By Mary Alice Murphy
[Editor's Note: This is part 1 of the HMS follow up community meeting on July8, 2025.]
The same facilitator from the first HMS (Hidalgo Medical Services) community discussion in late May, Lilly Irvin-Vitela, president of Community Connects Consulting of Peralta NM, again facilitated the Follow Up Community Discussion at the Grant County Veterans Memorial Business and Conference Center on Wednesday, July 9, 2025. With her was Simon, who handled the Zoom call and facilitated the Mentimeter program that people could use to ask questions.
"I believe that the solutions for the trickiest, thorniest, hardest things come from community from the people who are most impacted by policy and by systems. I think within people with an issue, the solutions reside. I know that I've had that proven time and time again, and I also believe that the most difficult, challenging, hard things are scarier when we're not talking to each other about them. So if we can make space in a respectful way, to hear each other, to disagree, to find common ground, there's nothing the community can't figure out for itself," Irvin-Vitela said in her introduction.
She presented a review of some of the things that were heard at the first meeting in May. "I've shared those notes with everybody who came to the last meeting. I'll share them again with folks who came tonight, because we want to make sure that there's some continuity in that conversation. To maintain transparency, we'll also be taking notes. I'll be taking them fast and furiously. Simon will be taking notes as well. We'll compile those together and we'll share those with you. That's why we ask for your email. We're not going to use your email for any other purpose than to communicate about the events."
She asked everyone to have a conversation with the others seated at the same table, whether they are friends or need to meet one another. "That might be a little awkward, because I'm going to ask you to cut through the small talk and go right to the heart of all the things that you could be doing with your evening. Why was it important to me to come here and be a part of this conversation, to build understanding about the issues and to look for solutions?"
Irvin-Vitela, after the five or six minutes were up, encouraged everyone to be respectful in their comments, so that they could build an understanding and pathways forward. She laid out the rules for the evening, which included a time limit of three minutes, a respectful tone, no interruptions of others, and to follow the agenda for the evening. She posed some sample questions, such as How is HMS meeting community health and behavioral needs? How is staff turnover impacting patient care? How is HMS meeting senior needs? What is working and what could be strengthened? She noted that national health care issues are not ones that should be focused on that evening, even though they impact everyone. She said comments should be personal and local. She laid out some of the issues that had been brought up at the previous meeting, including communications and how hard it was to get hold of people, issues with tech when signing in, and seemingly most important was the turnover and losing providers and having to start all over trying to build a relationship with someone that would understand the patient's needs.
Rusty Tolley, HMS board member, spoke up. He noted that it was minor, but not all those that had signed the original letter of no confidence were actually present or former HMS providers. Two, issues with turnover, recruitment and retainment are not just issues here, but are all over the country. "There is not one county in New Mexico, other than Los Alamos, which does not have issues getting and keeping providers." He noted that since Covid, 800 doctors have left the state. "We at HMS have been fortunate to be able to hire eight new providers since June."
Tolley also pointed out that the survey satisfaction scores were very high at 90 percent pleased with the services at HMS. The promoter scores, which measure patient satisfaction have been hovering from 60 percent to 70 percent.Nationwide it is about 35 percent.
Frances Gonzales thanked everyone for coming and said she thought it was important to attend as an elected official (Bayard councilor) and said that she has multiple sclerosis and her provider in Arizona, Barrow's, when she has to get an infusion at Gila Regional Medical Center, HMS has to approve it. "When I was between providers last year, I couldn't get approval. I'm not sure who, but I guess the head of nursing services at HMS, when Dan or Isaac Saucedo [who had since resigned] couldn't get it done, worked out a system so I could get my infusion. I think that's really a great thing they did. But then time for my appointment at HMS came, and they didn't have a provider for me, so I again went on the wait list for a provider. That impacts me in multiple ways. People talked about the physical health impacts of that, and people talked about feeling like they weren't really being deeply considered as people, that they weren't being treated the way that they should treat each other. And so that was a significant access concern. There were also some frustrations with technology in terms of access and calls don't always get a timely response or a response. That's challenging when it's important to us. We want to be important to our providers as well, and we want support from admin to make that happen. And then there are also concerns around access related to other people coming into the clinic sometimes, but the tech that's used there to check in or whatnot is off putting and frustrating. At the last meeting people also talked about some of the quality of care issues, and not surprisingly, they don't go neatly into a bucket of access and quality, but one of the bridge issues was really around continuity of care. So just when you're getting to know a provider, you feel like they're finally understanding your medical history, particularly if you have a complex medical history, and then suddenly they're no longer there, and you're trying to build a relationship with somebody else, and maybe your hopes are a little diminished, and your trust is diminished, and you're like, Why do I bother? How long are they going to be here?"
Irvin-Vitela noted that people at the prior meeting didn't feel like they were given quality of care, so that it impacted not just their belief in health care, or their belief in the relationships with their provider, but it was also having an impact on self worth, "like, well, if I didn't even matter to my provider or the clinic or the medical system that's responsible for providing care, and that's their job to care, why bother? Those were some of the bigger elements for other folks who were here last time."
She asked if there was a big theme that she missed that someone wanted to uplift. One person asked if there would be a discussion on leadership, and she confirmed they would definitely get to that.
Irvin-Vitela then posed the questions from the agenda. 1) Is HMS meeting community health/behavioral health needs? 2) How is staff turnover impacting patient care? 3)How is HMS meeting senior needs? 4)What is working? 5) What could be strengthened?
Simon noted they had received a question from Zoom that asked about the turnover rates. Tolley said he thought it was about 20 percent.
Otero said since January of this year, the turnover rate was 22 percent, which he said is below the state average. He also noted it was even lower last year, but didn't give the percent.
Another Zoom participant, unnamed, talked about the turnover of providers and asked what the board's plan is to address the issue. Irvin-Vitela said it was framed as a leadership issue and the person would like to know what steps were being taken to address it. "Because it will be addressed in the solutions section of the agenda, I will hold it for then."
Kate Brown, Grant County resident, spoke up. "I am a board member of the Mimbres Valley Health Action League, which helped bring the HMS clinic to the valley. Over the years, we've seen the turnover and have seen the old clinic close, before the new one was constructed. When there's turnover, people go elsewhere to get health care. I'm grateful to say, right now, the clinic is open four days a week. But it has been a struggle. It has been a long standing struggle that we've had to apply ourselves to for many, many years. So I just want everybody to hear that."
Otero said he has served at HMS as CEO since 2016. "I've been here my entire life. I have served to help this community, specifically the healthcare community, for 35 years in total, and I'm proud to do that, and I feel that I have always worked hard and worked with coming from a place of integrity and ethics, and I will continue to do that. I have a few things that I need to set the record straight on. But before I do that, I want to first and foremost, thank all of our 200 plus HMS employees. They're working hard for you every day."
He said he agreed with Kate Brown about the difficulty of turnover of providers.
"But I want to set the record straight," he said about "a 'press release' that came out today."
[Editor's Note: It was an article posted in the Beat: https://www.grantcountybeat.com/news/news-articles/massive-loss-of-health-care-providers-at-hms. It was not a press release. It was an article. The Beat also asked for the correct numbers, as he pointed out the errors. The Beat has not received them. ]
Otero continued: "As you know, we have actual data in our HR department. It says there were 17 medical doctors here when I started in 2016," Otero continued. "That is inaccurate right there. There were 11. It goes on to say there were 12 nurse practitioners and PAs (physician assistants). Also inaccurate. There were 11. The article says there were 29 practitioners, when there were actually 22. And the last misprint, uh, error I want to point out is HMS currently has six medical providers. There are 15 medical providers. I'm not trying to defend myself or HMS, but it's important to set the record straight."
He noted also that some social medial posts have said that HMS has failed the seniors in delivering meals. "That is absolutely not true. It is the opposite. We have increased access and have increased the number of seniors served and the number of meals served, the numbers of transportation and the number of home-delivered meals."
Otero said other comments have said that HMS is not using federal funds per federal regulations and that also is inaccurate. "So I just want to say that we're heavily regulated. By HRSA, which is the division of the Health and Human Services. They come in every three years. Audit all our records. Audit all our finances. We do annual financial audits and go to the board financially and the full Board of Directors."
He noted that he hired executives to run their divisions. "Yes, I am ultimately responsible, and I'll take full responsibility for your information, but I work at the pleasure of the board, and I hire executives to run the divisions. We hire CMOS to run the medical division. We hire chief behavioral health officers to run the Behavioral Health Division, and they're empowered to set the culture and hire their providers. Am I involved in those processes? Absolutely, it is my job to provide resources and support, to help make decisions regarding salary, skills, helping with decisions regarding recruitment model, et cetera. So I wanted to share that with you, and then I want to close out, if I have time, just to once again say I have watched our 200 plus employees go through a lot of pain because of what's happening. A lot of pain. Many of them are leaving because of what's going on. They're saying, 'I don't know what my job plan will look like tomorrow.' So my request to you is, please know that the HMS board of directors is very aware of all of our providers, they're fully informed. We don't keep anything from them,. I am fully transparent with the board of directors. And so I want to quickly introduce Carmen Acosta, our board chair, next to her is Barbara Guber. She's a long term board member and serves on the executive committee of the board and Randi Ibarra, who's also a board member and treasurer of the finance committee. Rusty Tolley you met and then quickly, if I may, we have Syl Manlove, our new Chief behavioral health officer with us tonight, and Amanda Frost, our Chief Operating Officer. She's been here over 14 years at HMS, also Cathy Diaz, our chief people officer, and Lacey Brown-Contreras, our compliance officer. Please call them if you're having trouble with access, if you're having trouble with transitioning or finding who your provider is going to be. Any of these people can help you with that."
Irvin-Vitela noted that Dr. Derrick Nelson (a former HMS provider), who was participating on Zoom, noted the common way to calculate the number of providers who left, during a time period is to divide the number by the average number of providers present during the same time period.
Irvin-Vitela went back to her list of those who wanted to speak, and a woman, who introduced herself as Zoe, and said she was a candidate for mayor at the Nov. 5,2025 election. "I signed up to speak tonight because I'm tired. I've been told multiple times that I need to sort of rein it in, dial back the passion, turn down the heat of the fire. And with respect, I disagree. I'm very tired. I've lived in this community my entire life, and three weeks ago Tu Casa saved me. We are at risk of losing a lot more than just a CEO or someone in Mimbres. We are at risk of losing this community's lifeline, my lifeline."
Simon noted that how the percentages of turnover are calculated perhaps should rely on the full-time equivalents, because not all providers work every day full-time, so full-time equivalent might be a better representation of that internal rate.
Irvin-Vitela said: "I think the bigger question is one of relationship trust. So when we think about solutions, let's also think about what would trust building look like? What would it take? What might be warranted?"
JoAnn Salcido said: "I want to say thank you to the board members that are here tonight. I wish you had been there at tat the first meeting, it would have helped you a great deal, so that you would understand what they are going through, and I just want to say there was other issues that were not brought up tonight that were discussed at the other meeting, and one is about sexual harassment going on at HMS."
The next article will continue with speakers and will begin to address potential solutions to the afore-mentioned issues.
