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Bills aim to help rural hospitals hang on

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It’s not just Rehoboth McKinley Christian Hospital that’s struggling to stay afloat. Small, rural hospitals across the state and the country are in the same boat, trying to keep up financially with their metro counterparts.

To try to fill the gap in New Mexico, legislators have introduced some bills this legislative session that would primarily help the state’s seven smallest hospitals, including RMCH.

Some offer short-term relief; at least one could improve the financial footing for small hospitals for the long term. Local officials are holding their collective breath to see which bills will pass.

What follows is a roundup of hospital rescue bills and their status at press time.

 

SENATE BILL 52 - EMERGENCY RURAL & FRONTIER HOSPITAL FUNDS

Senate Bill 52, titled Emergency Rural & Frontier Hospital Funds, would set aside $51 million from the general fund to give hospitals with fewer than 35 beds a one-time emergency infusion of $3 million each.

The bill was introduced Jan. 17 and sent to the Senate Indian, Rural and Cultural Affairs Committee Jan. 18 and reported with a Do Pass recommendation Jan. 25.

Bill sponsors are Sens. Pat Woods (R) and Randall Pettigrew (R).

 

SENATE BILL 161 - ACUTE CARE FACILITIES SUBSIDES

Senate Bill 161, titled Acute Care Facilities Subsidies, would create a fund for state - or county - owned hospitals and independent not-for-profit hospitals with fewer than 30 beds to tap to cover losses incurred from providing emergency medical care; inpatient services related to maternity, child and family health; increased costs of medical malpractice and property insurance premiums; inpatient acute care; and Medicare spending reductions known as sequestration.

The fund would get $50 million from the general fund, to be allocated over the next two fiscal years. To access funding of up to $3 million per year, the hospital applicants would have to have debt of more than $1 million – far below what most of the targeted rural hospitals are carrying – and less than 100 days of cash on hand. They would have to provide the Health Care Authority Department with a plan to have 100 days cash on hand within five years without reducing services; and quarterly progress updates through 2026.

The bill was introduced Jan. 22, passed the Senate on a 37-0 vote and sent to the House Health and Human Services committee Feb. 7 before going to the House Appropriations and Finance Committee.

Bill sponsors are state Sens. Roberto Gonzales (D) and Siah Correa Hemphill (D); cosponsors are Sens. George Muñoz (D), Woods, and Nancy Rodriguez (D).

 

SENATE BILL 17 - HEALTH CARE DELIVERY & ACCESS ACT

Senate Bill 17, dubbed the Health Care Delivery & Access Act, was introduced Feb. 5 and has the backing of the New Mexico Hospital Association. It would create a Medicaid-Directed Payment Program – an assessment on hospitals, based on inpatient days and outpatient billing. Whatever the assessment rates are determined to be each year, larger hospitals would pay 100%, rural and “special” hospitals would pay 50% and small urban hospitals would pay 10% of the full assessment.

A Medicaid-Directed Payment Program creates a match that opens the door to more federal funding. Forty other states have approved similar programs.

The bill requires that 90% of the fund go to hospitals, setting aside 10% for the state to administer the fund. Hospitals would be required to spend 75% of money they receive from the fund on delivering health care, including hospital operational costs, workforce recruitment and retention, staff and provider compensation increases, on-call physician coverage, ongoing training incentives, creation or expansion of services, community benefit activities or capital investments.

Once the bill wins approval in the state Legislature, it will have to pass muster with the federal Centers for Medicare and Medicaid Services, which sets payment rates and access rules for those two programs.

It was introduced Jan. 26 and won Do Pass recommendations from the Senate Health and Public Affairs Committee Feb. 5 and the Senate Finance Committee Feb. 7.

Bill sponsors are state Reps. Doreen Gallegos (D) and Jason Harper (D); joint sponsor Rep. Cristina Parajon (D); co-sponsors are Sens. Michael Padilla (D) and Elizabeth Stefanics (D).

RMCH Interim CEO Bill Patten, who testified Jan. 29 in favor of SB 161, urged legislators not to see the bills as either/or but a continuum, as if the financially strapped hospitals were patients.

“We have emergency, then we would have intermediate, then long-term [care],” he said. “This would be like someone is having a heart attack. We need to deal with the heart attack [SB 52]. Intermediate is, after they’ve survived the heart attack they need open heart surgery [SB 161]. Once they survive that, we need to get them in cardiac rehabilitation and diet and weight loss programs. That’s what SB 17 is.”

By Holly J. Wagner
Sun Correspondent

Blasting out of the rough

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Sporting clays game hits Gallup

They call it “golf with a shotgun,” and it is this comparative name that has thrust the target game of sporting clays to the forefront of outdoor recreation in the Indian Capital.

Sporting clay is a target game played with a shotgun and “birdshot” ammunition. The clays are launched by a machine called a “trap.” In virtually every situation, automatic traps are used at stations (holes in golf), and the presentations of these targets in flight to a shooter replicates game bird-shooting.

In some game scenarios, there are rabbit targets that run on the ground like jackrabbits. Just like no two golf courses are the same, no two sporting clay courses are the same, either.

The game was developed in the 1920s in England to allow shooters to stay sharp between hunting seasons. In Gallup, Shon Lewis, an Alabama native, U.S. Navy veteran and administrator at Miyamura High School, brought the sport to McKinley County this past December. Lewis works with Gallup businessmen Rudy Piano and Nate Yale in the budding Gallup Patriot Target League, a sporting targeting league for local youngsters.

“This is something that we hope takes off as a sport around McKinley County,” Lewis explained. “This has absolutely nothing to do with school shootings or anything like that taking place around the country. It’s sport and that’s how we approach it.”

The Background

The GPTL is a trap shotgun team which boasts eleven members ranging in age from 11 to 18 years old.  It is part of the New Mexico Youth Clay Target Association and, nationally, part of the San Antonio, Texas-based Scholastic Shooting Sports Foundation. The GPTL operates as a nonprofit organization supported by Gallup Shooters—which operates under the auspices of the City of Gallup. Membership is open to anyone with a thirst for gun knowledge, but that could change should the group become part of the Gallup-McKinley County School District and classified as a varsity sport.

Lewis, who served 26 years in the Navy, said the Gallup trap shooting team is not recognized by the New Mexico Athletic Association, a sanctioning body, as an official sport, so team funding comes via donations and sponsorships.

“Students can earn scholarships through the (Scholastic Shooting Sports Foundation) if you are recognized as being part of a league,” Piano says, noting the fact that the National Rifle Association is a source for scholarships and grants. Piano is a Gallup native and an assistant coach with the Gallup team. Lewis is the head coach and Yale the line supervisor of the Gallup team.

The Game

The shooting range is owned by the city of Gallup and is located west of the city in Mentmore. It is the same range used by professional law enforcement for practice and training.

Members of the Gallup trap team use Remington 1100 rifles and the accompanying rounds of ammunition. The targets are “clay pigeons,” redneck slang for small circular objects released into the air from a propeller. The guns are real and safety and professionalism are paramount.

The athletes on the clay trap team must maintain good grades and cannot have disciplinary concerns at school. The beauty of clay shooting, organizers say, is that males and females participate on an equal footing. Lewis, Piano, and Yale note that the game is statistically much safer than golf or even walking down the street, as accident incident levels are virtually non-existent.

Like with most sporting clay teams, shooters use 12-gauge shotguns with low recoil ammo. Approximately 15 percent of sporting clay shooters are female.

“It’s fun and I learn a lot,” Rhonna Shultz, 11, and a student at JFK Middle School in Gallup said. “The exciting part is when I hit a moving target.”

Typically, shooters encounter distances between 15 and 50 yards, and a more open “choke” is used for close targets, while tighter chokes are needed for targets shot at a distance. The choke is a restriction of the bore diameter of the muzzle of a gun.

It is a sport that relishes safety, discipline, knowledge, and precision. The sporting clay game has no physical performance barrier, so it is a game that an entire family can play.

“We hold our athletes to high standards and want them to represent Gallup in a very positive manner,” Lewis said, adding that coaches are trained as well as background-checked.

The Team

One of the goals in creating the team was to give youngsters who like to shoot the opportunity to gain gun knowledge and to get better at the skill, Nate Yale, a U.S. Air Force veteran and Michigan native, said.

Yale oversees the shooting line, from the moment a shooter yells, “Pull,” to the finality of bullet contact with a “pigeon.” A partner in the Gallup firearms training firm Bear Arms, Yale said clay sporting teams provide positive avenues for kids and adults, some who may not be athletic-types.

“The sport teaches skill and confidence, things like how to stand and hold a gun,” Yale said. “And most of all, the sport promotes safety no matter the age group. This really is something that everybody can do.”

Current Concerns

The trap shooting team is getting its start at a time when many students and others across the country are calling on state and federal lawmakers to take action on gun control in the wake of school shootings, most recently at Marjory Stoneman Douglas High School in Parkland, Fla. That incident took place on Feb. 14, where 17 people were shot.

Lewis said he believes that teaching team members the proper respect and knowledge for guns goes a long way. He said the team’s expenses for guns, pigeons, and ammunition are, for the most, part, covered by donations from parents.

Yale said hunting is part of the sport’s culture and background. The competitions and practices are not only a mechanism for team members to develop better shooting skills but a way for members of the team to meet others in their age bracket who might have knowledge to share.

“The sport is definitely growing in popularity,” Lewis said. “We will be here teaching and instructing for a long time.”

By Bernie Dotson
For the Sun

RMCH gets on the road to break even

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The road back to financial and operational health for Rehoboth McKinley Christian Hospital is long and filed with challenges, but management is taking steps on a path of incremental change that will affect staffing, vendor contracts and eventually management.

Interim CEO Bill Patten is excited about measures the hospital’s board approved in its Jan. 31 meeting.  Adding those to his ongoing efforts to reduce supply and service costs – which he has so far done to the tune of $38,000 a month – he hopes to get the hospital operating at break even on a day-to-day basis by May or June.

The hospital will begin a search for a Chief Operations Officer, a new position. The search will include internal and external candidates. Patten has asked staff to develop the job description, create a compensation package and develop the recruitment process in the hope of having the position filled within about six months.

The changes patients are most likely to see are merging the Medical-Surgical Unit with the Intensive Care Unit, which allows nurses to serve both patient categories more efficiently, Patten said; as well as some staffing changes that should open up more appointments. That’s good for patients and for the bottom line, as RMCH works to keep patients, and the revenue they generate, local.

The board approved contracts with High Desert Physician Management for two local providers who already work at the hospital: RMCH’s only pediatrician, Dr. Michelle A. Stam-McLaren, and podiatrist Dr. Matthew Spiva, who also specializes in wound care. Under the new contract arrangements, more appointments should be available with both doctors.

“[Dr. Spiva is] very busy. From a production perspective, he is our number two physician,” Patten said.

The demand stems from the high number of diabetes patients in the area. Because of the associated numbness and neuropathy in lower extremities, diabetes patients may injure themselves without even knowing it.

“It makes what would be simple wounds for you and I into complex wounds for diabetic patients … that wound turns into an injury that just doesn’t want to heal,” Patten said.

The board approved hiring a physician assistant or nurse practitioner to help urologist Dr. Christopher Hoover, who works half-time and is booked out for four months, Patten said. The assistant will help expand the practice, which will also support surgical referrals. Hoover will move to a five-day-a-week contract to deal with the backlog.

 

J-1 VISAS

Another change is a plan to hire two or three physicians under the J-1 visa program, which gives doctors who want to emigrate to the U.S. preferential treatment when they commit to work in a rural or underserved area for three years.

The first new hire under the effort is expected to be addiction medicine and preventative medicine specialist Dr. Sher-Ali Kahn, who’s been in Albuquerque while his residency papers are processed. Patten hopes to have him on board within a couple of months.

“The addiction medicine will be such an important new element for our community. We’re really excited about it,” Patten said.

A cardiologist – or two, or three – is also on the RMCH wish list.

“It would enhance ability in the emergency department, for hospitalists and surgeons,” Patten said. “They could get a local consult to determine that [patients] are OK for surgery.”

Another high priority is a gastroenterologist, Patten said, because currently a majority of G.I. work has to be transferred out of town.

 

FLEX NURSES

Among the measures is a plan to offer voluntary flex positions for three nurses, who would work in whatever department has the most need instead of the same department every shift.

They would be guaranteed pay for 36 hours – three shifts – per week, whether they work them or not. Extra shifts would carry overtime wages after 40 hours. For each pay period, two of the nurses would work day shifts and the third would commit to working night shifts, so nobody would be stuck working back-to-back shifts or switching shifts during a pay period.

Nurses who are qualified to float among medical surgery, the ICU and emergency departments will be eligible for an extra $7.50 per hour; for adding a fourth department, that could go up to an extra $10 per hour.

“What we are hoping is that some of our current nurses want these positions and then we can recruit for regular schedule nurses. We are very competitive on our salary and benefit structure,” Patten said. “It’s another way to reduce our dependence on travelers.”

Traveling nurses are more expensive than permanent staff. During the pandemic RMCH had as many as 47 traveling nurses, which added up to $1 million a month.

“When you have 47 traveling nurses and it’s costing you a quarter of a million a week, that adds up pretty quick,” Patten said.

Now that number is down to eight: Five in the emergency department, one in the operating room and one or two in ICU.

 

LOOKING AHEAD

In the months ahead, Patten wants to do a staff needs assessment, and develop a recruitment strategy for all levels of employees.

“Across the country, 9% to 15% of the population wants to live in rural America,” he said. “We need to make ourselves attractive to them.”

By Holly J. Wagner

Sun Correspondent

City receives funding for regional senior center

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A new senior center has been on the Gallup City Council’s priority list for a while now, but things are finally moving in the right direction.

At the Jan. 16 and 30 city council meetings, the council accepted large amounts of funding from the State of New Mexico Aging and Long-Term Services Department.

Both amounts came from a Capital Appropriation Project Grant, with the first amount coming out to just over $4.5 million. The council approved that on Jan. 16, and another grant that totaled almost $7.5 million on Jan. 30.

During the meetings the city’s Planning and Development Manager C.B. Strain said that the money is meant to help plan, design, construct, equip, and furnish the senior center.

Per the agreement, the city has to use the $4.5 million by June 30, 2026. The $7.5 million has to be spent by June 30, 2027.

In total, Strain estimated that the senior center would end up with a price tag of $20 million when the project is completely finished. He said that once Phase 1, which is just the design phase of the project, is done, the city will go to the state legislation and ask for more money.

“Our seniors desperately need and deserve a new senior center, and we owe it to them to do the best we can to make sure that happens,” Strain said. “With this [funding] we’ll be well on our way to getting that accomplished.”

Now that the council approved the funding, a bid for the design can go out. Once an interested designer makes a bid, Strain will come back to the council so they can approve the designer’s contract.

By Molly Ann Howell

Managing Editor

Duran faces pressure to resign post

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Faces 64 counts of criminal charges

SANTA FE–With calls for Secretary of State Dianna Duran to resign growing by the day, the talk is already starting to shift to who will next fill one of the most important elected statewide offices.n

Duran is facing 64 counts of criminal charges filed last week by Attorney General Hector Balderas for using campaign money for personal use. On Wednesday night, Speaker of the House Don Tripp, R-Socorro, said the State House members will explore impeachment proceedings even as many high-profile state Republicans, including Gov. Susana Martinez, are seemingly distancing themselves from Duran.

New Mexico’s two largest newspapers also urged Duran to resign in editorials this week.

If Duran resigns or is impeached by the state Legislature, Martinez will have to appoint someone to fill the role. That role could go to Mary Quintana, who currently serves as Duran’s deputy secretary of state.

Some Republicans rumored

Other Republican names for possible replacements are being kicked around by politicos, though they admit it is all speculation at this point. They are state Rep. Kelly Fajardo of Belen, Los Alamos County Clerk Sharon Stover, Valencia County Clerk Peggy Carabajal and former Albuquerque City Clerk Amy Bailey.

While Fajardo, Stover and Bailey didn’t return voicemails from New Mexico Political Report left Tuesday afternoon, Carabajal spoke with us.

Carabajal said she hadn’t heard of her name coming up as a possible appointee and that she would “really have to look into that” if it did. She added that her office was “shocked and saddened” to hear about the charges against Duran.

“I hope they do something quick, because that position is very important for all of us,” Carabajal said.

She also said that while we’re currently in an off-election year, county clerk offices will start working closely with the Secretary of State’s Office next January in preparation for that year’s primary and general elections.

Duran’s current term runs through 2018, but a removal from office and replacement chosen by Martinez, depending on the timing, could kick off an accelerated election for the post during the 2016 general elections—a full two years ahead of schedule.

The Democratic front-runner

Bernalillo County Clerk Maggie Toulouse Oliver is a Democrat who lost to Duran in the race for Secretary of State last year by 3 percentage points. She wouldn’t yet say whether she would seek the office again in a currently-hypothetical 2016 election and won’y make decision until Duran’s situation plays out.

“What I don’t want to do quite yet is predict the future,” Toulouse Oliver said, adding that she was also “shocked” and “really saddened” to hear about the charges against Duran. “I certainly ran for the office because I care about it deeply.”

She also stressed that her thoughts are “exclusively with the ability of that office to do important work at this time.”

Visit: nmpoliticalreport.com

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