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pharmacy. Unlike a physician’s office or a run-of-the-mill clinic, an FQHC is eligible for 100 percent reimbursement for Medicare and Medicaid services, which greatly increases its chances of staying solvent. “Presidio had always stuck out in their statistics as a place where this should be, but they didn’t know anybody [who could] launch it,” Sanders-McCrory said. Her flat Midwestern accent stands out in Presidio County, as does her scientific background, which includes academic grant-writing. Asked if she’d write a series of grant proposals to create a federal clinic in Presidio, Sanders-McCrory said she didn’t know much about health-care delivery. “I’m not a provider. I’m a basic scientist,” she recalls telling the officials. “I can research questions, I can write. They said, ‘Terrific.’ And I said, ‘Gosh, what did I get into?'” Wanstrom and Sanders-McCrory had met, and had talked casually about health-care issues. What followed for each of them was two years of grant writing, fundraising, research, anxiety, workshops, board meetings, paperwork hustling, and exhilarating moments of optimism. They checked in with each other frequently, puzzling their way through health-care regulations and complexities. Wanstrom is effusive, has a great cackling laugh, and tends to blast her conversations with exclamation points, as in, “Hey! Look! You’ve got a fever!” Sanders-McCrory is more tortoise than hare, methodically moving from goal to goal, meticulous in her attention to detail, from the aviatrix scarf at her neck to the statistical charts necessary for a grant application. Eventually a small salary was secured for Sanders-McCrory, though she has yet to cash a paycheck. “The organization needed the money,” she said. Sanders-McCrory racked up enough state and federal grants to get the Presidio clinic open for a month last fall, but it closed for lack of a permanent, full-time physician or nurse practitioner. Though Presidio is undergoing a small economic and population boom, doctors and other health-care providers are not always attracted to a place so far from a hospital or urban amenities. This fall, negotiations are in progress with Dr. Leo Altenberg, Presidio’s solo practitioner. A physician’s assistant who worked in the area a few years ago has moved back and is working at the Marfa clinic. When the Presidio clinic opens, he’ll go there once or twice a week to help. The application for FQHCLookalike status is in process. So is an application for federal Department of Agriculture grant and loan money to build a large clinic facility in Presidio. And the city of Presidio has obtained a grant that will pay for a new ambulance, which should roll into town soon. Fundraising for the community clinic in Marfa has been distinctly more down-home. Supporters of the Marfa clinic held a barn dance, bake sales, and monthly rock concerts, all conceived, organized, and attended by Marfa’s young people. Five local families co-signed a $145,000 note on a former Baptist church that would become the clinic’s home. Hordes of volunteers showed up to renovate the building, donating free demolition, and then wiring, plumbing, and painting. The white-and-blue, homemade lighthouse on the roofa holdover from Calvary Baptist daysremains. A religious organization in town called the Faith Alive Cowboy Church donated enough used dental equipment to fill two exam rooms. A mental health counselor appeared on the scene. A dentist moved onto a place near Valentine and was interested in part-time work. The Houston-based Brown Foundation came through with grants totaling $75,000. And clinic organizers struck a deal with county commissioners to provide health-care visits to the county jail, which brought in enough money to pay the mortgage and give Wanstrom a small salary. \(In lean months, said volunteer Scott, Wanstrom won’t take The Marfa Community Health Clinic opened last November. It offers clients sliding-scale fees for services as varied as treating the sniffles, doing “well-woman exams,” and dealing with the afflictions that beset a population in which diabetes and lupus are common. A dentist and a dental hygienist are in the clinic eight days a month, and a mental health counselor comes regularly. The place is booked solid and has been since it opened. As opening day at the Marfa clinic approached, state health officials suggested that the Presidio and Marfa organizers consider a partnership. A single, countywide organization would stand a better chance of getting federal funding, the officials said. The two groups became Presidio County Health Services, and a new board was created. “I think this is an extremely important economic and social benefit to Presidio County,” said Sanders-McCrory. “There are a number of instances where businesses have wanted to come into Marfa or Presidio, and they haven’t because of the lack of health care here. We can’t afford to do that.” Meanwhile, in May the Alpine hospital closed Marfa’s old Rural Health Clinic, where Wanstrom had resisted the “corporate approach.” The hospital’s new administrator is working with local officials on a deal that would pay Presidio County Health Services $4,000 a month to underwrite the Marfa clinic and other operations. \(By law, the local hospital district has to maintain a clinic in Presidio County, an obligation that for years had been fulfilled by the now-defunct the regional hospital district in July that there had been alternatives for the new contract in Marfa. “But we went with them because they do cover the entire county,” he said. “They represent planned clinics in Presidio as well as Marfa.” The monthly stipend, he said, “will speed up the process of getting a clinic in both communities.” 0 ne night last July, Wanstrom was among the crowd at a joint called Ray’s Bar, Joe’s Place, or Lucy’s, depending on whom you talk to. Marfa had been temporarily taken over by an oddball group of Texas music luminaries in town to celebrate the 44th anniversary of legendary singer and artist Terry Allen and his wife, Jo Harvey Allen. The Aliens, along with Robert Earl Keen, Guy 12 THE TEXAS OBSERVER SEPTEMBER 22, 2006