Health care execs raise red flags

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What’s keeping El Paso County’s health care leaders awake at night? First, there’s the current shortage of doctors and nurses – most of whom are 45 to 50 and older. Then there are overwhelmed emergency rooms that must often treat alcohol and substance abuse patients instead of handling more serious cases. Finally, there are the families that can’t afford health insurance – including almost 20 percent of El Paso County’s residents.

The good news: in the face of an El Paso County health care crisis, all four leading providers have vowed to work together to solve the problems.

At its October 22 annual meeting with more than 300 community health care and business leaders in attendance, Pikes Peak Mental Health hosted a collaborative panel discussion on the future of health care in the Pikes Peak region. The question-and-answer format program, moderated by Nicole Hernandez, news anchor with KKTV, focused on cooperation between the city’s two hospitals, Community Health Services and Pikes Peak Mental Health in their efforts to deliver medical or behavior health care services to a growing population of underinsured or underinsured and uninsured individuals and families.

“We see a growing problem in hospital emergency rooms, for example – often over-run with substance abuse clients or DUI clients who actually belong in a detox or crisis center; and we are all addressing the budget issues facing us with indigent care,” said Morris Roth, CEO and president of Pikes Peak Mental Health. Joining Roth on the panel were Rick O’Connell, president and CEO of Penrose/St. Francis; B.J. Scott, president and CEO of Community Health Centers; and Cherie Gorby, senior administrator, Patient Care and Services for Memorial Hospital.

Discussion was based, in part, on the results of a recent consultants’ survey, underwritten by the Sisters of Charity (through a Penrose/St. Francis request by O’Connell), to determine how El Paso County should best handle detox services and the growing number of uninsured and underinsured El Paso County residents.

All panelists agreed that access to health care still remains the community’s biggest issue. O’Connell and Gorby pointed to a growing shortage of doctors and nurses – and to El Paso County’s reputation for paying lower salaries than those offered on the coasts and in other areas of the U.S. “We need at least 40 to 80 more primary care physicians today,” said Gorby, “to serve the whole community.”

O’Connell agreed, stating that emergency rooms are becoming the delivery system for much of El Paso County’s primary care. “Doctors are referring more and more patients to us after hours,” he added, “and we just aren’t staffed to fill in for primary care physicians in a managed care world.”

With an estimated 80,000 uninsured or underinsured individuals and families in El Paso County, each panelist expressed concern for the future. Roth said that the current migration to emergency rooms for treatment comes as a result of clients having no money to go anywhere else. “This won’t work long-term,” he added. O’Connell agreed, stating that one-third of the nation’s hospitals are currently operating in the red. Nonprofits are not much better off, Roth noted, citing state and federal budget cuts that are crippling nonprofit efforts by community resources such as Pikes Peak Mental Health and Community Health Services.

“Do you realize that one in five El Paso County residents currently cannot afford health insurance?” O’Connell asked. He also sees a growing interest from employers who, tired of 35 percent increases in their insurance plans (recently reported in the Wall Street Journal), are ready to look at some form of national health insurance. Scott says her organization sees the same thing. “For every percent increase in employer-sponsored health plans,” she said, “14,000 more people in El Paso County lose coverage. We have two excellent hospitals, but they are seeing 80,000 to 100,000 emergency room visits annually – and we have 37,000 registrants on the books at Community Health. Over half of those have no insurance.”

Gorby reports that Memorial Hospital, too, sees its share of uninsured patients, including almost 39,000 visits in 2001. Many of those, she admits, are detox patients. “We’re currently helping them sober up and sending them back out on the street,” she says. “It’s too bad, but we can’t spend the taxpayers’ money on rehabilitation – we’ve got our own mission.” O’Connell said that 60 percent of Penrose/St. Francis Hospital’s detox visits are made by only about 40 people. “We see the same people over and over. The Sisters of Charity-sponsored survey has clearly identified a need for a long-term rehabilitation program in El Paso County. Unfortunately, Colorado is 49 out of 50 states for detox funding,” he said.

Morris Roth responded that Pikes Peak Mental Health has been working with substance abuse clients for more than 30 years. “After all those years as a service provider, the problem really becomes yours,” he observed. “But El Paso County has not funded any rehabilitative services – and our state funds have been cut twice already this year. Thanks to the consultant’s survey, we plan to present our collaborative solutions and ideas to the community soon.” Roth also recognized Penrose/St. Francis, and Linda Lewis, specifically, for their help in driving the process.

As far as the future, the for-profit representatives were optimistic, noting recent joint grant proposals and joint efforts to reduce duplication of services. B.J. Scott expressed a slightly darker view, stating that a “perfect storm” might be brewing. “I see continued difficulty for the community’s families to gain access to physical, behavioral and even dental care,” she said. “No one has successfully addressed this issue at the national level, and the issue is too big for just one entity to solve.”

All four representatives, however, did agree on one thing: collaboration would be key to the future. “We’ve got to get outside our silos,” said Roth. “And that may mean senior managers may have to be willing to put money on the table – and take our hand off the money.”