After nearly four years of operation, the School-Based Health Centers (SBHC) at Basalt middle and high school are closing at the end of December. As an extension of Mountain Family Health Centers (MFHC), patients from the Basalt SBHC can seamlessly transfer care to MFHC’s Basalt Integrative Health Center located at 123 Emma Road, less than one mile from the high school and half a mile from the middle school. These closures are the result of decreased patient volume and will help financially sustain MFHC.
“Care is not going to be as convenient as being in the school, but considering the proximity to the [Basalt] hub, I am hopeful we can continue serving those patients,” said Dustin Moyer, MFHC’s executive director. “We’re working closely with the Roaring Fork School District to ensure those patients know that we are still a resource.”
The closures will not result in any staff lay-offs. Employees will instead be relocated to the Basalt hub. Additionally, the hub will adjust its access strategy by extending hours on Wednesdays to 8pm. Patients may also receive faster care, considering the hubs have more support staff and rooms than the SBHC. Moyer hopes this inconvenience will not reduce access to care given MFHC’s core mission to support the entire community.
Since 1978, MFHC has been providing comprehensive healthcare, including medical, behavioral and dental, to patients across the socioeconomic spectrum. As a federally-qualified health center, MFHC meets the necessary criteria to apply for federal grants and to receive enhanced reimbursement and additional benefits from Medicaid. This creates more equitable access to healthcare, regardless of a patient’s insurance status. Patients who do not qualify for Medicaid can enroll in MFHC’s Sliding Fee Discount Program that subsidizes medical costs based on family earnings. Currently, MFHC has over 24,000 patients at five integrative health centers from Avon to Rifle and up to Basalt.
“We are serving everyone regardless of their insurance coverage or ability to pay,” said Moyer. “This makes us a really important resource for our communities.”
In addition to the hubs, there are five SBHC; however, once the Basalt centers close, in-school care will only be provided at Avon Elementary and the Glenwood Springs and Roaring Fork High Schools. SBHC patients receive the same integrative healthcare from medical doctors, therapists and dentists as they would at a hub. By offering care within the schools, patients can quickly see a medical professional in a setting that is comfortable and familiar. Moyer, a former employee at the Colorado Health Foundation, a nonprofit that has historically funded SBHC, emphasized SBHC’s role in ensuring quality care for children, the state’s most vulnerable population.
“I’ve been a longtime advocate for the model and what it means for access for our youngest patients,” said Moyer. “When we think about who we are serving, a lot of times it’s kids whose parents are busy with multiple jobs and paid time off might not be a guarantee. By having that access within the school district we’re a convenient resource for our patients and their families.”
While the Basalt closures present a logistical issue for patients, the decision to close illuminates the concern that many Coloradans are uninsured, resulting in revenue loss for health centers. For Colorado’s 20 federally-qualified health centers, including MFHC, Medicaid is the highest payer. This ensures low-income families have access to care while also creating a sustainable financial plan for the nonprofits. Realistically, the more Medicaid patients, the more financially sound the health center. In June 2023, however, the pandemic’s federal Medicaid eligibility expansion expired. In less than 12 months, the state had to redetermine over 1.5 million people. After redetermination, 575,000 Coloradans came off Medicaid, including 2,000 MFHC patients. Since then, MFHC has lost an astounding $1.5 million of its annual revenue.
“An acute problem we’re facing is the result of what we call the Medicaid unwind,” said Moyer. “We’re finding now that the infrastructure was probably not in place to handle that volume of applications, and we suspect many patients that should still be eligible fell off.”
Moyer added two systemic reasons that further explain why community health centers have a high level of uninsured patients, the first being a significant number of patients without documentation who are often ineligible for insurance or work for companies that do not offer private insurance. The second reason is that Medicaid does not adjust for cost of living. This means that ineligible Colorado patients are more likely to forego insurance to afford other basic necessities like food and shelter.
“From a patient perspective, losing coverage can be really stressful at best, or catastrophic at worst,” said Moyer. “As a nonprofit we operate really lean. So losing that $1.5 million was a pretty big concern, just from a sustainability perspective. We’ve been required to make some difficult choices, including the closures of the Basalt SBHC.”
MFHC’s integrative, high-quality healthcare is available to all patients, regardless of insurance coverage. For patients without insurance, bilingual enrollment specialists are available to help navigate the application process. Patients interested in supporting equitable access to healthcare should consider contributing to the Health For All Fund.
To learn more, visit www.mountainfamily.org