Nuestra Clinica del Valle, Inc. (NCDV), a federally qualified health center, has served the low income and uninsured families of Hidalgo and Starr Counties in the Lower Rio Grande Valley of Texas for the past 45 years. Incorporated in 1971, NCDV (formerly known as Hidalgo County Health Care Corporation) began as the Migrant Program of the local Health Department. In 1978, the migrant criteria was lifted and the Center starting serving the entire community. The service area covers 2,793 square miles directly on the United States/México border. NCDV is governed by a Board of Directors, with a 51% consumers majority as well as professional representatives from the areas of medical, dental, finance, legal, education and community service.
The service area population has grown rapidly over the past 10 years, reaching close to 800,000 residents. The population is primarily Hispanic (88%) and is among the poorest in the U.S. One in three residents has an income below the federal poverty level. Unemployment rates remained in the double digits in 2010 – up to 20% in Starr County. The area is also home to many migrant and seasonal farmworkers - most of whom have no health benefits. The primary populations served by NCDV are the uninsured, medically indigent residents and migrant and seasonal workers and their families.
The most significant barriers to health care access in South Texas are financial. It is estimated that one in three area residents has no health insurance coverage. NCDV serves as the safety net provider for the growing number of working poor families without the financial means or insurance to cover their health care needs. Of the nearly 28,000 users cared for in 2015, 82% had incomes below 100% of poverty and 81% had no health insurance. To ensure access to care for the low income population, services are offered to all residents on a sliding fee scale.
The health center's utilization reflects the growing number of people without access to affordable health care. Most of the adult clients are Spanish-speaking, poor and at high risk of health problems, particularly diabetes and hypertension. Close to one in four adult NCDV patients has diabetes. Hypertension comes in as a close second in leading diagnoses at the clinics.
To address the needs of the population, NCDV offers a complete set of integrated, accessible primary health care services at 11 locations – nine in Hidalgo County and two in Starr County. Both counties are defined as Medicially Underserved Areas. Starr County, also deignated as Health Professional hortage Area (HPSA) in primary care and dental health, has suffered a decrease in the number of clinicians. Both counties are also designated as Mental Health HPSAs.
Health services include family medicine, internal medicine, pediatric care, obstetrical and gynecological care, and podiatry. Pharmacy, laboratory services, selected radiological services, social services/case management, nutrition/health education, and integrated eligibility assistance are also provided. Three NCDV clinics offer dental services. Limited behavioral health services including care management and group counseling were added in 2006, addressing a critical unmet need in this population.
NCDV brings a unique public health perspective to the provision of primary care services. Accordingly, case management and patient education and prevention activities and community outreach have long been integral components of NCDV services. All of the clinics are linked through a centralized administration and data system.
NCDV has developed its overall service delivery plan for the area, including staffing based on area-wide data and historical utilization data of the NCDV population. While the demand has grown, the growth trend in number of users is linked to the number of providers available to serve those patients.
The center is accredited by The Joint Commission. NCDV will continue in its role as the only comprehensive primary care provider in this border community that opens its doors to the medically needy, uninsured population. Early intervention and timely follow up are key factors in reaching NCDV’s objectives for improving health outcomes and disparities in all focus areas. As more clients have access to quality care at an affordable cost, health outcomes for the underserved families will improve.
