Big Bend Regional Hospital District discusses grant funding for telehealth, psychotherapy 

ALPINE — At Monday’s meeting of the Big Bend Regional Hospital District (BBRHD), the board discussed two topics that they’ve been hoping to tackle for a long time: expanding access to telehealth options and mental healthcare services in the Big Bend. Executive Director J.D. Newsom proposed pursuing grants in each arena — ultimately, the board decided to apply for a grant to fund a telemedicine kiosk in Terlingua and opted to table one that could increase access to psychotherapy. 

Newsom told the board on Monday that he’d like to seek additional funding from the U.S. Department of Agriculture this year by applying to a grant specifically targeting telemedicine. Back in June, the BBRHD announced that they had received $5.5 million in funding from the USDA toward healthcare in Presidio and Terlingua. Eventually, that funding will go to the creation of an after-hours clinic in Presidio and a clinic in Terlingua, which hasn’t been served by traditional healthcare services in over 20 years. 

For this year’s round of USDA rural medicine funding, the BBRHD has been looking into a telemedicine unit from OnMed that can diagnose — and treat — certain health issues remotely. OnMed describes its products as “self-contained telemedicine kiosks” — patients are seen via videocall by a clinician and then by a pharmacist, who can dispense medication through the ATM-style machine. 

The grant application hasn’t been written yet, but the board is tentatively planning to pilot the telemedicine program in Terlingua, since the program targets extremely rural areas. The major downside of the OnMed proposal is that it’s expensive — the USDA grant caps off at $1 million, which would only fund licensing fees for a single machine for three years. 

The OnMed kiosk might help solve the perpetual problem of attracting healthcare professionals to live in the Big Bend, but questions about its feasibility lingered. The units have been successful in places like college campuses, where regular use pays off — a small and self-reliant community like Terlingua might not attract the traffic needed to justify the cost. “An important part of the discussion is, ‘Is this too much for a small community?’” Newsom wondered. 

Board Chair Buddy Cavness thought it wouldn’t hurt to put together a grant application, which, if successful, would require a 50% funding match. He appreciated that the proposed OnMed machine was self-sustaining, allowing the board freedom in how they decided to dispatch and operate the unit after licensing fees were paid for. “I like it because we’re not tied to somebody else,” he said. 

Next, the board discussed expanding regional access to psychotherapy by partnering with Texas Tech University’s Health Sciences Center, which offers a mental health fellowship program. The program would allow licensed professional counselors (LPCs) in-training to provide low or no-cost treatment to Big Bend residents during their 3,000-hour coursework. “We’ll be able to keep that person busy,” Newsom said. 

Newsom explained that Texas Tech is relatively flexible with how communities choose to implement the program — they offer telehealth options or in-person residencies, provided the BBRHD could provide space, administrative upkeep and other essentials. The requirements for the program would mirror existing services through Preventative Health Care Services and PermiaCare, which provide limited psychotherapy services to patients who have a mental health diagnosis. 

The board decided to table the idea for further discussion down the line — some board members balked at the idea of paying Texas Tech for a service that essentially allowed their students to charge money for services rendered during their training. Still, they felt it was worth further number crunching and data gathering. “I’m definitely supportive of anything we can do for mental health,” said Board Member Greg Henington.