[Editor's Note: Due to the length of the work session and the regular meeting, they will be broken up into several articles. This one will cover the report from WildEarth Guardians and the update from GRMC.]

By Mary Alice Murphy

Right before they began the Grant County Commission work session on Jan. 12, 2021, District 4 Commissioner Billy Billings asked who had sponsored the second group of presenters, which would be a report from WildEarth Guardians. District 5 Commissioner Harry Browne said he had invited them to present.

When technical glitches slowed down the connections for WildEarth Guardians executive director John Hornung and his co-presenter, Madeleine Carey, Browne was heard to say: "You'd think we would have figured this out after nine months."

Hornung came on and said that WildEarth Guardians had been in New Mexico for 27 years. His topic of the presentative was the recent settlement of a lawsuit by his organization against the U.S. Forest Service and Fish and Wildlife Service.

"In late October 2020, we settled the lawsuit," Hornung said. "Part of the agreement is a limited injunction on tree cutting, in the Southwest Region, including all New Mexico national forests and one national forest in Arizona. The lawsuit alleged the two agencies were violating an injunction brought in 2013 over the Mexican spotted owl."

Hornung said he has been doing work on the issue since 1994. The owl was listed as endangered in 1993. "I think this will be the last lawsuit on the issue. I believe the Forest Service and Fish and Wildlife Service are on the right path.

"One thing I hope you take from this presentation is that this does for the owls what your doctor would do for his patients," Hornung said. "What does it do? It commits the Forest Service to monitor the population of the owls across the Southwest Region up to 2025. They have been doing a population survey on an annual basis in a contract with the Bird Conservancy of the Rockies. It was a major dispute. When will the owl be delisted? The key provision in that decision is not until after years of monitoring any time the owl is impacted by individual projects. A further provision is an owl-recovery plan on how thinning, prescribed burns, logging and such affect the owl. The agencies must monitor the owl before, during and after projects, so they can get data. Another provision of the settlement requires the Forest Service to provide data on the long-term trends of owl habitat."

The last two provision deal with the agency process, a requirement to create an owl leadership team for disputes.

The final commitment is to work on a regional ecological team of groups to form an ecological management unit. "The benefit is to have coordination of groups to work at the regional scale. Our hope is that we assume the Forest Service and Fish and Wildlife Service will continue to promote healthy forests to promote owl habitat."

Browne said: "You said you were optimistic there would be no further legal action needed. What makes you optimistic? Will the forest continue to follow this agreement when they didn't previously?"

"I'm always optimistic" Hornung said. "This time the groups have come together to do the monitoring. I think the Forest Service is tired of lawsuits. This litigation ended in better ways. "

Browne said he hoped future leadership in the agencies will be as tired of losing as those today.

No one had any further questions.

At the regular Commission meeting on Jan. 14, 2021, commissioners heard the monthly update from Gila Regional Medical Center. Interim Chief Executive Officer Scott Landrum gave the presentation.

"I am happy to report that we concluded the interview with the first of three candidates for permanent CEO," Landrum said. "The second will be not this weekend, but next and then the third will follow. We had our medical executive meeting this morning. The hospital is using the Pfizer vaccine and all our physicians were vaccinated the first week we had it. Hidalgo Medical Services has the Moderna vaccine, and Dr. Skee's (Silver Health Care) is getting the Moderna vaccine soon. CVS and Walgreen's will be administering the Moderna vaccine at nursing homes to staff and residents. We are presuming that all that have had the first dose will continue with the second doses. The hospital will finish its vaccination program of health care workers and staff by the first of next month."

He said the hospital's staffing issues continue because of COVID—those who have it or are exposed to it. "We are facing a shortage in all areas and coping with it with travelers, as are those hospitals across the country in a similar situation. We don't want to use travelers because they are expensive, but we must to keep up our quality of service. We are adhering to the governor's policies in regard to tests and elective surgeries being on hiatus until Feb. 5. The surgical directors Dr. Brian Robinson and Dr. Michelle Diaz meet several times a week to decide what surgeries are essential. The criteria focus usually on whether damage will occur if a procedure is not performed. There are a lot of people waiting in line for things like joint replacement, which are not considered essential in most cases."

Landrum said there had been an initial meeting with the Coker group to address behavioral health issues and needs in Grant County.

He also noted that "we are wearing out our ambulances transporting behavioral health patients elsewhere. We appreciate Ms. (County Manager Charlene) Webb for helping us get funding for new ambulances. HMS, which is working closely with us, recommended this consulting group for behavioral health services. We are also working with (Southwest New Mexico Council of Governments Executive Director) Priscilla Lucero on finding behavioral health funding. She is also on our interview group for a CEO, as is our chief nursing officer. In my briefing with CEO candidates, it is my responsibility to be forthright and honest about what I believe our issues are. We have a lovely physical facility and as we get funds to fix the roof and the HVAC, as well as funds to update the IT system, and we're working with Prospectors to get some funding for needed equipment, with all that the hospital will be in very good shape. Our physicians are a great group. You are a critical access hospital on steroids, as I've said before, but essentially you are a surgery system that has an emergency room and also delivers about 300 babies a year. So, you have a considerable health care asset and advantages for the community here. Our biggest issue is the revenue cycle, and we are in the process of fixing it. The revenue cycle is everything from getting procedures scheduled to getting authorization from the insurance company to providing the procedure, to coding and getting paid for the process. We don't do well with that. We do do well with our quality. We have quality measures, which are consistently higher than the folks we are comparing against. We think we have great doctors, excellent staff. Our Achilles Heel is just simply getting people registered, getting them in and getting paid for it. Our biggest issue has been getting people registered for radiology—that is MRI, mammography and that is foremost on our docket. We have considerable reorganization and training going on right now. We are having staffing issues, mainly precipitated by COVID and by the limitations put on us because of that."

District 3 Commissioner Alicia Edwards asked about something Landrum had said to her earlier.

Landrum said that in their cash call with HealthTechS3 [the firm that manages the hospital] because of the limitations due to COVID, volumes are down, but the good news was in regard to the critical access designation, and the rebilling that the hospital will have to do back to July 1, 2020 when the designation was received. The rebilling is being done automatically through Medicare."

Edwards also noted that from that day (Jan. 14, 2021), everything is being billed at the critical access rate, which is almost a 5 percent bump in payments, according to Landrum.

Browne said the report commissioners heard on Tuesday, which can be read at https://www.grantcountybeat.com/news/news-articles/62272-grant-county-commission-hears-presentations-at-work-session-011221-part-1 was that about 40 percent of hospital staff was declining the vaccinations.

"We are not making the vaccination mandatory," Landrum said. "We can't legally. I don't know that we've have 40 percent decline, but we haven't finished. I hope those numbers go up in order to accomplish herd immunity with a large number of people being vaccinated."

Billings noted that Landrum had mentioned the radiology screening. "My wife got notice that she was due a mammogram and she got a call to schedule one, so I hope it is being fixed."

Landrum said it has become a personal issue for him. "It's disturbing. We need to get registrations done. Whatever it takes to fix it, I will do it."

Billings also asked for an update on the roof and HVAC.

"We just finished our regular call with the auditors," Landrum said. "The roof will be finished first and then the HVAC. We are in the queue for the funding. It's a question of process."

Billings also asked about the Labor and Delivery renovation update.

Landrum said the one thing holding them back from the move into larger rooms with private bathrooms is some dampers. "We will have to take the duct work apart to get to the dampers. The CNO is in touch with the company. So, the only thing stopping us is the certification of the fire dampers, then we will pursue moving to the larger area."

Billings also asked about the regular meetings on what procedures are essential. "Do you have local autonomy or is it state based?"

"Both," Landrum replied. "We have a form to fill out. We look at it locally on an individual basis considering whether if no procedure is done will a patient suffer damage."

The next article will address county reports and elected officials' reports.

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