BFL Construction Builds El Rio Expansion

December 2010

El Rio Community Health Center will open the new El Pueblo clinic built by BFL Construction Company, Tucson, at Irvington Road and Sixth Avenue.

Cutline for Photo:  Nancy Johnson, left, COO with El Rio and Ken Sand, project manager with BFL Construction check on the progress of the new El Rio Clinic.

As El Rio Community Health Care Center celebrates 40 years of service, they want to send the message to businesses and others in the region that it’s not the healthcare provider you might think it is.

Just like the industry itself, El Rio is keeping up with technology and providing cutting edge services.

While experts both inside and outside the industry are still wrestling with the details of health care reform legislation passed by Congress this year, officials at El Rio say they’re gearing up to be ready for what may come.

“The health care reform passed by Congress is more related to access to health care and not necessarily addressing the health care system,” said Nancy Johnson, chief operating officer. “Right now it is still just legislation because we are waiting for all the regulations to be written. We don’t believe it will change what we do, in fact it may even increase the number of patients we see. With more people having access to care, we believe we will have increased patients. The real challenge is going to be the staffing needs we will have.”

Johnson said she doesn’t believe that patients who were previously uninsured and now will have access to insurance will leave the community health center’s clinics.

“Many people are surprised to find you can come to El Rio with your regular insurance and be seen here,” said Johnson who added that the perception is only people on the state’s Medicaid or Arizona Health Care Cost Containment System (AHCCCS), utilize community health centers. “People are also very surprised to find the clinics are clean and modern and the quality of care they receive is extremely high.”

About 62 percent of patients served by El Rio are at or below the federal poverty line. In other words, 38 percent are above that level.

Today the health center serves more than 73,000 patients annually at its 16 patient clinic sites. Those patients make nearly 300,000 visits annually. The center has an annual budget of $75 million and does about $11 million in charity care every year.

Johnson said El Rio will be positioning itself as a health care home site and providing much more integrated primary care service as it continues to grow. This way patients can see multiple doctors or get necessary check-ups on the recommended schedules without having to make multiple appointments.

“This just speaks to the trend in health care right now to build more integrative models and El Rio is well positioned to do that,” said Johnson. “We can have pharmacy, lab, X-ray, dental, primary care physicians, and more all under one roof. We are doing that at many of our sites and it turns out to be a great model of care for all of us.”

One example is a new system they are testing with pediatrics that began last week. When a child has an appointment, and through electronic medical records El Rio staff can see it’s been a year since the child has seen the dentist, they will have a dental team available to see the patient immediately after their doctor appointment.

She said this model is intended to change the focus of health care away from strictly diagnosing diseases and addressing the health of each individual.

“We want to be aiming for health for our patients first, and screening and preventing health-related issues,” Johnson said. “In the coming years we are developing more community outreach and education opportunities so people can learn about important issues and take more self management of their health care to keep themselves out of the emergency rooms and hospitals.”

In December, El Rio will open the new El Pueblo clinic at Irvington Road and Sixth Avenue. It is the second clinic in as many years El Rio has opened – the other is the Southeast Clinic at 6950 E. Golf Links Road opened last year.

The new clinic has 51 exam rooms and will house multiple disciplines to follow the integrated primary care model.

The El Rio Santa Cruz Neighborhood Health Center opened its doors in October 1970 on Congress Street west of Interstate 10. The center renovated a former Pima County Juvenile Detention center with a $100,000 grant from Pima County and was initially set up to serve 10,000 residents.

The service boundaries then were from Grant Road to the north, Silverbell Road to the west, 29th Street to the south and Park Avenue to the east. To ensure that residents knew about the clinic, staff walked the neighborhoods in the service area and handed out flyers and talked to residents about El Rio.

The first year’s budget was $500,000 and there were 50 employees including doctors, dentists, nurses, nurse practitioners, lab, X-ray, pharmacy, social workers, community health workers and bilingual support staff.

Now, 40 years later, El Rio employs more than 700 people and it is the 14th largest community health center in the United States by the number of patients it serves.

“That is a matter of the comprehensive care our patients receive,” Johnson said. “We are on the leading edge of electronic medical records and that allows us to be more proactive with the primary care patients receive.”

While many health care providers have come and gone over the years, several of them have been with El Rio for the majority of its life.

Drs. Gerardo Carlos and Steven Rosenfeld are two such doctors. The duo opened the El Rio OB/GYN Associates clinic, now at 225 W Irvington Road, 23 years ago.

They were doctors that El Rio couldn’t afford but had a need for.

“They were just coming out of a bankruptcy at the time and they had been designated as having a manpower shortage in the area of OB/GYN,” said Carlos who got his first job with El Rio in 1978 as a pharmacist before heading back to school for obstetrics and gynecology.

Carlos and Rosenfeld were both in the National Health Service Corps — a program designed to help with the repayment of student loans in exchange for working in community health clinics designated for needs in the areas they specialize in.

“They had room to bring out one doctor for this, and Dr. Carlos had lived in Nogales, went to the University of Arizona and previously spent some time with El Rio, so he pretty much had the spot,” said Rosenfeld. “But he convinced them, that you couldn’t offer and OB/GYN clinic with one doctor and that you needed at least two and they brought me here also.”

The two set up shop on the campus of Carondelet St. Mary’s hospital — which was also in need of OB/GYN specialists — and basically had to set up and build their own clinic while contracted by El Rio to provide care to their patients.

“They really put the responsibility on us, it was a very interesting situation,” Carlos said. “When our term was up for the service corps, we both decided to stay because it was a unique partnership and relationship with El Rio that we really enjoyed.”

The OB/GYN Associates site has delivered anywhere between 15,000 and 20,000 babies over its 23 year lifetime. Today they deliver around 1,000 per year. Carlos and Rosenfeld are often on-call for the clinic site and they deliver babies at all hours of the night.

The duo could have gone anywhere and have each has received offers for new scenery with more money, but they’ve remained where they are because they believe in the community health center model.

“It’s never been about the money,” Carlos said. “It’s about the patients. It’s the “thank you” I get and the joy on people’s faces. It’s about being with them in times of loss. The patients drive us every day.”

Some of the smiles Carlos and Rosenfeld receive have been serviced by Dr. Greg LaChance, director for El Rio’s dental division — who also came to El Rio as part of the National Health Service Corps in 1980.

“I was just finishing my second year here — the last year of my service — and the dental director before me left to go back into full-time private practice,” LaChance said. “I was looking at heading back to Southern California but I was asked if I wanted to take over as the dental director. Tucson had grown on me and El Rio had too, so I stayed and it was the right decision.”

When LaChance took over, there were three dentists and two dental hygienists. Today there are 11 dentists, 10 hygienists, one pediatric specialist, one oral surgeon and a number of dental residents because the facility is a teaching site as well.

“All totaled up we have about 80 people on staff and we have 40,000 to 45,000 visits every year,” LaChance said. “I was just talking to a colleague recently who has been here a while with me, and I told he that one day, when we reach the end — whatever the end may be — we will look back at where we started and realize just how much we accomplished here.”

Biz Facts(520) 792-9890

El Rio Community Health Center

  • Broadway Clinic, 1101 E. Broadway
  • Birth and Women’s Health Center, 2595 N. Wyatt
  • Northwest Clinic, 320 W. Prince Road
  • Northwest Dental, 4009 N. Flowing Wells Road
  • Special Immunology Associates, 1701 W. St. Mary’s Road
  • Congress Clinic, 839 W. Congress St.
  • Congress Dental, 839 W. Congress St.
  • El Rio OB/GYN Associates, 225 W. Irvington Road
  • Southeast Clinic, 6950 E. Golf Links Road
  • MEL Center Clinic, 5101 S. Liberty Ave.
  • Southwest Clinic, 1500 W. Commerce Court
  • Southwest Dental, 1530 W. Commerce Court
  • Summit View Clinic, 1900 E. Summit St.
  • Pascua Clinic, 7490 S. Camino De Oeste
  • Sunnyside Teen Clinic, 1725 E. Bilby Road
  • El Pueblo Clinic, 101 W. Irvington Road

Contact reporter Joe Pangburn at or (520) 229-8751.