December 6, 2023 347 PM
FORT DAVIS — Jeff Davis County officials are currently pursuing grant funding to establish a federally qualified health center in the town of Fort Davis in order to help bolster the remote community’s healthcare offerings.
“We want to be able to offer healthcare so our citizens don’t have to drive back and forth to Alpine,” said County Judge Curtis Evans.
Jeff Davis County has been classified by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, as a medically underserved area since 1978. There is a higher percentage of people over 65 living in the county, 42.5%, and 21.3% of the total population is living in poverty, according to the U.S. Census Bureau.
Dr. James Luecke, who opened his private practice 36 years ago, is currently the only healthcare provider in Fort Davis. He said he sees around 100 patients a week from across the tri-county region.
Luecke’s eventual retirement — which the doctor said was not planned for five to ten more years — is one of the reason’s a new clinic is needed, said Evans.
“What happens to a town when it loses its doctor? Especially to a town that is demographically high in poverty,” said Jeff Davis County EMS Director Peggy Fonseca, who is also working on the initiative.
The cost of the clinic is estimated to be around $6 million — a sum the county intends to raise solely through grant funding, said Evans. While an exact location for the clinic has yet to be finalized, Evans said the effort is full steam ahead.
The county hired a consultant, Stephen Hofmann of Lone Star Consulting, who is actively searching for grants, he said. “We direct him to what our necessities are, our hopes and plans,” said Evans. “As soon as funds become available we’ll be moving forward.”
While many of the project details are still up in the air, the type of clinic the county is looking to open is referred to as a federally qualified health center, or FQHC.
There are a total of 72 FQHCs in the state — facilities that help “provide comprehensive health care services to underserved communities,” according to the Texas Department of State Health Services. Preventative Care Health Services, for example, is an FQHC.
Fonseca said the clinic would be able to offer a variety of services that “aren’t readily available to people in the community” — physical therapy, mental health, a fee-for-service pharmacy and more.
“The FQHC will offer services like dental, pediatrics, women’s care, things that we don’t see a lot of here,” said Fonseca.
Evans said they are also looking to expand telehealth offerings, which are currently operating out of the county library.
FQHCs are open to both insured and uninsured individuals, and those in need cannot be turned away due to an inability to pay. Thirty percent of the funding for these facilities comes from the federal government through the HRSA, with state grants and community funding making up the remainder of the clinic’s revenue.
Fonseca explained that while the county would receive the initial funding to jumpstart the clinic, it would likely contract with Big Bend Regional Medical Center, Texas Tech, or another entity to actually run the business.
“Managing services, I don’t see the county doing that, because then we’d have to employ doctors, we’d have a board of directors, we’d have to employ nurses,” said Fonseca. “It’s [more like] ‘Hey, look, this is our facility, and we would like to contract with you.’”
Fonseca argued that having a clinic in town would provide more comprehensive healthcare for the community’s elderly, who may require help managing medicine and more routine check-ins. She said the clinic would likely have same-day availability for patients who need appointments as well as be open after hours and on weekends.
Because the potential new clinic would be federally-designated and located within a medically underserved area, doctors working there would qualify to have their student loans paid off by the government. Fonseca said that incentive should allow the clinic to attract providers for two to three years at a time, or longer.
Dr. Luecke said he has seen a lot of doctors come and go in the area, but his loyalty to his patients has kept him in Fort Davis. He was unsure whether the county’s sparse population, which equates to a lower volume of patients, would support the new clinic, but overall expressed support.
“It’s kind of a small town, but certainly it would probably help the area to have something available, especially nights and weekends,” said Dr. Luecke. “I’m happy for whatever helps the area.”
The idea to create a new EMS facility adjacent to the new clinic is also being explored. Because EMS personnel are on-call 24-7 they would be able to help in emergency situations, said Fonseca. “We’re looking at building a separate EMS station to augment providership,” said Fonseca. “Paramedics are [helping] fill in gaps for providers in the rural areas.”
The county is estimated to complete its bunkhouse building project — a primarily grant-funded addition to the existing EMS and volunteer fire fighting facility that was designed to house first responders — by January 2024, said Evans.
The county is still in the process of envisioning what the clinic might look like, and discussions with potential partners are ongoing, said Fonseca. The county has met with U.S. Representative Tony Gonzales’ office on the matter, and may seek out a letter of support as well as funding assistance from him, she said.
It is unclear whether the clinic initiative has won the support of other members of Jeff Davis County Commissioners Court. Commissioners Jody Adams and John Davis told The Big Bend Sentinel that they still have a lot of questions about the potential clinic and more information is needed. Commissioner Royce Laskoskie declined to comment and Commissioner Roy Hurley did not respond to a request for comment.
Jeff Davis County isn’t alone in its pursuit of increased healthcare services for its citizens. The Marfa Country Clinic is launching new psychiatric and comprehensive care management (CCM) programs soon. Just last week, a new clinic funded by a $5.5 million USDA grant from the Big Bend Regional Hospital District — which will be run by the Big Bend Regional Medical Center — opened in Presidio.