Residents of Southeast Colorado Springs had little or no primary health care access before 2014, when Cory Arcarese founded Value Care Health Clinic. Many people called the area a health care desert.
Arcarese’s goal was to offer patients a medical home, where they would work with providers who got to know them and offered continuity of care, and where they could access general family medicine, vaccines, chronic disease management, non-life threatening urgent care and minor office procedures.
Arcarese not only achieved that goal but helped lead the way in attracting additional health care resources for Southeast residents, including a Peak Vista Community Health Center, a behavioral health clinic operated by AspenPointe, an urgent care clinic run by UCHealth, and a Women, Infants and Children office operated by El Paso County Public Health.
Arcarese sold Value Care to Matthews-Vu Medical Group in February 2019, which has expanded the practice, providing primary care access for more Southeast residents.
But Arcarese, who is now working as a business consultant helping small businesses get CARES Act funding, said the Southeast still lacks medical care for its 80,000 residents.
Specialty care is a need, but the biggest lack, Arcarese said, is a hospital.
“I’m very proud that there is now primary care, but we need a hospital,” she said. “I would never say it’s adequate until there’s a hospital there. When is there going to be a hospital where babies can be born in Southeast … where people can go if they have a heart attack? With no hospital there, you have a higher chance of dying from a heart attack because you have to go farther.
“If there’s a hospital, then the specialists will come with it.”
City Councilor Yolanda Avila agrees.
“We need a hospital in Southeast,” “In the northeast part of town, there are three hospitals, including the Children’s Hospital,” Avila said via email. “We do have [UCHealth] Memorial Central, where most of our residents seek care. We need a hospital in Southeast.”
Considering that the district she serves has the highest percentage of children in the city, “we are still in a health desert,” Avila said. “To alleviate this, we need a big and bold commitment via a partnership with both private and public health services. In other words, we have a long way to go.”
Avila notes that the El Paso County Board of Public Health has agreed to purchase part of the Beckett Event Center using CARES Act funding to expand the Fountain WIC (Women, Infants & Children) clinic and provide other services much needed in southeastern El Paso County.
“As far as I know, there has been no commitment from the county to expand health services in Southeast Colorado Springs through the CARES Act funding,” Avila said. “This is in spite of the challenges that the district faces with COVID-19.”
El Paso County officials pointed out that the new facility in Southeastern El Paso County will be accessible to Southeast Colorado Springs residents.
Michelle Hewitt, El Paso County Public Health information officer, said Public Health helped to form the RISE Coalition and procured a $500,000 Healthy Places grant from the Colorado Health Foundation that will be used to build a community hub at Mission Trace shopping center and assist the Solid Rock Community Development Corporation.
The short answer to why there is no hospital in Southeast, and why there won’t be one in the near future, is cost.
“We know that there aren’t enough services today provided in that community,” said Joel Yuhas, president and CEO of UCHealth’s southern Colorado region. “But hospitals are really high-cost locations for receiving care. When you have 75-80 percent of the market share in Southeast using UCHealth Memorial Hospital Central for its care, you wouldn’t build another hospital.
“And honestly, another hospital is just going to increase the cost of care in an environment where everybody is looking for health care reform and … reducing the cost of care. So I don’t see us building another hospital.”
What he does see, Yuhas said, is a continuing need for primary care and expanded relationships with other care providers such as Peak Vista.
Yuhas said UCHealth conducts a community health needs assessment, which is due to be updated soon. The system uses the assessment as a roadmap for where to locate primary care practices, where more depth is needed in current locations and what specialties are lacking across southern Colorado.
The assessment has shown a pressing need for primary care throughout the city that is even more pronounced in underserved areas like the Southeast.
“So what I see us doing is creating health care access points … and then looking at the specialty needs in that population and making sure that we resource them adequately,” Yuhas said.
“Creating these primary care centers and wrapping around them specialties as you need them is a way for us to improve access and keep the cost of care lower than if you built another hospital,” he said.
In the future, fewer people will be accessing care in hospitals and looking for lower-cost alternatives for care, Yuhas said.
“That’s not just because of the pressure to reduce the cost of care; consumers don’t want to be in a hospital if they don’t have to,” he said. “Wherever we can access more and more services at a more affordable cost in an outpatient setting, that is where I see our future. … I see us developing more primary care practices, working collaboratively with our partner at Peak Vista to look at the deficits in specialty care and partnering so that we can improve access collectively.”
UCHealth’s urgent care center at Circle Square is another way the system is helping to serve the Southeast, he said.
“That clinic, which serves a vast part of that community, is our busiest urgent care center in the UCHealth system and one of the busiest, I’m sure, in the state,” he said. “It actually has more visits than your typical hospital emergency room.”
Yuhas said he thinks part of the answer to better health care access for Southeast residents lies in addressing the social determinants, environmental factors and barriers to health care, such as improved transportation.
“A hospital can’t build roads and transportation,” he said. “You’ve got to work with your other constituents, where that’s in their wheelhouse to come up with models and improve access. It is a really complex challenge for our community that takes all of us working together.”
INCREASING PRIMARY CARE
The former Value Care clinic, now the southeastern office of Matthews-Vu Medical Group, has seen patient volume increase by 20 to 25 percent in the past year and a half, and there’s room to see more patients, said Debbie Chandler, Matthews-Vu CEO.
The practice’s founders, Drs. Rick Vu and Shabnum Matthews-Vu, “go down there a few days a week — they kind of rotate through, and that’s helped build our volume,” Chandler said. “We also have a new doc that is going to be joining us, and we’ve had a pediatrician down there a couple of days a week.”
While she thinks that there is more access to primary care in the Southeast than there used to be, “there just haven’t been too many medical operations that have ventured into Southeast besides Peak Vista and Matthews-Vu,” she said. “I would agree there’s not very many specialists. When we see patients, we’re having to refer them back up farther north to see specialists.”
The primary specialty the Matthews-Vu clinic offers is behavioral health.
“We do have an integrated behavioral health plan, and we have had some coverage of Southeast,” Chandler said. “It should be getting even better soon because we’re hiring more integrated behavioral health providers who will rotate just like we do at our Woodmen campus.”
El Paso County Public Health officials said they are anticipating future health-care needs as they make plans for the new facility at Highway 85-87 and Fontaine Boulevard.
The building will become the WIC location for Fountain; the current clinic has no room to expand and is losing its lease, said Susan Wheelan, director of El Paso County Public Health.
But it also will house a variety of services including assistance with food insecurity and services to support the community during the COVID-19 pandemic response and recovery phases, particularly COVID-19 testing and dispensing a vaccine when one is available.
“We’ll have a hub there to improve prenatal health outcomes and reduce maternal deaths and childhood injuries,” Wheelan said. “But the big-ticket item for this location is emergency preparedness and us gearing up to do points of dispensing for COVID as well as flu vaccines. … El Paso County is so vast, we’re going to need multiple dispensing sites.”
The center will serve clients from Fountain, Security, Widefield, Fountain Valley and Fort Carson as well as Southeast Colorado Springs; its location is a 10- to 15-minute drive from the Southeast, Wheelan said.
“I’m excited about this purchase because it is an opportunity for partnering,” said Dr. James Terbush, president of the El Paso County Board of Health, which approved the purchase Sept. 3.
The building “is large enough — about 30,000 square feet — that we can get together with others in the helping business,” Dr. Terbush said. “The key to our future success with this purchase is in co-locating and collaborating with partners, where we can provide a location for a variety of services to help our communities as we continue to deal with COVID-19.”
The $2.4 million facility, which is being purchased with CARES Act funding, will also be close to the Fountain Peak Vista community clinic, a food pantry, a Discover Goodwill store, the Independence Center’s Fountain site and the Department of Human Services and Pikes Peak Workforce Center’s combined location.
“That’s something unique, Hewitt said. “It makes it easier for folks because they have so many great services at their fingertips.”
While Public Health has not yet determined an opening date for the new facility, Wheelan expects it to come together quickly once the purchase is completed.
“This building is really turnkey ready,” she said, adding that the seller is leaving everything from furniture and artwork to refrigerators and security cameras in the facility.
There is plenty of room for physical distancing that will be observed when dispensing flu and COVID-19 vaccines.
There’s also room for additional public health services within the building.
“We want to make sure we are practicing prevention on all fronts as it relates to public health,” Wheelan said. “This building gives us that opportunity” in southeastern El Paso County.