Photos and article by Mary Alice Murphy

From the morning to early afternoon on Monday, Aug. 14, 2017, Hidalgo Medical Services celebrated National Health Center Week with informational tables and two bouncy houses set up for people to get information on HMS services.

From 11 a.m. to 1 p.m., HMS representatives held a private lunch with local elected leaders in Lordsburg.

In the evening, a private dinner took place, with Congressman Steve Pearce being the featured speaker and videos shown from U.S. Senators Tom Udall and Martin Heinrich. Also present were HMS board members and several staffers, as well as the founder of HMS, Charlie Alfero.

HMS Chief Executive Officer Dan Otero said the clinic was celebrating National Health Center Week along with the rest of the nation. "The purpose is to expand awareness of the impact community health centers have. More than 25 million Americans are served by 10,000 community health centers across the country."

He introduced the HMS board members, President Carmen Acosta, Vice President Bill Walter, members Magdaleno Manzanares, Priscilla Perea, Barbara Guber and Pam Archibald.

Also present was Chief Medical Officer Dr. Derrick Nelson and Chief Financial Officer Jim Hoy. He also acknowledged the other chief level personnel, Chief Mental Health Officer Dr. Neal Bowen, Chief Dental Officer Dr. Kaiyra Salcido (who came in late), Chief Compliance Officer K'Dawn Jackson and Chief Support Officer Edith Lee, who were unable to attend.

"HMS will not turn anyone away because of inability to pay," Otero said. "But we always seek payment. We have a sliding scale of payments to make it easier to afford services."

He said HMS wants to improve the experience of health care, while reducing costs, using a comprehensive integrated model.

HMS partners with the Department of Health and the Southwest Center of Health Innovations, as well as with Gila Regional Medical Center. He said a significant number of providers of primary care also want to provide hospital services, such as ob/gyn.

"Our services are extremely important in rural communities, where it is harder to keep specialists," Otero said.

Alfero gave some history of HMS.

"It's been an interesting ride," Alfero said. "Our first shot was in 1980-81. Our first iteration at developing HMS was as a free national health service core site. We brought in a federal physician. That lasted a few years until the physician left, leaving Hidalgo County with no physician. For about 10 years, we had no HMS, but Hidalgo County created a committee to recruit a physician."

Alfero went to work at the University of New Mexico and put in his contract that a clinic would start in Lordsburg. "On July 1, 1995, with my $35,000 contract, we restarted HMS in Lordsburg two days a week, under the DOH and New Mexico Rural Primary Care Act. The first day, we had a student, a nurse practitioner, who was studying telemedicine at Western and UNM. That was important because part of our mission has been to train as we develop."

He recognized many individuals, including Tommy Anderson, who was the Hidalgo County manager, for the first and second iterations of HMS. Because HMS had no cash flow, the first employees were county employees.

Alfero said Bob Martin of Western Bank told him at the time, when Playas was closing down, that if it hadn't been for HMS, he would have closed the bank. "It shows the economic impact our organization was having."

In 2002, HMS became a provider in Grant County, too, the first time something that started in Lordsburg had spread to Grant County. "It became a big thing for both communities. UNM has been a big help. We had the first teleradiology capability in the state. Sen. Jeff Bingaman was instrumental in providing funding for the Silver City and Lordsburg facilities."

On Nov. 1, 1997, Alfero said HMS received two grants and in one day went from a $250,000 budget to a $1 million budget. "We started rotating managers down from UNM. It's been a team effort, from local and far away, that helped make HMS happen."

Otero read the HMS mission statement. He said the combined population of Grant and Hidalgo counties, with Grant having about 29,000 and Hidalgo having between 4,500 and 4,600, supports 13 clinical sites, plus Grant and Hidalgo counties' senior centers, which bring zero revenue. "But we have a 100 percent commitment to seniors. We have a $20 million budget, with 215 professionals, making us one of the larger employers in the area. We are the only provider for Medicaid dental services."

He noted HMS is exceeding nine out of 15 federal indicators. "Eighty-eight percent of our patients say they receive excellent care. We contribute $50,000 in sponsorships going back into the communities. Our recruitment efforts continue. We created a recruitment model that brought us 19 medical personnel. We have to work on retention."

Dr. Nelson talked about the family medicine residency program, which he oversees. "August 13 was my seven-year anniversary here. I came from an urban and academic setting to join HMS. In 2010, HMS got a grant to bring up work force development. From that came the family medicine residency, which is the only one funded in the state. We have two residents per year and they stay for two years. We see 3,500 patients a year, so we are the best center for training family medicine providers."

He cited statistics that show 56 percent of family medicine graduates stay within 25 miles of where they trained.

Otero said the future family medicine practitioners are being trained in Silver City and Lordsburg. He commended New Mexico Sen. Howie Morales and Rep. Rodolopho "Rudy" Martinez for supporting HMS. They were unable to attend the event.

The next to speak was Lynn Carroll, the NM Public Health Division director. "New Mexico Department of Health and HMS share a vision of a healthier new Mexico. You share a special commitment to the community."

Carroll said teen birth rates continue to fall to the lowest in a decade. Teen cigarette use is lower, as is New Mexico's childhood obesity rate. "Our work results in lower chronic disease and less cost. Making the programs work still faces challenges. We are still poorer than the national averages, and teen pregnancy, substance abuse and chronic disease are still higher than national averages. Our clinical services are limited, but you, HMS, provide a comprehensive medical home. I imagine a future where we can help you more. We want to provide self-management workshops for those with diabetes, interventions for smokers, and to treat substance abuse. I congratulate you on your success. We want to work with you to prevent duplications."

Eileen Goode, New Mexico Primary Care Association CEO, said her group provides training and technical support services. "Celebrating national health centers is key to having healthier communities. People have access to quality care, which includes oral and mental health. Being community-based is a huge part of it." She noted 56 percent of all New Mexicans are at or below the poverty line, with 48 percent being uninsured.

"We have 185 sites in New Mexico, with 80 percent in rural areas," Goode said. "Next month, federal funding for federally qualified health centers will expire unless Congress votes to extend it. We intend to continue to earn your respect."

The main speaker of the evening was U.S. House of Representatives Congressman Steve Pearce. He said he grew up in a family of six kids in Nadine, N.M. on a five-acre farm. "At nine years of age, I got my first job. I got up at 4:30 a.m. to ride out silently with the farm owner to change irrigation pipe. At 7 he took me back for me to get to school, then after school, I went back out to the farm. Every day he took out a notebook and a stub of a pencil and wrote down my hours. I was keeping them in my head. I was pretty good at math. At the two-week point, he came driving up, stopped and reached in the back and got the notebook and a three-ring binder of checks. He added up the hours slowly carrying the one to the next row, and I was getting impatient, but his result was the same as mine. Then he takes out the pen, writes my name on the check, and a number beside it. It was one of the proudest days of my life that I had learned how to make my own way and to realize that someone values your work enough that he pays you for it. That memory has never left me."

He said he was a strong fan of public health, because "that was where we got health care. There were two ladies in white caps. I thought they were Navy admirals. I was scared of needles and it always hurt, but those ladies gave us health care. You must remember that when you go to your job, it is noble beyond belief. I hope you go with pride knowing that you are serving people who depend on you."

Pearce said he believes today there is too much politics and not enough service. "I don't want a single party state. I don't want to hear single viewpoints, because then you never arrive at the truth. Health care is complex and from a policy point of view, it's even more complex."

He explained that a bill cannot even get to the Senate floor without 60 votes. In 2009, when the House had passed the Affordable Care Act, Sen. Ted Kennedy died and was replaced by the unknown Scott Brown. "The Democrats knew the bill needed changes. The House passed it knowing full well it would come back for them to fix. But with Brown, the Democrats in the Senate had lost their 60th vote, so they couldn't get the votes to fix it."

The Affordable Care Act is in the process of turning inward. "We don't know if it will collapse, but young healthy people are getting out (of the ACA), which makes the costs ratchet up. Twenty-three exchanges were put in place; 16 are now broke and non-functioning."

He said he was called to the principal's office (President Trump) for not confirming he would vote for the Republican replacement bill. "When he said: 'I need your vote,' I said: 'I'm not going to give it to you. I represent my 700,000 New Mexico voters.' He was gracious at the time, but threatened later to run someone in the primary against me. Our message was: 'you do no run the voters in every district.' I think he's come to recognize that."

Pearce explained the reconciliation process, which can happen on only one bill a year. The House passes a bill, the Senate passes a different one and a conference committee hammers out a resulting bill. "This was the one bill this year. The Democrats and the Republicans all agree that the bill has problems that need to be fixed. I don't know where it's going to go, because Sen. McCain's no vote shut down the process. To me, his vote looks like a personal vendetta."

"We should run for office as Republicans and as Democrats, but the day after the election, we should serve as Americans, representing our constituents," Pearce said.

He referred to when John Boehner was House Speaker and many, including Pearce did not vote in lock step with the speaker. "He accused me of not being a team member, and when I continued to vote against items he wanted us to vote for," he took away Pearce's committee assignments.

"Both parties are doing things that do not serve the people," Pearce concluded. "You, the voters, are the feet on the ground. We thank HMS from a grateful state. God bless you. None of us wants to see neighbors live in difficulty. I'm glad you're providing a solution to the people. Mental and behavioral health was one piece Mom did not outsource," he said to chuckles from the audience. "Know that your funding is going to be OK."

U.S. Sen. Tom Udall, via a pre-recorded video, thanked HMS for great work. "We face enormous challenges in health care in New Mexico. Many New Mexicans live a long way from a hospital. What you provide is invaluable. I support the continued growth of health care centers. I'm fighting hard not to roll back Medicaid funding. I want to let New Mexicans chase their dreams. Thank you for ensuring health care to New Mexicans."

Kristen Sullivan, representing U.S. Sen. Martin Heinrich, introduced a pre-recorded video from Heinrich. "Thank you to HMS for inviting me to share a few words. Hidalgo Medical Services is a national leader in using innovation to provide health care."

In the video, Heinrich said HMS has integrated primary care, dental care and mental health care, strengthening health care to the community. "It is essential to recruit for rural areas and to invest in telehealth to provide care. You provide comprehensive community-based health care, which every New Mexican deserves. Count on me to make sure affordable care is available for all New Mexicans."

Otero read a statement from U.S. Rep. Michelle Lujan Grisham saying she appreciates the hard work of the dedicated practitioners at Hidalgo Medical Services.

U.S. Ben Ray Lujan, in a written statement read by Otero, said: "Thank you for the work you do, day in and day out."

Otero noted the impressive reputation HMS has in the state and nationally.

New Mexico District 38 Rep. Rebecca Dow attended the event and said preventative care is critically important. "Hidalgo Medical Services has the heart for people who could not otherwise receive care. Thank you for your service. I'm in early childhood care and the sooner children, from prenatal through school, receive health care, the better they do. I love the job skills you are doing to keep physicians in the local community. I love to advocate for quality, accessibility and affordability for health care."

Otero noted that county and city governments had created proclamations for National Health Care Center Week. He also specifically pointed out board member Barbara Guber, who he worked under first at Gila Regional Medical Center. "She was my mentor."

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