Lincoln Community Hospital learned today that a physician who worked briefly in our Emergency Department as a staff member of Docs Who Care, Dr. Justin Neisler, has been charged with crimes related to child pornography.  We are deeply disturbed by this news.  These allegations are fundamentally against all we stand for.  We are currently in the process of contacting all patients who were seen by Dr. Neisler (less than 15 patients).

 

Since we have first become aware, we have been working with the Hugo Town Marshall’s Office, Lincoln County Sheriff’s Department and the FBI. Although the investigation is ongoing, we have been assured by the FBI that the patients seen during the timeframe he was in our facility are outside of the profile of victims involved in this case. The health and safety of our patients remains our number one priority, and we assure the public that all providers who practice at Lincoln Community Hospital are submitted to a rigorous background check, in this case, Docs Who Care also conducted a background check on the accused and nothing was raised in either background check.

 

We received the following statement from Docs Who Care in response to the investigation:  “Docs Who Care is shocked and surprised that a physician that has contracted with us has been charged with criminal activity. This physician has only worked one shift for Docs Who Care as an independent contractor.  He is not scheduled to work any future shifts. We are troubled by these allegations which are in stark contrast to our mission and core values.  The health and safety of patients at the hospitals we serve is our number one priority.”

 

We understand that our community will have many questions regarding the investigation, and refer you to the FBI for any additional questions.

 

303-629-7171 ext. 1 or email denvermd@fbi.gov.

If you have any questions about our response to this incident, please contact Megan Mosher, PIO at (719) 743-2421 ext3260 or mmosher@lchnh.com.

Regional forum spotlights rural economies

Miller pleased to show strength of plains to state officials

By Sara WaiteJournal-Advocate Editor

POSTED:   03/24/2019 09:40:42 PM MDT

 

The Regional Economic Development Forum in Hugo March 12 was a good experience, according to Logan County Economic Development Corporation Executive Director Trae Miller.

Attendance at the event hosted by the Economic Development Council of Colorado (EDCC) was strong, with about 130 people there, Miller said. And while Miller had heard much of the information presented before — “It’s kind of a ‘preaching to the choir’ kind of thing for me,” he said — he was pleased to be able to spotlight the rural economies of the Eastern Plains for state officials.

“We definitely had the attention of the state,” he said.

Among the attendees were Lt. Gov. Dianne Primavera and Betsy Markey, executive director of the Office of Economic Development and International Trade (OEDIT). “Any time that we have the opportunity to have them as a direct audience is very, very important for the Eastern Plains and northeastern Colorado and Logan county and all of our rural communities. And especially with the new regime, and Betsy just taking over in January, we’re very fortunate to have gotten that time with her this early on,” Miller said. “It’s not necessarily about the content; it’s more about that we show the strength of the Eastern Plains to the state.”

Among the content that Miller did find helpful was focus on future trends such as precision agriculture.

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The EDCC said in a press release about the event that this type of industry will require a skilled labor force, critical broadband and cell service, and education around the industry. Speakers representing 21st Century Equipment, Roenbaugh Schwalb, Lamar Community College, Colorado Rural Workforce Consortium, Skillful — A Markle Initiative, Viaero Wireless, and SECOM discussed the opportunities and challenges with the build out of this industry. Along with the deployment of the Opportunity Zones Program, this industry has the potential to attract entrepreneurs and investors to the region.

Miller also noted a panel focused on broadband resources for remote workers and co-working, which is a topic he is intimately familiar with as he is spearheading a co-working project at the Logan County Courthouse Annex for LCEDC.

And Logan County was well-represented by Hoyt Skabelund, Division CEO of Banner Health’s Rural Hospitals, who served on a healthcare panel with the lieutenant governor and Kevin Stansbury, CEO of Lincoln Community Hospital and Care Center, that discussed some of the challenges facing rural hospitals. According to a press release from the EDCC, rural hospitals face much greater economic disadvantages over their urban counterparts, including declining younger populations, high percentages of Medicare and Medicaid patients, and aging infrastructure. The panel discussed ways in which the rural hospitals can be supported through thoughtful regulation as well as creative measures to help attract, retain, and grow talent to support the rural hospitals.

“I personally know that all roads lead back to health. Health care is not in a silo. Agriculture is part of it; if someone lives in a food desert they might not be as healthy as someone with access to fresh produce. We can collaborate to make Coloradans healthier and to save them money on healthcare,” Primavera said.

Miller said one of the main emphases of the forum was on regionalism, and attendees heard from officials from Commerce City who talked about the important of collaboration across the region. Miller said the concept was in place when he started with LCEDC, and he has worked to carry the collaboration forward through regional meetings for the whole of the Eastern Plains. “It was nice to see the collaboration to put this thing together from the north to the south,” he said.

However, Miller noted that when it comes to regionalism, rural areas face a unique challenge compared to more urban areas: distance. “We are such a vast area,” he said, noting that the location of the forum was chosen deliberately to be fairly central to the entire region.

He noted that the regional focus highlights that communities across the Eastern Plains face very similar economic challenges, especially compared to the state as a whole or even other rural communities on the Western Slope. “It was nice to see that come together and show value,” he said.

Markey, who served as the keynote speaker, touched on the various incentive and technical assistance programs focused on and available to rural communities.

“Rural economic development is a major focal point for Governor Polis, and the Colorado Office of Economic Development and International Trade is working in coordination with the Colorado Department of Local Affairs and Department of Agriculture to maximize rural impact,” she said. “It’s critical to deliver the programs and services that can solve existing rural needs, so events like this one are great opportunities to hear valuable feedback from our rural communities. Together, we are committed to ensuring that economic prosperity is felt throughout all of Colorado.”

“It was evident by the strong and diverse attendance, including a significant number of elected officials, that key stakeholders in eastern Colorado are committed to the engagement and collaboration needed to find creative solutions to the unique challenges they face in their communities. Learning and understanding how these same communities are leveraging technology to provide high-level healthcare solutions for their residents to precision agriculture technologies being used to create a more sustainable environment and provide greater transparency to consumers, was truly inspiring” said Tammy Fields, EDCC Board Chair and Chief Economic Development Officer for Colorado Springs Chamber & EDC.

Sara Waite: 970-526-9310, swaite@journal-advocate.com

Statehouse designates “Protecting Rural Hospitals Day” as small towns brace for cuts

Colorado lawmakers and hospital executives on Wednesday made it clear that small town healthcare faces the fight of its life in the coming year.

A resolution to declare March 8 “Protecting Rural Hospitals Day” passed unanimously in both chambers of the Colorado legislature yesterday, but budgetary constraints are worrying rural health leaders.

Colorado hospitals face a reduction in Medicaid funding of up to $390 million under a potential cut to the hospital provider fee that Gov. John Hickenlooper suggested in his 2017-2018 budget plan.

The fee is a state program that requires hospitals to pay money each year depending on the coverage they provide — some hospitals pay a lot, and some don’t pay any. The money is then matched almost dollar for dollar by the federal government and used to expand Medicaid, provide health coverage for Coloradans who are using emergency rooms for non-emergency treatment, and reimburse hospitals, especially rural hospitals, for care.

RELATED: What’s Colorado’s hospital provider fee, who cares and why?

The fee brought in nearly $700 million in 2015. In a proposal to address a projected state budget shortfall of more than a half billion dollars for 2017-2018, the governor proposed lowering the existing cap on the fee by $195 million. By reducing that stream of revenue, the state stays below limits set by the TABOR — the Taxpayer’s Bill of Rights. Going above the limits triggers provisions that require rebates to taxpayers. But the governor’s proposed cut also means losing the federal match, hence the $390 million loss of funding to hospitals.

Healthcare expert Steven Summer, the CEO and president of the Colorado Hospital Association, called the proposed cut “unprecedented” and compared the potential community impact to the economic struggle in Burlington, Colorado after the closure of the private Kit Carson Correctional Center.

“It’s a chilling and sobering thought to wonder if we’ll be reading similar stories in six months about rural communities who have seen their hospitals close,” he said.

Lt. Gov. Donna Lynne said the proposed cut to the fee was “done really as a last resort. Our hope is that we get a solution to the hospital provider fee problem.”

But that hope may have been quashed Wednesday afternoon, after a bipartisan bill that proposes to bring in $3.5 billion for transportation was introduced. Some Democrats at the state Capitol have been holding out hope that the state’s transportation needs would prove pressing enough to persuade Republicans to move the hospital provider fee entirely out from under TABOR restrictions. That incentive now dims as the newly introduced transportation bill instead relies upon sales tax increase and reductions in the state budget.

Lynne also acknowledged that ending the Medicaid expansion program as proposed by Republicans in Congress earlier this week would hurt the state budget and put Coloradans at risk. Under the current Republican healthcare proposal, she said, the state will soon face an annual budgetary shortfall of $1 billion if it continues to provide the same care and coverage.

Konnie Martin, CEO of San Luis Valley Health in Alamosa, said “we drive the economy in the San Luis Valley.” San Luis Valley Health provides over 650 jobs to the community, the largest employer in the area.

CEO of Lincoln Community Hospital Kevin Stansbury said the cuts could devastate rural communities like his.

“If we have to shrink our services — or worse, close our hospitals — patients would lose access to care, employees would lose their jobs, and many young people would see their futures put at risk,” he said.

Republican Sen. Jerry Sonnenberg, whose northeastern District 1 is home to 11 rural hospitals, said that protecting rural healthcare is his “number one priority” and that access to a rural hospital is often “a matter of life and death.”

Sonnenberg told hospital executives that, according to the state Joint Budget Committee, the hospital provider fee currently faces cuts of $150 million to $200 million. “The scary part of that,” he said, “is it could be double that. You know as well as I do that you can’t stand a $200 million cut; we sure as hell can’t stand double that.”

Colorado’s Rural Hospitals Nervously Ponder Their Post-Obamacare Future

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Audio: Rural Hospitals Are Worried About ACA Repeal, John Daley Reports

Ambulances parked outside of Lincoln Community Hospital in Hugo, Colo. The water tower that proudly displays the small eastern town’s name looms in the background.

John Daley/CPR News

Hospitals executives recently delivered a dire warning about the future of rural hospitals: They’re calling themselves the canaries in the coal mine. Many of their facilities are already facing a financial crisis.Konnie Martin, the CEO of San Luis Valley Health in Alamosa, is one of them. The south central Colorado hospital provides 670 jobs and is the region’s largest employer. It’s the “only hospital in the six-county region that delivers babies and the only hospital that does any specialty or surgical services,” Martin said.

The hospital has benefitted financially from the expansion of insurance coverage under the Affordable Care Act, Martin said. But it operates on a thin margin, one that could be upended if the ACA replacement doesn’t address their financial challenges.

“The hospital being the largest employer, the largest annual budget, if we become unstable through this period of uncertainty, it could destabilize our entire local community,” Martin said.

Four hours northwest of Alamosa, in Colorado’s rugged high country, is the Delta County Memorial Hospital. CEO Jason Cleckler has a similar story, his hospital is the county’s largest employer too, with 615 workers. He’s not sure what’s coming down the pike as Republicans look to rework the ACA. “I think that’s core of what keeps me up at night in regards to health care reform,” Cleckler said.

Both rural hospitals are on a list of eight the Colorado Hospital Association says are in critical condition, in danger of closing.

Brock Slabach, a Senior Vice-President with the National Rural Health Association said that they’re “very concerned.” His group has identified 670 hospitals nationally that are at risk of going under — that’s a third of all of the nation’s rural hospitals. He calls it the Rural Hospital Closure Crisis.

“They provide the employment for many of the physicians and nurse practitioners and physician assistants that work in these communities,” said Slabach. “Once these hospitals leave the community, they’re not going to be coming back.”

Julia Coonts is the mayor of the city of Limon, Colo. Kevin Stansbury is the CEO of the Lincoln Community Hospital in Hugo, Colo. Jason Cleckler is the CEO of the Delta County Memorial Hospital in Alamosa, Colo.

John Daley/CPR News

Under the Affordable Care Act, Colorado expanded Medicaid, but Slabach said many rural hospitals closed in states that didn’t expand it. Insurers, facing major financial losses, also pulled out of health care exchanges. That left customers in rural communities with few choices, and high premiums and deductibles. “For rural citizens, it’s extremely difficult because they’re already typically poor,” Slabach said. Under the ACA, “there were failures for rural America.”

A Republican repeal of the ACA could exacerbate the rural health care crisis, in many cases, these are the same counties that helped elect Donald Trump. In rural Colorado, Trump won 57 percent of the vote, compared to 35 percent for Hillary Clinton, according to the Colorado Health Institute.

The Lincoln Community Hospital in Hugo, Colo., is a 15-bed critical access facility, along with a long-term care and assisted living center and three primary care clinics.  CEO Kevin Stansbury says the annual budget is about $20 million.

John Daley/CPR News

On the state’s at-risk-list is Lincoln Community Hospital and Care Center. It’s in Hugo, a sparsely populated farming and ranching town in Lincoln County on the eastern plains. Seventy-eight percent of the residents here voted for Donald Trump. There also isn’t another hospital for 75 miles, which makes the facility critical for people in several counties.

“I think it’s a huge driver in keeping us all going and enticing people to move out here and live here” said Julia Coonts, the mayor of nearby Limon. “We need to provide these services.”

Health care is one of the top three job creators in rural Colorado and in Hugo, that translates to 175 jobs. They’re generally good-paying jobs and contribute more than $8 million to the local economy. Coonts said “it would be a huge impact and not just for this community but for the entire region out here,” if the hospital closed.

Medicaid expansion helped many rural and safety net hospitals because more people have insurance. Before the Affordable Care Act, care for those patients was uncompensated. The number of patients insured by Medicaid rose 44 percent in rural Colorado, as a result of the Affordable Care Act, according to the Colorado Rural Health Center.

But Kevin Stansbury, the Hugo hospital’s CEO, said many patients who got private insurance were swamped by high premiums and deductibles.

“So they might as well be uninsured,” Stansbury said. “They’ve got insurance for the real catastrophic stuff but they’re not able to take care of the things that happen on a day to day basis because it’s all out-of-pocket expense.”

When patients can’t pay for their care, he said that the hospital assumes those costs.

Federal requirements to invest in electronic health record systems became another major challenge for Stansbury’s hospital. They have four different systems because they haven’t been able to find one that works for their hospital, clinics, long-term care and home health and hospice departments. “It drives up our costs, it drives up our inefficiencies, and it’s all imposed upon us,” he said. “It’s a burden to us, not a benefit.”

Another chronic problem, according to Stansbury: reimbursement for care from the federal safety net programs Medicaid and Medicare doesn’t cover the full cost of those services. It’s a scary prospect when considered alongside recently released Congressional plans that would remove the Medicaid expansion some hospitals have relied on. States would need to make up for some of the federal funding if they wanted to retain the expanded coverage.

Whatever plan emerges, Stansbury said rural hospitals need steady funding.

“Without that predictable support, it’s tough to plan for the future,” Stansbury said. “Because then you’re just scrambling to keep the doors open day to day.”

Colorado lawmakers give initial nod to $26.8 billion budget that threatens hospitals

Colorado’s budget bill includes $500 million in cuts that threaten rural hospitals

Brent Lewis, Denver Post

Cheryl Galasso, left, jokes with Dr. Cyril Mauffrey, an orthopedic surgeon after an appointment at Denver Health in December 2015 in Denver, Colorado. Hospitals are at risk of losing their revenue from the hospital provider fee which would take funds away and slow programs and developments on the hospital campuses across the state.

PUBLISHED:  | UPDATED: 

The budget package cuts more than $500 million in payments to the state’s hospitals for uncompensated care in part of an effort to balance a spending bill in a year mired by fiscal constraints and increasing demands.

The hospital cuts dominated the initial discussion as Democrats fought to eliminate them from the spending bill.

“I really cannot vote for a bill that is going to throw economic health in disarray in our rural communities,” said Sen. Rhonda Fields, D-Aurora. “I can’t do it. There’s got to be a better way to balance a budget.”

The chamber’s Republican leaders acknowledged the reductions in hospital payments are tough but called them unavoidable. Others blamed the expansion of Medicaid, a health care program for low-income residents, for forcing cuts to other areas. And both parties are optimistic about addressing the situation in a separate bill scheduled for debate next week.

Kevin Stansbury, the CEO at Lincoln Community Hospital in Hugo, a 15-bed facility and the county’s largest employer, said if nothing is done the cuts “would have broad and devastating impacts.”

The Senate began debating the bipartisan budget bill in the afternoon, filling candy jars with chocolates and jelly beans and ordering Brazilian takeout for a session that extended toward midnight.

Democrats put forward dozens of amendments to cut money for private prisons and redirect it to education; boost spending on social safety net programs; trim college tuition increases; and add money for oil and gas regulators. Republicans blocked most of them but a slim bipartisan majority agreed to shift money on several items.

The amendments included the addition of $5.1 million in federal funds for the state’s health care exchange, $44,000 to implement the medical aid-in-dying law and $745,000 to conduct the Healthy Kids Colorado survey — three in a handful of items that Republican budget writers originally rejected on ideological grounds.

Democratic Gov. John Hickenlooper scored a major victory with the addition of $16 million from marijuana tax collections for affordable housing grants designed to help the homeless after personally lobbying lawmakers late into the night.

However, three Democrats broke ranks to reject Hickenlooper’s request for $3 million in film incentives, which budget writers cut from the bill this year. The measure had the support of a handful of Republicans, including Senate President Kevin Grantham.

Republican and Democratic lawmakers agreed to eliminate an extra 3 percent salary hike for judicial officers from the spending bill because it would also trigger a pay increase for lawmakers starting in 2019.

“We should not be voting on pay raises for ourselves,” said Sen. John Cooke, R-Greeley, who led an effort to redirect the $2 million to transportation projects.

Democrats then led their own push to revoke the judicial pay hikes and won approval for another amendment — a move that actually reduced judicial pay. The lawmakers suggested it was an inadvertent mistake and pledged to fix it later.

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