Big Bend residents turn out for town hall with big ideas for senior healthcare

Photo courtesy of Mitch Borden/Marfa Public Radio

TRICOUNTY – Over 100 Big Bend residents came together to discuss aging and dying in the region last Thursday night, as part of a new town hall series co-hosted by The Big Bend Sentinel and Marfa Public Radio at The Sentinel. Healthcare professionals and stakeholders filled the eight person panel of experts and citizens pressed them to discuss their needs, as well as their current resources and plans going forward.

In a remote region with sparse resources, healthcare for aging residents is not always comprehensive in the Big Bend. That leads many locals to relocate to El Paso or Midland-Odessa near the end of their lives, further from family and home than they would otherwise choose. The inaugural town hall was based on a Marfa Public Radio story covering this subject by Sally Beauvais.

While Big Bend Regional Medical Center CEO Rick Flores, Preventative Care Health Services CEO Linda Molinar, Directors of Nursing Cynthia Kirpatrick and Angela Juett from Agave Home Health represented some of the major healthcare institutions in the area, Dr. John Ray added a local doctor’s perspective and Yvette Lugo from the Rio Grande Council of Governments’ area agency on aging shared insights about funded efforts the agency is making in the area. Retired hospice nurse Marvie Burton who ran Hospice of the Big Bend for ten years and local hospice advocate Suzanne Dungan rounded out the panel.

Talking about needs in the area, BBRMC CEO Flores began a discussion on area needs, saying people most often ask for a nursing home, dialysis, hospice, home healthcare, clinics in Marfa and Presidio, urgent care in Presidio, and needs in Valentine, Candelaria, and other small communities in the area. He mentioned upcoming meetings with two dialysis companies, DaVita and Fresenius Medical Care. Flores’ laundry list of needs highlighted the gaps in care that often accompany rural living, but the hospital chief said their focus was on stabilizing the hospital and “establishing a strong foundation.”

Kirkpatrick of Agave Home Health noted the difficulties of not having the volume of patients to make providing care financially feasible, and that their company had difficulty finding and retaining qualified staff.

Financial difficulties were prevalent throughout, with Burton adding that Hospice of the Big Bend shuttered due to a fluctuating volume of patients and little government compensation for each individual.

Dr. John Paul Schwartz, a local practitioner, spoke from the audience to add another concern: “We need psychiatric care here. We constantly have suicides, all kinds of mental health issues,” noting that there currently is not a movement to address the gap in psychiatric healthcare.

Many that night, including Dr. Schwartz, pointed to the nutrition center as a beacon of hope. Lugo, whose agency supports the center, noted that the program helps aging locals socialize, which decreases depression and increases health outcomes.

With needs laid out, the conversation turned to resources and aspirations. Audience member Mary Fenton explained that Sul Ross is in the process of developing a nursing program, which the school hopes to launch in Fall 2020, generating a local workforce that is currently lacking.

Beyond the paid workforce, Marvie Burton discussed her previous hospice program’s greatest strength, “a strong army of volunteers” in every community in the region. Burton asked who would be willing to volunteer if hospice returned to the area today and over thirty attendees raised their hands.

Dungan then explained her advocacy work and the community members who have joined her in the fight for hospice in the region. “We have a big region, it’s the Big Bend,” she said, pointing out the challenges, “but we’re also capable of big ideas, okay?”

One of Dungan’s big ideas was to utilize the vacant office spaces housed in the Marfa Activities Center, where the nutrition center already operates. She imagined what an integrated healthcare facility might look like, saying, “It’s not home hospice care, but it is a place in the region that you can come and bring a family member that needs end of life care. And the family can come and stay and visit. It also has assisted living facilities.”

“And then we thought, what if we put in a childcare center, which is something else we don’t have, and the childcare center was in the same facility? And what if we had a nice restaurant in this facility that someone ran, where people in town can come and visit? And what if our older people can interact with our children and create a whole community center that serves everyone?”

Marfa City Councilmember Yoseff Ben-Yehuda responded encouragingly to Dungan. He thanked her for articulating the idea and said, “The city is definitely interested in expanding that, and I think your vision for it is right on.”

Dungan, who said she is seeking volunteers to work on developing a hospice project, said the volunteers would need to research, make phone calls and examine similar rural areas, “so that we’ve got the best ideas.”

At the end of the discussion, Beauvais prompted the Agave Home Health panelists to explain how a change in medicare that begins January 2020 is likely to endanger the entire home healthcare program.

“Most home healthcares will go out of business. Most affected will be rural areas,” the nursing director explained. Specific funding streams for physical, occupational and speech therapy will be cut off. She asked attendees to contact their representatives on their behalf, explaining, “Unfortunately the more chronic type of patients are the ones that are really going to be suffering as far as home health goes.”

Residents and stakeholders lingered afterwards, exchanging ideas and contact information to continue the discussion on how to bring more comprehensive senior care to the area.

The full livestream recording of the event is on The Big Bend Sentinel and Marfa Public Radio’s Facebook pages and materials handed out at the event that detail resources and contact information for interested participants can be found at Marfa City Hall’s front desk. The local news outlets plan to co-host quarterly town halls and invite readers and listeners to share their ideas for the next event’s topic.