Jason McCormick, of Fruita, explained the Basin Clinic’s options for paths forward in a community meeting May 19. McCormick, through grant funds, has spent time on Basin Clinic’s strategic planning this year. In Monday’s meeting at the Nucla Community Center, he explained the four options for the 501C3-designated rural health care clinic in Naturita.
McCormick said the goals are to strengthen financial viability, expand offerings and improve services, replace facilities and have local control. He added the health care trends currently are difficulty in recruitment for rural areas, inflation costs increasing, Baby Boomers impacting health care, rural places having high numbers of elderly and also the county denying tax money to cover rising ambulance costs.
McCormick presented four paths forward: Basin Clinic remaining a free-standing rural health care clinic as it is now; becoming a federally qualified health care center (FQHC); becoming a special service district (SSD); or becoming an SSD critical access hospital.
Remaining as-is
Basin Clinic could remain as-is, a free-standing rural health care clinic with no direct tax support. Sometimes it acts as emergency care, but it’s not. It can receive an ambulance, but doesn’t get reimbursed. It can do some labs and disperse some generic medications. Many in the audience, including Don Colcord, said this doesn’t seem to be working or sustainable.
Becoming FQHC and merging
Becoming an FQHC could mean federal grant resources, enabling Basin Clinic to provide care to the uninsured. It would also include the pharmacy rebate program. Only, it would mean that Basin Clinic would operate under Uncompahgre Medical Center in Norwood.
McCormick said FQHC’s are invasive entities; the grants allow for expansion. He said FQHCs must be approved by those in Washington, D.C., and there are restrictions. No emergency services are allowed. Dental and behavioral health are required, as is imaging.
FQHCs treat those without access, though they’ll take commercial insurance too. Sometimes the stigma around FQHCs isn’t good, but some are run well. FQHCs basically remain FQHCs. Not many close, but the feds can choose to shut one down.
Becoming an SSD
Basin Clinic could become a hospital district. In this way, it would remain a clinic within its hospital district, like several others in Colorado. It would operate under the state’s Department of Local Affairs, collect property tax, and have an elected board. It would be a state entity, not a town or county one. The elected board would approve budgets.
The process would involve going to voters with a ballot question in 2026, first by obtaining signatures to place it there. Then campaigning would happen before the April election, with voters ultimately deciding. If established, community approval would be required for capital projects.
Becoming an SSD with a critical access hospital
An SSD can transition to a mini critical access hospital. McCormick said the options include nursing home services and a swing-bed unit. It would enable a small emergency department, a lab, X-rays and physical therapy.
McCormick said something like two to three patients could be in the in-patient unit, with 12 to 14 beds for nursing home patients. He said the cap is 25 beds, but 22 could be nursing home beds. He said folks can come home from St. Mary’s in Grand Junction and rehab in the West End.
This type of facility would require approximately 70 employees, with one-third working the nursing home side. McCormick agreed it would grow the community a bit.
“Hospitals are the largest employers in rural communities,” he said. “Schools are usually second.”
He agreed hospital jobs are good jobs.
He said the West End could start with an SSD, and in few years decide whether or not to transition to a critical access hospital. Rangely has one; so does Blanding, UT.
McCormick has the ideas for grants, tax-credits and more. He said the critical access hospital reimbursements from Medicare would pay 50% of the annual costs, which helps with borrowing money or getting grants.
Already the Basin Clinic owns 11 acres in Nucla, and McCormick said it’s large enough, though soils testing and a feasibility study would be needed.
Ultimately, the Basin Clinic board will make a recommendation, and then the community will decide through the election process. Nobody can say at this point what a mill levy would look like. There’s no need to worry about housing in this stage either. County commissioners could help with equipment and other big purchases if the West End moves to a hospital district.
When asked about any benefit of merging with another clinic, McCormick said, “there’s no advantage to being a part of big system.”
He said that just means more CEOs and bureaucracy. He said small hospitals have less administrative fees.
At this point, the Basin Clinic board and the audience expressed interest in discussing the option of an SSD, a hospital district, with the option of having a critical access hospital in the future.
