Why Your Vote Counts in the Telluride Hospital District Election
by Bill Grun, Chair, Telluride Hospital District
Apr 08, 2012 | 1389 views | 1 1 comments | 9 9 recommendations | email to a friend | print
I write this to urge voters to cast their vote in the upcoming Telluride Hospital District Elections and to provide some information on the role of the Board of Directors and the challenges we are likely to face in the near future.

The Telluride Medical Center provides emergency care and primary care medical services to the Telluride region. Since the nearest hospital is 65 miles away over mountain roads, the healthcare services provided by TMC are vital to the local community and economy. TMC is a small healthcare business with gross revenues in excess of $5 million. This business is partially supported by about $1.8 million in tax income, most of which is used to provide emergency medical services on a 24/7 basis. Without that tax support, we could not afford to keep our emergency room open 24 hours a day and staffed with board certified Emergency Medicine physicians, nurses and radiology techs. Without that tax support, the Emergency Department would probably close entirely during Telluride’s off seasons.

We are fortunate to have an extremely talented, skilled and dedicated medical staff at TMC, and the quality of medical care that they provide is exceptional. Having easy access to this caliber of medical personnel is extremely rare for a community of this size. We are able to attract and retain a high quality medical staff because the Telluride region is a great place to live, and because TMC has become a great place to work.

The Telluride Medical Center is governed by the five-person Telluride Hospital District Board. Because of the tax support that TMC receives, this Board is elected by the voters of a special tax district whose boundaries mirror the R-1 School District. This Board of Directors has the critical job of providing leadership and direction for TMC by developing strategy and determining policies. Because TMC is a fairly small healthcare facility, most of the employees are medical personnel. Consequently, the business expertise provided by the Board has been an important factor in the success of TMC.

TMC is a business, and the responsibilities of the Board of Directors are similar to other business boards. Listed below are some of the tasks that members of the Board have accomplished in just the past three to four months:

Worked with TMC staff to develop and refine operating and capital budgets for 2012

Monitored financial performance on a monthly basis to ensure timely corrective action if business volume failed to meet budgeted levels

Reviewed 2011 performance including both financial results and accomplishments against specific strategic actions

Held a strategic planning workshop and updated and revised the TMC strategic plan

Reviewed compensation and benefit programs and approved annual bonus for TMC staff

Held a performance review with TMC’s Executive Director and revised his compensation

Reviewed performance of TMC Foundation including fundraising accomplishments for 2011 and programs and goals for 2012

Discussed TMC’s information technology plan and medical record security

Attended medical quality assurance reviews to ensure necessary board oversight

Reviewed patient survey responses and discussed ways to maintain high level of patient satisfaction

Helped direct TMC’s communication and public relations program

Reviewed visiting specialist program and revised patient survey to determine value of these services to the community

Reviewed status of land identified as possible locations for a future medical center

Developed and approved a Code of Conduct for the Board of Directors

Discussed Tri-County Health Network Initiatives and TMC’s participation

Discussed near term impacts of Healthcare Reform and development of Colorado’s Health Insurance Exchange

I have served on the Board since 2005 and been Chair for the last six years. I have seen TMC transform from a money losing operation with over $700,000 in debt into a financially viable business with over $1 million in the bank. During this period, the Board of Directors changed the business model for TMC, developed a strategic plan, developed a comprehensive plan for a new facility, and directed an extensive remodel of our emergency room after the changing economy postponed the need for new facility. A number of different Directors have contributed to this effort, as term limits ensure that we have a healthy rate of turnover. This experience gives me some perspective on how the Board can impact TMC.

Two of the five members of our Board of Directors are up for election in May. Both Dan Garner and Larry Mallard are highly qualified and experienced board members who have provided considerable value to TMC. Neither of them has had any potential conflicts of interest, and both have been able to participate fully in all Board and committee activities. Having competent and capable people in these volunteer positions has been essential in enabling the Board to complete the above list of accomplishments.

Dan Garner has served on the Board for four years and is our hardest working director. He brings strong financial and business skills and has an excellent knowledge of local governments and what is going on in the community. He was very helpful in ensuring that the recent emergency room remodel project was completed on time and under budget.

Larry Mallard has served on the Board for the last year and quickly became a strong contributor. He successfully runs a good-sized local business and brings great leadership skills. His knowledge of what is happening in the tourist industry and his familiarity with local business issues and employment practices have proven valuable to the Board.

It is great to see people interested in assisting TMC, and two new candidates, Pamela Shifrin and John Anderson, have signed up for this year’s election. This election is important to TMC, and I would encourage all eligible voters to participate. TMC will have information regarding the election on its website at We hope to have brief resumes of all candidates so voters can effectively assess their qualifications.

TMC is likely to face two important issues during the next four years. The most well-known and interesting issue for the community will be planning for a new medical center. The recent remodel of our emergency room and the poor economy of the last few years have delayed the need for a new medical center, but we must prepare for the future. Most people agree with the current Board that it would be preferable to keep the medical center in Telluride, but there is really only one good site in Telluride, and its availability is uncertain. TMC needs help from the Telluride Town Council and from the community to make that happen. Although determining the location of the new facility is critical, preparing a complete new facility plan is a much larger task, as the plan must cover many other important business issues such as when to build, what services to include, how large to build it, and how to finance it.

The second and perhaps most important issue will be dealing with healthcare reform and the changing healthcare business climate. Whatever happens, we know there will be continued pressure to reduce the costs of healthcare and improve the results. This will have impacts on the consumer, on healthcare providers like TMC, and on the medical insurance industry. I have heard knowledgeable healthcare professionals say that the biggest impact is likely to be on small rural medical facilities and practices. Telluride has recently seen a well-established medical practice close its doors. We all need to make sure that TMC does not return to the period of a decade ago when it was poorly managed and being taken advantage of by the insurance companies. This challenge is the main reason why the Telluride community needs to ensure that TMC has a capable and competent Board of Directors. Please vote for that kind of board.

Comments-icon Post a Comment
April 09, 2012
Thanks, great article. Can we get a broad spectrum of the wages paid for the TMC doctors, the executive director, and fringe benefits.

Having 1mm in the bank is impressive and is matched only by the incredible fees charged for ct scans and the like as opposed to nearby areas.

Clearly, TMC is the most expensive health care on the planet.

We need more information on how our dollars are used internally.

As an example, there is this incredible push to have the taxpayers set up an incredible new building for the TMC when the existing building is free to TMC...

SO, let the light shine in...we would like to know more about the expenditures