would help us know," Cunningham said.
"If it goes to the HMOs then money is skimmed off," Morales said.
"Beth, I want to thank you for telling it like it is at a committee meeting," Martinez commended Allred. "Are you aware of two separate funds being created to reimburse 100 percent?"
"One would increase Medicare rates and would benefit the larger hospitals," Allred said. "The second is an uncompensated pool for smaller hospitals."
"We need to stay on top of it," Martinez said. "We don't want to place a burden on smaller hospitals."
Grant County Community Health Council Coordinator Tiffany Knauf said she would give updates and what funding is being used for.
"We have a mandate to exist, but we are unfunded by the state," Knauf said. "We have survived using unencumbered funding and Gila Regional has provided us ongoing funding to keep us working. It's not sustainable. Other health councils across the state don't have these resources.
"We, last year, completed the community assessment and are working on the plan," Knauf continued. "The Health Council represents 30 sectors in the county and we have two new members pending—Robert Mendoza, Cobre superintendent, and Brian Cunningham.
"In our assessment survey, we had the highest response rate in the state—one in four in the county—and I haven't found a higher rate in the nation," Knauf said.
She said a profile draft of the assessment information was complete. The assessment showed the community's perception of needs matched with local, state and federal data. "We educate and share with community partners and providers to enhance grant applications. The 2007 Community Assessment, which had a 10 percent response rate brought into the county more than $15 million."
"For our Community Health Improvement Plan, we have four priorities—Behavioral Health, Community Health/Safety, Family Resiliency and Interpersonal Violence," Knauf said. "There are focus areas under each priority.
"Last year, the Legislature gave $195,000 to the Department of Health for health councils. There were three options, of which we chose No. 3, community health improvement cycles, because we had already completed options 1 and 2. Eighteen of 23 counties chose options 1 or 2. We are excited to help those who chose option 1 or 2.
"The Health Council does not provide services," she explained. "We assess, plan, collaborate and coordinate around our priorities to make a difference, through grant applications, community education, trainings, process improvement and coordinated community outreach events.
"We will ask for $900,000 to fund health councils across the state, which would provide $25,000 to each council," Knauf said.
"I appreciate what you do," Hamilton said. "You identify areas we need to work on."
"We have 30 members to represent different sectors," Knauf replied. "We meet quarterly, with a board of seven—the steering committee—meeting monthly."
"I served on the board a short time," Martinez said. "How is the information disseminated to agencies and the public?"
"Through the community profile," Knauf said. "The community knows that the profile helps on grant applications. We put out news releases, through our website, and through presentations."
"Twenty-three health councils received funding," Morales said. "Do the other counties not have health councils?"
"Others do want funding and there are definitely others in the works," Knauf said. "Bernalillo County reports to the state, but doesn't want funding. The Doña Ana County council is owned by the county."
"If you have no funding, how do you operate?" Morales asked.
"We take administrative fees for grants, the county offers us office space at low rent, and Gila Regional is providing funding," Knauf said.
"The state is 50th in child wellbeing and 49th in poverty," Morales said. "This might be an opportunity to offer a plan for these things. There is no plan to address."
"The Department of Health is undergoing accreditation," Knauf said. "It will need health councils for that accreditation."
"We also received funding from the Freeport McMoRan Community Investment Fund," Health Council Chairwoman Priscilla Lucero said.
Several spoke on behalf of Silver Regional Sexual Assault Support Services
"We know 23 percent of county residents have been assaulted within their lifetimes, with many in the past year," Colleen Boyd, director, said. "But that's only for those who report."
"We provide 24-hour intervention, case managements, patient referrals and all for a budget under $200,000," staff member Kristy Rogers said.
Dr. Robert Rickle, board member, read a long list of terrible statistics on sexual assault.
Stormie Flamm, sexual assault nurse examiner at GRMC, said: "The SANE program continues to grow. We are now allowed to see children under the age of 12. We've seen eight since July."
"We will send another nurse for training, and we also have sixe nurses in Hidalgo and Catron counties," Flamm said. We are also working with the Detention Center.
"We still need support," she continued. "We are grateful for the $650,000. We are asking for an additional $350,000 to make $1 million."
"You have made a huge impact and have made the state aware of the need," Morales said. "Rep. Martinez made it happen. I think $300,000 is doable.
"This ties into education and student achievement," he continued. "You locally came out and made it happen. I would like to see training for law enforcement."
"It's challenging to get law enforcement to show up for training," Boyd said. "I would like to see a change of requirements to enhance their training."
"We'll work with the Department of Public Safety," Morales said. "How was Shop with a Cop?"
"There weren't enough cops, but it was amazing," Flamm said.
"Senator, thanks for your making a connection with education and sexual assault," Boyd said.
"I introduced a bill for law enforcement to recognize PTSD and will work on this requirement, too," Martinez said.