In Part I of ‘Oh for a Bed’, we reported on the expanding Chaffee County need for mental health services and the issues and transfer delays it is causing. At present, patients needing to be moved to treatment facilities on the Front Range or elsewhere, sometimes sit for long hours at Heart of the Rockies Regional Medical Center while awaiting transfer.
HRRMC Chief Executive Officer Bob Morasko has said the hospital has a contract with the county for such patient transfers but feels the county isn’t holding up its end of the bargain.
The new Heart of the Rockies Regional Medical Center Pavilion opened May 20, consolidating HRRMC health services on their regional campus. Photo by Dan Smith
County Emergency Medical Services head Josh Hadley said the 2017 contract does not specify the transfer of those specific patients, who can represent a risk when transferred in a non-secure vehicle such as a standard ambulance.
County Commission Chairman Greg Felt expressed a desire to see the parties put their heads together to seek a solution. Some of the patient wait issues is also tied to the availability of beds at facilities in the Front Range or elsewhere.
While the commissioners have had a busy schedule, Felt said he feels it’s time for the parties to seek a community solution, and added that the county could review what capital solutions, such as a suitable transport vehicle for behavioral patient transfers. He also favors getting stakeholders involved in planning solutions.
Felt said the sheer growth in activity at the hospital has resulted in more non-emergent patient transfers overall but staffing has been ramped up and appears to be working well, in spite of the mental health patient transfer issue.
Solvista Chief Operating Officer Mandy Kaisner said they would like to be part of discussions among the stakeholders to look for a viable solution.
“Ultimately, we want to create local solutions for people who end up in the hospital with these health needs,” she said.
Solvista Health is in the planning stages to move its Salida clinic to the HRRMC campus. Courtesy photo.
Kaisner said Solvista is going to build a separate clinic facility on the hospital campus in the near future. It will rent space there before building, as space becomes available from the move of some service providers into the new hospital pavilion.
“We want to be at the table to ask how we access transportation now, but the real solution is to create local access to higher levels of care,” Kaisner said.
“We are really looking at what are some funding streams where we can pool resources so that I’m no longer sending someone to Grand Junction, or to Clearview or to Denver or to Colorado Springs, which is a huge amount of resources.”
She notes people do best when they stay in their community to get the best care and treatment.
Morasko wants to see the matter resolved more quickly. “I’m trying to get these patients treated as soon as possible, as quickly as possible, and mental health patients are medical patients, and we have to recognize them as medical patients and medical transports because they need to go,” he said.
HRRMC hired an independent consultant to review the transfer and building security situation. Morasko said [the consultant] came back with the conclusion that EMS does not want to take the mental health patient transfers because it would not be profitable.
Hadley points out that current staffing levels would be unworkable for patient transfers to the Front Range or elsewhere, taking one of the five current ambulances out of service for multiple hours.
Hadley said AMR [private ambulance service] also has used a more secure vehicle to transport behavioral health patients. He added that 2018 statistics show 92 percent of the behavioral health transfers were transported in a secure vehicle, similar to a patrol car with a secure barrier, as opposed to a more open truck-style ambulance. He pointed out that the county does not have a secure vehicle with a protective barrier, in its fleet.
There were about 60 transfers from HRRMC regarding behavioral health patients in 2018, five of which were managed by EMS in an ambulance, because of the patient needing medical (medication) intervention.
Hadley says he sees the need for a broad review of the issues. “Getting together as community partners and trying to figure out a solution that all of us can be part of it. Being just put on one person’s shoulders, one entity’s shoulders is not going to fix the problem.”
Morasko, who has spearheaded the growth of services at HRRMC and the current expansion, says he is passionate about providing excellent service.
“This hospital is — and will be the best — a model hospital in the United States. That’s been our goal and we’re close, if not already there … I’m not going to sit back – I didn’t come here to retire,” said Morasko. “I came here to make a difference… I didn’t come here to play politics, I came here to do what’s best for this community,” he added.
Hadley said the problem of mental health placement is not just a local problem, it’s a Colorado problem. “We’re not the only agency which that deals with things like this, and patient placement is becoming more and more and more of a challenge in this state,” said Hadley. “There’s more legislation right now that is occurring to try and send funding more in behavioral health’s direction to help create more facilities.”
Kaisner says she is open to a community approach. “The solution is for us all to come together as a community and say ‘what are the local solutions, could we look at accessing a higher level of care here?’”
With a Solvista facility planned for the HRRMC campus, she wonders what a regional assessment center would look like. A regional setting that would keep patients here and keep them safe, without the need to find a bed and getting them transferred to a facility as far away as Fort Collins.
“We are going to have to pool resources to create some of these local solutions,” said Kaisner. “We all have some level of involvement, so what if we sat together and really created really amazing solutions for our community?”
Oh for a Bed Part I: www.arkvalleyvoice.com/oh-for-a-bed-hrrmc-county-face-mental-health-patient-transfer-issues.
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