Editor's Note: This is part 8 of a multi-part series. This article covers three healthcare presentations—Gila Regional Medical Center, HMS Family Medicine Residency Program and Behavioral Health Local Collaborative 6.
By Mary Alice Murphy
Gila Regional Medical Center was represented by Chief Executive Officer Brian Cunningham.
"I want to talk about the great things happening at GRMC and our challenges," Cunningham said. "Our mission and vision are not just words on a page. They are very real to us, and we endeavor to live by them every day.
"I thank the Board of Trustees for their hours of service, and I want to express my appreciation to the whole new administrative team." he continued. "As you know, the former administrative team left us in the hole for $9 million at the end of the 2013 fiscal year. We created a whole new team.
"We are a 68-bed acute care hospital, serving four counties," Cunningham said. "We are a sole community provider and have more than 600 employees, which we call caregivers.
"We had $67 million in net revenue in fiscal year 2014," Cunningham said. "We are the second largest employer in the county.
"We continue to have challenges," he noted. "Through the new team's efforts, we turned around the hospital from $9 million in the hole to more than $1 million in the black in less than a year.
There are still a lot of things to be done. He said the hospital is receiving decreasing reimbursements, and it faces federally mandated information technology upgrades.
"We are looking for help and support on capital equipment," Cunningham said. "We need an emergency back-up generator to replace our aging one. That will cost $130,000. Our fluoroscopy equipment is unfixable for upper gastrointestinal tests. We need $300,000 to replace that so our patients can receive the test here. We need to upgrade our old boiler at a cost of $160,000, and we need a nuclear medicine camera at a cost of $300.000."
"How big is the generator?" Representative-elect John Zimmerman asked.
Cunningham replied: "I don't know, but I can get the information to you."
Rep. Dianne Hamilton asked about the hospital's nurse-patient ratio.
"It depends on the acuity of patient needs, so it shifts," Cunningham said. "We have a base staffing, but can call in additional help when needed."
"Doesn't that cause trouble in salary?" Hamilton asked.
"Many clinicians cross-train, so they can shift to where they are needed," Cunningham replied. "There are ways to optimize staffing needs."
"Thank you for your leadership," Sen. Howie Morales said. "Talk about economic development. This is at the heart of it. It is important to have a hospital to meet the needs of the community."
In the next healthcare presentation, Dr. Darrick Nelson represented Hidalgo Medical Services.
"We have no particular asks, but we do ask for general support for the HMS family medicine residency program," Nelson said. "Right now the state has a ratio of one physician to 1,450 residents. We will need a large increase in physicians, just to stay at that level. Albuquerque, Santa Fe and Las Cruces have lower ratios.
"We have developed the family medicine residency to meet shortages," Nelson continued. "Some specialists are primary care. Currently the University of New Mexico School of Medicine graduates 23 family medicine doctors a year.
"In May 2013, we welcomed two residents to Silver City for their second and third years," he noted. "Most residents do their first year of residency in Albuquerque."
He said HMS's family medicine residency has a great partnership with Gila Regional.
"UNM has increased family medicine graduates by 10 percent," Nelson said.
"We know that most graduates stay within 100 miles of their residency.
"We are the only federally funded family medicine residency program," he said. "The funding is due to sunset in 2015. We ask for legislative support to increase family medicine residencies serving rural areas.
"Have you done anything with the D.O. program at NMSU?" Zimmerman asked.
"Yes, the program has a family medicine residency at Memorial Hospital," Nelson said. "Our whole goal is to bring in more residents. We have begun to talk to Dr. Andazola with the NMSU program. The line between a D.O. and an M.D. is becoming more blurred. They are basically the same programs, with the only difference the initials after one's name."
"I compliment you and urge you to think outside the box," Morales said. "What can we do? I know you have the Forward New Mexico program. We're fortunate to have physicians grow up here and return to practice."
"Forward New Mexico is a long-term model," Nelson said. "We get into middle school where we can touch more lives. The B.A. to M.D. program students are just now graduating from medical school. We're interviewing residents, at least 10 of whom are UNM B.A. to M.D. students."
"What about dentists?" Morales asked.
"We partner with a dental school in Arizona," Nelson replied. "Their students are coming here on rotation. The UNM dental residency students are also coming here."
"You have created a model for the state and the nation," Morales said.
For the next presentation, Matthew Elwell, Luna County Detention Center administrator, and Mary Stoecker of the NM Department of Health Public Health Office represented the Southwest New Mexico Behavioral Health Collaborative 6.
"I am here asking for your support of the Inmate Support Program," Elwell said. "It passed the 2014 legislative session, but had no appropriation with it. We ask for funding to demonstrate a three-year model project. We want to look at detention as part of a continuum of care. We will follow inmates for six months after their release from prison. We hope to drop recidivism."
He noted that Medicaid terminates upon incarceration, and the detention centers pay for prisoners' medications. "If it's a mental illness, we see an 80 percent increase pre-adjudication without a continuum of care support."
"We send them out of jail with three days of medications," Elwell said. "They have nothing, no income support system. We will change that. We will get Medicaid to start again the day of release, get a doctor's appointment for them, and follow them in the community for six months. I think it will keep them stable in the community. Now, within 30 days of release, they are often back in incarceration.
"We are asking for $334,000 for three counties for a three-year pilot program," Elwell said. "We need a coordinator piece to the program."
"It was passed last year. Was it vetoed?" Morales asked.
"Yes, the governor vetoed it," Elwell replied.
"We need it in House Bill 2 for new money. Why $334,000?" Morales asked.
"For three counties for three years," Elwell replied.
"In-kind services cover part of the project, but not all pieces of the program," Stoecker said. "For inmate programs, we have commitments from some local governments. Luna County has committed funds for a coordinator in the detention centers. And we have a $10,000 commitment from Silver City. The Grant County manager thinks we can get a contribution for the three-year program. There is nothing yet from Hidalgo County. Whatever we receive, we will subtract from the request."
"How will it affect substance abuse?" Morales asked.
"While they are incarcerated, they are clean and sober," Elwell replied. "When they are released, we will have a hand-off set up with the treatment center and a sponsor, who will see they get to AA help meetings and appointments."
"Could the Grant County Continuum of Care fit into this?" Morales asked.
Stoecker said: "Yes. The continuum of care will offer mental health treatment, work toward a GED, and treatment can begin while they are in detention, then they will have a transition plan for the hand-off sponsor to get them to treatment, if needed. The service providers in the communities will have the same transition plan.
"Let us discuss this," Morales said. "We will have to start on the House side, and find someone to carry it."
"It seems like it will eventually save the counties money," Hamilton said. "Can we have figures when the bill is presented?"
"We can get the figures for you, and I think they are in the packet," Stoecker replied.
Note: This article is taken directly from a transcript this writer is paid to deliver to the Prospectors each year for them to put the differently formatted information into the legislators' notebooks to be used during the legislative session and throughout the year.