Mid­val­ley Fam­ily Prac­tice steps up to care for “lost com­mu­nity”

The Denver Post - - DENVER & THE WEST - By Scott Con­don

A mid­val­ley med­i­cal clinic that helps unin­sured peo­ple deal with COVID-19 is ex­pe­ri­enc­ing a surge in re­quests for tests as the eco­nomic re­open­ing un­folds.

Mid­val­ley Fam­ily Prac­tice per­formed 108 tests in El Jebel on June 25 at a spe­cial event co­or­di­nated with an Ea­gle County aid pro­gram called the MIRA bus. Since then, the clinic’s staff has tested be­tween 10 and 17 peo­ple per day at its fa­cil­ity in Basalt. That’s more re­quests for tests than they fielded even in the early days of the coro­n­avirus cri­sis.

Dr. Glenn Kotz and his team at the clinic founded a non­profit called Healthy All To­gether to raise funds to pro­vide care for what they be­lieve is a grow­ing unin­sured pop­u­la­tion in the re­gion. The need for ser­vices threat­ens to dwarf their cur­rent re­sources.

“We’ve started to talk about this as a lost com­mu­nity be­cause we don’t know how many peo­ple are unin­sured be­cause they have just stayed out of the pic­ture,” Kotz said. “Through the MIRA bus and through our of­fer­ing of the ser­vices, ev­ery day there are new peo­ple com­ing out of this lost com­mu­nity to say, ‘Hey, I’m sick and I don’t have in­sur­ance and I haven’t seen a doc­tor in years.’ ”

Mid­val­ley Fam­ily Prac­tice has an open-door pol­icy when it comes to COVID-19 test­ing. They don’t turn away the unin­sured.

How­ever, the care they pro­vide doesn’t sim­ply con­sist of ram­ming a cot­ton swap far up the nose of pa­tients for what’s known as a PCR test. The nurses of the clinic per­form a med­i­cal assess­ment of the peo­ple and some­times find is­sues that have been un­ad­dressed for years. High blood pres­sure, for ex­am­ple, is a com­mon find­ing.

“It’s a to­tal eval­u­a­tion,” said Lisa Rob­biano, a nurse at the clinic. “Many of the unin­sured haven’t been to a doc­tor for years.”

One re­cent in­ci­dent stuck out for the Mid­val­ley Fam­ily Prac­tice team. An en­tire fam­ily came in and all tested pos­i­tive for COVID-19.

The fa­ther is in his 40s and didn’t have any un­der­ly­ing med­i­cal con­di­tions when he be­came in­fected. He was winded just walk­ing into the clinic’s iso­lated sec­tion for COVID-19 test­ing. He also had a high fever. Mid­val­ley sent him to Val­ley View Hos­pi­tal, which sent him to a hos­pi­tal in Den­ver where, at last word, he was still on a ven­ti­la­tor.

“I don’t think we in the med­i­cal field know ex­actly why that hap­pens yet, which makes it more scary to us,” Ash­ley Burke, a nurse at the clinic, said about the se­vere symp­toms of the man in his 40s. “I think some­times the gen­eral pop­u­la­tion, some peo­ple any­way, like to throw it off like, ‘Oh well, the flu kills more peo­ple.’ But we kind of un­der­stand the flu. The flu has been around. This is new. We don’t un­der­stand it and peo­ple are dy­ing and get­ting ill that are re­ally young.”

While test­ing and as­sess­ing health, they reg­u­larly find peo­ple who are go­ing hun­gry be­cause they are un­em­ployed or un­able to pay rent be­cause they are out of money. They steer those fam­i­lies or in­di­vid­u­als to­ward re­sources in the Roar­ing Fork Val­ley.

Jarid Rollins is a men­tal health provider at the clinic and has been coun­sel­ing peo­ple since the coro­n­avirus out­break.

“Ini­tially when this all started there was this great com­ing to­gether. (Some) peo­ple were freak­ing out but peo­ple were also thank­ful that there was this respite where they could re­lax for a lit­tle bit,” Rollins said. “There was a plethora of re­sources. Peo­ple were get­ting un­em­ploy­ment. The coun­ties were sup­port­ing their res­i­dents as well. As this has dragged on, peo­ple are get­ting ex­hausted, they’re more anx­ious, the re­sources are fewer be­cause not every­one is in cri­sis mode, peo­ple are back to work, but those who can’t go back to work or who have been ex­posed or are pos­i­tive, they’re re­ally feel­ing the ef­fects of this.”

Rollins said the unin­sured rate among Roar­ing Fork Val­ley res­i­dents was about 16% pre-coro­n­avirus cri­sis, ac­cord­ing to best avail­able data. He be­lieves the per­cent­age is sig­nif­i­cantly higher now be­cause of all the peo­ple who lost jobs that pro­vided health in­sur­ance.

That swelling of the ranks of un­em­ployed spurred the Mid­val­ley Fam­ily Prac­tice team to form the non­profit to pro­vide care.

“There was a need be­ing pre­sented in the val­ley that we needed to fill,” said Lisa O’neil, a nurse at the clinic.

Fed­eral guide­lines ad­vised med­i­cal clin­ics early in the coro­n­avirus cri­sis to stop see­ing pa­tients in per­son and do tele-con­fer­ences. Mid­val­ley Fam­ily Prac­tice found al­most im­me­di­ately that peo­ple wanted face-to-face con­tact, so it started see­ing peo­ple for the coro­n­avirus in their ve­hi­cles in the park­ing lot.

“Early on in the process we started see­ing peo­ple from an hour to an hourand-a-half away,” Kotz said. “Any­where from Para­chute to Meeker and Gyp­sum.”

Many of their pa­tients come from Basalt, El Jebel and Car­bon­dale. They ex­ceeded 500 tests by the end of two weeks ago.

“Our pos­i­tiv­ity rate, which means out of those 500, how many are pos­i­tive, is 11, 12 per­cent,” Rob­biano said. The clinic is do­ing more tests, she said, but the pos­i­tiv­ity rate also is go­ing up. In other words, the pos­i­tive tests aren’t sim­ply due to more test­ing.

The state av­er­age is a 10% pos­i­tive rate.

Early in the cri­sis, most of the peo­ple they tested ex­hib­ited symp­toms. Since the sec­ond week of June, the vast ma­jor­ity of peo­ple they see are re­quest­ing tests be­cause they were ex­posed to some­one who tested pos­i­tive.

There is no sign that the re­quests for tests will drop any­time soon. June 20 was “in­sane” at the clinic, said Imelda De La Torre, who staffs the front desk. She had to turn away or resched­ule nearly 15 pa­tients.

Em­ploy­ees of Bin­billa Land­scap­ing line up out­side of the Mid­val­ley Fam­ily Prac­tice sick en­trance on July 2 to get tested for COVID-19. The land­scap­ing com­pany tested 15 of its em­ploy­ees as a pre­cau­tion af­ter one em­ploy­ees tested pos­i­tive 12 days ear­lier.

Pho­tos by Kelsey Brun­ner, The Aspen Times

Edgar Ruiz re­acts to the COVID-19 test as nurse Lisa O’neil ad­min­is­ters it July 2 in a sec­tioned-off wing of the clinic in Basalt, which has seen a surge in de­mand for tests.

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