It was the mission of Las Clinicas del Norte that attracted Executive Director Andy Lopez away from Los Alamos National Laboratory to the organization that provides medical and dental care to residents of Rio Arriba County and beyond.
“The mission has always been to provide access to health care, especially for those who are under-served,” Lopez said. “The mission in Los Alamos was to build bombs.”
It was 27 years ago that Lopez joined Las Clinicas, which was founded in 1973 and was then known as the El Rito Betterment Association. From a budget of $22,000 and a staff of three in 1984, Lopez has overseen the growth of Las Clinicas into a health care provider with operating expenses of $5.3 million, revenues of $5.9 million, 80 employees and three clinics in Abiquiú, El Rito and Ojo Caliente.
“It’s giving back to the community,” Lopez said. “Seeing my neighbors, knowing we can offer them quality low-cost services.”
Lopez, an El Rito native, hosted a managerial meeting in El Rito Aug. 9 and the seven attendees all had similar reasons for being there. The unity of their purpose to meet the medical, dental and mental health needs of local residents was evident, as all hailed from the surrounding area and expressed the satisfaction at being able provide for their neighbors.
“It has to be a team effort to be as successful as we are,” Lopez said. “It’s the commitment of the staff. We want long-term employees.”
As a community-based health center, Las Clinicas provides medical care for under-served individuals and families regardless of their ability to pay. Lopez said 52 percent of the patients served by Las Clinicas are uninsured.
Medical Director Suzanne Norman, an orthopedic doctor, commutes to the Abiquiú clinic from Cuba and serves as director for medical service providers.
“My mission has always been to serve the under-served,” Norman said. “The population we serve is wonderful. This is a good fit for me.”
The fit is equally good for Chief Financial Officer Kathleen Ngirbedul, of Vallecitos, who has been with Las Clinicas for 10 years.
“I enjoy looking at accounts,” she said. “I enjoy looking at numbers.”
School Health Center Director Andrea Sandoval, of Petaca, oversees the school-based health clinics that Las Clinicas operates at Mesa Vista and Pojoaque High Schools offering medical, dental and behavioral programs. Begun in 2000, the clinics reach adolescents at their schools, helping them get good health care without requiring them to travel to a doctor’s office and relieving their parents, who may be working, from having to take time off work to transport their children. The school clinics serve kindergarten through high school students.
“We looked at the demographics and noticed that we weren’t seeing adolescents,” Lopez said. “We wanted to be able to offer them care and be able to intervene as early as possible.
Sandoval has been with Las Clinicas for six years.
“I enjoy working with the students,” she said. “Being able to make a difference in their lives.”
Growth
The school-based clinics are the latest chapter in the expansion of Las Clinicas, funded by United Way of Northern New Mexico. The early years were marked by a constant turnover in medical personnel, which limited the company’s growth and the services it could provide.
“We were reliant upon National Health Service Corps personnel,” Lopez said. “They never wanted to stay in the community and they would leave. We would have to close the clinic down until we got a replacement.”
The Corps would place medical personnel in rural areas. Those personnel would then be forgiven loans they had received to pay for their education.
A turning point for Las Clinicas came when it was able to obtain funding through the state Rural Primary Health Care Act of 1983, enabling it to hire its own medical personnel.
“We were able to hire personnel out of private practice,” Lopez said. “Once that took place, we were able to stabilize our financial base.”
In 1987, Las Clinicas was able to hire a husband-and-wife nurse practitioner team in Bill and Coleen Atkinson. Their dedication to living and staying in the community further helped stabilize the financial base. Joining Las Clinicas in 1988 was Dr. Ed Trujillo, who would be instrumental in building the dental care facilities into some of the best in the nation.
“When I first came here, there were two operating rooms,” Trujillo said. “The overhead light was held up by pieces of baling wire.”
Another key factor in 1988 that enabled Las Clinicas to form a secure financial base was being classified as a federally qualified health center, allowing the organization to be reimbursed for medical services by Medicaid and Medicare, which now generate a substantial part of its revenues.
Lopez and Bill Atkinson planned the Ojo Caliente clinic, which opened in 1991. Because it was more conveniently located along a major highway (Highway 285), the growth of the company accelerated.
“It just took off,” Lopez said.
Las Clinicas opened its Abiquiú clinic, also along a major highway (Highway 84), in 1994. That same year, it added mental health services. It was a pioneer in providing these services.
Las Clinicas recently hired Rick Church as a behavioral health therapist and counselor, joining his wife, Dana Darrow, who is also a mental health therapist at Las Clinicas. Church previously worked for the Los Alamos Family Council. They live in Abiquiú.
“Not having to commute two hours to work is a plus, but also working in the community I live in is a big positive for me,” Church said in the most recent issue of El Aviso, Las Clinicas’ newsletter.
One of the most noticeable features of all the clinics is the lack of clutter. Thanks to Information Technology Manager Desi Lopez, Andy Lopez’s nephew, Las Clinicas’ records are kept electronically. They were pioneers in the process of going paperless.
Say ‘Ahh’
The present El Rito clinic opened in 1998 and features a state-of-the-art dental clinic that is rated among the top three percent of dental facilities in the country. It has four dentists, 11 operating rooms and is open six days a week. Trujillo, from nearby Antonito, Colo., has been the driving force behind the facility.
“I grew up in a small town and knew early on the difficulty of getting dental care,” Trujillo said. “I’ve dedicated my life to public health service.”
As dedicated as Trujillo is to his patients, they are just as dedicated to him. Aubrey and Yuvonnia Owen recently moved to Albuquerque from Abiquiú, but they still drive to El Rito for dental care.
“Because (Trujillo) is the best dentist we’ve known in our lives,” Yuvonnia Owen said. “It’s not too far (to drive) to see Dr. Ed.”
The dentists at the clinic find working there rewarding.
“It’s a good way to help people without worrying about making ends meet,” said Dr. Anthony Garcia, who joined the clinic from Santa Fe after 26 years in private practice. “Here, the wellbeing of the patient is first in your mind.”
The patients they serve are a big part of the dentists’ dedication to Las Clinicas.
“A lot of patients appreciate the care you’re giving them,” Dr. Roxanne Collins said.
Those patients are appreciated even by dentists not at El Rito.
“I refer some patients to Dr. (Terry) Carlsberg in Santa Fe,” Trujillo said. “He tells me, ‘Your patients from El Rito are super.’”
Giving Back
The patient-provider relationship is strong throughout Las Clinicas. At every clinic there were providers who were fulfilled by the work they were doing and the patients they served.
“It’s just fun,” said Annie Smith, a nurse practitioner for 13 years at the Abiquiú clinic. “I feel lucky to be here.”
Smith was training nursing student Pauline Tither from Franklin Nursing University.
“It’s nice to have students,” Smith said. “They keep you on your toes.”
Tither appreciated the opportunity.
“This is a great place to learn,” she said.
At the Ojo Caliente clinic, nurse Jeanette Lucero has been with Las Clinicas 19 years. An Ojo Caliente native, being able to give back to her community motivates her.
“We’re able to provide services to our own (people),” she said.
All three clinics include a small pharmacy and are able to do some in-house laboratory tests. In addition to the medical, dental and mental health services, the clinics also have diabetes management programs. They make monthly home visits to elderly patients who are unable to leave home, and outreach and eligibility services are also offered.
From July 2010 through May 2011, Las Clinicas saw 44,052 patients, including 18,900 in the medical services and 17,239 in the dental program. Las Clinicas not only draws clients from the area it serves, but patients travel from southern Colorado, Santa Fe, Taos and Albuquerque seeking affordable quality health and dental care.
“They did me pretty good,” said Gilbert Vigil, who drove from Chimayó. “I don’t have dental insurance, so they give me a break. It was worth it.”
Although its mission is to provide service to the under-served and uninsured, Las Clinicas accepts all patients, including those on Medicare and Medicaid, as well as those with private insurance. The variety of revenue sources helps cover the costs of providing for patients who cannot afford treatment but need it.
“What has kept us viable is we have a good mix of patients, not just those who pay the sliding fee,” Lopez said. “The diversity of revenue helps pay for the people who can’t.”
Forty percent of the organization’s revenues come from grants. The rest comes from payment for services, with Medicaid being the largest source, as well as contract services with the state.
Las Clinicas now provides 80 jobs, many of them filled by local residents. Its salaries and employee benefits total over $3 million, and its overall economic impact on the local economy is $7.7 million, according to Capital Link, a national nonprofit that connects community health centers with capital resources.
Future projects at Las Clinicas include the building of a new clinic in Abiquiú, as that clinic’s clientele is growing and exceeding the building’s present capacity.
Las Clinicas is also in the process of being certified by the National Committee for Quality Assurance, an organization dedicated to improving health care quality.
Although Las Clinicas has grown into an economic force with state-of-the-art technology for the communities of Northern New Mexico, it’s being served by local people who care about local people that appeals to many of its patients.
“What I love about the clinic is they’re so old-fashioned,” dental patient Joe Lopez said. “At dental offices they used to make me wait forever. Here they’re gracious. It’s wonderful.”