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Local Health Initiatives


Telluride A "Heartsafe Community" news

Telluride's Heartsafe (location of AED's) map

Mountain Village's Heartsafe (location of AED's) map


Introduction and Programs

The Local Health Initiative was established by an initial three year grant by the Colorado Health Foundation in the spring of 2006 (summary background see Appendix A). A regional Health Care Needs Assessment was commissioned from the Joffit Group, which was delivered in December 2006. A group of regional healthcare providers and knowledgeable local citizens assisted with the data gathering and final recommendations of the assessment.

Following the completion of the healthcare assessment, a regional advisory group, called the San Juan Health Council (SJHC), of providers and healthcare experts was established to advise the programs and priorities of the Local Health Initiative (LHI) (see list of members Appendix C). A medical director, Michael Kappy, MD and administrator, Gary Steinbach, were recruited and hired to direct LHI program development and implementation (staff resumes Appendix B).

Based on an internal evaluation of the results of the healthcare assessment, the medical director, administration and Telluride Foundation developed a list of goals, programs and priorities to launch the LHI. The SJHC met in February 2007 to provide input on the list. The consensus recommendations focused on the following goals for the LHI:

1) Identifying and establishing programs that increase access to healthcare services.

2) Identifying and establishing preventive healthcare services.

3) Identifying and establishing programs that increase knowledge and awareness of existing healthcare services and providers in the region.

The specific initial programs included the following:

1) Healthcare Services Directory

2) Medical Shuttle Service including a healthcare navigator

3) Tobacco Education and Prevention Program

4) CPR/Public AED program and training

5) Latino Preventive Healthcare Fund

6) San Juan Kids Cavity Prevention Program

7) Entitlement Enrollment Program

The LHI staff members identified regional organizations to establish strategic partnerships which would enable LHI to implement a quality and cost effective preventive healthcare delivery system for the selected programs. Multiple organizational partnerships that include both funding partnerships and facilities/staff sharing, have been established since incept. They include:

1) Telluride Foundation

2) Colorado Health Foundation

3) Caring for Colorado Foundation, Denver

4) El Pomar Foundation, Colorado Springs

5) The Children’s Health Fund, New York

6) San Miguel County Commissioners, Telluride

7) Uncompahgre Medical Center, Norwood

8) Telluride Medical Center, Telluride

9) Telluride Family Practice, Telluride

10) The Forsyth Institute, Boston

11) Community Dental Clinic, Montrose

12) CPR World, Telluride

13) Telluride Association of Realtors, Telluride

14) Telluride, Norwood, Ridgway and West-End School Districts

Personnel from seven of our programs listed below, delivered 1313 units of service in 2007, and involved the 14 strategic partnerships listed above.

1) Medical Shuttle Service: Working with the San Miguel County Commissioners and the Children’s Fund a weekly non-emergency transportation service to physician offices, hospitals and dentists has been established. To date, 81 individuals have utilized the service. A transportation navigator function has been organized with the Uncompahgre Medical Center to coordinate the service for residents in the service area.

2) Healthcare Services Directory: An internet-based healthcare provider service directory incorporating over 250 regional medical, mental health and dental providers has been developed. The Directory assists individuals seeking services as well as providers looking for consultants to assist their patients. Over 700 inquiries have been made seeking assistance from the Directory since August 2007. healthdirectory.html

3) Tobacco Education and Prevention Program: The State of Colorado has granted the LHI a grant to assist San Miguel Schools with youth tobacco use prevention. In 2007 the project helped school administrators evaluate and modify their policies to advance the prevention of tobacco use by students.


4) CPR/AED Training: Through the assistance of a visiting cardiologist, 32 Automatic Electronic Defibrillators have been purchased by the TF and installed throughout the Telluride community. To compliment this effort, the LHI procured funds from the Telluride Association of Realtors to provide scholarships for CPR/AED certification classes.


5) Latino Preventive Healthcare Fund: A donor to the TF has established a targeted preventive healthcare fund to finance primary and secondary preventive healthcare services to Latino’s residing in the Telluride area. The Telluride Medical Center and Telluride Family Practice have provided services to hundreds of Hispanic residents since May 2007.


6) San Juan Kids Cavity Prevention Program: A collaborative agreement with the Forsyth Institute, Boston has resulted in the implementation of its evidence-based cavity prevention program for children ages 1-13. This is a school-based program that has received funding for start-up from the Caring for Colorado and El Pomar Foundations. The Forsyth Institute program is evaluated by a National Institutes of Health Research Grant that reports a 51% reduction in cavities in children after one round of treatment and near zero cavities with children after two rounds of care. The program has been offered since July and has seen over 500 children since its inception.


7) Entitlement Enrollment Program: As a component of the Cavity Prevention Program, a dental navigator function has been established through the Uncompahgre Medical Center. The program is designed to enroll eligible children and their families in Medicaid and the Colorado Health Plan. To date, over 50 children have been identified to qualify for entitlement programs.


The LHI has concluded from its first year of program development that the following key success factors will be pursued:


1) All services provided will be evidence-based healthcare services.

2) All services and programs will be financially self-sustaining.

3) All services and programs must provide access to services for its users.

4) All services will have an emphasis on the provision of primary and secondary preventive services.

5) All services and programs must have the ability to leverage and pool resources of public and private healthcare entities. This includes facilities, staff, equipment and funding.

In consultation with the San Juan Health Council the programs and priorities for 2008 have been identified as follows:

1) Expand Medical Shuttle Service

2) Increase Provider Participations and Public Access to Health Services Directory

3) Increase Kids Entitlement Enrollments

4) Review Existing Immunization Programs and Initiate Expanded Services

5) Review Existing Medical Screening Programs and Initiate Expanded Services

6) Initiate a Uninsured Health Insurance Initiative

7) Support UMC’s Implementation of a Dental Service

8) Expand SJKCPP into School based health clinic sites in Delta and east Montrose Counties

9) Support Expanded Mental Health Preventive Services

10) Create and Maintain a Public Awareness Campaign of Services and Programs


Local Healthcare Initiative Background Summary

The Telluride Foundation was awarded a three-year grant, from the Colorado Health Foundation, to develop a “Local Healthcare Initiative” (LHI) for residents of Western Montrose, Ouray and San Miguel Counties to identify and address urgent healthcare needs to improve the health status of the regions residents.


  • Improve the health status of residents in west Montrose, Ouray and San Miguel Counties through programs that provide solutions to critical healthcare needs.

The Components of the Program include:

  • Conduct a healthcare needs assessment to identify prevalent healthcare issues, service gaps and provide a comprehensive community health services inventory.
  • Hire project staff including a medical director and healthcare administrator to develop, implement, evaluate and track program outcomes.
  • Establish a regional advisory group, the San Juan Health Council, which represents the healthcare delivery system in the region. The Council will help establish priorities for program development and support its implementation.
  • Implement the State Tobacco Education and Prevention strategic plan and programs in San Miguel County.

The Healthcare Needs Assessment identified the following health care issues as a “priority” to be addressed through the LHI:

  • Outreach to Community and Providers
  • Substance Abuse Treatment
  • Mental Health Services
  • Dental Care for Underserved Populations
  • OB/GYN Education about the availability of prenatal care/birth control
  • Non-emergent Medical Transportation
  • Senior Services
  • Uninsured and Underinsured Populations in the Region

Staff Biographies

Michael S. Kappy, MD, PhD

Medical Director

Dr. Kappy received both his MD and PhD degrees from the University of Wisconsin and has distinguished himself in both academic medicine and with rural pediatric outreach clinics in Colorado, Montana and Wyoming.

Michael Kappy is a Professor of Pediatrics and Chief, Pediatric Endocrinology at the University of Colorado at Children’s Hospital, Denver. Dr. Kappy’s work has taken him to under-served children in Washington DC, Northern Florida, the Western slope of Colorado and the Navajo and Hopi reservations. He has a special interest in the development of healthcare partnerships to improve low-income children’s health through treatment and prevention programs. In 1996 he started outreach clinics in pediatric endocrinology in Durango, Montrose, Glenwood Springs and Grand Junction, Colorado and in Billings, Montana.

Michael Kappy’s depth of knowledge, dedication and experience in working in rural healthcare uniquely qualify him to serve as the medical director for the Local Healthcare Initiative.


  • B.A.: Johns Hopkins University; Baltimore, MD-1957-61
  • MD, PhD: University of Wisconsin; Madison, WI-1961-67
  • Pediatric Internship and Residency: University of Colorado Health Sciences Center/The Children’s Hospital, Denver-1967-68 and 1970-72
  • NIH Children’s Research Program: Bethesda, MD-1968-70
  • Pediatric Endocrinology Fellowship: Johns Hopkins Hospital-1978-80

Academic Appointments

  • Professor, U. Colorado Dept. of Pediatrics- 1994-present; Tenure awarded- July 2001
  • Chief, Pediatric Endocrinology, The Children’s Hospital, Denver- 1994-present
  • Program Director, Pediatric Endocrinology Fellowship, 1994-2004
  • Mentor: Child Health Associate/Physician’s Assistant Program- University of
  • Colorado Health Sciences Center, Denver, CO- 1994-present


  • Career Teaching Scholar Award from the Department of Pediatrics ((The Children's Hospital/University of Colorado School of Medicine)
  • Lifetime Teaching in Pediatrics Award from St. Joseph's Hospital and Medical Center, Phoenix.
  • “Top Docs,” Pediatric Endocrinology, 5280 Magazine, Denver: 2005, 2006, 2007
  • Who’s Who in Medicine and Healthcare, 1999-2006
  • Johns Hopkins University Distinguished Alumnus Award, 1994
  • University of Wisconsin Medical School Alumni Citation Award, 2004

Community Health Care Activities

  • Developed volunteer health care clinic: Anacostia, Washington, DC-1968-70.
  • Developed model primary care private pediatric practice in an underserved community: Commerce City, CO 1972-75.
  • Developed and supervised adult and pediatric health care trainee program on the Navajo and Hopi reservations- 1975-78.
  • Conducted pediatric endocrine outreach clinics: Northern Florida (Daytona, Panama City, Tallahassee) with local health care agencies- 1980-85.
  • Developed comprehensive services for indigent children and young adults with chronic illness- State of Arizona- 1985-93
  • Consultant, Children’s Health Fund (CHF): A program to deliver health care services to homeless children- 1987-present. This program, supported by a consortium of private and governmental agencies, is the largest provider of services for homeless children in the United States and has 17 sites throughout the nation.


Gary R. Steinbach, M.H.A.


Gary R. Steinbach has a Master of Hospital Administration degree from the University of Minnesota and has worked in rural health care communities in Idaho, New Mexico, Montana and Colorado.

He has lead 5 healthcare organizations in advancing the scope and quality of rural healthcare services. Mr. Steinbach is skilled in strategic healthcare business planning and is a published author in The Harvard Business Review. He also has a strong performance record in healthcare philanthropy in Colorado.

He has served on the Board of Directors for the Idaho Hospital Association and Idaho Lung Association and was the recipient of the 2005 “Innovation in Healthcare Award” from the Montana Hospital Association.


  • B.A., Concordia College, Moorhead, Minnesota, 1969.
  • M.H.A., University of Minnesota, Program in Healthcare Administration, Minneapolis, Minnesota, 1971.
  • L.N.A., Licensed Colorado Nursing Home Administrator, #2201, 2005.

Career Experience:

  • Director, Dental Program, San Juan Health Department, Durango, Colorado; 2006 to present
  • Administrator & CEO, Southeast Colorado Hospital & Long Term Care Center; Springfield, Colorado; 2004 to 2005
  • Hospital Administrator, Ruby Valley Hospital, Sheridan, Montana. Served as CEO for a Critical Access Hospital and two Rural Health Clinics; 2003 to 2004.
  • Senior Director, St. Vincent Hospital; Santa Fe, New Mexico; 2000 to 2003.
  • Househusband; Durango, Colorado; 1992 to 1999.
  • Administrator and Project Director, Charter Medical Corporation; Chandler, Arizona & Macon, Georgia; 1986 to 1991.
  • Administrator, Community Hospital; Durango, Colorado; 1984 to 1986.
  • Vice President, Corporate Development; Albuquerque, New Mexico; 1982 to 1984.
  • Administrator, Blaine County Hospitals and President; Sun Valley Health Institute, Sun Valley Idaho; 1972 to 1982.

San Juan Health Council Members

As of January 2008


1. Nancy Anderson, Executive Director

San Miguel Resource Center

135 W. Colorado Ave. Ste. 315

Telluride, CO 81435



2. Celia Clark, RDH

Community Dental Clinic

1901 S. Townsend

Montrose, CO 81401

970-765-5056 cell

970-252-8896 work


3. Jo-Jo DeSantis, RN

San Miguel County Health Department

333 W. Colorado Avenue, Ste. 315

Telluride, CO 81435



4. Allan Gerstle, Director

San Miguel & Ouray County Social Services

333 W. Colorado Avenue

Telluride, CO 81435



5. Paul Glanville, MD

Basin Clinic (Wed. & Thurs.)

21945 Hwy. 550

Ridgeway, Co 81432

970-865-2665 work

601-416-1913 cell


6. Jon Gordon, Director; (alternate: Patsy Boyle)

Midwest Mental Health Center

P.O. Box 1208

Montrose, Co 81402

970-252-3210 cell

970-352-3214 work


7. Sharon Grundy, MD

Telluride Medical Center

500 W. Pacific Avenue

Telluride, CO 81435

970-728-3848 work

970-729-0245 cell


8. Michelle Haynes, Director

Uncompaghre Medical Center

P.O. Box 280

Norwood, CO 81432

970-327-4233 work


9. Ann Hemme RNC

Montrose County Health Service Office

PO Box 39, 851 Main Street

Nucla, CO 81424

(970) 864-7319


10. David Homer, MD

Telluride Family Practice

135 W. Colorado Ave. Ste 2D

Telluride, CO 81435

970-728-6654 work


11. Michael Kappy, MD, PhD, Chairman

Department of Endocrinology

Children’s Hospital

13123 E. 16th Avenue, B265

Aurora, CO 80045



12. Paul Major, President & CEO

The Telluride Foundation

620 Mountain Village Blvd. Ste 2B

Telluride, CO 81435

970-728-7818 w

970-209-2880 c


13. Cheryl Roberts, RN, MHA, Director

Ouray County Public Health Department

302 2nd Street

Ouray, CO 81435



14. Gary Steinbach, MHA, Healthcare Administrator

Local Health Initiative

321 Oakcrest Drive

Durango, CO 81301

970-946-0016 c

970-385-4055 h


15. Hillard Zallen, MD

Uncompaghre Medical Center

P.O. Box 280

Norwood, CO 81432