[Editor's Note: This is part 1 of a series of articles on the Grant County Commission work session on Dec 6, 2022 and the regular meeting on Dec. 8, 2022. This one begins with presentations at the work session.]

By Mary Alice Murphy

Hidalgo Medical Services Chief Executive Officer Dan Otero presented a few brief highlights. "The health care system is going through some difficult changes. We currently have 40 open positions, with turnover as the major problem. The 'Great Resignation' started before the pandemic. About 30 percent are moving to other positions, with about 5 percent getting out of the field all together. We have 16 physicians and nurse practitioners on our staff. Twenty-two of our staff are in behavioral health. We recruited three dentists and three hygienists. We continue to have on staff a dietician and a chiropractor."

"We are progressing on reopening our residency program," Otero continued. "The entire faculty left. We are making an offer to a physician to be program director."

District 3 Commissioner Alicia Edwards noted that the 5 percent who left the field make about 1.5 million people who have left health care in 2022. "I have complete sympathy for the 335 physicians who left health care last year. The impact will be greatest in rural communities."

Otero said the state is taking steps to keep health care in the state stable.

Dr. Teresa Arizaga, HMS chief mental health officer, gave an update on Tu Casa, the substance abuse facility run by HMS. "Although we are doing well, we do have a lot of openings. Last month we had 845 patients booked, of which 559 were completed. Two hundred-four of those were unique clients. With our MAT program, medication assisted treatment, we had 93 booked appointments, 56 completed and 42 unique patients. That has stayed pretty steady throughout the year. Currently eight of our providers are MAT providers. They have their waivers to serve patients who need suboxone [used to treat substance abuse disorders]. These are a combination of psychiatric and medical providers."

District 5 Commissioner Harry Browne asked why only about 60 percent of booked patients are completed.

Arizaga said the about 35 percent uncompleted may be "no shows or cancellations. It sounds high, but it's actually really good for this patient population. It was higher before. Right at the beginning of the pandemic, we provided open access. Instead of having people book multiple appointments for weeks in advance, we just booked one appointment. It really cut down on the no shows. And it opened up appointment slots, so if someone needed an appointment within 72 hours, we were able to do that. And it also opened up slots for people who were having trouble getting in. We saw many more new patients than we had seen before."

"I would like to take this opportunity to introduce members of the Tu Casa Advisory Board who are here," Arizaga said. She introduced Ron Hall, Susie Trujillo, Joseph Andazola and Commissioner Edwards.

Edwards then acknowledged the increase in MAT providers from one to eight in less than 3 years, "so congratulations on that. It has a significant impact on the community. We appreciate your hard work on that."

District 4 Commissioner Billy Billings said: "It is hard to know what you don't know. But do you have something to measure your success? Maybe explain a bit more about what you do?"

Arizaga said: "Tu Casa provides a variety of services. We have mental health providers. We have licensed alcohol- and drug-abuse counselors. We provide individual therapy. We provide assessments, and group therapy for people struggling with substance misuse. We provide the MAT services. We have a couple of psychiatric providers that see patients there. We also provide crisis stabilization, so anyone in crisis who walks in will be seen. It's all for people 18 and above. We are working on starting an adolescent group. We're also working on better ways of tracking how successful we are and looking at people who graduate from the programs and people who need to come back."

Billings asked if the majority come through the courts. Arizaga confirmed that most that come to Tu Casa come through the probation program. "We do have some that are self-referrals or family referrals."

The next presentation came from the Grant County Community Health Council. Karen Whitlock gave the report, filling in for co-chair Marilyn Alcorn.

"Last week, Priscilla Lucero and Evangeline Zamora represented the health council at the Prospectors Legislative forum," Whitlock said. "A particular request is to have funding put in the budget for $5.7 million for all health councils in the state. This would provide $125,000 per health council. In addition, the health council requested $50,000 in junior monies to help the council fulfill its mission as outlined in the County and Tribal Health Councils Act, also known as HB 137 passed in 2019. It states what the health council is statutorily required to do. The Health Care Task Force of the Health Council is standing down for now. It was a key part of the Covid response in Grant County and we would really like to thank the members of this task force for all their hard work. This task force will be brought back as necessary. I want to acknowledge Terry Anderson, who is retiring and stepping down from the health council after many active years of service in childcare. When the state completely defunded health councils, she was one of the few that kept it going. I want to note that she received the Linda Kay Jones Humanitarian of the Year Award at the Chamber awards banquet last week."

Whitlock talked about the community health improvement plan survey. "It is part of the deliverables under the County and Tribal Health Councils Act. We invite you to fill out the survey. The more input we have the better we know what the community wants and needs. We would also like to remind you that it was suggested during the Commission special meeting that the commissioners have a workshop to discuss health councils and a potential Health and Wellness Department in the county. We would like to ask that the meeting take place the first two weeks of January before the legislative session."

She introduced Phoebe Schroeder, the health promotions specialist with the Department of Health. She will talk about work the health council and the Department of Health are working on around housing and homelessness issues.

Shroeder said: "A quick update on the housing insecurity task force. We wanted to use junior monies toward addressing these issues. It's been difficult as we lost our coordinator and our admin. Jeff Fell and I are co-chairing this effort. We have conducted a preliminary survey with key informants in the community, including SPIN and the Gospel Mission, as well as some of the clients of these facilities in order to understand what the housing insecure may want. We are also progressing on gathering our task force on housing insecurity that will review what we want to spend the money on and how we will move forward. Jeff Fell and I, along with the health council are working on developing a comprehensive list. We would like to have representation from the county and from the city. We hope to have the group put together in December, so we can hold our first meeting in January."

Edwards said she had a question for Whitlock. "The last survey was done when Tiffany Knauf was health council coordinator. It was significantly different from what I'm seeing in front of me. Is there going to be another survey that was similar to that one done in, I think, 2012?"

Whitlock said the last one was done in 2014. "This is it for now. We have a short turnaround, so we can get this into the state Health Improvement Plan. We plan to do a more comprehensive one in 2023. Without any administrative help and without a coordinator, this was what we could do now."

Edwards noted that the average person might not have knowledge about some of the things on this survey. "Gila Regional is also planning a survey. I would encourage you to work with the hospital so as not to duplicate efforts."

Whitlock said they would be incorporating information from other surveys, such as the annual HeadStart survey. "We will also include information from the recently completed Community Partnership for Children survey."

The next article will begin with the next presentation, which evolved from its primary report into a more in-depth conversation about a Gila National Forest issue.