A Letter from the CEO, Brad Cochennet
The Pagosa Springs community voted to fund a hospital district several years ago. While the district developed plans for a future hospital, they also provided EMS services, with most emergent care patients transported out of the community via ambulance for their care. After 30 years of work by many dedicated board members, a new hospital for the community finally came to fruition. On January 8, 2008, an 11-bed hospital opened with a staff ready and willing to serve the community. Late to arrive, but with a strong vote of community support, the health services for the area was dramatically expanded with the birth of this new hospital. The initial hospital district became the Upper San Juan Health Services District (USJHSD) and the EMS services, along with the new hospital, were governed by the standing USJHSD Board of Directors.
After the opening in early 2008, many felt the challenges to bring a hospital to the community was complete. Over $1,000,000 in community donations helped fuel the hospital upon opening. $12,000,000 in 20- year bonds were firmly in place, and a $650,000 cash reserve was earmarked to cushion the district from potential financial swings. Staff was trained and ready, and the community began streaming in for health care services at the new facility. The hospital was a true community success. However, the opening only signaled an end to the planning process. It was just the beginning of the next phase – managing health services for the community in an ever-changing health care environment.
The first major test was to generate additional funding for equipment and operational funds beyond the initial capitalization of the new facility. With the help of community donations generated by the Dr. Mary Fisher Medical Foundation as well as grant funds from the Department of Local Affairs (DOLA), a new x-ray machine and C-arm were purchased. In addition, a new ambulance was funded with a 50% match from the State of Colorado and the Dr. Mary Fisher Medical Foundation. Since the opening of the hospital in 2008, hospital staff has generated more than $1,000,000 in grant funds to expand our health services capabilities. The Dr. Mary Fisher Medical Foundation also continues to work hard to raise money to maintain and expand services for the future of the USJHSD.
The second major challenge confronting the USJSHD was the shortage of primary care services. Due to several providers leaving the community as well as the increasing demand for emergency room coverage, the existing medical providers in our area were stretched too far. To augment the private practice medical professionals, the USJHSD focused on recruiting new primary care providers and emergency room staff. The USJHSD met the challenge and brought more than 12 new providers to the community recently.
To make sure primary care providers continued to stay and thrive here in Pagosa Springs, the USJHDS also recognized the financial challenges of primary care providers in private practice. Over the last several years, reimbursement for primary care services has continued to decline. The USJHSD took on the initiative to bring a Rural Health Clinic (RHC) to the community to solve that problem. Medicare and Medicaid tremendously enhance their reimbursement payments to RHCs compared to private practitioners. Complimenting the existing providers in private practice, the RHC opened in 2010 and has developed an operational capability of serving over 15,000 visits for the 2011 year.
The third and most comprehensive challenge undertaken by the USJHSD is to provide prevention programs along with health care services. Historically, health care in the United States could be better described as sick care. Patient care is typically provided after someone is ill rather than programs to keep them healthy.
With the aim of making our community members healthier, we have developed early detection and wellness geared towards community health improvement. Thanks to a grant from the Colorado Prevention Center, more than 1,000 community members have received a free cardiac screen via the Heart Healthy Solutions program. This screen provided them with valuable information regarding their potential for cardiac disease.
In addition, the National Prostate Council has provided a very low cost ($6) PSA screen for men in our community, which resulted in hundreds of men finding out if they have any indication of the potential for prostate cancer. The Colorado Colorectal Screening Program (CCSP) also has contracted with our USJHSD and beginning in early 2011, colon cancer screening colonoscopies will be taking place in our hospital. In the near future, we hope to provide women in our community access to timely, high-quality screening and diagnostic services to detect breast and cervical cancer at the earliest stages. Other programs will be explored to add to the early detection offerings.
While those are being investigated, we have developed a Wellness Center. Now the community has a center, staff and support team ready to help people make the personal changes necessary to improve their health. Wellness is a broad term but describes individuals focusing on staying well. “Live Better, Live Longer” is our wellness tag line, and we are putting energy into helping make the tag line literally come to life.
It is very difficult for individuals on their own to make lifestyle changes in order to improve their health and to avoid poor health. As a component of our primary care services, we developed a Wellness Center to provide education on specific aspects of health, tools to support individuals, lab services, individual coaching by personal trainers, and access to The Mayo Clinic Embody Health web portal.
Providing a catalyst for behavior change, all of our wellness efforts are directed toward motivating and sustaining health behavior change with the goal of improving population health, productivity, and of course, the associated healthcare costs.