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Health District opens limited clinic facility

As part of a multi-faceted plan to provide comprehensive community healthcare, the Upper San Juan Health Service District will open a one-day-a-week “under-served, under-insured” clinic Tuesday.

As described by Pagosa Mountain Hospital (PMH) administrators, the Pagosa Mountain Clinic, as it’s called, is a precursor to a planned rural health clinic (RHC) now scheduled to open sometime next spring. In order to receive required federal certification as a RHC, however, the facility must first pass state inspection, while already providing healthcare services to under-served segments of the community.

During a Monday morning interview, PMH Chief Executive Officer Brad Cochennet explained that in order to become a RHC, “we have to be open and available for inspection. Once certified, the RHC will provide expanded Medicare and Medicaid services to the community, while utilizing existing hospital personnel and infrastructure.”

Based on a recent feasibility study, the RHC will receive two to three times the federal reimbursement of a private primary care facility. Reimbursements are fixed on allowable costs, thus reducing operating expenses and charges for patient care.

As a RHC extends care to Medicare and/or Medicaid patients, local private practices will better provide primary care to non-Medicare/Medicaid patients who enjoy sufficient healthcare coverage.

Pagosa Mountain Clinic (PMC) on the other hand, will see under-served patients who have little or no insurance, no Medicare or Medicaid coverage, or any access to primary healthcare. Funding will come largely from grants, starting with a three-year $231,000 endowment from the Colorado Health Foundation (CHF).

Beginning Nov. 24, the clinic will see patients every Tuesday, by appointment only, with fees based on a sliding scale. As part of a commitment made by the health district to the CHF, a patient’s income will determine how much he or she can afford to pay per visit. As additional grants, patient volume and fee collections increase, office hours will expand to include additional days per week.

Cochennet insists more grants will come, as Pagosa Mountain Clinic performs. “There are more grants out there,” he said, “and we’re going to impress the heck out of these guys.”

According to CHF communication specialists, “The Colorado Health Foundation works to make Colorado the healthiest state in the nation by investing in grants and initiatives to health-related non-profits that focus on increasing the number of Coloradans with health insurance; ensuring they have access to quality, coordinated care; and encouraging healthy living.”

Though separate entities with individual funding, Pagosa Mountain Clinic and the rural health clinic will occupy adjoining Pagosa Mountain Hospital (PMH) space that once housed the former Dr. Mary Fisher Medical Center. Beginning Tuesday, Nurse Practitioner Dan Keuning will man Pagosa Mountain Clinic, while continuing work at Pagosa Family Medicine with Dr. Jim Pruitt.

Meanwhile, once the Rural Health Clinic opens, Keuning and hospital personnel, including Dr. Matt Phillips, Physician’s Assistant Martin Neuberg and Physician’s Assistant Robert Gruver, will likely see patients in both clinics. Gruver hasn’t begun work at PMH yet, but will in February.

With a primary care hospital in place, an under-served clinic about to open and a rural health clinic looming on the horizon, the health district launched an early detection program in September, and plans a wellness program after the first of the year.

Funded by a grant from the Colorado Prevention Center, the early detection program has already provided free or low-cost screening and diagnostic services to 583 people, even as grant terms require 600 per year. Due to previously unknown conditions like high blood pressure, excess weight or substance abuse concerns, many patients have since been referred to primary care docs for follow-up consultation or treatment.

To complement the early detection program, the wellness program will include a mental health component that will aid those struggling with anxiety, depression or low self-esteem. It will focus on education, as a means of realizing specific behavioral changes necessary to overcome potentially life-threatening conduct.

According to recent studies, expanding services and programs will provide more timely primary medical care, without flooding private clinics with Medicare/Medicaid patients at lower reimbursement levels. Too, they will send fewer patients to the hospital emergency room, increase facilities funding and compensation, and reduce patient expenses.