Despite holdup at county level, Marfa officials say contact tracing will soon begin

MARFA — After weeks in the works, the Marfa contact-tracing program is finally ready for lift-off. Last Tuesday, Marfa City Council voted to hire three contact tracers at a rate of $20 per hour, transforming local contact-tracing plans into an official city program.

The plan hit a snag on Wednesday, after Presidio County commissioners voted to postpone signing an agreement with the city pending some final details, including more information on the agreement between the City of Marfa and the Texas Department of State Health Services. But Teresa Todd, city attorney for Marfa, says the city’s program will likely start next week regardless — at least for people who live within city limits.

Marfa city officials first started considering setting up a contact-tracing program after hearing mixed reviews of state efforts. Chief among those officials was Councilmember Buck Johnston, who said she wanted to find a way to continue helping constituents through the coronavirus pandemic after Governor Greg Abbott stripped local officials of many of their emergency powers, including the ability to impose mask mandates.

With some exceptions, like in big cities, contact-tracing efforts are handled by the Texas DSHS. But many local patients weren’t hearing from the state until during or after quarantine, if at all. Marfa city officials felt they could more quickly find cases and investigate possible contacts.

For a while, questions swirled about whether Marfa could in fact start a contact-tracing program. Citing conversations with state officials, county officials said probably not.

But city officials thought otherwise. After some digging, they ultimately scored a meeting in July with several DSHS officials and Sushma Smith, the chief of staff for Senator José Rodríguez, who helped arrange the meeting. The agency approved Marfa’s plan, and the city council voted in August to seal the deal with DSHS.

But then another issue emerged: Dr. John Paul “J.P.” Schwartz, the local health authority for Presidio County, is technically a county employee. Though he hasn’t been directly involved with Marfa’s contact-tracing efforts, the fact that Presidio County has a local health authority was basically the legal basis for why Marfa could set up a program. And Presidio County Judge Cinderela Guevara didn’t want Schwartz making any informal arrangements with the state and city without first discussing it with county commissioners.

By the time Todd presented to the commissioner’s court last week, that wasn’t really an issue: Don Culbertson, a physician assistant who will run Marfa’s contact-tracing program, was already in contact with DSHS. Besides, Todd found laws showing that Marfa, if necessary, could also appoint its own local health authority.

But there were still other issues. Though Marfa already has state and city-council permission to do contact tracing, it can’t legally serve people just outside Marfa without the consent of the county.

“We’re moving forward with our program,” Todd said in an interview this week. But “we don’t have any inherent authority to do contact tracing outside the city limits.” And until the county gets on board, that means no contact tracing for neighborhoods like Sal Si Puedes, which lies just outside the city limits.

At the meeting, Teresa Todd explained the vision for the program. She called Marfa’s contact-tracing efforts a “pilot program” that would be a first for a small Texas town.

“This is not a program that will replace contact tracing,” she said. “It’s not an either/or with the state.” Instead, she said it would be a “collaborative” program that is “basically triage.”

Rod Ponton, Presidio County attorney, said he was concerned the proposed agreement between Marfa and the county didn’t sufficiently limit the county’s liability. He also said he wanted more information on the agreement between Marfa and state health officials.

Some at the meeting expressed concern that those discussions could slow down Marfa’s coronavirus response during the ongoing pandemic. “I, for one, do not want to hold up this program,” said Commissioner Eloy Aranda. And David Beebe, a justice of the peace who was also present on the call, said county officials needed to “move forward” and not “second guess ourselves.”

“If there’s any roadblocks,” Beebe added, “they need to be taken down.” In the end, though, county officials decided to take the advice of their attorney and get more information. They voted to postpone those discussions until their next meeting — which barring a special meeting, will happen next week.

In an interview this week, Ponton said he was simply doing his due diligence as county attorney. “I wasn’t trying to slow anything down,” he said.

The agreement with Marfa “has four to five paragraphs making sure the city would have no liability for using county powers,” he said. “But there’s nothing in it protecting the county. What do you expect me to do?”

Judge Cinderela Guevara said in an interview that she’d be happy to call a special meeting to help speed along the process. “Hopefully we’ll go ahead and make a final decision on this agenda item,” she said.

But first, she said she agreed with Ponton that the county needed to make sure it had addressed any concerns around liability. “We just want to do this the right way,” she said.

In the meantime, Marfa’s contact-tracing plan is going forward — albeit without outlying neighbors like Sal Si Puedes for now.

Within the next week or so, Marfa officials will take out ads informing locals about the program and urging them to call contact tracers if they’ve had a coronavirus diagnosis or any contacts. And that, chief city contact tracer Don Culbertson says, will mark the true start to the program, because that’s when local residents will know to start reaching out.

“Until that phone number’s out there and published and advertised, we don’t have a program,” Culbertson said. “I’m simply an agent of the city; I’m not a graphic designer or a copywriter. It’s up to [city leaders] to make all that happen.”

Still, as a physician assistant at Marfa Clinic, Culbertson has said that he’s already done some informal contact tracing as people with coronavirus diagnoses and/or contacts come into the clinic for medical advice. On Friday, for example, someone with positive coronavirus test results contacted the clinic for health advice.

That person hadn’t yet been contacted by the state, Culbertson said — but Culbertson quickly jumped into action, asking the man about possible contacts. The experience was a sign, he said, that while Marfa’s contact-tracing program might not be “heavily funded” like the state, it could nonetheless be more “quick and agile” in reacting to local cases.

“They’re Goliath, I’m David,” Culbertson said, contrasting himself with the state DSHS. “They’ve got the big sword and armor. I’ve just got a slingshot — but I can run around fast.”


Related