Paul Reich

 

As a board member what do you see your role being in creating a new med center?

Under my leadership as Board President, the current board has made great progress in evaluating the future facility at Society Turn as we wait for the final conveyance of the land to the Telluride Regional Medical Center (TRMC). We have engaged a nationally recognized health care consulting group, and in concert with senior leadership at TRMC, have determined our future licensure, our estimated size requirements, and the added services we can offer to the community in the new facility. The board must continue to collaborate to educate the community about the critical importance of a new facility, work in consultation with the Telluride Hospital District Foundation to engage with donors, and in coordination with TRMC leadership ensure that we are building the right facility to be able to offer the right services when we open and position the organization to grow and adapt as the community’s needs and health care changes in the coming decades.

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As a board member what role would you play in keeping medical costs low for our community?

The current board has hired a permanent CEO and CFO with extensive healthcare experience, improved our capture of insurance reimbursements, supported significant operational changes in our finance and clinical operations to both improve efficiency and improve patient care, and ensured that TRMC can serve all community members regardless of their ability to pay. There are many challenges in running a rural healthcare facility in a remote and expensive resort community especially considering the national trends in healthcare. TRMC’s current licensure, payer mix, patient demographics, and challenges in rural staffing and logistics define TRMC as a community resource rather than a profitable business entity. The community has a long history of supporting TRMC through their property taxes and charitable giving, extending our ability to offer healthcare to all individuals regardless of their station or circumstances in life.

 

Over the past 18 months we have updated our infrastructure to be more effective and efficient, made significant investments in our staff which has resulted in reduced turnover costs, improved efficiency in operations and patient volumes, secured grants, and improved our financial position to fund uncompensated and reduced cost care for patients who need it.

 

Given the current administration's challenges to public health policies and equitable healthcare access, how do you see the clinic's responsibility in safeguarding and promoting health equity, particularly for marginalized and underserved populations?

TRMC has a long history of providing care to all in the community regardless of their ability to pay, their immigration status, their status in our community as a long-time local, a one-time visitor, or a new member of our community. Our obligation is to provide care to all who need it when they need it. Under my leadership as Board President, the current board formally adopted a policy in January of this year to codify our long-standing practices. In part, the policy states, “The Telluride Regional Medical Center (TMC) wants to reassure everyone that we are a safe place for all. TMC continues to uphold its obligation to help protect our patients. All people who need care are welcome in our facility and our primary duty is to our patients and their health. At Telluride Regional Medical Center, we believe that health is a fundamental human right. Our doors are open to you, and we are honored to serve this community.” We have taken steps to allow individuals to receive services via tele-health if they are uncomfortable coming into the clinic, and we continue to ensure that patient data is protected, and patient confidentiality is maintained at all times.

 

What do you believe is the Telluride Regional Medical Center’s role regarding women's reproductive rights?

Our clinicians have made Women’s Reproductive health one of the central pillars of our primary care practice. Under the direction of Dr. Grundy, we offer a comprehensive suite of services. Our integrative approach puts our patient’s well-being and health as our priority. Our team offers comprehensive care beginning in a women’s youth and adulthood spanning through childbearing years, unexpected diagnoses, and menopause. Some of the specialties we provide through our primary care department include reproductive health, gynecology, pregnancy, and fertility consultations. While state and federal funding in this area is subject to change, The Telluride Hospital District Foundation continues to seek out alternative funding sources to ensure that we can continue to provide this critical service to our community.

 

What do you see as the Telluride Regional Medical Center’s role in mental health care in our region?

As a former employee and board member of a community mental health provider, and the former Behavioral Health Program Manager at Tri-County Health Network, I recognize the critical importance of providing behavioral healthcare at TRMC to our community. TRMC was one of the first healthcare facilities on the Western Slope to offer integrated care by combining behavioral health services into the primary care department. That tradition continues today with an expanded behavioral health department of three clinicians who can offer both immediate care as well as longer term therapy to TRMC patients. Recently, our team has expanded our substance use treatment options by offering Medication Assisted Treatment. The board recognizes the critical importance of behavioral health services and looks forward to a new facility with dedicated space for behavioral health providers and continued financial support for the program. It is important to note that providing integrated behavioral health requires subsidies to fund operating losses for this service (this is true in Telluride and across the country for behavioral health providers). We choose to do this because we recognize the need for these services in our community. 

 

What opportunities do you see for the Telluride Regional Medical Center to adapt its current model when moving to a new facility?

Under my leadership as Board President, the current board has engaged a nationally recognized health care consultant to work with the board and senior leadership at TRMC to develop a strategic plan for the new facility. This has included deciding the best type of licensure to ensure the best reimbursements from payers and figuring out the right mix of existing and new services that can be offered in our remote community in a sustainable and cost-effective manner. While the final mix of services may change as we get closer to opening the doors on a new facility, we know that we will continue to offer emergency services 24/7/365 in a stand-alone emergency room. We will offer expanded imaging services including the addition of an MRI and other advanced imaging tools to improve our diagnostic capabilities and give patients the choice to remain local rather than travel out of the area for certain procedures. With expanded space for visiting specialists and dedicated space for procedures and enhanced lab capabilities, we expect that we will offer expanded services in orthopedics, wound care, radiology, gastroenterology, cardiology, and gynecology.

 

What type of partners would you want to see TRMC working with?

We continue to enjoy strong partnerships with our local public health office, local nonprofits working in the community, our emergency services of the Telluride Fire District, and local governments. In addition, the current board and senior leadership at TRMC have consistently engaged with regional healthcare providers, including St. Mary’s Hospital, Montrose Health, Uncompahgre Medical Center, Gunnison Valley Health, Cortez Hospital, and others, to help coordinate patient care, ensure that we are filling the gaps in regional health care, and find areas where we can collectively reduce costs and improve patient outcomes through collaboration and communication.In addition, we have strong partnerships with Denver Health and Children’s Hospital in Denver for case consultation, and coordinating care of patients with complex medical needs.

 

Share something about your own experience with the Med Center.

My family have been patients at TRMC in the emergency department and primary care for longer than we have been full time residents here (since 2001). We have had broken limbs set, IVs delivered, vaccinations provided to our five children and appreciated the thoughtful and patient care of our providers when addressing the emergent needs of a crying (screaming!?) toddler in pain and fear on a late-night visit to the emergency room.

 

While our children no longer live in the area, both my wife and I are patients at the medical center and rely on the excellent clinicians in both the Emergency and Primacy Care departments to keep us healthy. They have been there when accidents happen, at countless well child checks, for annual physicals to ensure that we can continue to live in the community as we age, and we hope that they will continue to be able to focus on delivering the best healthcare to us in the years to come.

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What do you see to be the strengths and weaknesses of TRMC?

Our providers are, without a doubt, the number one strength of TRMC. We have an awesome group of board-certified providers on staff at TRMC. They are the reason TRMC continues to be a vital community resource, and it is because of their commitment and professionalism that the community has shown dedicated support for TRMC over the years. They are supported by a strong and highly effective administrative team that ensures that as clinicians they can focus on patient care. The current board ended the revolving door of senior leadership and hired a full-time CEO and CFO, providing much needed direction and focus. Their work has dramatically improved our financial performance, allowing us to build reserves, receive proper reimbursement from payers, and ensure the long-term viability of TRMC. The current board, under my leadership as Board Chair, has improved its practice of governance, has rebuilt relationships with staff, and has eliminated the chaos that marked prior board tenures.

 

Like many healthcare providers across the state, we work in a broken healthcare system. Declining reimbursements from insurance companies, an increase in uninsured patients due to cost and disenrollment of thousands from Medicaid, high inflation in healthcare, the affordability of our community for our staff, and the extreme volume fluctuations in a resort community contribute to the challenge TRMC faces in providing care. Fortunately, through community support and our dedicated team of clinicians and support staff, we continue to defy the odds and offer the highest quality health care to our community.

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Please share some of your thoughts on the current services offered at the Med Center.

Despite working in a decades-old building that was never designed to be a healthcare facility, we have been able to grow and adapt and offer a range of services to our community—in other words, “we punch well above our weight.” Our current facility limits the types of services we can offer, as well as the level of reimbursement we receive from insurance payers. For example, we cannot be licensed as a free-standing emergency department and instead are one of two legacy facilities with a lower licensure in the state. Often, administering CT scans for emergent situations are not covered by insurance because of that licensure. A new facility with a higher licensure category will allow us to capture those costs.

 

The current board has supported the expansion of visiting specialists, including the addition of a cardiologist, the use of tele-health for neurologic and psychiatric disorders, and the future in-person services of a gynecologist.

 

Most importantly, the current board and the greater community, continues to support our board-certified emergency room providers who offer care every day of the year. Patient visits in the emergency room are subject to seasonal demands, but I am thankful that if I need emergency care on a quiet Sunday in off-season, when most stores and many restaurants are closed and enjoying some down time, I know that access to high quality healthcare delivered by board certified emergency room physicians, is a short drive away.

 

Tell us about experience you have in Rural Health or running a rural business.

For twenty plus years my wife and I ran two retail stores in Telluride and are familiar with the challenges associated with running a business in a rural, remote, tourism-based community. In addition, I served on the board of our regional community mental health center for 7 years and worked in the field of mental health for both a community non-profit (Tri-County Health Network) and a community health center (Axis Health Systems) delivering care across our rural and frontier region.

 

I spent 9 years on the Telluride School Board, 4 as President of the Board, and am familiar with the challenges of providing high quality education in a rural community. Both entities thrive when their respective boards focus on their mission, respect their staff, and minimize the chaos that ineffective or misguided boards bring to an organization.

 

For the last three years I have served as Board President of the Telluride Hospital District. I have learned firsthand the challenges of delivering health care in our community. I have gained a deep appreciation for the complexities of providing healthcare at 8,750 feet, the challenges of operating in a resort community with limited and expensive housing options for our staff and navigating the ever-changing broken system of healthcare in America. I have built board capacity to govern and brought much needed stability and calm to the board room, have built strong bonds between staff and board, and ensured that the board has educated itself to be an effective contributor to the organization.

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Tell us about a successful fundraising experience that you have had.

I have been consistently engaged with our Telluride Hospital District Foundation (THDF) to work with our donor community over the past three years. We are fortunate to have the strong leadership of Clifford Hansen, the THDF board chair, an engaged and committed board of the THDF, and an experienced and effective director of the foundation, Katie Singer, at the helm. As a board member, fundraising over the next four years will be critical to ensure that we are well-positioned financially through charitable donations to build, open and run a new healthcare facility that the community needs and deserves.

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What is the number one skill or experience that you think you bring to board?

Experience. As the only incumbent among 7 candidates, I am the only candidate with real-world board leadership and experience in rural healthcare. I have a deep understanding of the real-world complexities TRMC faces in delivering health care to our community. I have experience on nonprofit boards, and publicly elected boards, as well as working as an employee for health care providers in the region.

 

Is there anything else you want to tell voters about yourself?

I care deeply about the Telluride Regional Medical Center and the fantastic team of clinicians and support personnel who deliver the highest quality of health care to each of us, our neighbors, friends, coworkers, and employees. As we learned during the COVID-19 pandemic, TRMC played an essential role at that time to protect our community and ensure the health of its members. Every day our staff showed up to work despite risks to their own health, and manned the white tents on Townsend in all sorts of weather, spent weekends in the school gym delivering vaccinations, and supported patients and their families when their health suffered and they faced hospitalization in Montrose, Grand Junction or Denver. That dedication to the community inspires me every day to support them as best I can through my actions as a committed, thoughtful, and caring board member. I hope to have the privilege to continue to serve in that role for another 4 years.