CHALLENGE
The community of San Luis in South Yuma County, Arizona lies on the border with Mexico and is a vibrant and growing community with two ports of entry. Despite the growth of the community to nearly 35,000 full time residents and up to 30,000 people commuting daily to work on area farms from Mexico, the community does not have access to hospital or urgent care services locally. This resulted in residents seeking care from local emergency services personnel, such as EMTs and firefighters, by literally knocking on the fire station doors to get help. For primary care of a population that is younger on average than the state average, there was a large unmet need for access to pediatrics, obstetrics, and other ambulatory services. In community interviews, local residents expressed concern about the cost of services at Yuma Regional Medical Center as well as long waits for care in the emergency department and area physicians indicated needs for expanded diagnostic tests and ambulatory services such as CT, MRI, x-ray, cardiopulmonary, plus surgery and endoscopy.
Unfortunately, the population’s health status reflected the historical under-investment in providing adequate services to the community. Health indicators for Yuma County as a whole are poor in a number of different areas, most notably reflected in the number of people reported in ‘poor or fair’ health being significantly higher than the state and US average and the number of primary care physicians is low resulting in the community being designated as a “Health Professional Shortage Area” by the Federal government. The lack of locally available healthcare further constrained economic growth and development for the area with developers actively moderating housing and commercial projects throughout the area due to concerns about the lack of local services for their customers.
PROCESS
The Regional Center for Border Health (RCBH), led by Amanda Aquirre, a former state senator, planned a first-of-its-kind Medical Mall to meet the needs of the community. StroudwaterGCL staff worked with RCBH to engage the community and existing providers in the region in planning for expanded services that could be provided in a high-quality and sustainable manner. As a result, RCBH identified the following four objectives for : 1) Provide high quality medical care for routine tests and procedures, 2) Improve the overall population health through better access to services and in improving health behaviors, 3) Recruit more primary care providers to the area to help people stay healthy and provide patient centered medical home care, and 4) Partner with local groups like EMS, insurance companies and others that can provide incentives for lowing the total cost of care. To meet these goals, RCBH planned a new facility, the Medical Mall, totaling approximately 64,000 square feet at a total project cost of $35.1 million. The facility is designed to make the biggest impact on population health by housing primary care, diagnostic, and outpatient procedural services initially; however, the facility is designed to be expanded to include hospital-based services in the future as the community needs continue to evolve.
RESULTS
StroudwaterGCL’s team secured permanent financing commitments from the United States Department of Agriculture (USDA) Community Facilities loan program to fund the project at the lowest interest rates available in the marketplace. Construction of the new facility was completed in 2020.