August 23, 2023 602 PM
PRESIDIO — Last Wednesday, the dining room at the Presidio Activities Center filled to standing room only as community members gathered to learn about a new clinic and community paramedicine program coming to Presidio. The panel of hosts included representatives from the City of Presidio, the Big Bend Regional Hospital District (BBRHD), Preventative Care Health Services and Presidio EMS.
The meeting was a coordinated effort among these agencies to educate the public about a grant awarded last summer that will allow Presidio and Terlingua to expand their healthcare services. A total of $5.5 million dollars was allotted for the two communities — and represented just one of thirteen such grants awarded to healthcare entities nationwide.
The BBRHD and Terlingua Fire and EMS hosted an equally well-attended town hall for south Brewster County residents back in June. For Terlingua, the grant will provide for the opening of a part-time clinic and the launch of a community paramedicine program that will expand the scope of care that EMS personnel can provide to local residents.
Presidio will take the lion’s share of the grant in order to offer Presidio County’s largest population center with an after-hours clinic to supplement the existing Preventative Care Health Services (PCHS) clinic that operates during business hours. The grant will also provide for a community paramedicine program similar to the one being launched in Terlingua.
Linda Molinar, CEO of PCHS, gave an overview of the history of the clinic and how far it had come over the years. The community went from having no clinic to having a once-weekly clinic to the present day clinic — which has three rotating internal medicine doctors on staff serving patients regardless of their financial status. “There wasn’t a voice for the people,” she said of the days before PCHS. “I worked very hard to bring [a clinic] to town. Now everybody who comes is treated the same whether or not they can pay.”
Jesseca Murillo and Stephanie Rivera of Presidio EMS gave a presentation about the concept of community paramedicine. With additional training — and a boost from the USDA grant — Presidio’s paramedics will be able to provide certain home visits, preventative healthcare and education for the community’s most vulnerable.
Murillo began by explaining the challenges facing the rural emergency service: hundred mile ambulance rides, broken equipment and strained finances. Many patients complained of weeks-long waits to get appointments at the clinic, leading many preventable health issues to snowball until they became emergencies. “This is the reality for Presidio,” she said. “Unfortunately, there just aren’t the resources here.”
The community paramedicine program would help ease the strain on the clinic by allowing EMS staff to treat some of these issues with home visits — instead of waiting for illnesses and injuries to become a crisis, community paramedics could provide non-emergency services such as changing bandages and colostomy bags, administering blood tests and checking to make sure patients were using their medications regularly and correctly.
Helping Presidians with their medication was a top priority in the program. The community faces a particularly high rate of cardiac conditions and diabetes, where a regular regimen is key. Many older folks have mobility issues or simply can’t get a ride to the clinic.
Others have grown used to long clinic wait times and the lack of a pharmacy. While the PCHS clinic currently services a pharmacy, that wasn’t always the case — when there was not a pharmacist on staff, patients were reliant on a weekly medication delivery from City Drug in Alpine.
Presidio EMS personnel were hoping that those issues would quickly become a relic of the past. The approach would be two-pronged: first by extending the hours of the existing clinic, which would be open three days a week until 10 p.m., allowing more time to treat acute, urgent problems.
The community paramedicine program would help medical providers spend more time with each patient in the comfort of their own home. “Fifty percent of what we’re going to do at your house is education,” EMS Director Troy Sparks said. “Sometimes doctors [in physical clinics] just get you in and out, and they don’t have time to educate you.”
The entities involved in administering the grant — the BBRHD, PCHS, Big Bend Regional Medical Center, Presidio EMS and the City of Presidio — were still hashing out all the details of the program. At press time, there was an open position for someone to take calls answering questions and schedule appointments, to begin on September 1.
After September 1, the operator will be physically located at City Hall and can also be reached by phone at 432-229-3273.