The article was updated to include information about the proclamation signed by Gov. Jared Polis naming Aug. 12 as Salud Family Health Day.
The Estes Park Salud Family Health Center began 34 years ago with one exam room, eight hours of service a week, and a simple goal: give people without a primary care provider somewhere to go other than the hospital emergency room.
Today, the clinic on Redtail Hawk Drive provides integrated medical, dental, and behavioral health care and recorded 6,555 patient visits during the past 12 months.
But the financial problem that has followed the clinic almost from its beginning has become increasingly difficult to overcome.
Salud staff, foundation representatives, elected officials and community leaders gathered at the Estes Park clinic Wednesday for Salud Family Health Day to discuss the center’s role in the community — and growing concerns about sustaining it amid rising health care costs, flat federal funding and changes in Medicaid coverage.
The meeting included Estes Park Mayor Gary Hall, Town Trustees Bill Brown and Frank Lancaster, state Sen. Janice Marchman, Estes Park Salud Foundation President Doug Frisbie, Estes Park Health Foundation member Richard Woessner, representatives of the Salud Health Foundation, president Doug Frisbie and board member Jack Boatman, along with Salud medical, dental, behavioral health, and administrative staff. There were no representatives of UCHealth or the Park Hospital District at the meeting.
The local discussion was part of Salud Family Health Day, which was recognized across Colorado on Aug. 12. Salud invited elected officials and community leaders to its clinics to learn about their work and the funding challenges facing community health centers.
Salud is a nonprofit Federally Qualified Health Center that provides medical, dental, behavioral health, pharmacy, and care management services, primarily to low-income and medically underserved patients.
1,513 patients, 6,555 visits
The numbers presented on Wednesday illustrate the scope of the Estes Park clinic.
During the past 12 months, Salud served 1,513 patients in Estes Park through 6,555 visits. Medical care accounted for 3,811 visits (58%); dental care accounted for 1,975 (30%); and behavioral health accounted for 769 (12%).
The clinic’s insurance mix also underscores its role as a safety-net provider. Thirty-two percent of patients were covered by Medicaid, 8% by Medicare, 17% by CHP+, 17% by private insurance, and 26% were uninsured.
Figures provided at the meeting show 732 patients — 48% of the clinic’s patients — had incomes at or below the federal poverty level. Another 560, or 37%, had incomes between 101% and 200% of the federal poverty level.
That means about 85% of the patients served by Estes Park Salud Family Health live at or below 200% of the federal poverty level. The 1,292 patients represent approximately 22% of the population of the Town of Estes Park.
Salud’s model is built around providing a “health care home” where patients can receive preventive and ongoing care before medical problems become emergencies. The organization emphasizes prevention and early intervention to improve health outcomes while controlling health care costs. The costs for Medicaid patients treated through community health centers are 24% lower than those treated in other primary care settings.
That distinction between primary care and higher-cost urgent or emergency care became a central theme of Wednesday’s conversation.
Participants discussed what could happen if Salud’s services were reduced or if they disappeared. Some patients would likely seek medical treatment in the emergency department at UCHealth Estes Valley Medical Center, others might travel down the mountain for care, while still others might postpone or go without care.
The last group was of particular concern because untreated conditions can eventually become more serious — and ultimately more expensive to treat.
One Salud clinician at the meeting noted that many conditions that feel urgent to patients do not require emergency treatment. A primary care provider can evaluate symptoms, begin diagnostic testing, manage pain, and determine whether a patient needs a higher level of care.
The broader issue, participants said, is not simply where 3,811 medical, 1,975 dental, and 769 behavioral health visits would go. The dental and behavioral health services make up more than 40% of Salud’s local visits, services that cannot simply be replaced by a hospital emergency department.
A clinic created to keep people out of the ER
That conversation echoed the circumstances that brought Salud to Estes Park in the first place.
In the early 1990s, Claude Priest, chief financial officer of the Elizabeth Knutsson Memorial Hospital, the predecessor of Estes Park Health and now UCHealth Estes Valley Medical Center, was concerned about uninsured residents using the hospital’s emergency room because they had no primary care provider.
Hospital staff, including physician Paul Fonken, volunteered at a weekly free clinic, but the effort could not meet the community’s needs.
Priest approached Jerry Brasher, then executive director of Salud Family Health Center in Fort Lupton, about establishing a clinic in Estes Park. Salud agreed.
In June 1992, Salud opened a one-room clinic near the River Walk in the old Range Realty building, now The Mountain Vault on Elkhorn Avenue. Family Nurse Practitioner Eileen Flaherty staffed the clinic with support from volunteers. Patient records were kept in a four-drawer filing cabinet, and volunteers at Crossroads, located next door, helped schedule appointments.
The clinic initially operated eight hours a week. By the time it left the location six years later, it was open about 30 hours a week. And as the Estes Valley grew, demand continued to grow.
A second clinic with two exam rooms was designed and built by Eagle Rock School students as a community legacy project under the instruction of Garth Lewis. Located in what is now the KeyBank building in Lower Stanley Village, the space was outgrown within a year.
The Estes Park Salud Foundation later purchased a third location in Aspenwood Professional Plaza. That clinic had five exam rooms but still lacked sufficient space for the community’s dental needs.
A funding problem unique to Estes Park
There was a catch to bringing Salud to Estes Park, however, and it remains important more than three decades later.
Although Salud is a Federally Qualified Health Center, Estes Park’s relatively high median income prevented the community from receiving designation as a medically underserved area, leaving the local clinic without some of the federal financial support available to Salud clinics elsewhere.
The need was nevertheless clear. Patient numbers and clinic hours continued to increase.
In 1997, Frisbie recruited a board to establish the Estes Park Salud Foundation specifically to help close that funding gap. The local foundation has supported the clinic ever since, helping pay for staffing, buildings, equipment and expanded services.
The foundation raised $1.9 million toward construction of the current 11,000-square-foot facility and has funded equipment and improvements, including an ultrasound unit, dental equipment, X-ray equipment, an additional dental treatment room, expanded behavioral health space and another medical exam room.
The foundation has also helped with staff-related expenses, including housing, mileage, benefits and bonuses.
The current center was made possible in part through a land donation from Paul and Kathy Kochevar, who were developing a housing project near Dry Gulch Road. Sally Park led volunteers who raised $1.9 million for the facility, which opened with eight exam rooms and three dental operatories.
The center brought medical, dental, behavioral health and pharmaceutical assistance together under one roof.
Foundation being asked to do more
The challenge now is that the financial gap is growing. Foundation representatives at the meeting said the Estes Park clinic does not financially support itself. It has historically relied on the larger Salud organization to absorb part of its deficit, but that arrangement is under increasing pressure.
Frisbie told the people gathered at the table that the local foundation is being asked to raise approximately $125,000 toward the clinic’s shortfall — something it has not previously had to do at that level.
“We need to do our part,” Frisbie said, while emphasizing that repeatedly raising money to cover an annual operating shortfall is not a substitute for finding a long-term funding solution.
Both Salud and the foundation point to rising health care costs, flat federal funding, and reduced Medicaid coverage as factors contributing to the current financial pressure. Foundation members are working with local, state, and federal officials to identify longer-term solutions.
The Estes Park Salud Foundation’s current fundraising campaign describes the situation as a “critical financial crisis” and cites the same combination of rising costs, flat federal funding, and Medicaid changes.
Wednesday’s conversation included discussion of whether local government could have additional tools to support community health care and whether state legislation could provide more flexibility, particularly for statutory towns such as Estes Park.
Marchman said she would research possible legislative mechanisms and indicated she would also raise questions about Salud’s role in the community, and the importance of preserving its medical, dental and behavioral health services.
The discussion also raised a larger economic question: What would it cost the rest of the local health care system if Salud were no longer here?
Participants suggested that a financial analysis comparing the cost of supporting primary care at Salud with the potential cost of shifting patients into more expensive hospital and emergency services should be done.
With 6,555 Salud visits in a year, they said, the consequences would extend beyond the clinic itself. Dental care reaches into the schools Salud’s community role also extends beyond its Redtail Hawk Drive building.
A partnership with the Estes Park School District R-3 has provided dental screenings and treatment to students since 2024. Through the program, 153 students have received services during 179 encounters, with $34,421 in dental services provided. The program identified 26 urgent dental needs, provided 166 fluoride applications, and placed or repaired 91 sealants.
A related voucher program has served 87 uninsured children with more than $25,000 in foundation funding. Families are not billed for those services, and children are eligible to enroll regardless of insurance coverage.
The program is designed not only to treat dental problems but also to catch them before pain and infection interfere with children’s ability to attend school and learn.
From eight hours a week to an integrated health center
Salud has grown considerably since its modest Estes Park beginning.
Statewide, the organization served nearly 60,000 Coloradans in 2025 through 13 clinic locations in 10 communities. Since its founding in 1970, Salud says it has provided care to more than 2.3 million patients.
In Estes Park, what started as an eight-hour-a-week experiment has become a five-day-a-week health center offering medical, dental and behavioral health care, along with pharmacy services.
But Wednesday’s gathering made clear that the question facing the clinic is increasingly the same one that led community members to establish a foundation nearly 30 years ago:
How does Estes Park pay for a health care service that fills an important community need but does not generate enough revenue to support itself?
The Estes Park Salud Foundation plans another fundraiser in October as it works to meet its immediate fundraising goal while local, state and Salud officials explore longer-term solutions. Details of the fundraiser are expected to be announced later.
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