Commissioners, health staff discuss Medicaid changes and limited local access to routine women’s care

Commissioner Padgett raised concerns on Aug. 5 about national and state Medicaid changes and the practical effect on local residents’ ability to access routine women’s health care. “Do we know if we have enough providers in… where are folks gonna go for who are on Medicaid for routine women's care?” Padgett asked.

Linnea, the county human services director, told the board that Medicaid provider availability has been a long-standing challenge in the county: “I think you know we've always struggled with what that Medicaid care looks like in your Ray County. There's always never been enough Medicaid providers. I do know that there are a handful of providers in the Montrose area that do take Medicaid.” Linnea said state and county human-services directors are working through new federal work requirements and other changes and that Colorado is “being proactive” with work groups to understand county-level fiscal and operational impacts.

Public Health Director Kristen Kelly told the board that county public health would like to provide more direct services, but funding and staffing limit immediate expansion. Kelly said the department is pursuing partnerships for free STI/HIV testing and a sharps disposal program and is exploring the state’s “Birth Control For You” (BC for You) program, though eligibility and utilization vary. “Without funding, it is really hard,” Kelly said. She also said the public-health agency is implementing an electronic health record that could, over time, enable billing Medicaid and Medicare directly.

Commissioners and staff discussed potential interim measures: quarterly STI/HIV testing through a Western Colorado Health Network partnership, periodic on-site pop-up clinics for routine women's services, exploring Cedar Point Health and regional service authority relationships, and piloting ideas such as using EMS/paramedicine or leveraging San Miguel County’s underused BC for You equipment. No new program was approved at the Aug. 5 meeting; staff were asked to continue exploring partnerships and funding options and to report back.

The discussion combined human-services caseload observations, the state’s planning for federal Medicaid rule changes, and public-health operational constraints and ongoing partnership efforts. Board members emphasized urgency given reporting that fall changes could affect insurance premiums and coverage and requested additional information from Linnea on provider capacity and from Kelly on what public-health could implement with incremental funding.