Board of health hears local issues


ALAMOSA — Local health care providers and officials from around the Valley had the rare opportunity to speak face-to-face to the Colorado Board of Health yesterday. Usually the board conducts their monthly meetings in Denver. However, they occasionally tour the state to listen to regional concerns.

After the board conducted their regular meeting, Dr. Patrick Thompson and Alamosa County Sheriff Robert Jackson told the visitors about providing health care in the overcrowded jail.

Thompson, who is the jail's physician advisor and medical director, said that roughly 80 percent of the inmates come in with a heroin addiction. Since inmates lose access to veteran's benefits and Medicaid upon arrest, caring for them can be costly.

"You're looking at a lot of money our community absorbs with no money coming in," Thompson said. "It becomes a burden on our local community to pay for this."

Thompson also mentioned that the burden on the sheriff's office has been lessened when they hired a full-time nurse.

"We cut the number of hours needed by the sheriff’s department in half by not having to take them to the emergency room or clinic," he said.

Dr. Larry Wolk, the executive director and chief medical officer of the Colorado Department of Public Health and Environment, spoke about his own experience working in jails.

"The challenges you described are unfortunately not dissimilar from what a lot of communities experience," Wolk said. "There's a lot of apathy in the general community because they don't remember that these folks who are now inmates were previously part of their community and will return to their community.

"It’s in everybody's best interest to try to do what we can to address the health needs while they're captive."

Multiple providers talked about the importance of Health Care Program for Children With Special Needs. Dr. Kelsey Walker, a family doctor at Rio Grande Hospital, said that HCP is both important as a provider and as a parent of a child that needs neurology care.

“When we moved here we had an honest fear that our child may never walk," Walker said. "He's 2 now and he's walking, running and jumping. It's been such a joy to watch him develop that way."

Dr. Tony Cappello, the president of the board, agreed and said that HCP is one of the most important programs in public health.

The majority of the meeting was the directors of the San Luis Valley Public Health Partnership discussing with the board issues they're having to provide better health care.

Connie Edgar, the director of Conejos County Public Health and Nursing Service, mentioned the difficulty of getting grants because they lack the resources. " We've been at capacity to serve," said Edgar. We can't take on any more grants and we can't take on any more projects. We just can't do it."

If they decide to fill out the paperwork then there's the hurdle asking for money as a small entity. "We often have the same reporting requirement as the larger areas. It's hard to negotiate the indirect costs for our agencies because we have one fiscal person."

Cappello, who is the public health director for the Northeast Colorado Health Department, said his district had the same issues. Since they had to hire their own grant writer Cappello offered to provide advice on how to get that started.

Alamosa County Public Health Department Director Della Cox-Vieira said that the departments are struggling with recruitment and retention. She mentioned how when a professional who is in a relationship relocates and is hired, their partner doesn't always find the right job so the pair eventually leave. On the other hand it's also difficult for them to recruit young single professionals.

"It's not always easy to meet people in a rural town when you don't know anybody," said Cox-Vieira.

Alamosa County has been looking for a physical therapist for a region-wide home health program for over two years.

It was also brought up that telemedicine can help staffing issues. However, that's only a viable solution if there's better internet for it to work properly.

Though it won't be a fast solution, Cox-Vieira said that they're now looking to grow their own health care providers by working with local schools and possibly start an internship or residency program.

"I may not get that locally-grown physical therapist for 15 years," she said, "but it'll be great 15 years from now."

Evelinn Borrayo, who has a doctorate in psychology, agreed with the strategy. "They're more likely to go back and raise their family there because they have family there," she said.

However, both discussed how it would only work in a rural area if there was financial support via scholarships.

"If we don't help these students then there's no way that their families will be able to make the financial investment," said Cox-Vieira, "especially for a program that requires eight years of higher education."

At the end of the meeting the local public health providers thanked the board for coming to visit and the board thanked them for hosting.

"We at the department don't want to be part of the problem," Wolk said. "We want to be part of the solution. There are untapped opportunities we can try to help you with."

Click here for continued coverage of the meeting.