ROARING FORK BROADCASTING COMPANY
The school-based health centers at Basalt Middle and High schools closed Thursday after Mountain Family Health Centers decided to shutter the two locations to cut costs, moving all staff and services to its Emma Road location.
More than 2,000 of MFHC’s patients lost their Medicaid eligibility between May 2023-April 2024, according to Dustin Moyer, CEO of MFHC, resulting in a $1.5 million budget shortfall for the nonprofit.
The approximately 1,000-1,200 pediatric patients who receive care at the two locations will have the option to relocate to the Basalt MFHC location at 123 Emma Road in Basalt, about a mile from both schools. The nonprofit health center is planning to extend its Wednesday evening hours to help accommodate Basalt High students, who are released early on Wednesdays.
By closing the centers, Moyer anticipates a $200,000 bottom line improvement in their budget. The measure also saves costs on consolidation — though Moyer said all school center staff were able to be absorbed into the Basalt hub.
“We were able to, fortunately, close those and consolidate without any layoffs, so we're going to have the same staff capacity,” Moyer said. “We're working with the school district to ensure that those students, even though it's not a service in their school, are still able to access Mountain Family as a resource.”
Schools are typically a less sustainable model for community health centers, Moyer said, even though there are better coverage options for children. With the nearby Basalt hub, closing the health centers and absorbing the patients and staff made more financial sense for MFHC.
MFHC is a federally qualified health center based in Glenwood Springs with locations from Avon to Rifle to Basalt. With that designation, they must provide preventive health, dental, behavioral health and other core services regardless of insurance status and offer a sliding pay scale.
In 2024, MFHC reported $25.1 million in revenue and $26.07 million in expenses in their annual report.
For MFHC, they offer sliding scale payment up to 400% of the Federal Poverty Level. They serve about 20,000 patients over an 18-month period and Moyer estimates that about 10,000 of them are uninsured.
Medicaid was by far their largest insurer and a critical revenue in the budget, but a recent Public Health Emergency “unwind” in Colorado following the pandemic resulted in nearly 575,000 lapses in Medicaid and Child Health Plan Plus enrollment, according to Moyer — a deep impact to budgets for organizations like MFHC.
The unwind happened after the federal government ended a restriction on unenrolling patients from Medicaid during the pandemic. The government was then responsible for verifying eligibility and enrollment again after a multiyear pause, resulting in enrollment lapses.
Lindsay Maisch, the human services director with Pitkin County, said that despite unchanged eligibility rules, other changes in the economy and job markets have directly impacted eligibility today.
“The reasons people are losing coverage is because they are over the income limits and aren't eligible based on the pre-COVID rules, which have not changed (but likely should be addressed),” Maisch wrote in an email. “The eligibility limits were never increased or changed, COVID emergency rules just locked everyone in whether they went over income or not until the wind down happened, during a time when inflation increased in a way that didn't keep up with the rules.”
She said that counties are strictly adhering to state guidelines and are checked by the Colorado Department of Health Care Policy and Financing through audits.
Still, Moyer said the unwind resulted in two to three times as many unenrolled patients as anticipated for both MFHC and the state. He attributes the high rate to patients not knowing they needed their eligibility redetermined, a complicated application process and outright mistakes.
“I don't have strong data to indicate this, but I've heard from a number of our partners across the state that some of their patients that had enrolled were rejected for administrative reasons,” he said.
Moyer is hopeful that about 60-65% of their patients who lost coverage are still eligible, but whether or not they can get reenrolled is less clear. He directed conservative budgets to prepare for lower reenrollment.
“We're trying to get a hold of those patients to let them know their coverage has lapsed,” he said. “I think a lot of folks probably won't realize their coverage has lapsed until they need to come see us for something, at which point we do have what we call our outreach and enrollment team.”
The financial loss has altered MFHC’s business beyond the school-based health centers.
In the past 18 months, Moyer said MFHC has had layoffs, a stretch of hiring freezes and a suspension of employer contributions to staff's retirement benefits. Their behavioral health team was restructured and they’ve made other cuts. The outreach and enrollment team is working at and over capacity.
They’ve also ramped up their development and grant seeking opportunities to help fill the gap.
“I think you know any sustainable approach is probably going to be more policy rooted than philanthropy rooted,” Moyer said. “We're having to continually monitor the impact of (the unwind) to see if patients are able to reengage in the system, or if they haven't been able to yet.”
At their Dec. 10 meeting, the town of Basalt allocated a $50,000 one-time grant to MFHC from its tobacco tax revenue to support the nonprofit. They have an intergovernmental agreement between MFHC, Pitkin County, Eagle County and Aspen Valley Hospital to help offset the cost of serving uninsured patients.
Despite the budget challenges, Moyer said MFHC is still fully prepared and committed to serving their patients and accepting new ones.
“A lot of times folks think a community health center is not a place that they should go if they have commercial insurance, but I definitely would encourage folks, if they need a new provider, to reach out,” he said.
MFHC’s school-based health centers at Roaring Fork High School, Glenwood Springs High School and Avon Elementary School will remain open.