When released from West Springs Hospital in Grand Junction, someone who wasn’t Medicaid eligible and didn’t have a ride would need to take a bus back to Steamboat Springs.

Well, two buses: One to Denver and another to get to the Yampa Valley.

“That’s stupid,” said Doug Pattison, interim chief operating officer of Mind Springs Health, which runs the hospital. “We’re going to fix that. … We’re going to put them in a cab.”

The leader of the behavioral health care provider has already vowed to increase transparency across the 10-county region in which it operates following the resignation of long-time CEO and President Sharon Raggio earlier this month. An absence of transparency and trust is where problems occur, Pattison told commissioners Jan. 11.

Beyond transparency, Pattison told commissioners during another conversation Monday, Jan. 24, he wants to take a “bottom up” approach to rebuilding the nonprofit, talking to people in communities to understand how Mind Springs is or isn’t working for them. The inconvenience of taking the bus to Routt County was something he learned about in his meeting with commissioners earlier this month.

“We need to have more of a dialogue at the local level and say what’s working, what’s not,” Pattison said. “(We need to) talk to law enforcement, talk to church leaders, talk to librarians — librarians have a lot of interaction with homeless folk — talk to school teachers, talk to the users of the services.”

Pharmacies trying to renew prescriptions and not being able to talk to someone with Mind Springs has been another issue. Pattison said they now have someone answering the phones and are looking into other ways to improve the system.

Mind Springs is responsible for providing mental health care for Medicaid recipients and people who are indigent, underinsured or in crisis in Routt, Moffat, Jackson, Rio Blanco, Grand, Summit, Eagle, Pitkin, Garfield and Mesa counties.

Three state agencies are now auditing the group’s work on the West Slope, where some county leaders, particularly those in Summit and Eagle counties, have been outspoken about their displeasure with Mind Springs’ work.

In Routt County, Commissioner Beth Melton said they have questions but not a high level of concern.

“A lot of the questions are just understanding where’s the money coming from? Where’s it going? What services are being provided?” Melton said. “We just don’t feel like we have enough of an understanding to know what we should be advocating for.”

Pattison explained where a lot of Mind Springs’ Medicaid funding comes from, which is based more on the number of Medicaid eligible residents in the county and not necessarily the services provided.

The services are then looked at by the insurer, in this case Rocky Mountain Health Plans, to ensure Mind Springs provided services valued within 3% of their Medicaid payment, which was about $15 million last year.

The complexity of this funding structure made it difficult for Pattison to come up with a clear answer to Melton’s question, and she asked a similar one at the end of the discussion.

“If we had one easy overarching answer to how much money is being spent in Routt County and what we are getting as a result of that,” Melton said. “If in your thinking you have some new way to think about how to help us answer that question, that would be much appreciated.”

Pattison said that may require another discussion, but he added that he has welcomed these discussions in each of the counties where Mind Springs operates. He also said he wants to win commissioners’ confidence, trust and their partnership.

“That’s my heartfelt conviction, not just to you, but all the commissioners we are talking to,” Pattison said. “Not everyone is embracing it, but that’s my offer.”