TOMAGWA HealthCare Ministries looks to federal designation for sustainability

TOMAGWA HealthCare Ministries—founded more than 30 years ago to serve uninsured residents in the Tomball, Magnolia and Waller areas—has grappled with treating patients during the COVID-19 pandemic, as all health care organizations have.

But unlike some other providers, TOMAGWA has not had access to the same resources because it is not a federally qualified health center, CEO Timika Simmons said. The federal Coronavirus Aid, Relief, and Economic Security Act has awarded $1.3 billion to health centers nationwide, including $1.8 million to nearby Conroe-based Lone Star Family Health Center, according to the U.S. Health Resources and Services Administration.

As such, TOMAGWA leaders have expedited their plans to become an FQHC, Simmons said.

“We were already struggling in the market before COVID, and then [during] COVID, so many safety-net clinics just are drowning,” she said. “Becoming a federally qualified health center was something that was a part of our strategic plan to try to look at for way, way later for sustainability, but COVID kind of gave us a push to say, ‘You need to look at this right now.’”

According to the HRSA, community health centers are community based and patient directed and provide primary health care services on a sliding-fee scale. FQHCs are health centers receiving federal grant funds.

TOMAGWA officials are hoping to apply to the HRSA in January to receive approval as a “look-alike health center” in May, Simmons said, which means the clinic would operate with the same standards as a FQHC but has not yet received a federal grant denoting the center as an FQHC. This would then allow TOMAGWA to compete for grant funds in July, she said.

“[Health centers are] one of the best ways to deliver health care and one of the most cost-efficient and effective,” said U.S. Rep. Kevin Brady, R-The Woodlands. “I think this is the next step for TOMAGWA, and it can make their good work available to even more families that need it.”

Defining health centers

Karen Harwell is the CEO of Lone Star Family Health Center, an FQHC with locations in Conroe, Willis and Spring. Harwell said the HRSA denotes locations with less than a 5% penetration rate—or the percentage of low-income residents serviced by existing health centers—as areas of high need.

According to information from TOMAGWA, the penetration rate in Tomball and Magnolia ZIP codes ranges from 1.63% to 7.13%.

“If you can enter an area where you can show very, very low penetration, you have a much better chance of receiving the [federal] grant,” Harwell said. “We really don’t view [other centers] as competition. ... It’s another partner we can work with that our patients can benefit from.”

Harwell said she is looking forward to the opportunity to share specialty resources with TOMAGWA, which could lessen staffing costs for both clinics and make patient services more robust.

As of mid-November, TOMAGWA needed to raise $225,000 by year’s end and $500,000 by July to implement new programs, staffing and technology, Simmons said.

“TOMAGWA is in a unique position to be able to take advantage of this opportunity ... so we are asking people to dig very deep and look at significant one-time contributions,” she said.

While she said TOMAGWA’s long history in the community, quality service and partnerships will ease the financial burden of the transition, the look-alike process still requires TOMAGWA to transform much of its organization.

Jana Eubank, the executive director of the Texas Association of Community Health Centers, said four aspects differentiate health centers from other primary practices: Centers are located in medically underserved areas, service all patients, offer comprehensive services and are consumer driven—meaning at least 51% of the center’s board members are patients.

Beyond medical, dental, pharmacy and behavioral health, health centers customize their offerings to community needs, such as vision or substance use, Eubank said.

“If that community needs it, then the center tries to figure out how to cobble together the resources and get the providers to be able to provide that,” she said.

During the transition, TOMAGWA must add mental health and translation services, more robust women’s and pediatrics programs, and a transportation program, Simmons said, which could mean using private vehicles or ride-hailing services to get patients to their appointments. TOMAGWA currently offers basic pediatric and women’s care, lab, dental, vision, pharmacy and primary care services.

Despite the benefits, Simmons said TOMAGWA has not pursued an FQHC designation previously because of concerns of partnering with the government.

“TOMAGWA’s culture has been extremely important to us. ... There have always been great concerns that if we were in a relationship with the federal government that they would require us to modify or even prevent us from practicing our Christian faith openly,” she said. “We’ve been very excited that TOMAGWA will not have to make any modifications to our Christian faith and our values and our principles and how we care for our patients.”

Seeking sustainability

Since the onset of the COVID-19 pandemic, TOMAGWA has added about 10 patients each week as unemployment rates have risen, Simmons said.

“We have to be here for our existing patients and then all of these newly unemployed in our service areas who are terrified,” she said.

TOMAGWA relies largely on its donors to fund its $5 million annual budget, Simmons said, causing funding challenges at times. In March 2019, TOMAGWA closed its Magnolia clinic for five months because of financial hardship, Community Impact Newspaper previously reported.

TOMAGWA’s pursuit of look-alike approval will make it more competitive when applying for a federal grant once funds are appropriated by Congress, Eubank said.

Funding expires in December, Brady said, but extending funding is among his priorities when Congress reconvenes this fall.

“It’s important that it be extended at least a year, although I’d like to see it extended for two or three years just to create that certainty local clinics need,” he said.

With funds expected in 2021, grants are only released every few years, Simmons said.

“That’s why the timing is so critical now. The base grant will afford us $660,000 per location to cover operational expenses, so you’re talking about roughly a $1.9 million investment about this time next year from HRSA into the community we serve,” she said. “Not only will it make us sustainable; in the future it gets us out of the roller coaster of having funding now, not having enough funding later.”

In addition to the base grant, TOMAGWA could begin billing Medicare and Medicaid in May, a demographic not currently served.

Simmons said TOMAGWA could collect $150 and $170 per visit for Medicare and Medicaid patients, respectively, from the Centers for Medicare & Medicaid Services, a rise from the clinic’s average payment of $25 per visit. Within Tomball and Magnolia ZIP codes, 11.59% and 11.74% of residents receive some sort of Medicaid or Medicare coverage, respectively, according to 2018 U.S. Census Bureau estimates.

“We can stumble along and keep things going, but when you get things like COVID or a downturn in the economy, then a lot of your revenue sources dry up and the services you provide become less,” said Tom Gloyer, the owner of the Home Health Store in Tomball and an ex officio board member of TOMAGWA. “I think [the health center approval] should help make it more consistent as well as expand how many we serve and what we do.”
By Anna Lotz

Editor, Tomball | Magnolia & Conroe | Montgomery

Anna joined Community Impact Newspaper as a reporter in May 2016 after graduating with a degree in journalism from Cedarville University in Cedarville, Ohio. In July 2017, she transitioned to editor for the Tomball|Magnolia edition. She began covering the communities of Conroe and Montgomery as well in 2020. Anna covers education, local government, transportation, business, real estate development and nonprofits in these communities. Prior to CI, Anna served as editor-in-chief of Cedars, interned with the National Journalism Center in Washington, D.C., and spent time writing for the Springfield News-Sun and Xenia Daily Gazette.


Lone Star College-Magnolia Center will be a satellite campus of LSC-Montgomery, which is pictured. (Anna Lotz/Community Impact Newspaper)
Construction anticipated to begin this summer for Lone Star College-Magnolia Center

“It’s been an adventure. It’s been one hurdle after another but ... I believe we are in the home stretch here," LSC-Montgomery President Rebecca Riley said.

Imperio Wine & Spirits sells a variety of liquor, beer, wine and spirits. (Courtesy Adobe Stock)
Imperio Wine & Spirits opens in Katy; Montgomery Chick-fil-A to open dining room and more Houston-area news

Read the latest business and community news from the Greater Houston area.

In addition to constructing a new 43-acre campus, Harris County Emergency Services District No. 11 will be buying a fleet of 40 new ambulances and hiring 150 new staff. (Courtesy Cypress Creek EMS)
Executive director gives preview of ESD 11 Mobile Health Services

In addition to constructing a new 43-acre campus, Harris County Emergency Services District No. 11 will be buying a fleet of 40 new ambulances and hiring 150 new staff.

Todd’s Auto Shop officially opened in its new location at 32000 Hwy. 249, Pinehurst, on April 1. (Courtesy Todd's Auto Shop)
Masones Pub & Grill opens in Northpointe, Todd's Auto Repair relocates: 4 business updates in Tomball, Magnolia

Todd’s Auto Shop officially opened in its new location at 32000 Hwy. 249, Pinehurst, on April 1.

See how some Greater Houston area school districts are planning to go back to school for the 2021-22 academic year. (Courtesy Adobe Stock)
See how some Greater Houston area school districts are planning to go back to school for the 2021-22 academic year

While some school districts in the Greater Houston area are doing away with face mask requirements and virtual schooling completely, others are pivoting to continue offering online learning options for students and plan to require face masks.

CDC ends all mask requirements for fully vaccinated people

The guidance states fully vaccinated people do not need to wear masks indoors or outdoors.

Construction is underway for an expansion to the criminal justice building in Magnolia. (Screenshot via Montgomery County Precinct 2)
Sheriff's Office expansion underway in Magnolia

An expansion underway on Unity Park Drive in Magnolia will reduce the time local law enforcement agencies spend traveling to Conroe, Montgomery County Precinct 2 Commissioner Charlie Riley said.

Single-family home sales were up 47.4% compared to last April with 9,105 units sold versus 6,175 a year earlier. (Courtesy Houston Association of Realtors)
HAR: Houston-area home sales in April up 47% compared to last year

Single-family home sales were up 47.4% compared to April 2020.

House Bill 1024, signed into law May 12, allows restaurants and bars to permanently sell alcoholic beverages to-go. (Courtesy Pexels)
Cocktails to-go are here to stay in Texas: Gov. Greg Abbott signs change into law May 12

Supporters say the change will help restaurants continue to recover from the economic effects of the coronavirus pandemic.

New details could emerge soon on the potential use of underground tunnels to carry flood water in Harris County, and officials voted May 11 to dedicate an additional $3.26 million to study efforts along Buffalo Bayou. (Kelly Schafler/Community Impact Newspaper)
County commissioners expand scope of flood tunnel study as next phase nears completion

New details could emerge soon on the potential use of underground tunnels to carry flood water in Harris County, and officials voted May 11 to dedicate an additional $3.26 million to study efforts along Buffalo Bayou.

Texas Workforce Solutions-Vocational Rehabilitation Services provides a variety of services to assist eligible people with disabilities in preparing for, obtaining, retaining or advancing in competitive integrated employment. Similarly, Workforce Solutions Gulf Coast is a public workforce system in the 13-county Houston-Galveston region of Texas that helps employers meet their human resources needs and individuals build careers. (Courtesy Adobe Stock)
Texas Workforce Solutions-Vocational Rehabilitation Services to relocate from Tomball to Willowbrook

Six vocational rehabilitation staff with the Texas Workforce Solutions-Vocational Rehabilitation Services will move May 18 from 444 Holderrieth Blvd., Ste. 3, Tomball to the Workforce Solutions Gulf Coast office located at 17725 Hwy. 249, Houston, according to a May 11 news release.