ALAMOSA — Citing safety and monetary reasons, Valley-Wide Health Systems CEO Gigi Darricades told the San Luis Valley County Commissioners Association on Monday that after 41 years they’d no longer be able to take care of patients incarcerated at county jails. The discontinuation of service will take effect within 60 days of August 1.
"We wanted to meet with you to give you a heads up before we sent you a formal letter," said Darricades.
Valley-Wide sees the most inmates in Bent County among all of their locations in 12 counties. In the Valley the majority of the inmates are in Alamosa County.
"This just sucks," said Alamosa County Administrator Gigi Dennis.
Aside from the larger and better-equipped Denver Health, Darricades said Valley-Wide was the only other federally qualified health center in Colorado seeing inmates—sometimes without compensation.
"We've been doing a lot of free work for the counties and that adds a burden to our finances," Darricades said. "Perhaps we should have pursued payment methodologies harder."
The other reason to stop is that the Federal Tort Claims Act, Valley-Wide's malpractice insurance through the federal government, does not cover the care. "That puts a high risk to us," she said.
Darricades provided the commissioners with two solutions: take the inmates to the emergency room when necessary or hire medical personnel such as a nurse practitioner (NP) or physician assistant. Valley-Wide Chief Operating Officer Adam Roberts said that an NP would cost at least $90,000 or higher if they have a psychiatric background to handle inmates' mental health issues.
Alamosa County hired a registered nurse last year, yet because they can't prescribe medication like an NP they need a doctor to supervise. Conejos County receives assistance with a NP but it is unsafe for them to go to the jail for inmate evaluations.
If deputies are present for security, there is then the question of whether or not that violates the patient's privacy.
"Sounds like a way bigger issue than we're going to wrestle with here in the Valley," said Saguache County Commissioner Jason Anderson, "because most of us don't have the capacity. This sounds like a state issue."
Colorado House Representative Donald Valdez was present at the meeting to listen for topics that he could possibly address at the state legislature.
"This is an issue that's going to happen all over the state," said Valdez. "If we can help our counties here, and the cost of an NP is out of our budgets, we need something that's going to help us move forward."
"It exposes the counties to liabilities from a civil liberties perspective," added Valley-Wide Chief Administrative Officer Alonzo Payne.