Health on the Rio Grande 2016 by Valley Publishing

Health on the

FREE Take One

Rio Grande A Guide to Health Services in the San Luis Valley

2016 Valley Publishing

852-3531 • 835 First Ave. • Monte Vista

Health on the Rio Grande 2016

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In 20th year RGH continues expanding BY ANTHONY GUERRERO

RIO GRANDE COUNTYâ&#x20AC;&#x201D; In its 20th year of operation Rio Grande Hospital and Clinics continues an extraordinary expansion. The award-winning hospital organization is also becoming a Valley favorite for medical needs See RGH on Page 24 Hospital employees explain the difference between the new scope (left) on the upgraded colonoscopy machine and the old traditional scope (right). The new scope has three cameras and gives better views. Courtesy Photo

Features

Lab passes inspection with no deficiencies New pill bottle could reduce prescription drug abuse Homelake celebrates 125 years of serving those who served VWHS continues to grow, innovate Valley native to represent Luxottica in Tanzania, Africa Emergency staff receives grant for IDs SLV offers top-notch medical programs ASU Human Performance Lab offers fitness testing Emergency responders receive lift ticket training More Colorado teens getting vaccines SLV Behavioral Health, lending a helping hand SLV AHEC welcomes new Community Health Worker State board lifts ban on diet soda in high schools TSJC Nursing Program receives accreditation CDPHE releases recommendations to reduce premature births, deaths Hospital tops state in patient safety CHA Drug Diversion Summit educates health leaders What exactly is cancer? Monte Vista Estates receives five-star rating Medication mismanagement can be prevented Foods can help reduce the risk of cancer Emergency responders need support, too River Valley Inn coming to Del Norte Colorado adults remain leanest in the nation Advertisersâ&#x20AC;&#x2122; Directory

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www.AlamosaAssistedLiving.com

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Health on the Rio Grande 2016

Lab passes inspection with no deficiencies

CONEJOS COUNTY— Who likes an audit (or survey)? Usually nobody, especially when the surveyors seem to find every little detail to “write you up” about. Well, congratulations to the awesome work being done by the folks in SLV Health’s Conejos County Hospital laboratory, because they just passed their Clinical Laboratory Improvement Amendments (CLIA) inspection with no deficiencies. It is very difficult to pass any type of survey without at least one area in which to improve. CCH Lab Director Brent Lehto, upon hearing the news, reported this about the results, “The survey showed that all CLIA condition-level requirements were met during the onsite survey. There are hundreds of CLIA requirements to meet to get zero deficiencies. The inspector goes through our records for the last two years since the last inspection

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Pictured with Brent Lehto from left to right are: Ernestine Winchester, Rowella Sy, Debbie Thomas and Lani Garrido. and talks to me and the other observes staff to see if they are work that’s been done to follow staff to verify how we are do- following procedure. I’m very protocol with each and every ing things. The inspector also proud of our team and the hard patient we serve.”

New pill bottle could reduce prescription drug abuse S TAFF R EPORT SAN LUIS VALLEY—Alamosa Health Mart Pharmacy and La Jara Health Mart Pharmacy are participating in a new pilot program to test Locking Prescription Vials (LPVs) for consumer use. The LPVs are a modified pill bottle with a four-digit combination lock that only the customer and pharmacies know how to open. The code is designed to prevent anyone else from opening the bottle, such as younger family members. According to Safe Rx, a Colorado-based company that makes the LPVs, more than five million kids are abusing prescription medication. A more restrictive bottle will help prevent teen drug abuse

and stop them from potentially becoming addicted to other drugs such as heroin. Independent pharmacies across the state, and in parts of Wyoming and Utah, are participating in the trial. People who wish to participate in the free program need to fill out a waiver at the pharmacies. Participants will also be sent a survey to gather feedback on the LPVs. Pharmacist Polito Martinez has only one customer using the new design but he hopes to see more. “I know of a kid who took Suboxone while his dad was asleep,” Martinez said. “He liked how they tasted and took a whole bunch. He’s alive today, but he can’t see or hear.”

Photo by by Jefferson Geiger

Pharmacist Polito Martinez demonstrates the new Locking Prescription Vials available at Alamosa Health Mart Pharmacy and La Jara Health Mart Pharmacy.The new bottle is designed to cut down drug abuse by preventing unwanted access to a person’s medication.

Health on the Rio Grande 2016

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Homelake celebrates 125 years of serving those who served BY SYLVIA LOBATO HOMELAKE — Serving those who served our country, the Colorado State Veterans Living Center at Homelake is celebrating its 125th birthday this year. Home to more than 4,000 service veterans, their spouses and Gold Star parents, the center was established by an act of the Colorado State Legislature in 1889 after lobbying by the Grand Army of the Republic (GAR) for a home for the aging and disabled veterans of the Civil War. The first resident was admitted in November 1891 — 125 years ago. It began its long history as the Soldiers’ and Sailors’ Home and is listed on the Colorado Register of Historic Properties, with many of the original buildings still standing. The mission of the home was to provide a peaceful and comfortable home for aging and displaced Civil War and Spanish American War veterans. When it was designed, it was to be self-contained and it was, including a chapel, post office, hospital and infirmary, a farm and ranch, a herd of milk cows and more, reflecting the center’s philosophy of caring for the medical, physical, mental, social and spiritual needs of its residents. Many of the historic buildings are still in use. Shortly after the home began

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The Colorado State Soldiers’ and Sailors’ Home at Homelake held a dedication ceremony on July 4, 1882. accepting residents in 1891, designed capacity. The museum is also a reFreeman Morris, a Civil War It was expanded recently pository for military medals, veteran who served with the through efforts of veterans, documents and memorabilia left Colorado Volunteers and fought community members and orga- behind in safety deposit boxes at Glorieta Pass was buried and nizations. over the years. the cemetery was designed. Between 1898-1905 the barVolunteers have compiled and In 1912, the Denver Marble racks, commander’s residence, made available for public access and Granite Company dedicated administration building and cha- the records of the residents and a memorial featuring a Span- pel were added to the community. the veterans of the San Luis Valish American War soldier and The center is also home to a ley through an online database. dedicated in the honor veterans growing history museum, which This database is being developed of that war, as well as the Civil will eventually be housed in from the records of the Veterans’ War. Since then, veterans from the old administration building, Center, newspaper articles, perthose wars through the Iraq War which was finished in 1898 and sonal communications, cemetery have been buried in the cemetery, used until 1995. It is currently records and forms filled out by which eventually reached its undergoing renovations. veterans and families of veterans.

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Health on the Rio Grande 2016

VWHS continues to grow, innovate

SAN LUIS VALLEY— Forty years ago, several young physicians recognized a need for primary medical care for underserved persons in the San Luis Valley. Due to their efforts, Valley-Wide Health Services (VWHS), Inc., now known as Valley-Wide Health Systems, Inc. was formed in 1976, with primary care clinic sites in Antonito and Alamosa. They focused on the health of farmworkers, as well as maternal health, child health and the wellbeing of families. Today, Valley-Wide is recognized for making health care services available for agricultural workers at their work places. More than 250 health center executives, consumer board members, clinical leaders and farmworker advocates attending the recent 2015 National Farmworker Health Conference agreed upon a “call to action” to work collectively to develop more effective strategies to increase access to care for migrant and seasonal agricultural workers and their families over the next five years, is necessary. This is a result of a declining number of farmworkers served — approximately 18 percent of the estimated number of agricultural workers in the U.S. are being served by health centers. “Ag Worker Access 2020” calls on every migrant health center grantee to increase the number of agricultural workers served by 15 percent each year over the next five years. With those caring roots and a history of growth and innovation, Valley-Wide Health Systems (VWHS), Inc. now provides strategically located primary care services at 12

Photo by Jennifer Alonzo

The Edward M. Kennedy Clinic in Monte Vista opened in October of 2011, replacing the clinic known as the Rio Grande Medical Center. health centers (with the new Alamosa South Health Center opening soon), oral health services in seven sites, physical therapy at four clinics and is working to integrate behavioral health in the primary care sites. Located in multiple rural counties in southern Colorado, these full-service clinics are complemented by numerous ancillary health services to address routine and/or complex needs of the patient populations and communities served. Over the 40 year span, VWHS has continued to provide quality services with your health as the number one priority, and they treat you like family with trusted professional care. Their mission statement reflects a passion to make high quality, safe, effective and integrated health care services available to all persons in the communities served with special consideration for medi-

cally underserved populations. VWHS strives to provide these services in a respectful and inclusive manner to all patients, says Gigi Darricades, VWHS president/CEO. “As we look to our future, we intend to continue to grow and to strengthen our delivery system. We have a focus on quality integrated health services. We will continue to serve all who come to us and we will continue to meet the needs of the medically underserved. Our employees are dedicated and committed to our mission. We are proud and respected for who we are and look forward to serving you in the future.” Fueled by the original passion of a handful of innovative young professionals, VWHS works constantly to provide quality health care for all, becoming a national leader in the health care field and a model for comprehensive,

community-based health care. A Community/Migrant Health Center (C/MHC), VWHS is a private non-profit 501 (c)(3) corporation governed by a volunteer community board. A total of 330 grant funds and 340B pharmacy savings are utilized to maintain VWHS’ outstanding services. Along with multiple outreach programs, Valley-Wide oversees a Farmworker Health Service Program that provides vouchers to patients in areas of the state that do not house C/MHCs. All ages are served through a family practice focus approach. Emphasis is placed on assisting the patient, reducing barriers such as cost, culture, language, literacy and transportation that may hinder use of appropriate health care services. See VWHS on Page 17

Health on the Rio Grande 2016

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Emergency staff receives grant for IDs S TAFF R EPORT

Jordan Hamilton

Valley native to represent Luxottica in Tanzania, Africa

SAN LUIS VALLEY—OneSight is an independent nonprofit providing access to quality vision care and glasses in underserved communities worldwide. OneSight is committed to eradicating the global vision care crisis that affects more than 1.1 billion people, many of whom could have their vision restored with an eye exam and a pair of glasses. San Luis Valley native and former resident Jordan Hamilton, who is

a sales supervisor for Luxottica in Provo, Utah was chosen to travel to Tanzania, Africa on Sept. 9. He is one of only 70 people from the United States. He will travel with a group of OneSight employees to hand deliver much needed, free eye care and eyewear through temporary clinics and mobile vision vans. Every year, more than a thousand of Luxottica employees travel the globe to staff OneSight Vision Clinics.

ALAMOSA—Soon almost all emergency personnel in the Valley will have a standardized identification system. Alamosa County Emergency Manager Francis Song told Alamosa County C ommissioners at Wednesday’s meeting that the department received a $7,500 grant for the project from the Colorado Division of Homeland Security and Emergency Management. This project allows first responders in the Valley to have credentials that are recognized no matter where they assist in the entire state. Along with the local fire departments, police departments, sheriff’s offices and emergency medical services, the IDs can be used for volunteer organizations. “I’m really excited that we were awarded this project so that we can get this going as soon as possible for our own first responders,” said Song. “It’s already being put into effect across multiple counties throughout the state.” The ID cards, manufac-

tured by Midwest Card and ID Solutions, are scanned through smartphones and tablets and data is collected in an application. “Instead of trying to track down sheets of paper,” Song said, “this’ll all be pushed to a secure cloud-based system so that no matter where we are we know exactly who’s going to what, how much money is being spent and what vehicle is where. It has amazing capabilities.” The grant will be matched equally with five counties paying $1,500 each. The system’s software will also have a small annual fee. The only county not participating in the program is Rio Grande County because they do not have an emergency manager. “It’s so important when we share resources in such a wide area to know who is actually responding,” Commissioner Michael Yohn said. “You know what they can do and what they’ve been trained to do.” Training with the IDs will begin in November and Song hopes that they’ll be implemented in December.

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Health on the Rio Grande 2016

SLV offers top-notch medical programs BY LYNDSIE FERRELL SAN LUIS VALLEY— Adams State University (ASU) welcomes students of all backgrounds and helps them excel in their areas of expertise. The school’s medical program has helped students achieve their goals and become doctors, nurses, physical education specialists and so much more. The San Luis Valley community surrounding the school is home to many alumni that are proud to say they received their education through Adams State University and continues to strengthen the partnership through outreach programs outlines the school’s 2020 strategic plan. The medical field is one of the most secure professions to enter in this day and age, giving it a slight edge on local college programs for area students. The university is located in Alamosa and is no different, offering a wide range

of classes during different times in order to best suit the students attending. Trinidad Junior College is also in the league, bringing degrees to students in less time with hands-on training and on the job internships. ASU has spent the last few years upgrading their campus, bringing it into the 21st century for every student’s needs and desires. It is one of the best schools to attend prior to dental or medical school, giving medical majors a head start on their long journey ahead. Programs include pre-dentistry, pre-medical, preoptometry, pre-pharmacy and much more. There are faculty members on campus dedicated to

See MEDICAL on Page 8 Adams State University nursing students Courtesy Photo

ASU Human Performance Lab offers fitness testing

ALAMOSA– The Adams Department (HPPE) continues will be located in the Human PerDr. Tracey Robinson, profesState University Human Perfor- to offer the community a variety formance Lab room 106, located sor of HPPE, and graduate asmance and Physical Education of affordable fitness tests. Testing in the East Campus Building. sistant Alex Jordan will conduct the tests from 5 p.m. until 7 p.m. every Thursday. Fitness testing appointments are mandatory. This is a great opportunity for families and individuals to develop a healthier lifestyle. The graduate students are more than willing to help identify current fitness levels and develop individualized fitness plans based on personal goals, needs, and physical limitations. Lifestyle modifications are not easy on your own, graduate students can give the personal drive you need. Fitness tests available include VO2 Max $50, Wingate anaerobic power test $10, FitnessAge $15, and body composition $10. The VO2 max test is an aeroCourtesy Photo bic endurance assessment of the Test your physical fitness at the Adams State University Human Performance and Physical Education Department Human Performance Lab. Pictured, graduate students test on the VO2 Max. See LAB on Page 8

Health on the Rio Grande 2016

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Emergency responders receive lift ticket training

MINERAL COUNTYâ&#x20AC;&#x201D; On Sept. 11, 17 members of Mineral County Search and Rescue, Rio Grande County Search and Rescue and Mineral County EMTs participated in lift ticket training offered by Flight For Life Colorado. Lift ticket training is required for emergency responders to be airlifted to remote locations to assist injured or stranded individuals, and the training must be updated annually. Participants were instructed in helicopter operations and landing zone safety. Flight For Life Colorado offers this training free of charge to attendees. Mineral County residents and visitors to the area are urged to get Search and Rescue cards which are available at the sheriffâ&#x20AC;&#x2122;s office. The cost of the cards ($3/year) goes into a statewide search and rescue fund which helps defray some of the costs incurred by the county in conducting search and rescue operations. Anyone with a hunting or fishing license or an OHV or snowmobile registration already pays into that fund and need not purchase an additional card.

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Above: Emergency responders from Mineral and Rio Grande counties line up in front of Lifeguard5 after completing their annual lift ticket training. Right: Terry Morgan, Mineral County Search and Rescue and EMT student, acts as landing zone ground command while Lifeguard5 lands at the airport.

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Health on the Rio Grande 2016

More Colorado teens getting vaccines COLORADO—More teens in Colorado are getting recommended vaccinations, according to the Centers for Disease Control and Prevention’s 2015 National Immunization Survey for Teens. The national survey of teens ages 13-17 found an increase in the percentage who had received the vaccines routinely recommended for 11- and 12-year-olds. The tetanus, diphtheria and pertussis (Tdap) vaccine had a 93 percent coverage rate, and significant improvements were made in coverage rates for the human papillomavirus (HPV), varicella (chickenpox) and meningococcal conjugate vaccines. In 2015: Nationally, for one dose of Tdap vaccine, coverage dropped slightly, to 86 percent. In Colorado, the Tdap rate increased three percentage points,to 93 percent. Nationally, for one dose of meningicoccal conjugate vaccine, coverage went up two percentage points to 81 percent. In Colorado, the rate increased nearly nine percentage points,to 86 percent. Nationally, for girls who received the recommended three doses of HPV vaccine, coverage increased about two percentage points, to 42 percent. In Colorado, the rate increased four percentage points, to 46 percent.

Nationally, for boys who received the recommended three doses of HPV vaccine, coverage increased more than six percentage points, to 28 percent. In Colorado, the rate increased more than 15 percentage points, to 37 percent. Nationally, for two doses of varicella vaccine, coverage went up two percentage points, to 83 percent. In Colorado, the rate increased eight percentage points, to 92 percent. Nationally and in Colorado, the two-dose coverage rate for measles, mumps and rubella (MMR) was unchanged at 91 percent and 92 percent, respectively. “We’re very proud of the progress we are making in protecting Colorado teens against vaccinepreventable diseases,” said Dr. Larry Wolk, executive director and chief medical officer at the Colorado Department of Public Health and Environment. “Thanks to all the health care providers who continue to strongly recommend vaccines when teens come in for checkups or sports physicals. “Even with these gains, many teens remain unnecessarily vulnerable to serious diseases, especially HPV,” Wolk said. HPV vaccinations are recommended for girls and boys to pro-

MEDICAL specific fields of study in order to help students in their desired fields to excel. Preparing for a future in any type of medical field is easy to do at ASU. The nursing program offered at ASU is extensive with hands-on training and two degrees offering the top education for professionalism. The college offers both BSN in Nursing and Registered Nursing programs with stateof-the-art training facilities and professional faculty to prepare nursing students for the current nursing field. Help with tuition

Continued from costs, grants and scholarships are available through the ASU Nursing programs. Trinidad State Junior College (TSJC) is one of the leading schools in the area offering premedical, pre-dental and other classes formed to fit the needs of their students. Programs also include options to become a nursing aide, home health care professional or long term care professional. Each class offers a diverse study in leading edge technology and trends in the nursing field. TSJC also offers

tect against cervical cancer, genital warts and other types of oral and anal cancers. Health care professionals should talk with parents about the importance of all kids getting HPV vaccinations starting at age 11 and 12, and recommend HPV vaccine on the same day and in the same way they recommend other preteen vaccines. Colorado has met federal

Healthy People 2020 goals for Tdap, meningicoccal conjugate vaccine and varicella coverage but not for HPV. HPV vaccine originally was licensed only for girls but has been available to boys since 2011. To learn more about Colorado immunizations, go to www.coloradoimmunizations.com or find us on Facebook and Twitter.

LAB

Continued from Page 6 maximum amount of oxygen a ments can determine body body is able to utilize during fat percentage as well as lean high intensity aerobic activ- mass; test time is approxiity. The lab also tests your mately 5 minutes. The FitnessAge test is a blood lactate levels to assess individual lactate thresholds, comprehensive assessment which are used to determine of muscular strength and proper training intensities for endurance, cardiorespiratory maximal benefit. Test time is endurance, flexibility, and body composition. Individual approximately 45 minutes. The Wingate power test is test results are compiled to an assessment of anaerobic give an overall fitness power. It consists of a 30 “age.” Test time is apsecond maximal effort on a proximately 20 minutes. To set up an appointcycle ergometer; test time apment, contact Robinson proximately 10 minutes. Body composition assess- at tlrobins@adams.edu or ment consists of skin fold 719-587-7663; or Jordan measurements from several a t a l e x j o r d a n @ a d a m s . sites on the body. Measure- edu.

Page 6 several financial aid opportunities for students who qualify. Both ASU and TSJC offer an extensive amount of programs in sports medicine, exercise science, health and recreation, as well as human performance and physical education. Classes introduce students to the field of study pertaining to how the human body works and what it is capable of. Courses also explore general health and fitness as well as educate students in the mental attributes of sports science. Whether wishing to begin a

career in the medical field or enhance the knowledge already acquired, both local schools are equipped to provide top programs to help any student succeed. Faculty members are trained in the most recent state requirements to provide excellent class settings. Small class sizes also provide individual attention needed to learn the chosen profession through one on one training. For more information or a list of programs available, visit www.trinidadstate.edu or www. adams.edu.

Health on the Rio Grande 2016

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Health on the Rio Grande 2016

SLV Behavioral Health, lending a helping hand ALAMOSA — Perhaps a family member has passed away, or a divorce is in progress. A loved one may be suffering from depression, PTSD, anxiety or anger issues. A child may be experiencing behavioral difficulties. Whatever the problem, help is only a phone call or keystroke away. According to San Luis Valley Behavioral Health Group (SLVBHG), one in four families is impacted by a mental illness such as depression and anxiety and these conditions require both intervention and prevention measures for quality family life. SLVBHG was formerly San Luis Valley Community Mental Health Center. Mental health professionals understand that in order to function spontaneously in the community, mental health assistance is needed to improve personal relationships, set and attain goals, and thrive in one’s work and family environment. SLVBHG can provide the assistance needed to make this happen. The group treats families and seniors, children, adolescents, veterans, the homeless and college students. They offer domestic violence and substance abuse services, also education and training on an outpatient basis. A 24-hour crisis hotline is available at 719-589-3671 or 844-493-TALK. Outpatient services listed at the website also address mental health, offender issues and domestic violence issues. The following is available for domestic violence issues: • Community education

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According to the National Institute of Mental Health, anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18 percent of the population. • Victim Advocacy services • Alternative to Violence Program — a 36-week certified, domestic violence treatment program which teaches anger management, positive communication skills and alternatives to violence. Anger management classes Sexual offender treatment program – Providing court ordered treatment for adolescents and adult sexual perpetrators Useful public service – Coordinates court-ordered community work assignments

Substance abuse services – programming and alliances.” Substance abuse treatment and On their website, the group classes for DUI/Probation. answers questions such as, • “How do I know if I need SLVBHG’s website reports, help? “During our organization’s his• “Is counseling confidentory we have built our system to tial?” ensure the survival and vitality • “How long does counselof mental health services in ing last?” the San Luis Valley. We have • “Do I have to take medicacontinued over the last 30 years tion?” to develop new programs and Other questions also are anservices to increase clinical swered for prospective patients. quality and improve service In addition, SLVBHG assists and efficiency. with living wills, power of attorney, and other end-of-life “We share skills and resourc- decisions. For more information, call es with other agencies in the San Luis Valley and the State 589-3671 or visit http://slvbhg. of Colorado to build stronger org/

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SLV AHEC welcomes new Community Health Worker

CONEJOS COUNTY — SLV AHEC welcomes Melanie Salazar, the new Community Health Worker for the Hearty Healthy Solutions Cardia Risk Assessment Program for Conejos County. She has been on the job for one month and is acquainting herself with the community. Melanie is a Valley native, growing up in New Mexico and returning to the San Luis Valley. Please welcome her as she reaches out to provide cardiac risk assessment screenings. To request free screening blood pressure, cholesterol, triglycerides and blood glucose for individuals or agencies, please call her at 274-6070. Her office is based out of Conejos County Hospital in La Jara. Join her at the Saturday, Oct. 15 health fair at the Guadalupe

Parish Hall from 8 a.m.–12 p.m. noon in Conejos for a free screening and program participation. A big thanks goes to Rodney Sandoval, CHW for Conejos County, for eight years of service to the Heart Healthy Solutions program. Rodney retired on Aug. 15. He was a steadfast employee who cared about the health of his community. He will continue to reside in Conejos County. The SLV Area Health Education in collaboration with the Colorado Prevention program has offered the Cardiac Risk Assessment Program for the past eight years in Conejos and Costilla counties. For information about screening in Costilla County call Lisa Casias at the Costilla County Health Department at 672-3448.

Melanie Salazar

State board lifts ban on diet soda in high schools COLORADO— The State Board of Education recently approved an effort to realign Colorado’s Healthy Beverages Policy with federal rules, a move that gives local school districts more control over what types of beverages can be sold at high schools. The revised Healthy Beverages Policy will continue to restrict the availability of unhealthy beverages during after-school activities for all grade levels, and it continues to prohibit the sale of beverages other than milk,

100 percent fruit and vegetable juices, and water at middle and elementary schools. In 2013, USDA released Smart Snacks in Schools, which are science-based nutrition standards for snack foods and beverages sold to children during the school day. Since then, Colorado districts have been required to adhere to 10 federal regulations and 11 state regulations for the sale of beverages. The state rules included more restrictive requirements and specifically prohibited diet soda

sales in high schools. “Districts said the complexity of following two different sets of rules created a regulatory burden and was a source of confusion,” said Board Chairman Steve Durham. “This change will streamline the rules, and at the same time put control over the issue where it belongs – in the hands of local school districts.” The board voted 4-3 to approve the revised policy, with members Pam Mazanec, Deborah Scheffel and Joyce Rankin voting for the revised rules along

with Durham. Vice Chairwoman Angelika Schroeder and members Jane Goff and Val Flores opposed the change. “Parents expect us to do what we can to protect kids,” Schroeder said. “I’m opposed to increasing access to beverages that we know are unhealthy and potentially harmful to growing children.” The new rules will go into effect on or before the 2017-2018 school year to allow districts some flexibility in implementation.

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Health on the Rio Grande 2016

TSJC Nursing Program receives accreditation

ALAMOSA – In April the Accreditation Commission for Education in Nursing (ACEN) announced initial accreditation for the Trinidad State Nursing Program for a five-year period. This signifies the high caliber of nursing education offered by Trinidad State in both Trinidad and Alamosa. ACEN accreditation proves a program supports its students at the highest level. “It’s making sure that you have met all the measures, that you’re teaching enough in biology and clinical calculations, that you have equipped labs, that you have adequate student engagement, and that the students are performing,” said Trinidad State Vice President of Academic Affairs Lynette Bates. “Basically, that whatever the students need, that we’re providing.” Nursing graduates must be certified by ENCLEX (National Council Licensure Examination), which is a nationwide nursing exam. ACEN accreditation requires a three-year average pass rate on the first attempt, which

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Trinidad State nursing students is equal to or above the national Hamilton said all of Trinidad average. Last year Trinidad State State’s nursing graduates over graduates passed on their first try the last three years obtained jobs 95 percent of the time, well above in the health care field, and this the national average. accreditation is a strong indicator Director of Nursing LoriRae of their skill set.

CDPHE releases recommendations to reduce premature births, deaths COLORADO — Premature birth is the leading cause of infant death in Colorado, accounting for 38 percent of infant deaths each year and contributing to lifelong problems in health and development among surviving “preemies.” Although Colorado infant death rates have been declining for 30 years, they remain three times higher among AfricanAmericans than whites, Hispanics or Asians. In mid-September the Colorado Department of Public Health and Environment and the March of Dimes released

“Recommendations to Reduce Preterm Births in Colorado,” prepared by a work group of public health experts, university researchers and health care providers from across Colorado. The publication, released in conjunction with September’s National Infant Mortality Awareness Month, provides 11 core recommendations for community groups, health care providers and policy makers. In alignment with national, evidence-based guidelines, the recommendations focus on: • Access to services.

• Preventive care. • Planned pregnancy. • Assisted reproductive technology. • Medical interventions. • Mental health promotion. • Avoidance of substance use, including tobacco. • Innovative uses of technology. “While we’ve made progress in reducing the health impacts of premature birth, there are still too many babies born too soon,” said Karen Trierweiler, deputy director of the Prevention Services Division at the See BIRTHS on Page 18

“There are quite a few hospitals in quite a few states that to get your license in that state or to work in that hospital they require that you graduate from a nationally accredited school,” said Hamilton. “We’ll definitely continue what we’re doing. It’s proof to the current students that what we are doing is working. They’re out there to take care of the patients but they’re also out there to advocate for our profession.” Trinidad State has about 80 students in its Registered Nurse program between its two campuses. The Trinidad Campus offers traditional class times, plus a nights and weekends program. Applications are currently being accepted for fall. Trinidad State has no waiting list, but uses a point system to determine which students are allowed into the program. Trinidad State also offers nurse aide training, medical assisting, and emergency medical services classes. For more information, call Kelly at 589-7077.

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Health on the Rio Grande 2016

Hospital tops state in patient safety STAFF REPORT

ALAMOSA — Staff at the San Luis Valley Health Regional Medical Center believe a hospital stay should not make a patient’s health worse. This attitude is reflected in the Alamosa hospital’s recent Centers for Medicare and Medicaid Services patient safety indicator rating, which was the best in the state. San Luis Valley Health’s score for the last year was 1.5 on a scale of 1 to 10. In this case, a low score is a good score, explained Chief Medical Officer Dr. Gregory McAuliffe, “like playing golf.” Hospitals in the 6.75-plus rating — which includes 13 of 45 acute care hospital in the state and 575 across the country— are financially penalized. (Smaller hospitals such as Rio Grande and Conejos were not included in the ratings.) See www.qualitynet.org “I am really happy we are here,” Dr. McAuliffe said. “I am very proud of our team,” added San Luis Valley Health CEO Konnie Martin. “I feel like we are very diligent about safety and about good quality care, and while we have always been good at this, to be recognized as great at it is a real compliment.” She said while there are errors in healthcare simply because “we are human beings taking care of human beings,” it is the staff’s goal to deliver the best care possible every day. Martin said the highest risk is in surgery and ICU, and the surgical team emphasizes carefulness and safety in the way it handles every patient. It doesn’t take much to drop in the ratings, McAuliffe cautioned. Director of Anesthesia Alan

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From left are Alan Taylor, CRNA; David Geiger, DO and AnnaRae Martinez, surgical services supervisor, who are vital to maintaining patient safety at SLV Health. Taylor agreed, saying, “We cannot sit on our laurels. This is a constant vigilance.” McAuliffe explained that the Centers for Medicare and Medicaid Services considers two categories or domains of hospital-acquired conditions in determining what kind of rating a medical facility will receive. One domain includes situations such as a pressure ulcer, blood clot, accidental puncture or fracture. The other domain encompasses infections that could occur while a patient is in the hospital, such as an infected surgical wound or catheter line. This data is not self-reported but is extracted data from claims, McAuliffe explained. The Centers for Medicare and Medicaid Services takes into account all of the incidents occurring in these categories or domains and through a weighted formula develops an

overall score for the medical facility. SLV Health Director of PR & Marketing Donna Wehe said an important component of the Affordable Care Act was patient care. “We want to make hospitals safer for patients,” she said. San Luis Valley Health has made improvements to ensure patients’ health while they are in the hospital’s care. For example, the hospital has upgraded equipment including endoscopy equipment, new surgical equipment and a new autoclave, which is used to sterilize equipment. “Each generation of equipment is so much more effective than the last generation of equipment,” Martin explained. She added that in being fiscally sound, the hospital is able to make investments in new and upgraded equipment and infrastructure.

The hospital has also streamlined its process for implementing a checklist for staff to follow to ensure patient safety and has reminded staff and support staff what to look out for in situations such as post-operative recovery. “We are talking about safety all the time in all circumstances,” McAuliffe said. “It’s awareness.” He added, “The most important thing we do is keep our patients safe. There’s nothing more important than that.” As important as it is, it can involve such simple acts as hand washing and sterilization or pointing out to a surgeon if he or she inadvertently touches a non-sterile surface in the operating room and should put on new gloves. “Learn from mistakes, learn from others, not in a punitive but in an educational way,” McAuliffe said.

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CHA Drug Diversion Summit educates health leaders

SAN LUIS VALLEY—On Friday, Aug. 19, the Colorado Hospital Association hosted a Drug Diversion Summit which was attended by SLV Health’s Chief Medical Officer Dr. Greg McAuliffe, Human Resources Director Mandy Crocket, Conejos County Hospital Administrator Kelly Gallegos and Nursing Director Shannon Muniz. The summit hosted roundtable discussions and the sharing of best practices which focused on hiring and safe medication practices for hospitals. “Drug diversion can happen anywhere,” commented McAuliffe, “and at SLV Health, we want to create awareness, provide education to our staff and the public, as well as implement best practices to do our best to prevent this or catch this if and when it would happen in our facility.” Drug Diversion is loosely defined as the situation that can happen when a staff member steals or uses drugs for an

inappropriate purpose other than patient care. The media has highlighted a recent case at Swedish Medical Center where a nurse admitted doing this for his own benefit. “The cost is high when this happens,” commented Shannon Muniz, “because it potentially could put our patients at risk. Attending this summit helped educate me on possible ways staff could be diverting. This increased awareness not only benefits me, but the whole team at SLV Health. Unfortunately, while staff who are not diverting are busily taking care of patients, it could occur with other staff who are creatively finding ways to do this.” Crockett spoke about how employees might not be aware that this is an offense that has to be shared when they are seeking employment elsewhere. Also, former employers of employees who violate these policies are typically resistant to sharing that information with other po-

Did you know? Despite the ongoing efforts to study cancer and cancer treatments, in many ways the disease remains a mystery to researchers and medical professionals alike. According to data published by the research-based healthcare company Roche, for reasons that are not entirely understood, breast cancer is more common in the left breast than the right. The left breast is 5 to10 percent more likely to develop cancer than the right breast. The left side of the body is also 10 percent more vulnerable to the skin cancer melanoma than the right side of the body. AC169426

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tential employers, even though State law protects them to do so. “Sharing this offense on an employee record is mandatory. But, knowing that there are some individuals who won’t be truthful about their conduct, hospitals must work together, report and communicate when called upon as a reference,” commented Crockett. “We wouldn’t want to hire someone where this has become habitual in their nature, so why would any employer not be willing to warn the future employer of this breech?” Gallegos added, “Now I feel better prepared and more confi-

dent to quickly use the resources to press charges and open an investigation if/when a drug diversion is suspected. After attending this summit, I feel like we have more tools in our toolbox and are more prepared to take immediate action.” Presenting at the summit were agencies such as the Colorado Department of Public Health & Environment, the Colorado Department of Regulatory Agencies, the Denver Police Department, the U.S. Drug Enforcement Agency as well as the U.S. Food and Drug Administration.

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Health on the Rio Grande 2016

What exactly is cancer? Cancer can affect anyone. Sometimes it strikes with no warning, while other times people may have a genetic predisposition. Various medical organizations say there are between 100 and 200 different types of cancer. Everyone has heard of cancer, but some are still unsure of what cancer is. Defining cancer The organization Cancer Research UK defines cancer as abnormal cell growth. Cancer cells are cells that divide in an uncontrolled way. New human cells normally grow and divide to form new cells as the body requires them. As healthy cells grow old or become damaged, they die off and new cells take their place. However, when cancer develops, this process goes haywire. Damaged cells become even more abnormal and can survive when they would normally die. These cells keep multiplying and eventually can form lumps or masses of tissue called tumors. This is the case in most cancers, with the exception of leukemia, wherein cancer prohibits normal blood function due to abnormal cell division in the bloodstream. Not all lumps in the body are tumors. Lumps that remain in place and do not spread to other areas of the body can be harmless or benign. According to the American Cancer Society, cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. Cancer stages actually are determined based by how far cancerous cells have spread beyond their point of origin.

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to particular criteria based on each individual type of cancer. Generally speaking, lower stages of cancer, such as stage 1 or 2, refer to cancers that have not spread very far. Higher stages of cancer, such as 3, mean cancer has branched out more. Stage 4 refers to cancer that has spread considerably.

Common forms of cancer Cancer can occur just about anywhere in the body. Cancers of the breast, lung, colon, and prostate cancers affect males and females in high numbers. Classifying cancer involves understanding where the cancer originated. Cancer Treatment Centers of America offers these classifications: • Carcinomas begin in the skin or tissues that line the internal organs. • Sarcomas develop in the Cancer stages Cancer is staged according bone, cartilage, fat, muscle or

other connective tissues. • Leukemia begins in the blood and bone marrow. • Lymphomas start in the immune system. • Central nervous system cancers develop in the brain and spinal cord. Cancer is treated in various ways and depends on the cancer’s stage, type and effects on the body. A person’s age as well as his or her current health status also may play a role in treatment decisions made by both the patient and his or her medical team. Surgery may be conducted to remove a tumor, while chemotherapy employs chemicals to kill cancerous cells. Radiation therapy, which uses X-rays to direct radiation toward cancerous cells, is another potential cancer treatment. The side effects of each treatment vary, and there are ways to mitigate these effects.

Why does cancer occur? Cancer develops for various reasons — some of which may not be fully understood. The National Cancer Institute states genetic changes that cause cancer can be inherited from a person’s parents. Cancers can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA that results from certain environmental exposures. Cancer-causing substances include the chemicals in tobacco smoke. Ultraviolet rays from the sun also have been linked to cancer. Learning more about cancer can help people reduce their risk for developing this potentially deadly disease. Individuals should always speak with their physicians if they have specific questions about cancer. AC169349

Health on the Rio Grande 2016

VWHS

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Continued from Page 4

VWHS’ pharmacists are honored for the ease of access for patients. as evidenced by the availability of Narcan/Naloxone through the pharmacy and how it has saved lives. VWHS pharmacists make it available, even after the grant providing Narcan/Naloxone supplies and training has run out. VWHS pharmacists provide low cost prescriptions for underserved patients, anticoagulation services diabetes self-management classes. Also offered with pride by VWHS, the Nurse-Family Partnership (NFP) is a nationwide, free, voluntary program for low-income, first-time mothers and falls under ValleyWide’s umbrella of services in the San Luis Valley. Nurse home visitors offer program services to mothers and their children throughout all six counties of the San Luis Valley and serve clients who are currently seeing San Luis Valley providers. Program services begin in pregnancy and continue until the child’s second

birthday. NFP is evidence-based and provides mothers and their families with important education by nurse home visitors. The program affects pregnancy outcomes by helping women improve behavior related to substance use, nutrition and prenatal care; to improve child health and development by promoting parent’s responsible and competent care of children; to improve parent’s life course by promoting prevention of subsequent unintended pregnancy, completion of education, finding employment and strengthening support systems. Each community member is encouraged to actively participate in health care decisions, formulate care plans and determine individual health care goals. Care coordination includes the management of patient care services between the patient and their care team to help support the delivery of health care services at the right time and in the right order.

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VWHS also is committed to providing confidential family planning services, taking the time to listen, answer questions and address individual needs. All information is strictly confidential. A care team will discuss individual needs and concerns in a private setting and help decide what will work best for the individual. Family planning allows individuals and couples to plan, anticipate and attain their desired number of children, including no children, as well as the spacing and timing of their births. It is achieved through use of contraceptive methods and/or the treatment of involuntary infertility. Valley-Wide also offers quality obstetric (OB) care. The practice of family medicine is based on knowledge of

the patient in the context of the patient’s family and the community. Family medicine emphasizes disease prevention and health promotion. Beginning in August, VWHS’ Women, Infants and Children (WIC) program began to spread the year-long message, “Breastfeeding Does a World of Good,” with an annual celebration Aug. 31 for breastfeeding mothers and the public at Alamosa’s Cole Park. Local partner agencies including Nurse Family Partnership Program, Early Childhood Council, Bright by Three, La Llave’s Safe Care, SLV Women’s Resource Center and Alamosa County Public Health’s Baby and Me Tobacco Free shared program information. For more information on VWHS, visit vwhs.org

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Photo by Chelsea McNerney-Martinez

Monte Vista Estates is one of only two nursing home facilities in the Valley with a five-star rating.

Monte Vista Estates receives five-star rating STAFF REPORT

MONTE VISTA—Quality of life is important when people near the end of their lives. Monte Vista Estates, a nursing and rehabilitation facility, is glad to receive a five-star rating from the Centers for Medicare and Medicaid Services to prove that they care about their residents. “You come to a nursing home to live and to be nurtured,” said Social Services Director Donna Segura. There are three different aspects that go into determining the overall five-star rating. Health inspection data is gath-

The 60-bed facility has a dedicated ward for those suffering from dementia or Alzheimer’s. Doctor Mugabe Walker is the medical director for Monte Vista Estates and meets with the management team monthly to inspect the facility. Finally, 11 different physical and clinical measures are studied. This tells how well the homes are caring for their residents and the information is gathered from the residents themselves. “We don’t want residents in their rooms all day long,” said Segura. “We want them

out and engaging with the environment. So we have a lot of activities and we also want a homelike atmosphere for them.” According to the Centers for Medicare and Medicaid Services, more than 12 million assessments of the conditions of nursing home residents are used in the rating system. Only one other nursing home facility in the Valley has a fivestar rating, the Veterans Center. “I say to myself, ‘How would I want to live?’ and that’s how I treat our residents,” Segura said.

Continued from Page 12 solutions to preterm birth are policymakers, advocates, public complex, the guidelines high- health professionals and other light strategies that can be community service and support employed, ideally in coordina- programs. About 25,000 infants die each tion, by all who have a role in reducing preterm birth: pregnant year nationwide, leaving the United women, health care providers, States with one of the worst infant

mortality rates in the world, ranking 131st among 184 countries. Colorado averages 400 infant deaths per year. Reducing premature births would significantly reduce the number of infant deaths in Colorado and nationwide.

ered from the three most recent years, with the most recent results having a heavier weight. More than 180,000 reviews are analyzed nationally. Staffing is the second factor in compiling the score. This tracks to see if there are specialized nurses to handle residents’ specific needs and how many hours a day they’re available. “It’s important to get to know our residents and see if their needs are being met. We know transition can be hard so we’re always making sure they get what they need and deserve,” Segura said.

BIRTHS Colorado Department of Public Health and Environment. “We need to recognize the causes of premature birth and work together to give all babies a healthier start in Colorado.” Because the causes of and

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Health on the Rio Grande 2016

Medication mismanagement can be prevented Medication management is an important issue for seniors and their families. Failure to properly manage medications can threaten the lives of seniors, highlighting the emphasis families must place on ensuring seniors take their medications in strict adherence to their physicians’ instructions. Polypharmacy, or the taking of multiple medications for different conditions, can be a potential health hazard for the thousands of seniors who must manage health conditions with prescription drugs. Harmful drug interactions are a result of the confusion that can arise when seniors take multiple medications at the same time. The American Society of Health-System Pharmacists estimates that more than 34 percent of senior citizens are prescribed medications by more than one physician, and 72 percent use medications they were prescribed more than six months prior. Many people also have begun “pharmacy shopping” to save money. According to a study published in 2010 in American Nurse Today, 44 percent of men and 57 percent of women older than age 65 take five or more

medications per week, with some taking as many as 10. Medication confusion is one risk, but older adults also metabolize medications differently than young people. As a result, they may be more susceptible to overdose or other ill effects. Families looking to help seniors effectively manage their medications should consider the following tips. • Keep a running list of medications. Maintain a list of all medications being taken, noting both prescription and over-thecounter medications and any supplements and herbs. Provide a copy to any new doctors you visit and any new pharmacies you patronize. • Use pill sorters. Medication sorters can keep medications organized and eliminate some of the personal error in medication management. Organizers have daily slots and may also differentiate between nighttime and daytime medications. • Understand why each medication is being prescribed. Ask your pharmacist and doctor to explain why each medication is prescribed. This information

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should be printed on the prescription label. Some drugs designed for one symptom may actually be used to treat other issues as well. • Ask for help. Some seniors may benefit from friendly reminders from a loved one regarding when to take certain medications, especially if they need to take multiple doses throughout the day. Cognitively impaired seniors may require the services of a visiting nurse or another caregiver. • Recognize that not all medications are right for seniors. The American Geriatrics Society

maintains a list of medications that older adults should avoid or take with extreme caution. Some drugs pose a high risk of side effects or interactions, while others are less effective. Discuss alternatives with your physician if you are prescribed one of these medications. • Keep a medication diary. Record any side effects that occur and how the medications make you feel. Always bring up issues promptly with a doctor. Proper medication management can help seniors avoid drug-related accidents or worse. LS168314

Foods can help reduce the risk of cancer

Cancer affects millions of people across the globe each year. While those diagnosed with cancer face the biggest challenges, cancer patients’ friends and families also must deal with the consequences of a cancer diagnosis and the heartbreak that often accompanies seeing a loved one undergo cancer treatments. Strong support systems can help cancer patients during their treatments, but men and women need not wait until a loved one has been diagnosed with cancer to begin fighting the disease. Taking steps to prevent cancer may be easier when tackled together as a family or a group of friends. According the University of Texas MD

Anderson Cancer Center, one of • Peas (fresh or frozen) the world’s leading centers devoted • Red or purple grapes (preferGrains to cancer patient care, research, ably organic, if imported) • Lentils education and prevention, many • Tomatoes (no salt added if • Regular or instant wild rice or foods can help men, women and buying canned tomatoes) brown rice children reduce their cancer risk. • Whole grain pasta When shopping for household Protein groceries, families and groups of • Lean chicken or turkey Bread friends living together can aim to • Lean fish, including salmon, • Whole grain bread, tortillas make the following cancer-fighting halibut, redfish or red snapper or buns foods part of their daily diets. • Low-sodium black, red or pinto beans Condiments Produce • Low-sodium garbanzo beans • Canola oil • Broccoli • Tofu • Low-fat or fat-free salad • Cauliflower dressing • Brussel sprouts Dairy • Olive oil • Oranges • Eggs or egg substitutes • Organic spinach • Low-fat cheese Spices • Organic kale or collard greens • Turmeric AC169366 • Skim, or fat-free, milk

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Emergency responders need support, too

Emergency responders, which includes the police, firefighters and paramedics who are the first to arrive at the scene of an incident, are in the business of protecting others and helping to save lives. These workers are on call during natural disasters, technological failures, terrorist attacks, and many other potentially traumatic events. Emergency responders are the unsung heroes of many communities that they work hard to keep safe and secure. While emergency responders are heroes, it’s important that people know these brave men and women sometimes need assistance, too. The pressure and stress associated with being an emergency responder can sometimes be overwhelming, and it’s times like that when emergency responders need help. Comprehensive statistics on stress-related medical conditions among first responders are difficult to tabulate because many incidents go unreported or unshared. However, pressures of the job and post traumatic stress disorder, or PTSD, can take its toll on paramedics and law officials. EMS World reports that, between January and September of 2014, the United States had around 58 documented fire/ EMS suicides. In Canada, 25 first responders were known to have committed suicide in a five-month period in 2014. Addressing the stress of being an emergency responder can help responders and their families better

cope with the pressure and stress of the job. The National Institute for Occupational Safety and Health recommends that all workers involved in first-responder activities should help themselves and others to reduce the risk of stress-related psychological and physical health effects from their jobs. Certain symptoms and behaviors may present themselves when emergency responders are having difficulty coping with the demands of the job. These symptoms may include: • Changes in sleeping patterns • Passive or fatalistic behavior • Frequent conflict and argumentative behavior • Limiting social networks and general withdrawal • Poor problem-solving abilities • Poor concentration • Inability to rest • Self-medicating with alcohol While there is no single method to cope with the physical and psychological demands of a first reponder’s job, a combination of therapies can help. The Centers for Disease Control and Prevention advises that responders need to take care of their own health to maintain the constant vigilance they need for their own safety. These steps can put workers on the right track. • Form a support network in which each responder looks out for one another. Knowing support is available can be a big help. • Take frequent breaks to clear the mind and rest the body. Try to

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take breaks away from a work area. •Accept what cannot be changed, such as chain of command or long hours. • Take advantage of mental health support services when they are made available. Recognize that it is not indicative of weakness to discuss difficult emotions. • Maintain a healthy eating pat-

tern and try to get adequate sleep. • Exercise, which can reduce feelings of stress and be a healthy way to clear the mind and strengthen the body. Recognizing that emergency responders are not invincible and may need some emotional support can be the first step in getting these workers the help they need and deserve.

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Health on the Rio Grande 2016

River Valley Inn coming to Del Norte Ground was broken at the future location of River Valley Inn nursing home on Saturday, April 30. Marty Asplin, Kelly Kitchen, Mike Hurst, Bonnie Asplin, Joyce Humiston and Bernadette Martinez used a special small golden shovel to turn the dirt. Community leaders are excited for the new building which will replace the one lost in 2013 and help to generate an estimated $485,400 in earnings in different economic sectors and create around 70 new jobs. Photo by Anthony Guerrero

Colorado adults remain leanest in the nation

COLORADO—Colorado remained the leanest state in the nation in 2015, with a 20.2 percent adult obesity rate, according to the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Colorado’s obesity rate increased dramatically from 2000 through 2010 but since then has leveled off. Nevertheless, one in five Colorado adults is obese, and obesity rates are higher for AfricanAmerican (27.7 percent) and Hispanic (28.3 percent) Coloradans. “Our efforts seem to be contributing to a growing awareness across Colorado of the health costs of obesity and the benefits of a healthy lifestyle,” said Joan Brucha, manager of the health department’s Healthy Eating Active Living Unit. “But we can see there’s clearly more work to be done to make Colorado the healthiest state in the nation.” Obesity is a complex prob-

lem, with many causes and consequences. Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer— some of the leading causes of preventable death. Colorado is the secondfastest growing state in the nation, according to new Census Bureau data, attracting people drawn to its outdoor opportunities, abundant sunshine and active lifestyle. Coloradans rank first in physical activity according to United Health Foundation’s annual health rankings. But it has experienced the same growth in the prevalence of obesity as other states in the nation. Gov. Hickenlooper’s 2013 State of Health Report named statewide obesity prevention and reduction a priority, as he called for making Colorado the healthiest state in the nation. The Colorado Department of Public Health and Environment and local public health agencies also have prioritized

obesity reduction. While obesity is a complex, serious and costly public health problem, state and local health agencies are making progress implementing proven strategies across multiple settings and sectors to reduce obesity, including: • Breastfeeding: We encourage exclusive breastfeeding for the first six months, work with employers to accommodate lactating moms, and work with hospitals to be certified as “baby friendly” by supporting breastfeeding initiation. • Built environment: We work with local communities to shape land use and transportation planning, policies and practices to increase physical activity. • Colorado Healthy Hospital Compact: We work with 17 hospitals statewide to improve the nutrition of food and beverages offered to to patients, families, visitors and staff and are recruiting more hospitals to join.

• Early Childhood Obesity Prevention: We provide obesity prevention resources and tools for child care, primary care and public health providers throughout Colorado. • Healthy food environments: We work with the food industry to increase the availability of healthier food in retail stores, corner stores and small grocery stores, and promote food service guidelines and nutrition standards in hospitals, schools and state agencies. • Worksite Wellness: We provide guidance to employers implementing comprehensive worksite wellness programs. • Healthy schools: We work with schools and other local partners to ensure young people have access to healthy eating and physical activity. • Health Disparities Grant Program: We fund local public health and nonprofit agency efforts to prevent obesity and chronic disease in low-income, racially diverse communities.

Health on the Rio Grande 2016

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