Warning: Amendments 60, 61 and Proposition 101 will be hazardous to rural health care in Colorado. Looking at three hospital districts – in Yuma and Garfield and Huerfano counties – make this clear.
Each of these districts serves a wide area – Yuma on the Eastern Plains, Grand River in Rifle and surrounding communities and Huerfano in south-central Colorado. They are vital institutions in their communities. Combined, the districts employ about 860 workers and provide health care for about 45,000 Coloradans. They manage three hospitals, two long-term care nursing facilities and three clinics and medical centers.
These cases represent only three communities, but the stories would be repeated throughout rural Colorado. Here’s a glimpse of the impact from Amendments 60, 61 and Prop 101.
Amendment 60
In all three districts, citizens voted to retain revenue above the TABOR limit – so-called de-Brucing elections. These decisions would be wiped away, and that would mean lower revenues.
The Grand River district would feel the greatest impact. The district estimates the drop in revenue would be so steep that it would not be able to pay its debt obligations and that many services would have to be reduced or eliminated.
“It would be a struggle just to maintain primary care and emergency room services at the level we currently have,” said Martie Wisdom, Grand River’s chief executive officer. “Whatever technological innovations that come up in the future, we would not have the money to buy them.”
Amendment 60 would also require the previously exempt Yuma and Huerfano districts to pay property taxes, which will increase operating expenses. “That will be a significant cost for us,” said Todd Oberheu, Huerfano’s chief executive.
Amendment 61
All three districts have borrowed money in order to expand or make improvements. Yuma built a new hospital, replacing one built in the 1940s. Grand River’s in fast-growing Rifle replaced a facility built in the 1960s.
Had Amendment 61 been in place, these projects would not have been built. Grand River could have borrowed only one-eighth of the amount it ultimately secured. Under the amendment’s requirement that any loan be paid back within 10 years, none of the districts could have moved ahead with construction.
“Our facility was constructed about three years ago. If (Amendment 61) had been in place, there is no way that we would be here. There is no way that we could have continued with a $27 million project,” said John Gardner, Yuma’s chief executive. “Rural hospitals don’t have those kinds of treasure chests. For any hospital to be funding debt with a 10-year window, that would be a scary prospect.”
Huerfano plans to expand and upgrade the emergency room at Spanish Peaks Hospital. If 61 passes, “it will nix that whole thing,” said Oberheu.
Proposition 101
Proposition 101 would reduce operating revenues for all three districts. In 2009, the Grand River Hospital District received approximately $893,800 from specific ownership taxes; that would fall, over four years, by about 98%, to $9,800. Yuma and Huerfano would see 98 percent reductions as well.
Huerfano County would face greater difficulty because Spanish Peaks in Walsenburg is a “critical access” hospital. It cannot choose among a variety of specialty services to reduce or eliminate.
There is yet another health care impact tied to these ballot measures: Colorado community colleges train a majority of the state’s nurses and most first-responders. Grand River, Yuma and Huerfano are all dependent upon local community colleges for those professionals, as well as technical and ancillary staffers. Higher education, and in particular community colleges, would face severe cuts under the amendments.
Public health and safety also may be affected because of fewer resources for emergency medical services and road maintenance. “We already see some impact on emergency response in Yuma County due to budget shortfalls,” Gardner said. “Snow removal on key north-south state highways does not occur after 6 p.m. Further reductions of snow removal would put our population at risk to receiving appropriate emergency transportation.”
Huerfano’s Oberheu summarized the potential impact of 60, 61 and 101: “If that all happens and this facility can’t be here any more, people that live in my community are looking at over an hour and a half to get to the next hospital. That is really scary.”
These stories ought to be chilling to all Coloradans. Hospitals and health care facilities are important for the jobs and the care that they provide, but they are more than that. They are bedrock institutions that give meaning to the word “community.”
Endangering rural health care is reckless and short-sighted – but that is exactly what 60, 61 and 101 would do.
Bob Semro is a policy analyst with the Bell Policy Center in Denver who specializes in health and health care issues. EDITOR’S NOTE: This is an online-only column and has not been edited.
