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Northwest Colorado Health warns home health and hospice services face imminent shortfall; asks county to consider sustainable funding
Summary
Northwest Colorado Health told Routt County commissioners that long-running reimbursement gaps in Medicare and Medicaid have pushed home health and hospice into the red and urged the county to partner on sustainable funding, including a possible property tax mechanism or other community funding options.
Northwest Colorado Health CEO Stephanie Einfeld told the Routt County Board of Commissioners on May 12 that the nonprofit’s home health and hospice programs are operating with a growing, structural budget shortfall and need a sustainable funding solution to avoid reduced access or program cuts.
Einfeld said the organization serves roughly one-third of Yampa Valley residents regardless of ability to pay and that home visits in Routt County totaled about 5,000 last year. She told commissioners that Medicare reimburses roughly $2,500–$3,000 for a typical 60-day home-health episode while the cost to provide that care is about $6,000, producing a large unreimbursed loss when multiplied across the program’s caseload.
The county discussion focused on why the services matter locally and what tools the county could use. "Not caring for hospice patients in this community is not an option," Einfeld said, describing a recent family who struggled to arrange end-of-life care when hospice capacity tightened last year. Commissioners pushed for options the county could support, and asked whether a property tax or mill levy could be structured to fund services that are countywide in scope.
Commissioner Macy's and other members asked about alternatives to a single-agency ballot measure and whether a broader health-and-human-services fund — modeled on programs in other Colorado counties — might be more politically viable. Einfeld said the organization has explored donor campaigns and one-time grants but that those sources are not reliable for ongoing operational deficits.
Einfeld described prior steps the nonprofit has taken: forming a home-services committee with community partners, engaging consultants to identify efficiencies, and conducting donor outreach. She reported an operating reserve goal of roughly 50–60 days cash on hand but said much of the available cash is restricted by grants and cannot cover recurring program deficits.
Commissioners pressed for concrete next steps. Einfeld asked the county to partner in developing a plan and to let voters decide the approach; she described a range of funding options, including a county-limited mill levy targeted to Routt County residents only if the county so chose. Commissioners agreed to investigate options, including whether to pursue a countywide ballot question, and to discuss the issue with municipalities in upcoming joint meetings.
The board did not take formal action on funding during the meeting. Commissioners requested follow-up items: county staff will map possible funding vehicles, look at comparable county models (including Pitkin County’s health fund and other rural mill-levy approaches), and report back with options and cost estimates. Einfeld said Northwest Colorado Health will continue advocacy, fundraising, and program adjustments while pursuing longer-term support.
