NM Senator tours Raton medical facilities
Dr. Don Belknap, an Emergency Room physician at Raton’s Miners’ Colfax Medical Center, said that when he first started there five years ago the hospital might see 15 patients on an average day. Last Thursday the hospital saw 31 patients. U.S. Senator Martin Heinrich, D-N.M., was clearly impressed by that increase and by the hardworking staff and fine facilities available to prospective patients.
Sen. Heinrich toured the hospital and long-term care center as part of a weeklong Rural Health Care Listening Tour that included tours of medical facilities in Santa Rosa, Clayton, Mosquero and Raton in an effort to determine the current status and ongoing needs of health care in rural northeastern New Mexico.
Dr. Belknap said the number of certified physicians at the Raton hospital had also increased from just one to the current total of eight full- and part-time doctors, and Heinrich asked him what factors had driven that recent change.
Belknap said the 25-bed hospital had been able to attract higher quality doctors and partner with other medical entities and insurance companies to ensure a steadier flow of patients. The center was recently listed as a “Top 100” critical access hospital by iVantage.
The senator and some of his staff members were taken on a tour of the hospital’s acute care services by Shawn Lerch, CEO of the Medical Center, who showed them its new Rural Health Clinic, its Primary Care Clinic and Miners’ Mobile Outreach Services.
Lerch showed Heinrich the newly installed CT scanner, its Intensive Care Unit, Pediatrics Unit and many other features. In April 2014, the new Raton Veterans Administration (VA) Community Based Outpatient Clinic opened near the hospital. Lerch said the Medical Center’s staff had enjoyed excellent interactions with the new VA clinic.
“Actually it’s been great, because we collaborate with them,” Lerch said. “The veterans can get great access to care over there, but for specialized services we have a wonderful partnership do they are able to come here the expanded veterans health care and be served over here also. They serve the area with their practitioners. They’re top notch.”
Surgeon Dr. Tropha Wright told Heinrich about the difficulty of attracting highly qualified nurses at the hospital.
“The limitations here, I feel, are the pay grade for our nurses,” Dr. Wright. “I’m lucky enough to have two local registered nurses in our operating room who live here, so they want to work here. They are paid $25 to $50 an hour less than they could get across the state line in Colorado and in the prison system here. How do you keep them here? Some of them want to be here, and there are a lot of benefits to living here, in terms of cost of living. We can’t keep them all here. We have two local nurses but there are no local nurses working on the floor. They’re all traveling nurses.”
Traveling nurses typically work on three to six month contracts and usually make more money than permanent staff nurses, which negatively impacts the Medical Center’s bottom line. More than half of the nurses at the Raton hospital are traveling nurses. Lerch said the hospital could save as much as $1 million per year if it didn’t have to pay more money for traveling nurses. The salaries permanent staff nurses earn are set by the state.
Senator Heinrich took in these sobering facts, commenting that they were similar to other statements he had heard about the challenges faced by rural hospitals while traveling through Northeast New Mexico on his listening tour.
Two students from the nursing program at Trinidad State Junior College were working on the hospital floor that Thursday, which is another example of the regional collaborations MCMC works to sustain.
MCMC’s Women’s auxiliary group has raised a combined total of $800,000 for the medical center over the past 40 years, and has contributed more than 10,000 hours of volunteer service.
The tour concluded with a tour of the long-term care facility.
On the car ride between the hospital and long-term care facility, Heinrich talked about some of the key issues facing health care in rural America and some of the initiatives he and members of Congress were doing to address those issues.
The senator was asked what kind of initiatives he was working on in the Senate to address the serious concerns faced by rural healthcare providers.
“I think one of the first things we have to recognize is that health care in the West is different than what a lot of my colleagues think about health care,” Sen. Heinrich said. “Recognizing that healthcare in Northeastern New Mexico and Southeastern Colorado is a lot different than what somebody from Iowa or Illinois faces. What I would like to see are more incentives for what I would call Frontier Medicine, whether that is differential pay scales for these kinds of critical care hospitals that are in truly remote areas, separate from the underserved designations that, frankly in New Mexico, kind of apply everywhere. In addition I think we need to look at more incentives for people to relocate and start their careers in some of these facilities. We found that when people do move someplace and spend the first three years of their career there, then there’s a much higher chance that they’re going to stick around and make it their home long term.”
Heinrich was asked if he thought Donald Trump’s victory in the recent presidential election would impact the Affordable Care Act, or Obamacare, going into the future.
“Well, I think it depends dramatically on whether they take a pragmatic approach and say, ‘let’s talk about what we change and what’s not working and how we fix that,’ or if they take a more ideological approach and say, ‘let’s throw everything out.’ Because if you get rid of the tax credits, for example, you could see a large number of people just flat out lose their insurance, and then they end up in Indigent Care or the Emergency Room. My hope is that we can find a number of partners across the aisle, so we can take it one issue at a time. I’ve had a history of partnering with Republicans like Sen. Dean Heller out of Nevada. We recognized early on that what they call a ‘Cadillac tax’ was not going to a thing that worked well in our states, and we were able to repeal that over the past two years and we hope to make it permanent. But I think it’s going to be key that we focus in on the issues and not throw the baby out with the bathwater, as it were. I think the other thing that’s important in places like Raton is that New Mexico, for example, has such a high rate of volunteerism in the military, is making sure that our VA system integrates well with the local health care, such as MCMC here in Colfax County or Union County General Hospital in Clayton.
“Veterans Choice is a new program that we supported very strongly that allows veterans to be treated in their own communities. It’s a good supplement to things like the community-based outpatient clinic that we were able to see opened here in Raton. It’s a model of serving veterans in their communities, and it’s a very important piece of rural healthcare overall.”
Tele-medicine seems to be growing exponentially, and Heinrich said that type of service was a key factor in rural health care.
“It should be growing because there are going to be times when it doesn’t replace having access to a doctor, but there are many times when you need, literally five or 10 or 15 minutes consultation with a specific kind of physician and you really don’t need to be on the interstate for three hours to make that 15 minutes happen. So having access to really robust tele-health infrastructure is one of the ways that we maintain good healthcare services in rural, frontier areas.”
Opiate drug abuse is a scourge in many parts of rural America, and Heinrich was asked what moves the federal government had taken recently to deal with that problem. He said Congress recently passed a very good anti-opioid, treatment-based policy bill.
“What we need to do now is step up and put the dollars in place so that those changes in procedures that we know are scientifically based and will be successful and are more accessible. Without the funding, people are not going to be able to take advantage of that treatment and get the help they need. When you don’t treat something as serious as serious as opiate abuse, the impacts, not only to that person, but also to their community, their family to their income potential, are just staggering. We need to meet this scourge head on and the reality is that it’s going to cost money. In the long run I think it’s absolutely a must to make that commitment.”
Any job market needs motivated workers who will show up on time and do that every working day. The Senator was asked what more could be done in the schools to educate students about the importance of being responsible, committed workers.
“I think it’s having a continuous educational pipeline that starts with early childhood, which is something we historically have not done adequately in New Mexico. Having early childhood education that is funded, that gets kids into Kindergarten knowing the things that they should know when they start. We do a pretty good job with those students who show up ready to learn, and with the basics. Where we have people who fall off and never get back on track is when they don’t show up ready to learn.
“So starting with early childhood education, matching that up to a continuous pipeline all the way into high-quality technical and vocational training, and that’s something we’ve gotten away from to some extent in this country and it really needs to be a focus, that in addition those folks who are going to get a four-year degree, we need to focus just as much on long-term technical skills, because those produce most of the good middle class jobs.
“Where you see opportunities to grow economies in rural America you see things like increased transmission to move electricity from one part of the country to another. The opportunity for new wind farms and new solar facilities that spring up around that transmission, those are the places where we need a really solid, well-educated workforce, and those jobs are high-quality jobs in rural America. That’s where we should be focused, not just on quantity but on quality as well. We need careers, not just jobs.”
Senator Heinrich’s listening tour gave local people the chance to express their feelings on their own health care needs, and the opportunity for them to find out what’s been going on at the federal level concerning those issues.
