An ambulance for Marfa and a hospital for Presidio County: Last week at the hospital district

The lack of a hospital in Presidio County has been a recurring point of contention for some residents and officials.

TRI-COUNTY — It was a packed agenda at last week’s meeting of the Big Bend Regional Hospital District, as board members discussed Marfa’s broken-down ambulance, the possibility of a new hospital in Presidio County and more.

By the end of the meeting, the board welcomed a new member and pledged to look into whether it would be economically feasible to build a new medical center in Presidio County. Among the highlights of the meeting were:

An ambulance for Marfa

Towards the start of the meeting, Mandy Roane, the city manager for Marfa, briefed the hospital district on problems the city’s EMS service has been having with one of its ambulances.

The ambulance is “worn out” and having problems with its chassis, Roane said — and with the vehicle regularly in the shop, the problem is getting “very serious.”

“I’m worried that at one point we’re going to get into the position where we have a very critical patient and the ambulance will not work,” she explained.

Roane and the city’s EMS director, Bert Lagarde, hoped the district could help them cover the cost of a new ambulance. The city’s initial plan, Roane said, was to wait until the summer, when there would be grant funding available to help pay for a replacement.

But issues with the vehicle have “become critical,” Roane explained. “We’re not able to make it until the end of the summer or beginning of the fall.”

The district initially seemed receptive to helping out Marfa’s EMS. But Greg Henington, a board member, instead suggested that the city try out for emergency funding grants from the state’s Department of State Health Services.

“That’s exactly what that fund is for,” Henington said. “To provide money for ambulances that are broken down and are putting EMS at risk.” He worried it would be a “slippery slope” for the district to comp the ambulance expenses without Marfa trying for DSHS funding first.

Ultimately, the district voted to table Marfa’s request. But Buddy Cavness, another board member, encouraged Marfa to let the district know if they didn’t end up receiving DSHS funding. In that event, he said, the district would reconsider Marfa’s request. And if the problem became even more urgent, he said the district would be open to calling a special meeting about the issue.

A hospital for Presidio County

Marfa’s ambulance wasn’t the only time Presidio County’s health needs showed up on the agenda. Board members also revisited the possibility of starting a hospital or even urgent care center in Presidio County.

Though the district is responsible for healthcare throughout the tri-county, the only hospital in the region is Big Bend Regional Medical Center in Alpine — and that’s long been a source of contention for some Presidio County residents and officials. Though Marfa residents are just 30 minutes from BBRMC, the drive is more than an hour for residents of Presidio city and even farther for more remote communities like Candelaria.

According to the district’s enabling legislation, board members must “periodically review the feasibility and desirability of operating a hospital in Presidio County.”

At a board meeting in 2020, the district voted against starting a new hospital after deciding it just wouldn’t be economically feasible. But now, a year later, the issue was coming up again.

J.D. Newsom, the executive director for the district, had an idea for how to examine the issue without alienating Presidio County residents. The district, he said, should hire an independent consultant.

“My guess is a hospital is going to be impossible,” Newsom said — but hiring a third-party consultant “without skin in the game” would make it clear the district was considering a new Presidio County hospital in an “unbiased” way.

Newsom said the consultants could look into other healthcare options for Presidio County that would be less expensive than a full hospital. “Maybe it’s an urgent care or acute care, a micro-hospital or something,” he said. Until independents studied the issue and looked at potential costs, “we can’t really answer that.”

Regardless, the board was open to the prospect of a new hospital, at least in theory. “I have a great desire to spread hospitals all over,” Boardmember Greg Henington said. In the end, the district voted to hire Houston-based Capital Healthcare Planning, which will study the issue for a cost of around $17,500.

A new board member and secretary

At the meeting on Wednesday, the district was also looking to replace a board seat vacated by Alfredo Armendariz, who’d previously served as the district’s secretary. And tuning in virtually to the meeting was a Presidio health worker who said she was interested in the role.

Andrea Perez, a pharmacist at Preventative Care Health Services, explained that she’d grown up in Presidio and attended pharmacy school in San Antonio. She moved back to Presidio around a year and half earlier, she explained. According to her online resume, she’s worked at PCHS since October 2019.

“I’d like to help, in any way possible, the community and its surroundings,” Perez said — and the board was happy to have her join. Board members voted to accept Perez as the newest member of the district’s board. Minutes later, they also voted to make her its new secretary.


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