Since convening in June of 2023, the La Plata Healthcare Improvement Coalition (LPHIC) has has traveled, as Paul McCartney sang, “a long and winding road.” Over the past seventeen months, some 65 coalition members and volunteers have come together to identify and address the healthcare needs and challenges of our community. Through six months of facilitated discussions, the five LPHIC work groups – Accessibility, Affordability, Availability, Community Benefit, and Healthcare Data – focused on strengthening and improving our local healthcare system.

Based on the priorities established by the work groups, LPHIC then convened small task forces to further flesh out and develop action plans. These task forces met for 3-4 months with the following outcomes:

The Plan for Aging Task Force gathered La Plata County demographic and healthcare utilization data and reviewed age-friendly initiatives from other Colorado communities. A summary report was created that included a recommended process for community stakeholders to collaborate on developing and adopting a county-wide Plan for Aging.

The Healthcare Literacy & Advocacy Task Force surveyed 26 organizations in May 2024 to evaluate the availability of, need for and capacity to provide Healthcare Literacy and Advocacy (HL&A) support services in La Plata County. HL&A services provide residents with support and assistance accessing and navigating our local healthcare system and include healthcare insurance/financial support and healthcare navigation. Typically, HL&A services are free and are provided by case managers, nurse navigators, social workers, community health workers, insurance agents, and others embedded in community organizations.

The summary report is available here.

The Healthcare Workforce Recruitment & Retention Task Force created an online survey to evaluate the housing needs of our local healthcare workforce. The following healthcare employers distributed the voluntary survey to their employees:

  • Animas Surgical Hospital
  • Axis Health System
  • Durango Dermatology
  • La Plata County Public Health Department
  • La Plata Family Medicine
  • Pediatric Partners of the Southwest

A total of 70 responses were received. The summary report highlights the complex housing challenges facing healthcare workers in La Plata County, affecting workers across various roles, income levels, and life stages. It suggests a need for multi-faceted solutions that address both immediate affordability concerns and long-term community sustainability.

Key informant interviews were conducted with four local healthcare employers to evaluate workforce recruitment and retention challenges and initiatives. The summary report reveals that healthcare providers in La Plata County face multi-faceted challenges in recruiting and retaining workforce. While each organization has developed strategies to address these issues, there is a clear need for community-wide efforts to support the healthcare workforce.

Addressing healthcare workforce challenges in La Plata County will require coordinated efforts between healthcare providers, local government, educational institutions, and the broader community. By focusing on key areas like housing, education, childcare, and community integration, La Plata County can work towards building a more stable and robust healthcare workforce to serve its residents.

Housing, Childcare & Transportation Task Force
This task force was not formerly created but representatives from LPHIC participated and collaborated with existing community housing, childcare and transportation initiatives.

Community Care Hub Task Force
Input from surveys and key informant interviews identified the following as barriers to care in our region:

  • Local providers of social determinants of health (SDoH) support services indicate the greatest barrier preventing people from using their services is a lack of awareness of who they are and what they provide.
  • Providers also express a lack of understanding and awareness of what other services and resources are available in the community and mention that current resource directories may not be adequately maintained.
  • Residents express frustration finding community resources that meet their health and SDoH needs, particularly those marginalized populations such as older adults, immigrants, people who are food insecure or unhoused, and people with disabilities.
  • There is high demand among residents for assistance resolving issues with healthcare insurance claims and medical billing.
  • Colorado Health First (Medicaid) members receiving Long-Term Services and Supports (LTSS) and Home and Community Based Services (HCBS) often have SDoH issues that would benefit from care coordination. The local Regional LTSS case management agency, public health department, social care agencies and healthcare providers report high demand for SDoH support services, but don’t have the capacity to adequately address the need.
  • Current referral processes to Case Management Agencies (CMAs) may not capture all those with physical and intellectual disabilities in need of support and care (i.e. seniors, those suffering from dementia, chronically obese, injured, etc.)
  • Systems of record for case management and care coordination are often siloed, resulting in inefficiencies, lack of care continuity, duplication of screening processes, inconvenience to the client, lack of tracking and reporting.
  • In addition to the barriers experienced by all residents, people with disabilities experience additional health disparities. People with disabilities are four times as likely to report their health as fair or poor than people with no disabilities and have significantly higher rates of obesity (40% for people with disabilities vs. 28% people without disabilities), diabetes (16.7% vs. 7.4%), and smoking (23.1% vs. 12.3%). These health disparities are attributable to the differences in SDoH experienced by people with disabilities, who are more likely than the general population to be unemployed, live in poverty, and be reliant on social programs.

To address these barriers to care and disparities and ensure access to healthcare services for Southwest Colorado residents with disabilities, LPHIC proposed to develop a community care hub program called Southwest Colorado Cares (SWCC). A critical aspect of SWCC is increasing the capacity of care coordination across the rural communities of Southwest Colorado. This includes expanding the resources and capacity of existing care coordination providers as well as adding care coordination services to fill identified gaps.

In August 2024, LPHIC engaged with Community Connections, Inc. (CCI) to serve as the host of the program. As a 501c3 nonprofit organization and the regional Case Management Agency (CMA), CCI is contracted with the Colorado Department of Health Care Policy and Financing (HCPF) to provide case management services to children, adults and seniors with disabilities and their families across a five-county region of Southwest Colorado (La Plata, Montezuma, Archuleta, Dolores and San Juan counties). CCI provides person-centered case management services, helping children and adults with disabilities and their families navigate the system of supports, and providing eligibility and enrollment assistance as well as case management for Medicaid Waivers and other long-term services and supports.

In 2025, Community Connections will begin contracting with Rocky Mountain Health Plans who has agreed to fund two full-time care coordinators to be employed by CCI.

CCI has recently submitted a grant application to Colorado’s Office of eHealth Integration (OeHI) to provide funding for SWCC.

The initial goals of SWWC are:

  • Build and manage a local Care Partner Network (CPN) of healthcare service providers, social service agencies, non-profits, governments, insurance professionals, community health workers (CHW), and volunteer patient navigators.
  • Connect CPN members to share information, discuss issues and collaborate on outreach and programming opportunities to reduce health disparities and improve outcomes.
  • Create and provide ongoing maintenance of a public-facing, multi-lingual, Web health resource directory. The directory will be available for embedding in other organizations’ Websites and will include data-sharing capabilities to make updated resource listings available to 2-1-1 and EHR platforms such as Epic, Cerner and NextGen.
  • Integrate referral functionality into the Website for secure self-referrals and provider-to-provider referrals. The platform will provide tracking and outcomes reporting.
  • Serve as a recognized, trusted, centralized source that residents can turn to for information, guidance, and support with access, affordability and availability issues.
  • Establish a team of CHWs to provide care coordination and navigation services to support residents in accessing community resources. CHWs will provide warm hand-offs between services, offer assistance with accessing health services (including support with insurance claims), and identify barriers and gaps in services and potential solutions to those barriers.

 

Thank-You and Farewell!

On behalf of the League of Women Voters, Jan and I want to thank you for your support and participation in LPHIC this past year and a half. It’s been an honor to work with you and we greatly appreciate all of the time and energy you devoted to this important initiative. It’s rare that a community comes together and works constructively to identify issues, establish priorities and create workable solutions. We are so very impressed with the quality of leaders in our health and social care community and have enjoyed our collaboration. We have no further plans for LPHIC at this point, but please don’t ever hesitate to reach out if you have questions or concerns.

Be well!

Greg Phillips 
Chair

Jan Phillips
Vice-Chair