WESLACO, RGV – The biggest obstacle to improving healthcare in the Rio Grande Valley is transportation to the offices of a primary care physician or a community clinic, argues a top public health official.

Eduardo ‘Eddie’ Olivarez is chief administrative officer for Hidalgo County Health & Human Services. Olivarez gave an exclusive interview to the Rio Grande Guardian during a diabetes forum hosted by Unidos Contra la Diabetes.

The event was held at the UT-Rio Grande Valley’s Center for Innovation & Commercialization.

“When people ask me now, what is the No. 1 issue in healthcare and getting people the healthcare they need, I say No. 1 issue is transportation – by far. That might have been No. 2 or No. 3, 15 years ago. Now, it is No. 1,” Olivarez said.

Olivarez pointed out that there are now more than 800 physicians in Hidalgo County.

Eddie Olivarez

“We have clinics. We have low-cost clinics. We have floating scale clinics. We have access. But, if you live in the faraway areas like El Flaco or the northwestern part of Hidalgo County and the closest physician to you is 15 or 20 miles away, and you do not have reliable transportation, you are not going to get there,” Olivarez said.

“Or, if you have to come for an MRI or some kind of mid-level or advanced intervention at a hospital and you are out in Hargill, Texas, which is 35 miles away from McAllen, transportation is a big issue.”

A reporter pointed out to Olivarez that similar comments were made during a recent healthcare panel discussion at the Starr County campus of South Texas College in Rio Grande City. At that event, Dr. Tony Falcon, Dr. Jose Vasquez and Dr. Carlos Cardenas highlighted transportation as a major concern.

“Starr County is desperately needing help with that,” Olivarez agreed.

Huge impact of UTRGV School of Medicine

Discussion on transportation issues came up when a reporter asked about the 1115 Waiver, a mechanism through which federal Medicaid dollars are distributed to the Valley.

“We have to thank the South Texas legislative delegation, especially Senator Hinojosa. Going back nine years ago, Senator Hinojosa and the delegation were instrumental in helping with the UPL (Upper Payment Limit) program, and with the 1115 waiver eight years ago,” Olivarez said.

The South Texas legislative delegation worked on a local provider participation program to help local hospitals secure funding to offset their uncompensated care. The subsequent agreement between Valley counties and a healthcare consortium comprising local hospitals helped pay for indigent healthcare. The legislation was passed during Rick Perry’s time as governor and expanded to other parts of Texas during Gov. Greg Abbott’s watch. State Sens. Juan Hinojosa and Judith Zaffirini are credited with championing the legislation.

“It all started back in 2006. We are going back 13 years with all these programs. But 1115 singlehandedly was a game changer because it brought over $762 million in resources to be used for healthcare,” Olivarez said.

“In fact, that was the fulcrum that tilted the scales towards us having the UTRGV medical school here in the Rio Grande Valley. That in itself was the No. 1 force behind getting the UTRGV medical school. And the UTRGV medical school singlehandedly, in my opinion, from Brownsville all the way to Starr County, has made the biggest difference in access to healthcare and to the development of future of allied health professions in partnership with the College of Health Affairs. That system has singlehandedly made the biggest difference in healthcare in our community.”

It was pointed out to Olivarez that UTRGV School of Medicine now has 20 community clinics around the Valley.

“That goes to demonstrate how UTRGV has singlehandedly changed access to healthcare. I remember the time you would interview me and you would say, Eddie, what is the No. 1 issue involving healthcare, 12 years ago, 15 years ago. I would tell you access to healthcare. That was the No. 1 thing. Well, access to healthcare, we have improved because of UTRGV, because of Nuestra Clinica del Valle, because of Su Clinica, because of Hidalgo County Health, because of Cameron County Health, because of Hope Clinic. Because of all of these partners, we have increased access to healthcare. Our AHEC, the allied health education component with UTRGV, we have increased access to healthcare.”

Analyzing the Data

In his remarks at the Unidos Contra la Diabetes forum, Olivarez said he was going to say something controversial. He said that in terms of human resources, he needed more data analysts than promotoras, as community educators are known in the Valley’s colonias.

“It is not that I don’t need promatoras. I do have them. One of the participants said, what is the importance of statistics, numbers, data. Why aren’t we teaching statistics, numbers, data in high school and college more? The more data we have, the more money we can draw,” Olivarez said.

“I said, I agree with you 100 percent. I have promatoras, I have community educators. I do not need more of those. I need informatics. I need statisticians, I need microbiologists, I need scientists, I need data collectors and interpreters.”

Olivarez said he has “tons of data” that needs analyzing.

“We do over 3,000 epidemiological investigations a year. I need to get that data compiled and used in a way that is going to help develop policy, that is going to help the way we look at public health in our community. I need that data assessed, analyzed, and looked at to directly impact our policy development and our public health rules and regulations,” Olivarez said.

“We are getting to the next level. Hidalgo County is growing and getting to the next level. We need this type of professional now so we can get to the up and coming level with resources and development, much like Houston and Dallas already have. They were at this point ten or 15 years ago. We are barely reaching this point. I am not putting promatoras down. I am just saying the need for this level of education, study and analysis, is very important.”

Olivarez told the audience of public health professionals about the top item on his wish list. Interviewed afterwards, he explained in detail what his big ask was.

“I wanted to stress the importance of data. We have to give Austin or Washington the data that will help us draw down the funding or the policy changes we need in South Texas. Data is so critical,” Olivarez said.

“Electronic medical records, there has been a large effort with the health information exchange and we have made some advances with it. However, the reality is, I wish that the State of Texas had an electronic medical records system that integrated public health into it. We do not have that as of right now. There is the primary care component but when you are dealing with integrating tuberculosis information, immunization information, STI information, when you are looking at integrating public health data, epidemiological information, that integration is either none existent or it is very, very, expensive to integrate.”

Asked if UTRGV could pick up the slack, Olivarez said:

“UTRGV has some very, very, bright graduate students and PhD candidates. This would be a great opportunity to maybe develop the software or develop the capacity to integrate that. The State of Texas wants it but they are waiting for somebody else to develop it. I have talked to many vendors from other parts of the country and public health is not at a level… public health does not have money. We are not rich. We are not attractive as compared to primary care or chronic disease.”

Olivarez explained why electronic health information should include public health.

“Public health integration is critical because, one of the things we spend trillions and trillions of dollars on stopping illnesses. But, if we were to spend half the money on preventing that illness, I think we would be in better shape in the next couple of generations. But that is just my opinion.”

Editor’s Note: The above news story is the third in a four-part series based on a recent diabetes forum hosted by Unidos Contra la Diabetes. Click here to read part one. Click here to read part two. Part Four, featuring the analysis of Jenny Newcomb and State Rep. Armando Martinez will be posted in Thursday’s Edition.