Twenty-eight years of growth has become too much for the Waco Family Medicine center at 1600 Providence Drive, so officials are proposing a new $51 million facility to carry the community health center forward.
They will make a pitch Tuesday for $2.5 million each from the city of Waco and McLennan County as they start to assemble funding from public and private sources.
A walk through the existing facility tells a story of growing pains in a body that cannot grow anymore: narrow hallways that wind through the building, offices subdivided so staffers can share, multiple entrances that confuse clients and lead to deliveries stacked near doorways, services scattered to several locations inside and outside the building, and a facility designed for an early way of training doctors.
Chief Clinical Officer Dr. Mike Hardin Jr. said he remembers creating scavenger hunts with color-coded maps for incoming medical residents to acquaint them with the health care labyrinth where they would be spending their next few years. One resident later told him he had worked there two years before discovering the vending machine for residents’ use.
After 28 years in its current location and three building expansions, the Waco Family Medicine Health Center is finding its current physical limitations a serious curb to meeting community and client needs, leaders said.
“We don’t want to create obstacles to care,” CEO Dr. Jackson Griggs said. “We want to remove them.”
Several years of planning by Griggs and his colleagues, Waco Family Medicine Foundation trustees, and their supporters have brought them to the proposed solution. The $51 million facility would triple the center’s existing floorspace, integrate client health care with supportive community services, facilitate team training for residents and allow for future growth.
Waco Family Medicine and its 583 employees provide medical, dental and behavioral health care for a considerable number of low-income and uninsured city and county residents. Of the 58,850 patients who came to the center and its 15 clinics last year, 84% were below the federal poverty line and 37% had no insurance. Medicare and Medicaid patients provide most of the center’s revenue.
Waco Family Medicine and its clinics offer the crucial link of service in the county’s $3.6 million indigent health care program, which aids 200 to 250 people in a typical year, said Heather Travers, health services director for McLennan County Indigent Health Care.
“We serve many of the same clients,” Travers said.
Waco Family Medicine provides primary care, basic dental care and wellness services for those who qualify in the county program, with those needing specialist attention forwarded to Baylor Scott & White and Ascension Providence medical centers.
Primary care and health education from Waco Family Medicine also keeps some clients’ medical issues from requiring more expensive hospital attention. McLennan County contributes $747,000 for indigent care at Waco’s two hospitals.
The Waco Family Medicine center’s location in north-central Waco is significant as well. At the time construction began on the center in 1993, the area’s two major hospitals operated within several miles of the center, Providence Hospital adjoining the center and Hillcrest Baptist Medical Center 2 miles away. Since then, both Ascension Providence and Baylor Scott & White Hillcrest Medical Center have moved to new facilities on the southwest edge of Waco and closer to regional traffic arteries of Interstate 35 and State Highway 6.
That makes the Waco Family Medicine center an important source of health care to surrounding neighborhoods, with examining and treatment rooms, X-ray and imagining facilities, labs and more.
“I feel it’s such a win to have this in the core of the city,” said City Council Member Kelly Palmer, whose District 4 includes the center.
Waco Family Medicine officials agree, which is why they intend to build a new center at the same location. When a team of Baylor University students surveyed center clients, they found roughly half would not return if it moved, Hardin said.
“If we left this site, it would leave such a hole in the community,” he said.
An expanded facility also would address the needs of the Waco Family Medicine’s medical residency program, a major supplier of Waco family physicians. Since starting with a handful of medical residents based in the Providence Hospital basement, the residency program has graduated 464 doctors with 38 residents and 17 physicians on faculty. More than 800 medical students apply for the several dozen residency openings each year, drawn in part by what Hardin said it offers: training with an emphasis on compassion and cultural sensitivity. An important part of that training comes in the local residents who come to the center for medical help.
“The practice is the curriculum,” said Hardin, who oversees the residency and fellowship programs as president of the Waco Family Medicine Institute.
A more spacious center would allow the residency program to accommodate more easily the collaborative team treatment approach in community medicine, where behavioral health and wellness specialists often accompany doctors on their diagnostic rounds.
After an analysis of the existing building several years ago found a fourth expansion unfeasible, officials began to think about a new space. Teams drawn from across the center shared their present and future needs while a 2019 assessment of county and community health provided context for the future.
Designs for a new center started to crystallize as planners sketched out what their new building should provide:
A Marketplace area where patients and their families could meet providers of other community services, such as legal services, child nutrition and housing assistance.
An expanded pharmacy space.
Wide corridors and larger rooms, designed for efficient traffic flow of patients and medical personnel.
Meeting spaces for the community, center staff and medical residents.
Easy-to-access entrances, designated for clients, employees and deliveries of medical supplies and equipment.
A greenspace area outside for the community and demonstration gardens.
“Then the pandemic hit,” CEO Griggs said.
The coronavirus drastically diverted local health care resources for all area providers, including Waco’s two hospitals, the public health district and the Waco Family Medicine center.
The center shifted its regular operations to handle COVID-19 cases, helped organize community testing and education efforts, expanded telehealth options and, once a vaccine was ready, delivered more than 15,000 doses to Waco and McLennan County residents. Griggs, who served on a city health response team, became a regular participant at the city’s coronavirus press conferences, sharing the latest medical findings and advice on the disease.
As COVID-19 cases and hospitalizations began to drop this spring due in part to community vaccinations, Waco Family Medicine officials resumed their planning work on a new center. The Waco Family Medicine Foundation board hired Intrepid Development as project managers with HKS Architects as design leaders.
The year lost to the pandemic has altered the usual fundraising approach for an organization seeking to build a large community facility, which typically would involve securing a measure of funding from private donors before going to local governments seeking public money.
Millions of dollars in federal American Rescue Plan pandemic relief and support given to Waco and McLennan County, however, are available now, with federal guidelines allowing their use for strengthening community health resources.
As city and county officials make decisions how to spend that federal money, as well as prepare their annual operating budgets, Griggs and Waco Family Medicnie backers want funding support for a new center among the options considered.
McLennan County Judge Scott Felton and Waco Mayor Dillon Meek did not want to speak for their respective council members and commissioners, but both said local governments have built a strong relationship with Waco Family Medicine over the years.
“I’m personally in favor of (the project),” Felton said.
It likely would be among the items included in the commissioners’ current budget discussions, he said.
“We have a long relationship with Waco Family Medicine and they’ve been an incredible community partner,” Meek said. “We’re looking forward to their presentation.”
Council Member Palmer agreed.
“I’m excited to see the plans. I think they are a phenomenal partner in working for a healthier and more equitable Waco,” she said.