Q & A with candidates for the West Custer County Hospital District Election on May 6

May 6, 2025 is the date for the West Custer County Hospital District Board elections. This year, there are six candidates running for four Board positions. The Tribune submitted questions to all the candidates in order to give them a chance to introduce themselves to Custer County voters. Five out of the six candidates submitted their answers, printed below in the order in which they were received. A sixth candidate, Clifford Brown, had not answered as of press time.

Wet Mountain Tribune: Tell us a bit about your qualifications and background. Why are you interested in running for the Hospital Board?

Cindy Alvarado (incumbent): I currently serve as Treasurer on the WCCHD Board. With over 35 years of accounting and finance experience, including managing the accounting department of a community resource non-profit for nine years, I am uniquely qualified to serve in this position on the Board. My expertise ensures fiscal responsibility and transparency, critical for managing taxpayer funds and supporting quality healthcare. Since moving to Westcliffe in 2021, I’ve been deeply engaged in our community, co-owning Thrifty Cliffe in downtown Westcliffe with my Mom and volunteering at Sangre De Cristo Fellowship. I’m running for re-election to continue leveraging my financial acumen to strengthen the hospital district’s operations and advance healthcare services through the Clinic and EMS.

Ron Terry (incumbent): I have lived in Westcliffe with my wife and six dogs for the past 12 years. My medical background includes 25 years as a Wilderness First Responder and 5 years as a Custer County EMT. I have served in an appointive position on the CC Clinic Board for the past year and enjoy sharing my medical and managerial experiences with this group.

Shanna McKellip: I have over two decades of experience in healthcare, with the last twelve years dedicated to data and analytics in healthcare quality, patient safety, and regulatory compliance. I’ve had the privilege of working in esteemed healthcare systems like the Mayo Clinic, SSM Health, and CommonSpirit. Additionally, I’m a former EMT, which has given me a deep appreciation and understanding of emergency medical services. I hold a Master’s degree in Business Intelligence and Data Analytics and am currently pursuing my Doctorate of Science in Integrative Medicine.

Why am I a good candidate? I’m deeply passionate about this community and its values. I want to be a voice for the residents of Custer County and ensure that the needs of all our community members are heard. My passion for health and wellness drives me to continue supporting our current hospital and EMS services while also encouraging the vision for future growth and partnerships.

James Gilbert: I decided to run for the WCCHD Board because I believe that excellent health care is the right of all, regardless if you live in a rural region or not. Rural areas have issues providing that care, and I believe I can help with that. I observed my father put in place a network of RHCs associated with a larger medical center. This is the model Heart of the Rockies has decided to pursue, with our clinic as the first installment.

My background as a scientist in infectious disease diagnostics and therapeutics provides my technical understanding to be effective. My Departmental and Business Unit management gave me the fiscal responsibility training to manage the District money. Additionally, my role in joint venture management with corporate partners prepared me to be a benefit to the Heart of the Rockies relationship. While my background is industrial (Biotechnology and Biopharmaceuticals) I am confident that I can meet the challenge of serving the district taxpayers.

Tom Shepard: I served on the board from 2019-2024. We expanded EMS services from scheduled on-call EMT-B (Basic) teams with EMT-P ALS (Paramedic Advanced Life Support), as needed and available, to 24-7 EMT and Paramedic teams staffed and domiciled at the ambulance barn, ready to go. We also contracted with Heart of the Rockies Regional Medical Center (Salida), their multi-specialty medical teams and services, and their established primary care clinics in Salida, Buena Vista, and Saguache. I was licensed for forty years in active practice as a physician assistant in hospital ER and urgent care. I kept my license for another 10 years while volunteering with MRC. I’m no longer licensed, and I’m no longer current in the field.

I did administrative work as medical director for AMAX/Henderson Mine and Mill and clinical/medical director for the Colorado Compensation Insurance Authority (State Fund), then Pinnacol Assurance. I worked for some years with the Colorado Department of Labor, Division of Workers Compensation developing Medical Treatment Guidelines for numerous work-related injuries and illnesses. I also served as medical advisor to the Evergreen Ambulance Service and Fire Rescue Teams.

Tribune: Do you use patient services at Heart of the Rockies Regional Medical Center and/or the Custer County Medical Clinic? If not, why not?

Alvarado: As a resident of Custer County, I value the services provided by the Custer County Health Center, and have utilized its primary care and pharmacy services. My family and I appreciate the convenience and quality of care offered locally, which supports our commitment to small-town life.

Terry: I am a Vietnam veteran and utilize the VA for my medical services.

McKellip: I do use patient services at Heart of the Rockies Regional Medical Center and the Custer County Medical Clinic.

Gilbert: I use the Custer County Medical Clinic (now known as the Salida Hospital District Rural Health Clinic) for my primary care. Should the need for a specialist arise, I seek out that care based on referrals, medical reputation, insurance (I am using Medicare) and location. Our EMS will be critical in a bona fide emergency, but trauma requiring stitches can be dealt with at the Clinic or a nearby emergency room.

Shepard: Yes. I am a patient of Dr. Marc Stephens, and my wife Dee is a patient of Dr. Amy Beauprez.

Tribune: What clinic services do you think could be added or improved?

Alvarado: To better serve our community, I believe the Custer County Health Center could expand access to specialized services, such as regular geriatric care consultations and enhanced telehealth options for elderly patients with mobility challenges. Improving outreach and education about our existing services, like HRRMC’s Women’s Wellness Connection program, could increase utilization among eligible residents. Additionally, continuing to invest in updated equipment and facilities would enhance operational efficiency and patient satisfaction.

Terry: One of my focus is to work in coordination with Heart of the Rockies Medical Center in bringing an Urgent Care facility to the Valley.

McKellip: I’ve noticed the high demand and utilization of physical therapy services in our community. This is a highly sought-after service here, and expanding it would be fantastic to ensure that our community members don’t have to drive to Cañon, Pueblo, or Salida to access these services.

Additionally, I feel the community would greatly benefit from the availability of urgent care services on weekends.

Gilbert: Current services that I use have been excellent. I would need to canvass the patients of the community to determine what real needs remain. Then, I would work diligently to convince the Heart of the Rockies that the addition makes clinical and financial sense. From a WCCHD perspective, I see an opportunity to attract a home and hospice care business to the community. I fully plan to live out the rest of my days here in this magnificent Valley. There are hurdles to establishing a business to provide this care. Creative thinking and action by the WCCHD Board can remove impediments for that business model.

Shepard: I know many residents and visitors believe we should offer urgent care services 24/7. The challenges are hugely different from when we did this in Evergreen in the ‘70s. The statutory requirements and costs are daunting. I believe we need to continue to explore the options and document our findings with respect.

Tribune: Custer County has, demographically speaking, one of the highest concentrations of elderly residents in the country. The Hospital Board is currently working with an advisory group to better plan services for this population. How much do you know about what the Long-Range Advisory Committee is currently working on, and what would you suggest as service areas?

Alvarado: As a Custer County resident with an aging mother, I am deeply committed to the Long-Range Advisory Committee’s efforts to address the healthcare needs of our elderly population. Located in one of Colorado’s oldest counties, our rural community faces unique challenges in serving seniors. I am proud that, during my tenure on the WCCHD Board since April 2024, the Long-Range Advisory Committee has conducted a community survey, developed a comprehensive long-range plan based on its findings, and engaged a consultant to guide implementation. I will continue to advocate for prioritizing service areas such as in-home care support, expanded rehabilitation programs, and chronic disease management tailored to seniors.

Terry: I chair this committee along with other dedicated volunteers. Although there are some exceptions, primary concerns still remain “transportation and housing for our seniors.” Another group, The Consortium on Aging, representing several local entities, has devoted innumerable hours to consolidating and publishing resources for seniors. This group meets monthly and continues to work on behalf of our aging population.

McKellip: Attending the Hospital Board meetings over the past 1.5 years has provided me with valuable insights into the Long-Range Advisory Committee’s goals. I firmly believe that their purpose and mission are of utmost importance to our community and that providing essential services to our aging population is a top priority. In-home healthcare has emerged as a much-needed service in our area. However, I have also heard of several challenges that hinder its implementation and success. My goal is to assist in finding solutions that bridge these gaps and enable our community members to receive care in their own homes rather than being confined to long-term nursing facilities.

Gilbert: The WCCHD is working with a consultant to examine Elder Care Services in Custer County. This includes gap analysis, draft implementation plan and draft fund development plan. I was pleased to see that the Board is addressing the services I identified above. The key to success of this effort is identifying creative funding and implementation, and then standing behind completion of the service addition. In short, the WCCHD Board can pave the way for establishment of hospice and home health care for the elderly as a for- profit or non-profit business. I look forward to driving this effort.

Shepard: I am somewhat aware of some of the work being done by Dr. Alma Golden and her committee. I am interested in knowing a great deal more.

In the 70’s (I think) Walt Kelly, in his comic strip POGO, wrote “We Have Met the Enemy and HE IS US.” I’m 76 and I feel every day what those words might be applied to.

Tribune: What threats or challenges do you see ahead for the Hospital District as a result of federal government cuts to health spending?

Alvarado: Federal reductions in Medicare and Medicaid funding could pose significant challenges for the WCCHD, particularly given our elderly demographic’s reliance on these programs, which impacts reimbursements for services. These cuts could strain the district’s annual subsidy for the Custer County Medical Clinic. As Treasurer, I would advocate for diversified funding sources, such as grants and community partnerships to support our EMS, and collaborate with HRRMC to optimize operational efficiencies, ensuring sustained delivery of quality care despite fiscal constraints.

Terry: I cannot speak to the ways and means of the Federal government and the impact of proposed cuts to rural county health initiatives.

McKellip: Cuts to federal healthcare spending could have significant impact on rural hospitals and those receiving benefits through Medicare and Medicaid. It’s important to proactively assess how much of an impact these potential cuts could have on our Hospital district and its services to determine how we can continue to provide exceptional care to our community in the event these cuts come to fruition.

Gilbert: Much of the clinic revenue depends upon Medicaid and Medicare insurance coverage. If the SHDRHC should become insolvent due to cuts in these programs then the Heart of the Rockies can sever their relationship with the WCCHD. Ours is not the only clinic facing this threat. The challenge to the WCCHD then becomes do we keep our rural health clinic, and if so, how?

Shepard: I think it’s too soon to predict those challenges, but I think the funding we receive through grants is especially threatened.

Tribune: What other challenges do you see facing the clinic and EMS, and what would be your plans to address them?

Alvarado: Due to the rural nature of our community and the rising cost of housing, attracting skilled medical professionals remains a significant challenge for the Custer County Health Center and EMS. I commend the WCCHD Board’s recent efforts to increase compensation for EMS staff, which have successfully drawn high-quality paramedics and EMTs. As Treasurer, I will continue to support this strategy, advocating for competitive salaries and strategic budget allocation to ensure EMS maintains exceptional staffing levels to deliver quality healthcare.

Terry: Staffing is always a key concern for CC EMS along with “second” call coverage to outlying areas of the county. I also want to explore how the CC Clinic might better advertise its existing services. There seems to be a considerable gap between what the average citizen understands about the availability of general medical and specialized services provided by their local clinic.

McKellip: We are experiencing rapid growth and are witnessing a significant surge in the utilization of emergency medical services. On multiple occasions each month, EMS is dispatched to multiple incidents simultaneously. Consequently, we have reached a critical juncture where we must expand the number of crews on duty to meet the escalating demand.

Gilbert: As a rural county, the healthcare challenges that will arise are in large part driven by demographic changes or natural forces. These changes must be recognized as happening early on in order for a responsible Board to take timely and effective action or to assist other entities (Public Health for example). Close collaboration with our Heart of the Rockies, Public Health Agencies and Emergency Management allies assures the best efforts to meet these changes.

Shepard: One big threat that is already looming is access to preventive care. Vaccinations are a key part of children’s health. How do we keep children safe across the socioeconomic spectrum? If we can’t get federal funding, can we be assured of state funding? In Florida? In Texas? Where do most of our out-of-state visitors come from?

Are those of us who got childhood vaccines 70+ years ago still immune? What happens to our community pool, the rest of our health center? We had herd immunity to most of the community-acquired diseases that threaten kids and, by extension, all of us. Are the most vulnerable among us, immune-compromised like cancer survivors, or seniors, in trouble? Are sexually active kids and adults screwed? (No, that’s a medical term.) Will states step in? Will taxpayers let them?

Will drug companies lower costs? Will insurance companies step in? Will anyone be able to afford it if they don’t? Be afraid. I know I am.

Tribune: Anything else you would like to add?

Alvarado: My dedication to Custer County is both professional and personal. Since assuming the role of Treasurer in April 2024, I have championed fiscal transparency and supported the hospital district’s mission. With my extensive financial expertise and deep community ties—through volunteering, co-owning a local business, and raising a family here—I am committed to advancing the WCCHD’s vision for compassionate, high-quality healthcare, particularly for our elderly residents. I respectfully request your vote to continue this critical work.

McKellip: I eagerly anticipate the opportunity to serve our community and collaborate with the various committees within it to enhance our overall well-being.

Gilbert: No, I think I’m good.

Shepard: Much of the clinic’s (CCHC) and ambulance service’s (CCEMS) extraordinary growth is attributable to the leadership of WCHD president Bob Tobin, Barry Keene, Justine Beach EMT-P, Steph Geibieg EMT-P, Jeremy DeWall, MD, FAEMS, NREMT-P and Bob Morasco CEO HRRMC.

I hope I still have your trust to serve as a board member. Members of Custer County Ambulance are among the most caring, dedicated and finest practitioners of prehospital medicine I’ve been privileged to know.

– Elliot Jackson