Steamboat Pilot & Today

A map showing more than 100 community health centers in Colorado is noticeably blank in the Northwest region of the state.

Health care providers and community leaders hoping to change that met at Yampa Valley Medical Center on Friday to learn about various options for meeting the health needs of an increasing number of uninsured and underinsured residents in the region.

"What we have here is an enormous number of people struggling between 150 to 200 percent of the poverty level," said Sue Birch, executive director of the Northwest Colorado Visiting Nurse Association.

The VNA hosted Friday meetings in Steamboat Springs and Craig to gauge interest in pursuing one of several types of public health clinics.

Birch noted that geographic barriers can prevent residents in South Routt, Hayden and other areas from accessing quality health care. There also is a growing demand for prenatal care, and communities are seeing the "ripple effects" of increased use of methamphetamine and other drugs.

Meeting participants pointed out other needs, including more dental, mental health and childhood development services, which are becoming increasingly hard for nonprofit organizations to meet because of a lack of sustainable financing.

Community health centers are nonprofit clinics that serve uninsured patients on a sliding scale as well as insured patients. Federal funds help offset costs for uninsured patients.

To receive those funds, centers must meet staffing and other requirements and serve patients from a "medically underserved area," or MUA.

The only MUA-designated area in Routt County is Oak Creek, said Mindy Klowden, community development manager for the Colorado Community Health Network, which represents community heath centers.

"The challenge is that each of our little communities don't fit the criteria," Birch said.

Competition for federal funds is stiff, but an application may be stronger if its service area is designated as a "health professional shortage area," or HPSA, which is the case in Oak Creek, Yampa and parts of Moffat and Rio Blanco counties.

Colorado is home to 15 community health care centers with more than 108 statewide, including the Salud Family Health Centers, located primarily in the northeast part of the state.

Salud centers, like all community health care centers, are governed by community boards. Former patients account for half of board members.

Jodi Hartmann, development director for Salud, emphasized that although federal funding helps operations, "it's not the answer to the equation."

About 62 percent of Salud's funding comes from patients' co-pay fees, which are a minimum of $10, and Medicare and Medicaid reimbursement. Federal funds make up about 27 percent of funds, and the remainder comes from other grants, Hartmann said.

Denise Denton, executive director of Colorado Rural Health Center, explained that rural health centers provide services similar to those offered by community health centers but have different requirements.

Rural health care centers must be in nonurban, HPSA-designated areas. The centers do not receive federal funding and do not have to meet the MUA requirement.

Denton emphasized that Routt and Moffat counties also should consider other models including mobile clinics.

"It (a community health center) is a good model, you can make it work for you, but I encourage you to look at other models," she said.

Birch and meeting participants agreed the next step is evaluating specific health care needs and demographics of areas within Routt and Moffat counties to define a service area and find a model that will fit those criteria.

The VNA plans to hold additional meetings to facilitate that process.

-- To reach Tamera Manzanares call 871-4204

or e-mail tmanzanares@steamboatpilot.com