On Colorado’s Eastern plains, there is one hospital on the I-70 corridor between Denver International Airport and the Kansas border: Lincoln Community Hospital in Hugo. It serves an area the size of Connecticut, with a population density of about one person per square mile. It has two emergency room beds.
“We usually have a couple patients in the hospital a day. Eight ER patients a day,” says Lincoln Health CEO Kevin Stansbury.
“My personal opinion is, like most areas of the country, it is probably here and it just hasn’t been diagnosed yet,” he says. It being COVID-19.
Rural health providers like Lincoln Health face unique challenges when it comes to combating COVID-19: fewer doctors, fewer rooms, older populations and long-standing financial issues.
For instance, a 35-bed nursing home is attached to Lincoln Community Hospital, presenting a challenge for hospital workers to keep those who present with illnesses away from an older population that is more susceptible to complications if they contract COVID-19.
“[COVID-19] doesn’t present as being a real acute illness in most people who are going to travel,” Stansbury says. “Having said that, we’re very concerned if it should come to the community that a large portion of our demographic is older folks we want to protect, and the mortality rate rises dramatically for patients that are 65 or older.”
So, like hospitals in more dense communities, Stansbury is asking residents to be screened via a phone call before coming to the ER. “By keeping folks out of the building, that is better for us and for our patients.”
Only family members who are essential to patients’ care are allowed to enter the nursing home. That doesn’t mean, however, that people in Lincoln Health’s care are quarantined from all human interaction. Family members and friends are welcome to sit outside the window of people in assisted living, and the facility even hosted a “Corona party,” serving a case of Corona beer that was donated to the facility last Christmas. Lincoln Health also facilitates Skype meetings between patients and family members.
But access to critical medical equipment to combat COVID-19 is a challenge. Though Stansbury says there have not been any confirmed cases in the area, they are evaluating several cases and are awaiting results.
“Our biggest shortage is the access to testing kits and delays that happen when you send them in, and a number of people are working to resolve that issue,” he says. “We have a shortage of the isolation masks. We still have some and we’re working through those.”
Given the reality that Lincoln Health might not get masks before running out, or that other, more densely populated areas might be prioritized first, the local community is stepping in to help, Stansbury says.
“We’ve had generous members of the community offer to sew masks for us, and we’re working with folks around the state to ensure masks are safe.”
The state has ordered all hospitals to delay elective surgeries and procedures in order to minimize exposure and ration personal protective equipment, which Lincoln Health is doing. But such procedures are vital to the financial viability of rural hospitals —Stansbury says it “constitutes most of our revenue.” In turn, Stansbury suggests people from the Front Range think about accessing Lincoln Health’s care during this time so that the hospital system can make ends meet, lower the burden of hospitals that service denser areas and help people get the medical care they need.
“We have excess patient capacity,” Stansbury says. “We are willing and able to receive patients from the city who would be willing to let us care for them.
“You have good nurses out here. Good doctors,” Stansbury adds. “We take good care of our patients, we just know what our limits are.”
Mental health care goes online
With stay-at-home mandates in Boulder and Denver, and further restrictions on gatherings of more than 10 people, Mental Health Partners (MHP) is taking its services online to help treat those struggling with addiction, mental health issues, housing insecurity and more.
“We have been really successful in moving 90% of our services online,” says Kristina Shaw of MHP. The organization oversees a network that includes everything from Alcoholics Anonymous meetings to crisis and detox centers to one-on-one therapy, and much more.
“We have the tech infrastructure to move people remote and still be able to provide services and care, which is very important now because a lot of people are feeling mental health anxiety and stress,” Shaw says. “People who are currently being treated for mental health issues, we want to keep them in a stable environment and not send them to the ER.”
MHP has canceled all its in-person groups, and clinicians are able to reach out to people in groups and offer one-on-one therapy. It is also working to provide clients with phones, or minutes on their phones, to access care.
People can still access MHP’s 24/7 crisis and addiction center at 3180 Airport Road in Boulder (unless they are experiencing COVID-19 symptoms, in which case they are advised to call or text 1-844-493-TALK). And they can still receive medical evaluations at locations in Boulder, Longmont and Broomfield.
Though making sure all of its 13,000-plus clients have access to the necessary technology to get care has been a challenge, there have been some benefits to moving things remotely, Shaw says.
“Some clients are finding it easier to open up being on the phone or being on a Zoom call because it does reduce that barrier,” she says. “And then a couple clients, they sometimes have the challenge of getting to places because they have a physical disability or [no] transportation. If they don’t have to leave their home, they are expressing gratitude for that.”
And Shaw says there has been broader community support online — in this time of high anxiety, MHP is posting mental health tips on social media, and the response has been overwhelming.
“We have seen engagement through Twitter through the roof,” Shaw says. “People are sharing everything.”
For mental health tips and more information on accessing care, visit mhpcolorado.org.