Importance of rural health clinics apparent in pandemic

El Centro Family Health steps up to fill the gaps

In northern New Mexico’s more rural areas, access to hospitals and other health care facilities can be severely limited, making it hard for residents to get basic services.

This lack of access has been accentuated by the COVID-19 pandemic as the bulk of testing for the coronavirus occurs primarily in more urbanized parts of the state.

Networks of rural health clinics, such as El Centro

Family Health, have stepped up to fill in the gap.

With 27 separate locations around northern New Mexico, El Centro has provided health care services for rural residents for years. Now, those services include COVID-19 testing.

El Centro Chief Operations Officer Jerome Williams said the clinics often are the only places people can get tested or access information about the virus, unless they drive multiple hours to the nearest hospital.

“We’re serving marginalized communities,” Williams said.

Many El Centro patients do not have their own health care plans or cannot afford the co-pays at another facility, Williams said. During the

pandemic, El Centro clinics have waived all co-pays and are providing free testing.

However, like other health care institutions in the state, the pandemic has seriously impacted El Centro’s operations, both physically and financially.

For example, most visits with patients have shifted to a “telehealth model,” in which patients can talk with providers by phone or over the internet.

But for providers located in rural areas defined by a lack of technology, organizing telehealth appointments can be especially trying.

“Access to technology is always an issue, including for us,” said Mark Bjorklund, El Centro’s chief clinical officer. “We don’t have the infrastructure in many of our clinics to do as well as we could.”

El Centro’s Truchas location has only one working phone, limiting the number of telehealth calls and preventing other employees from making outside calls. Williams said they have ordered more phones.

Many residents in and around El Centro locations also lack internet access, and while many have telephones, some do not.

Bjorklund said some residents have government-issued cellphones, sometimes referred to as “Obama phones,” but that those phones have only a certain number of minutes for phone calls, making in-depth health appointments hard to complete.

Improving the phone systems and internet bandwidth, Williams said, are among the top priorities currently for El Centro.

Some clinics also struggled to get enough personal protective equipment, known as PPE, early on, although numbers have improved in recent weeks. Even when PPE did arrive, getting fitted for N95 masks proved difficult, since there are very few places to get fitted near the clinics.

“At this time, we are OK,” Bjorklund said of El Centro’s PPE supply. “We’ve stayed ahead of things. Initially, we were not real sure that we were gonna do that.”

But those improvements, as well as added services to help patients during the pandemic, mean El Centro’s finances have also taken a hit.

“We’re doing OK, but we could always use more funding,” Williams said.

While the lack of revenues from co-pays has had an impact, a gradual reduction in funding from the federal government — which constitutes 80% of El Centro’s total budget — has been felt much harder.

“What makes it more difficult is when the federal government doesn’t pass a budget,” Williams said. “They give us a budget for three months, and we’re hoping and praying for a renewal.”

He said they received $11 million this year, when they usually receive $18 million.

Despite the financial difficulties, El Centro has not laid off any employees or staff, differing from larger hospitals in the state, such as Presbyterian in Albuquerque, that laid off some non-emergency staff.

And the more than 1,000 COVID-19 tests performed in El Centro clinics has boosted testing numbers in counties where the clinics are based.

Rio Arriba County, home to four clinics, currently boasts the fifthhighest per capita testing rate in New Mexico.

County Health and Human Services Director Lauren Reichelt said El Centro has been key in testing the county’s more rural residents.

“People in rural communities have been really interested in testing,” she said. “We’ve been going out to them.”

Reichelt said Rio Arriba has been aggressively testing for the virus since the pandemic started.

Leo Maestas, manager of San Miguel County’s Office of Emergency Management, said El Centro will go ahead with testing those living in San Miguel’s group homes. Nursing homes and behavioral health centers have been hit particularly hard by the coronavirus.

“They’ve been tasked to do percentage testing of some of the at-risk populations,” Maestas said.

Williams said services provided by El Centro have always been essential, but have taken on an added importance recently. Sometimes, people from as far away as Colorado come to clinics for health services.

“Even in small communities, places like El Centro Family Health are extremely important,” he said.