Crucial clinic to close doors
Aspen Times Staff Writer
A midvalley health care clinic that serves 1,200 uninsured, lower-income residents annually will be forced to close its doors due to budget cuts at Aspen Valley Hospital.
In an emotional meeting last night, the Aspen hospital board decided to end funding to the Aspen Basalt Care Clinic on Dec. 31. Instead, it will direct financing to the Mountain Family Health Center, a federally funded health care program for the poor in Glenwood Springs.
Several health care officials in attendance, including the head of the Aspen hospital’s emergency room, decried the vote. They contend patients in Basalt and El Jebel will not travel downvalley for medical help and will instead seek ER care in Aspen, resulting in increased hospital expenses.
The Aspen Basalt Care Clinic, located at the Basalt Midvalley Medical Center, is a department of Aspen Valley Hospital. It was founded in 1992 to provide primary health care to the valley’s working poor. The clinic was conceived to take pressure off the hospital’s emergency room by treating illnesses in the indigent population before they required acute attention.
The clinic has struggled since its inception. Seen by many to be underfunded, it is currently open only 12 hours a week, at an annual expense of around $160,000 to the hospital. Clinic patients pay on a sliding scale determined by how much they can afford.
Glenwood’s Mountain Family Health Center provides the most extensive health care for the indigent on the Western Slope. It is currently open five days a week and has plans to expand to evening and weekend hours by next summer. It treats approximately 4,000 patients annually, compared to the approximately 1,200 at Aspen Basalt Care Clinic.
While the resources for the midvalley clinic have dwindled since its inception, the number of uninsured, working-poor has increased drastically during that time.
As a solution, Verna Bartlett, AVH chief financial officer, recommended the board consolidate the Basalt clinic with the Glenwood center.
Bartlett’s proposal came with the support of several influential figures, including Nan Sundeen, the Pitkin County Health and Human Services director. Dave Adamson, director of Western Slopes operations for the Mountain Family Health Center, also supported the proposal.
“The huge increase in uninsured, working poor in the valley has become too much for the Basalt clinic to handle,” Adamson said. “Glenwood has the apparatus and overhead to deal with this issue more effectively.”
Several people at the meeting, however, spoke against the closure. Their main concern was whether indigent patients will have the time or resources to travel to Glenwood for primary care once the Basalt clinic closes.
Lisa Robbiano, the nurse practitioner at the Basalt clinic, pleaded for the board to consider keeping the Basalt clinic open in some capacity, either as a satellite clinic of the Glenwood center or as an independent nonprofit.
“I think it’s a wonderful idea to merge with Glenwood,” Robbiano said. “My concern is that the people we serve in Basalt won’t have the means or know-how to make it down to Glenwood.”
Bartlett replied that the hospital had researched the possibility of a Basalt satellite clinic, but found the idea to be “prohibitively expensive.”
Dr. Scott Gallagher, who runs the Aspen hospital’s emergency room, also expressed his dissent. He said that, in the absence of the Basalt clinic, many midvalley uninsured residents would show up at the Aspen ER.
“I think this is a bad idea,” Gallagher said after the meeting. “It’s not only going to cost us a lot in increased ER expenses, but the patients are going to receive worse care as well.”
During the meeting, board member Bob D’Alessio echoed the concern that patients won’t travel to Glenwood.
“Transportation is the biggest issue,” he said. “If we can’t solve the problem, we are inviting the ER room to swing wide open. We can’t have patients receiving primary care in the ER.”
To assuage these concerns, Kris Marsh, executive director of the Aspen Valley Medical Foundation, said the foundation would be willing to fund vans to transport patients from the Basalt clinic to Glenwood, at least for the first six months following the Basalt closure.
Board members also agreed to monitor Aspen’s ER and intensive care unit along with the Glenwood clinic for sixth months. They want to ensure that patients are indeed being treated at Glenwood and that the Aspen hospital is not put under increased financial stress.
With the above agreements in place, the board voted 3-0, with one member abstaining and one absent, to end the Basalt clinic’s funding.
“If the board’s decision works, the facts will speak for themselves,” board President John Sarpa said in conclusion. “If not, we’ll have to do something about it in six months, because this is obviously a sector of our population that’s important to us.”
[Eben Harrell’s e-mail address is firstname.lastname@example.org]
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