Caring for the community

New clinic to treat low-income residents

Jaynee Fontecchio-Spradling Enlarge photo

Jaynee Fontecchio-Spradling

One day every month, Dr. Jay Ciotti sets up an exam room at Manna Soup Kitchen. While most visitors are seeking a warm meal, many are also in desperate need of medical care.

“I see patients every month who are grateful for help with their infection or blood pressure but also have significant issues with mental and dental health. I end up referring them elsewhere with no guarantee that they will be able to get the full care that they need,” Ciotti said.

These basic doctor visits have prompted Ciotti and other concerned residents to acknowledge that a community clinic is needed in the area.

The new La Plata Community Clinic will open its doors in November near the Durango Public Library to assist in fulfilling that need. It will specifically serve homeless, working poor, uninsured and low-income adults.

All services and care to be provided at the clinic – medical, dental and behavioral –will initially be 100 percent donated. Volunteers will offer their time and services. A paid full-time director will manage and administer the actual clinic, recruit and coordinate volunteers, and fundraise to sustain the clinic.

The staffing model may change as other sources of sustainable funding are identified and secured.

Patients will be screened for eligibility based on income levels combined with a lack of health insurance. The clinic is not free, as all patients will be asked to pay a fee according to their income.

The sliding scale will be designed to accommodate patients – the exact eligibility criteria and sliding scale are still being determined by the LPCC board of directors.

Initial funding by the Karakin Foundation will allow the clinic to be open seven hours per week.

Jenny Wrenn, who serves on the LPCC board of directors, said that long-range plans include significant expansion of those limited operating hours.

“We will increase hours based on community need and support within the first year. Ongoing need plus continued Karakin Foundation and other grant support, community resources and volunteers will determine the increase of hours in future years,” Wrenn said.

Board member and retired physician Bob Cox, and other board members believe that the demand for the clinic will only be proved once its doors open.

Cox visited a number of other Colorado clinics and found this to be the case. A recent community health assessment revealed that almost 5,000 adults in La Plata County are low-income and uninsured. That number may actually be conservative with a higher, but hidden, population in need of myriad health services.

Cox said that the clinic is expected to benefit not only our low-income residents, but the La Plata County community as a whole.

“By providing preventive care, chronic disease management and behavioral health support, we can reduce E.R. visits and hospitalizations, lowering overall costs for the community,” Cox said.

Current evidence also suggests that the most effective way to support and serve low-income people is to provide services through integrated systems of care.

Michelle Appenzeller, Director of Mercy Home Health and Hospice of Mercy, is also a clinic board member.

“Basic health care is only one piece of the puzzle. Research shows a multidisciplinary, case-management team approach to be most successful,” she said.

The La Plata Community Clinic will strive to provide that integrated approach.

The Citizens Health Advisory Council played a lead role in the development of the clinic along with many partners.

Since 2001, CHAC, a grass-roots organization, has been a community voice for quality, accessible health care, partnering with many local organizations to develop many successful health programs in La Plata County. LPCC is seen as the culmination of a decade of work by CHAC and its partners to provide “Better health for all through: coordination, affordability and accessibility.”

Ciotti said, “This clinic will hit the sweet spot for people who earn too much to qualify for government-funded insurance but not enough to afford private insurance, a gap that is getting bigger and costing all of us in the community more every year. More importantly, it will provide compassionate, respectful, quality care to our neighbors most in need.”

Board member Marsha Porter-Norton said: “This is truly a community effort – for the community, by the community. Everyone who learns of this effort volunteers to help in some way. The response has been absolutely amazing. This is just one more example of the incredible caring and generous spirit of our community.”

If you are interested becoming involved in the new La Plata Community Clinic, contact

Emily Burns is a preventive medicine physician and member of the LPCC board of directors. Reach her at

Jaynee Fontecchio-Spradling is executive director of the Citizens Health Advisory Council and treasurer of the LPCC board of directors. Reach her at

Enlarge photo

Cliff Vancura/Durango Herald