[Editor's Note: This is part 4 of a multi-part series of articles on the work session and regular meetings of the Grant County Commission in December 2020.]

By Mary Alice Murphy

At the beginning of the regular meeting District 1 Commissioner and Chairman Chris Ponce wished District 2 Commissioner Javier "Harvey" Salas a Happy Birthday, and Salas said: "And back to you." They share a birthday, but not in the same year.

The first item of business was the monthly report from Gila Regional Medical Center Interim Chief Executive Officer Scott Landrum.

"This afternoon [at the monthly meeting of the GRMC Governing Board, made up of the five commissioners], one of the items of business is to approve the new radiology work group," Landrum said. "They will work three days a week at the hospital and will be reading images after hours. They also cover hospitals in Las Cruces. It's a new group for us, because the former group was retiring."

He continued and said the hospital is changing out all the IV pumps. "We lease them as do most hospitals, so we can stay up with the latest versions. We already this morning held a medical staff meeting. We're adhering to the governor's health order on essential procedures. The medical process for procedures is very involved. The essential ones that will continue are emergency. and we have continued with outpatient procedures. As you know we have a 25-bed hospital. Our biggest challenge is staffing. Yes, we have some COVID patients in the hospital. They are well managed. The numbers change often. We don't have any on a ventilator. We are continuing with our normal procedures. All is well at the hospital. One of our biggest things we are doing is our staffing is at an appropriate productivity level. Our biggest issue is our revenue cycle. We brought in someone who is a revenue cycle specialist, and he will be here for some time, dealing with registration, coding, billing, etc.—the beginning to the end of the patient process. It has been our hospital's Achilles Heel for a long time. We've been able to continue to provide quality care, but not necessarily get paid appropriately for it. We're going to fix that. We, along with HMS have signed a contract with a company that I have worked with a lot, that is going to assess our behavioral health needs in the community.

"We are working on communication and have started a weekly newsletter out to the whole medical staff every Friday. As of last night (Dec. 16, 2020), we had vaccinated 60 front-line people with the Pfizer vaccine. We are going through the directive that is part of the CDC guidelines. We are considered a pod. The vaccine goes into Las Cruces and then is distributed out to the pods. We purchased a super-cold freezer for the hospital. When it arrives, hopefully in another 20 days, we will make it available to all other health care providers in the community, HMS, Silver Health Care, Fort Bayard, everyone. The Pfizer vaccine once thawed from its super-cold state has to be used within five days. It is thawed, mixed and injected. And after the first dose, the person vaccinated has to get the second shot 21 days later. Everyone who is vaccinated is given a card for their wallet or purse to show they have received the first dose if they need to show it. The Moderna vaccine will be available next week. We are signed up to get them, too. I just want to assure you that the hospital is stable, as it has been all along. We continue to take care of COVID patients and others. We are happy to have the vaccine. Some people want to take it; others don't, the same as with the flu vaccine. When it comes my turn, I will take the vaccine."

Ponce asked about those who have allergic reactions.

"It is part of our screening process," Landrum replied. "Anyone who carries an Epi-Pen I can't tell you that we are vaccinating any of those right now. We are waiting for CMS on guidance. On the news I heard that two frontline providers were vaccinated, had reactions, but they are fine. The biggest issue we've seen is a sore arm."

District 4 Commissioner Billy Billings asked if the Moderna vaccine also requires a second shot booster.

Landrum said he believes it does, but he thinks the AstraZeneca will not require a booster, nor will the Johnson and Johnson vaccine. The difference between Pfizer and the Moderna is that the Pfizer requires the super-cold freezer.

Billings asked if there is immunity between the shots.

"I have heard there is not full immunity between shots, but there is after the second shot," Landrum replied. "I don't think we truly know if there is immunity between shots."

District 3 Commissioner Alicia Edwards noted there will be "all these different vaccines. How do we know? Clearly they are all different."

Landrum replied that he has heard the recommendation is "to take the first one available to you."

Edwards asked who is in charge of determining who will be able to get a vaccine when.

Landrum said they are in the very initial phase of determining that. "In our case, it is our Medical Director Dr. (Ronald) Dalton and our Infectious Disease Specialist William Hemmer that are putting together the list. Right now, we're still with first responders like EMS, who have come in contract with COVID in the community, and physicians and nurses in the community. The national news says that it will likely be mid-year before everyone is vaccinated. Since we're in the early stages, I can't tell you when right now, but there is a process that is ratcheting up. We are adhering to CMS and DOH guidelines. After the front-line workers, then it will be nursing homes, and I'm hearing that nursing homes will be getting the Moderna vaccine."

So, the answer to community members when they ask questions on distribution is: "We don't actually know."

The next article will begin the regular meeting agenda review at the work session and the discussions there, as well as at the regular meeting when action was taken.