[Editor's Note: This is part 2 of a multi-part series of articles on the Jan. 22, 2019 Grant County Commission work session and Jan. 24, regular meeting. Part 2 covers the HMS monthly report. Future articles may address the work session and the regular meeting on Jan. 24.]
By Mary Alice Murphy
The second presentation at the Grant County Commission work session featured Hidalgo Medical Services Chief Executive Officer Dan Otero giving updates on the organization.
"It's interesting to listen to the challenges in health care, and obviously, we all face them," Otero said, in reference to the report from Gila Regional Medical Center, which can be read at http://www.grantcountybeat.com/news/news-articles/48732-grant-county-commission-holds-long-work-session-012219-part-1-grmc-report
Otero said his report would cover Oct. 15 through Dec. 31, 2018.
"I'll start with Tu Casa," Otero said. "We opened up on Oct. 15, and we had 579 service encounters through Dec. 31," he said. "We are wrapping up the application for the 24/7 triage to submit to the state Department of Health, so we can ramp up our hiring for the 24/7 services. We had to wait for rules and regulations to be promulgated at the state level before we could submit the application."
HMS has an additional location on Hudson in Dr. Spark's previous clinic. "It's our facility for Bridges to Care," Otero said. "It's the care coordination and integration center. Three things will happen at the facility. We've already moved our Care New Mexico employees there and are ramping up with an additional 15-20 employees to provide care coordination for Medicaid with Care New Mexico. We will provide care integration for all other non-Medicaid patients. We will also move some family support staff there. It's not just for HMS patients. Anyone can walk through the door to find out about health care access, what they need and where to get care. Our goal is to get people re-engaged in the health care they need, whether medical, dental or behavioral health. It's a relatively new concept in this country. I was at a presentation in Santa Fe last week where a Delta Grant was talked about. It's to take information from this work and expand it nationally to get the care coordination that people need."
He gave an update on the Mining District for HMS. "We worked with the hospital, which owned the facility we were using. We will move out, so they can do renovations. We hoped to have a new facility open by February 1, but licensing challenges in Santa Fe have held it up. A mobile clinic was a problem for Santa Fe. We're still working on it with our legislators. We are dedicated to assuring that HMS provides services to people in the Mining District. Due to the challenges, we will be providing transportation for HMS established patients from the Mining District to our clinic in Silver City on a route basis, until we get a clinic set up."
Otero also addressed the Border Patrol and immigrant situation from the HMS perspective. "HMS has been established as the community health center in Lordsburg since 1995. We've been serving migrants since that time. We had about three to five a month. For the past four months, it's been about 35 a month up to our closing at 6 p.m. We've been in dialogue with Border Patrol and had made a commitment to open provider schedules, so we could provide services as needed when these big groups come in. We were finalizing those services until last week, when we were advised that our services were no longer needed. The federal government has contracted with Loyal Source Government Services to provide 24/7 services within the Border Patrol facility. It's good news for those needing care. We'll continue to see any patients in Lordsburg. With that 24/7 it may alleviate things there."
The final update was that HMS has made a move to create a clinically integrated network to work together to improve the quality of care and the cost of care. "It's pretty exciting. I and others have been working toward it." Otero said HMS made the move to improve care with the IHI (Institute for Healthcare Improvement) Triple Aim – improve quality overall, improve the experience care for individuals, and reduce costs for those we serve. The fourth element is to engage and provide satisfaction to the providers. Unfortunately, we, as a community, haven't been able to pull it off. When I went to HMS in 2016, I advocated at the state level for a clinically integrated network. All the federally authorized clinics in the state have joined together and each put in a significant amount of funding. The outcome will be better quality care for Medicaid patients at lower costs. We have formed an LLC, and we will decide whether we will ask local providers and the hospital to participate."
Commissioner Javier Salas asked if HMS still plans to have a permanent clinic in the Mining District.
"A mobile clinic is on its way," Otero said. "We are still working on a permanent building."
Salas asked about the different doctors that have come through the clinic in Bayard, before it closed. "Was it a planned rotation or what?"
Otero said the doctors have been the same ones for the past year. "Occasionally we lose some when they move back home. Overall turnover is low."
Salas said the clinic has been busy.
Commissioner Alicia Edwards asked about the Loyal Source Government Services. "It is a contractor with Border Patrol or ICE?"
"The services will begin 24/7 on Feb. 1," Otero said. "It's with Border Patrol. The services will exclude emergent care. They will be sent to hospitals, such as Gila Regional. There will be practitioners at the Border Patrol facility."
Edwards said the conversation had been about keeping money in the community. "But now it will be leaving the community."
About the Bridges to Care program, Edwards asked how challenging it is to attract professional medical providers to Grant County. "How is the recruiting going?"
"We are not having trouble recruiting," Otero said. "When I started in 2016, we were down eight providers. Now we have one faculty M.D. opening for the residency program, and one opening for an M.D. ob/gyn. There is a challenge across the country for behavioral health professionals."
Edwards asked when the Bayard clinic would close. Otero said Jan. 25 was the last day.
"So, the only way to get service is to use the transportation?" Edwards asked.
Otero said that the Silver Health Care Clinic is open in Bayard five days a week, and after renovations, Gila Regional will have a primary care clinic there, too. "Once we get our mobile clinic, the Mining District will have three health care services."
Additional articles will follow.