Mental health, the Affordable Care Act, and Medicare/Medicaid reimbursements/mandates were the leading topics when hospital employees met with Congressman Scott Tipton last week. Rep. Tipton toured the hospital with CEO Jason Cleckler, chief clinical officer Jody Roeber, hospital board member Bill Hellman and other members of the leadership team before meeting with department heads. Tipton was joined by his wife Jean, which he said is "a real rarity." He was also accompanied by two staff members, George Rossman, constituent services field representative, and Brian Meinhart, regional director/policy advisor, both from his Grand Junction office.
Cleckler introduced the congressman, saying he was a "true champion for western Colorado." While recent awards have put DCMH on the radar nationally, Cleckler said the hospital has been on Scott Tipton's radar for some time.
"He has been a real supporter of not only DCMH, but the whole community, whether that's working on economic development, or being concerned about what's happening with the coal mines. It's a great honor for us to host him."
Tipton kept his comments brief before opening the discussion. He said he can't question the intent behind the Affordable Care Act, but he does question some of the outcomes, including a move toward regionalization of services. "That's great if you live in that community," he said, "but I can not overstate the importance of rural hospitals."
He also noted a real separation from urban counterparts, in terms of reimbursement, access to resources and the connectivity that's vital for remote medicine and to implement new technology.
The first question from the audience came from Misty Sakala, emergency room manager, who said the hospital is seeing a huge influx in the number of mental health patients. They have no access to care, no followup, no inpatient care, she said.
Tipton agreed more resources should be redirected to address that issue. He suggested the transition from inpatient to outpatient care, a nationwide trend rooted in the Affordable Care Act, might open up hospital bed space for mental health patients.
On a related matter, Tipton said he recently met with a Drug Enforcement Administration (DEA) official who identified Delta and Pueblo as two of the highest areas in Colorado for opioid abuse. Tipton said he was glad to hear DCMH is taking steps to monitor opioid use. In Washington, he is working on legislation to address what he says is a growing problem across the country. Cocaine and heroine use is also on the rise. While Tipton said he recognizes medical marijuana is effective in treating some conditions, DEA has tied the availability of recreational marijuana to the uptick in opioid abuse.
"It was the intent of our state, the will of the voters [to legalize marijuana]," he said, but had the issue gone through the legislative process, more questions would have been asked. Now the law enforcement community is playing catch up.
Ultimately, Tipton said, the issue is likely to come before Congress. "We're going to have to look at the classification of marijuana," he said. "A lot of members on both sides of the aisle are just watching Colorado and the other states that have legalized marijuana."
"Again, I'm going to be very respectful of the vote we had in our state, and our state legislature is now going to have to be in a reactive position to make sure we've got the right monitors in place. The debate will continue."
The issue hit home for hospital employees, who have dealt with traffic accidents caused by marijuana use, and have seen mothers test positive for THC shortly after giving birth.
Jason Cleckler turned the discussion back to the economic challenges in Delta County. "There's a real connection between the success of the hospital and the local economy," he said.
Tipton agreed there's a huge disparity between the economic growth in the Front Range and what's taking place across the 3rd Congressional District. In discussions with chambers of commerce and economic development officials, rules and regulations are consistently cited as the number one issue. The private sector, nationwide, is paying $2 trillion in regulatory costs, he said. That number is important to everyone because those costs are passed on to the consumer. He mentioned several pieces of legislation that address this issue, particularly as it relates to banks -- the most regulated industry in America -- and hospitals, which come in a close second.
Tipton is working on legislation to modify the Affordable Care Act. "There are two areas we can all agree on -- we would like affordability, and we would like accessibility," he said. "But I'm not sure we're achieving that goal."
For example, Medicare/Medicaid patients can have difficulty finding a physician. And while more people are covered by insurance, many still struggle to pay deductibles and co-pays.
Cleckler observed that about 75 percent of the hospital's reimbursement comes from Medicare/Medicaid, and the Center for Medicaid and Medical Services (CMS) has a tremendous amount of control. When questioned about possible reforms to CMS, Tipton agreed those discussions should be on the table.
Cleckler said at least a dozen hospital employees, including some new hires, are needed to keep up with the new mandates. Some of those mandates have proven beneficial for the hospital and its patients, but none have been funded so they're an added expense.