shawn mchugh/daily press
Dr. Anna Lundeen, a Northwest Colorado Visiting Nurse Association physician, stands next to a new ultrasound machine Friday. During February’s board meeting, Lundeen was granted obstetric privileges at The Memorial Hospital, meaning she can now offer prenatal care to uninsured and undocumented pregnant women.

Photo by Shawn McHugh

shawn mchugh/daily press Dr. Anna Lundeen, a Northwest Colorado Visiting Nurse Association physician, stands next to a new ultrasound machine Friday. During February’s board meeting, Lundeen was granted obstetric privileges at The Memorial Hospital, meaning she can now offer prenatal care to uninsured and undocumented pregnant women.

VNA physician receives obstetric privileges to treat underserved pregnant women


A lot can go wrong in the nine months before a woman bears a child.

Ultrasounds, prenatal vitamins, maternal diabetes and other health concerns can mean the difference between a healthy baby and a complicated labor.

However, undocumented and some uninsured pregnant women rely on emergency Medicaid, which provides coverage only at the time of delivery and not in the nine months prior.

Such a pregnant woman might never see the inside of a doctor’s office until she is in labor.

Dr. Anna Lundeen, a Northwest Colorado Visiting Nurse Association family practice physician, said it has been a dream of hers to work in a medically underserved area such as Moffat County, where the VNA provides preventative options for undocumented people through programs like the Prenatal Assistance Program.

With a new ultrasound machine, fetal monitor, federal grants and Lundeen — who began work at the VNA in August 2009 and has a passion for obstetrics and indigent care — the Prenatal Assistance Program now offers about 70 women 12 free visits during their pregnancies and one postpartum visit to monitor their progress and check for problems that may arise.

“What we need to realize is that we are going to take care of them one way or another,” Lundeen said of undocumented expecting mothers. “Either they’ll be taken to the hospital without having had any care, or we’re going to provide good care to give them good outcomes.”

A healthy outcome for Moffat County babies is all the VNA hopes to accomplish using federal funds and grants.

The Prenatal Assistance Program recently received a one-year grant for $50,000 from the Caring for Colorado Foundation. The program has also received $15,000 from the Colorado Trust Equality in Health Initiative and $15,000 in additional funding from Yampa Valley Medical Center in Steamboat Springs.

The program began four years ago with 12 patients and has since expanded to cover 70 women in 2009 in Moffat and Routt counties, equaling 90 percent of the total undocumented population of pregnant women, said Diane Miller, VNA director of clinical and quality services.

“We’re talking about babies,” Miller said. “Pregnant women and babies, and we just see this as part of what needs to happen. Prenatal (care) is pretty darn important.”

Still, Miller said it’s not cheap to care for these women.

The program costs about $120,000 a year to run for 70 patients.

To alleviate some of the costs, Lundeen put in an application to be granted obstetric privileges so she could perform more procedures and deliver the babies of some Prenatal Assistance Program patients.

Currently, the uninsured prenatal patients are sent out to the five other obstetric-privileged physicians in Craig — doctors Scott Ellis, K.C. Keating, Larry Kipe, Troy Phillips and Greg Roberts — for most of the prenatal visits and the actual deliveries.

Although they get paid less for seeing these patients, Miller said the obstetricians in the community have been enthusiastic about the program.

“It’s the (nurse practitioners) and (physician’s assistants) and the doctors that are just totally dedicated to providing this care no matter their ability to pay,” Miller said. “In a lot of cases, these patients come from some complex situation, and we really just have to treat them.”

In its monthly meeting Feb. 24, The Memorial Hospital board voted, 4-3, to approve Lundeen’s obstetric privileges.

Some board members felt that the number of doctors practicing obstetrics was already sufficient and adding another would dilute that skill set.

“She’s genuine about this,” board member Melton Sullivan said of Lundeen. “But, the hospital has a mission of taking care of anyone that shows up. It’s a good thing, but she’s not providing anything that isn’t already provided. I wish her well, I just think it’s not the perfect situation.”

Miller said she was “thrilled” Lundeen was granted obstetric privileges to add to the services of the VNA’s Prenatal Assistance Program.

“We’ll still continue to refer to those providers who already participate, and hopefully Anna will be able to take on some of them and provide a little continuity of care,” she said. “It’s also a cost benefit for (the VNA).”

Hope Cook, a prenatal nurse at the VNA for five years, said she has seen several positive outcomes in patients of the Prenatal Assistance Program who might have otherwise gone without care.

“I think that the one thing that we all sort of hope is there’s a good outcome,” Cook said. “Whatever you can do to hopefully promote a healthy baby, in the long run costs our society less. A lot of these women are not citizens, but they have jobs and are contributing to society. There is no other place for these women to go.”

She said the prenatal visits for the underinsured and undocumented are also a chance to explain to women who’ve had limited medical exposure that using health care in a preventive sense can cost less.

“Hopefully it can be a better start for them,” Cook said.

For Lundeen, she sees the need for indigent health care as more pressing than ever in difficult economic times.

“There are people just walking into the delivery room and they had no care whatsoever,” she said. “What we’re trying to do is offer care that’s efficient and affordable to give people a primary care base so they don’t use the emergency room as their primary care. By doing so we’re hoping to decrease the burden on the hospital and decrease their bad debt, because we’re keeping most of that here.”

She said even since she moved to Northwest Colorado in August, she has seen the need for health care in the Craig community.

“There are so many people who have lost their jobs, and there’s just nowhere else that does that sliding pay scale for them,” she said. “(Offering preventative care) is just so much better than the alternative.”


stillinsteamboat 7 years, 1 month ago

No offense but when our child was born we didn't have insurance either. My husband and I, both service industry workers had to pony up the almost $10,000 ourselves. All without any medicaid, and no there is no family money. We did it the old fashioned way, we earned it ourselves. We ate canned beans, turned off the phone service, tv service, turned the heat off unless it got below 55 degrees inside our mobile home.


Frank Estey 7 years, 1 month ago

stillinsteamboat, Go across a border, lose your papers then sneak back across the border without papers… everything will be free.


CindyLou 7 years, 1 month ago


Mmmmm I call B.S. Both of you are working service jobs and didn't qualify for Medicaid? I find that hard to believe. My husband and I both worked full time when we got married and we didn't have insurance either, but we did qualify for Medicaid for the birth of our first child. And if you both worked full time for a major hotel or food chain they do offer insurance that would have covered a good part of your birth. $10K for the birth and the hospital didn't give you any kind of discount at all? I had to pay cash for a surgery and the hospital reduced my bill by about 40% because I was uninsured. The last child I had cost a total of $6,500 bucks for both the doc and the hospital so you must have had some complications with your birth if it cost $10 grand. So how long did it take reducing your food bill by $300 bucks, your phone phone by $75 bucks and your heat by $125 bucks a month to pay off $10,000? I cacluted that if you did all that it would take you almost two years if you diverted $500 bucks a month toward your hospital bill. I highly doubt that it was that big of a priority for you to get your bill paid. Half this town doesn't pay their water bill on time (trust me I know)let alone are willing to pay an extra $500 a month for their hospital bill.

So, long story short I doubt you had a $10,000 bill and/or paid full retail for the birth of a child if you were in fact uninsured.


dogfan 7 years, 1 month ago

CIndyLou, Did she say when her child was born? I can say from experience that a 10,000 dollar hospital bill on a new born is very possible. One of ours was more, we had insurance through my job but that did not pay the all of the bill. We pinched pennies and made payments and finally paid it off.

I believe she was trying to state a fact that many of us are feel. Why do we have to pay for medical service for undocumented people. If these women are undocumented they should be shipped back to where they come from. Take care of them, let the kid be born here than they can stay. I for one am sick of seeing our country take care of them and let our own people starve and go homeless.


cowgirlmc 7 years, 1 month ago

I agree with Dogfan. I had my daughter three years ago. By the time you add all the prenatal visits, hospital for you and child it runs close to 10 grand. For a normal noncomplicated birth. I am SO fed up with paying for illegal people and their illegal children. Its a shame.


JAHM 7 years, 1 month ago

I can tell you right now with my first child it cost 10 grand for her and it was a normal birth no complications what so ever!!!..........even though I had insurance it did not pay a lot of the bill and my husband and I spent a couple years paying off the bill!!! and he has a very very good job! so I do not think that stillinsteamboat is B.Sing anyone in anyway! me and my husband had to change a lot of things in our lives for those couple years to make those payments to get it paid off so tha it would not go to collections and hurt us in anyway!!! that was 3 years ago. that was NOT including the OBGYN visits throught the pregnancy! so not only did we have a hospital bill to pay off we had several hundreds in OBGYN bills to pay off as well....................


McGruber 7 years, 1 month ago

So I assume cowgirlmc, JAHM, and dogfan are all for health care reform right?


dogfan 7 years, 1 month ago

NOT. Just sick of how we are allowing these people to come into our country and get everything handed to them.


cowgirlmc 7 years, 1 month ago

PLEASE McGruber. I think that the health care reform is one of the biggest jokes EVER...... I think that insurance companys and the medical systems need to be completely redone. And I DO NOT think that IF this reform passes any good will come of it. I once again agree with dogfan. Im sick and tired of paying for other people and myself... WHOS helping me???? NOT the gov...


als362 7 years, 1 month ago

I have no use at all for government run health care. The are only 2 reasons that this is being introduced.
The first is so all the special interest groups like AARP can put thier hands in the pot and grab all they can.
The other is so we can be forced to pay for every worthless immigrant that has only 2 desires to sit on thier duff and grab up every free benefit they can.
Between free health care, frew food, and free rent its no wonder that this country is in trouble.
I pay my own way and so can they. If they can't then they should go back where they came from. See if thier own government wiil give them all this free stuff. Government run anything is a joke. If there was a law that stated if you want to sell it in America, it must be made in America. Then manufacturing would get going again, and people would get health care from thier employers. Then there would be no health care issue.
Those that choose not to work would have to do without.


justthefacts 7 years, 1 month ago

Fact: 80% of the clients served by the VNA are illegal!!!

Fact: To check the facts just walk into the VNA someday,ANYDAY!!

FACT: City and County governments in the Yampa Valley support the VNA with large sums of money to provide services to illegal ailens that lie about thier income and marital status.

Fact: VNA now has a doctor to specialize in illegal babys that become U.S. citizens when they are born.


CindyLou 7 years, 1 month ago

Just the facts,

Fact: You are a retard and don't know crap. Go ask them for their financial statements. THey will give them to you if you really want to know the "facts". The county's budget is easy to read too. THe county give them about a 100,000 or so, which is only a drop in the bucket of what services they provide.

Fact: The VNA provides more than just doctor visits. They provide shots to all school children that MFC, TMH, and KFC send to them because they can provide shots to all people at a fraction of the cost that the other clinics do because they are a non profit organization. They also provide dozens of other services that require a person to be a documented citizen to get.

Fact: you wouldn't know crap from peanut butter even if you had a mouthful.

Fact: the VNA doctors provide care to all people regardless of whether they can pay or are citizens. If they didn't then they end up in the ER and get the care for free anyways, it would just cost the tax payers more money because ERs aren't cheap.

Fact: You are a dumb @$$


westslopeguy 7 years, 1 month ago

Really, it's time for a new screenname!

What facts do you have to prove that "80% of the clients served by the VNA are illegal!!!"? As your screenname suggests, present them.

You can identify one's citizenry or alien status authorized by the United States Government, by SEEING a person? Our government, (admittedly, you have no regard for), at least requires proof or identification papers, (admittedly falsified in SOME cases). Present the facts to us as your screenname suggests.

"large" is a subjective term, (Psst... subjective is not factual). Exactly how much do the "City and County governments", (sic), contribute to the support of the VNA? Just asking for the facts you claim to present.

I believe the article stated the VNA now has a doctor to specialize in underprivileged babys, (sic)-(again), not necessarily illegal ones. Again, as your screenname suggests, please present the facts to support your statement.

Once again four facts, (sic), presented, of which all are opinions, neither are facts.

If you would like to present the facts, I'd be more than willing to discuss them here or at my personal email: If, however, you choose to just post or argue your biases, don't bother, or at least as previously requested, change your screenname.

At least I, (and anyone who takes the time to read my posts), know this is just

My 2cents. Paul


westslopeguy 7 years, 1 month ago


You just beat me to it, CindyLou . I was so incensed again after reading his, (her?) post. I went outside for a cigarette. (I'm not in Craig where it's negative whatever it is there). By time I got back, you had posted before I completed my post.

Shall I suggest him for removal? I'm thinking the CDP will remove as a falsified screename. He (she?) has not posted one "fact" in this or previous posts, ergo he is misrepresenting him(her)self and presenting false statements in violation of use and standards policy.

I'm thinking this is more facts than just



daybyday 7 years, 1 month ago

Removal for falsified screenname...that cracked me up. I might recommend JustTheSlander, JustTheLibel, or JustTheDefamationOfCharacter. I prefer JustTheHogwash, as I don't think the contributor's views hold any weight or power nor would or should be considered worth a second thought by anyone with a thinking mind. Everyone has an opinion (some have a vendetta) and, as they say, there's one in every crowd.


justoncrack 6 years, 10 months ago

I thought this screen name might be a winner, but now I've got it.


Craig_gal 6 years, 10 months ago

I Hope I can be at the next fund raiser for VNA. I have not seen any other organization that serves so many people for so many reasons. When my friend needed someone to help with the dying process they were there everyday helping, & assisting. I think it is only fitting that they have a doctor there who will help and assist people with the birthing process in the same caring non-judgmental way.


justoncrack 6 years, 9 months ago

I completely agree with Craig_gal. The VNA is an incredible resource and the docs that work there (Lundeen and Hornung) are absolute rockstars.


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