Southside Clinic Aims for Integrated Health

Presbyterian Medical Services welcomed US Sen. Ben Ray Luján, D-NM, Wednesday on a tour of its new Santa Fe Family Health Center, a site where the organization aims to provide integrated health care services on the Santa Fe’s Southside.

“I think we should all celebrate when there are more facilities, more providers in our communities providing more care to everyone,” Luján said during the visit to the 47,000-square-foot facility, which consolidates behavioral health, primary care and dental services (a first for PMS) from the formerly separate Santa Fe Community Guidance and Santa Fe Family Wellness centers.

Currently, federally qualified health centers such as the Family Health Center care for about 15% of New Mexico’s population and nearly a quarter of uninsured New Mexicans depend on this form of care, according to a 2021 report from the New Mexico Primary Care Association.

For this reason, the center will employ staff who help enroll people in Medicaid and the New Mexico Health Insurance Exchange if they qualify, and will provide community support services to address needs like housing, transportation and employment. It also offers a sliding fee scale for uninsured patients, discounting up to 80% of bill charges, according to PMS Director of Legislative Affairs Larry Martinez.

“And, if they can’t pay the 20% co-pay, even in those situations, no ones going to take anyone to a collection agency or a bureau to try to receive that pay,” Martinez said during a news conference.

Before the new facility’s construction, Presbyterian Medical Service buildings were more scattered around town. The building at 4730 Beckner Road is a strategic move to serve the shifting population, he said, estimating the center will serve about 8,000 people.

“The vast majority of the population in need of services lives in the south side of town. We’re serving huge neighborhoods down here,” Martinez said, adding later, “We hope that by being located in the target population area that it’ll improve access to care, because that is one of the key problems.”

The new facility employs an integrated approach to health care, with behavioral health services for children and adults taking up a large part of the building. Programs include a “psychosocial rehabilitation” program that educates and coaches patients in a variety of life skills to help them live more independently through stress and anger management, communication skills, self-care coping skills and money and health management.

Luján said he supports the growth of integrated health care because it addresses the negative stigma associated with mental health care.

“If you break a limb, wrist or ankle, you immediately go get care for that,” he said. “But when it comes to mental behavioral health, you don’t always ask for help or look for help.”

Lujan is part of a Senate working group on primary care, he explained to PMS staff: “I was insistent that mental and behavioral care be treated as primary care as well…More people need to speak up about this, and I am happy to say that in New Mexico, providers, communities, constituents—more people are speaking up.”

By providing primary and mental health care under the same roof, providers from different units can refer patients back and forth between primary care and behavioral health, rather than sending patients out to find the resources on their own.

PMS North Central Region Director Yvette Sandoval said most patients access PMS through behavioral health first.

“We often have a behavioral health therapist or a case worker from one of our services that will walk the patient right over to medical, and can quickly be seen for what the issue is that day,” she said. “Those warm hand-offs really make a significant difference in accessing care.”

PMS plans to have six full-time medical care providers at the center, but at the moment, only the primary medical and adult behavioral health units are open. Sandoval said a pediatrician will start next month and two dentists have also been hired, with one starting in November and the other in January.

When it comes to physicians, Dr. Santiago Ayala and Family Nurse Practitioner Estelle Elliott have been supporting the primary medical care team with patients since the facility opened in late August.

Martinez says despite its recruiting work, PMS primarily relies on nurse practitioners and physician assistants due to the national shortage of doctors and physicians. Between 2017 and 2021, the number of primary caregiver physicians in New Mexico declined by 30%, according to a 2022 study from the University of New Mexico.

“When it comes to behavioral health, I think that’s probably the most critical area in terms of shortage,” Martinez says. “Finding behavioral health therapists, there’s a very limited pool, and everybody who is doing behavioral health is trying to hire from that same small pool…Over the years, behavioral health has been perceived as a high-stress, difficult service to provide, and people burn out quite a bit. When I got into healthcare 47 years ago, I always thought of primary and medical care as being what most of health care was, with behavioral health being an adjunct. I think it’s really the other way around—most of our problems are behavioral health, with physical primary care being the adjunct.”

Editor’s note: The description of statistic from the 2022 UNM study in this story has been updated for clarity.