Randy Murray has tried out nearly every kind of care La Familia Health has to offer.
He first arrived at the Santa Fe organization about 15 years ago in search of grief support after the sudden death of his partner. He still sees one of La Familia’s behavioral health practitioners about once a week.
From there, Murray plugged into the organization’s primary care services and received extensive dental work at La Familia’s dental clinic. “I never left,” he said. “They were my stability.”
Dr. Brendan Vahey, dental director at La Familia Health, works on a root canal Thursday at the clinic.
Despite the stability La Familia Health offered its patients, the organization — which serves a large population of uninsured patients and people living in poverty — was on the verge of collapse in October 2023. It had only about 90 days of operating cash on hand and lost about 40% of its providers, current CEO Brandy Van Pelt-Ramirez said.
Things have changed in the past two years. An emergency fundraising campaign, new leadership and operational changes kept La Familia’s four Santa Fe clinics open. Now, the organization is hiring new providers and expanding critical services as well as establishing new ones, like pediatric dentistry and retail pharmacy, while planning to weather the tumult facing health care providers following federal policy changes, Van Pelt-Ramirez said.
“We have come a long way,” she said. “The good news is, we are not anywhere near the situation we were in, but there seems to be these new up-and-coming challenges every single day that we’re facing in health care.”
‘A time of rebuilding’
Two years ago, Dr. Matthew Schmidt submitted — and then rescinded — his resignation to La Familia administrators.
“There was a lot of turmoil,” said Schmidt, who joined La Familia in 2012 right out of his medical residency. “It just didn’t seem like the organization was headed in a positive direction on many different fronts.”
At the time, a number of doctors and dentists had quit. The organization dismissed then-CEO Julie Wright, hired about seven months earlier, after La Familia’s remaining physicians, dentists, nurse practitioners and midwives voted to establish a union.
After at least five years of financial losses, La Familia Health in late 2023 initiated $2 million in budget cuts, including 17 immediate layoffs and 10% pay cuts for staff. The organization openly requested emergency donations from Santa Fe community members.
Van Pelt-Ramirez, who became the clinic’s interim head in 2023 and then permanent leader in 2024, said the La Familia leadership team was determined to keep going.
“We decided that we were going to see this through and figure out every way we could to become sustainable,” she said.
A key part of that was coming up with a funding formula that would continue to serve un- and underinsured patients, Van Pelt-Ramirez said. La Familia clinics served 14,891 patients in 2025, according to the organization’s data. Of those, nearly 43% were uninsured, meaning the clinics couldn’t bill insurance companies for services provided.
However, because of La Familia’s status through the Federally Qualified Health Center program — as a safety net clinic that receives federal funds to serve medically underserved populations — it can’t turn away patients who can’t pay.
La Familia’s total budget for fiscal year 2026 is $23.2 million, compared to an annual budget of $18.6 million at the peak of the organization’s financial woes.
According to information from La Familia, 31% of its revenue in the current fiscal year is from federal, state and local government grants, while another 31% is from patient revenue and 28% from a discount pharmacy program — which was converted in recent years from cash-only to accepting insurance coverage for medications.
Patients stepped up to help, too.
“We had patients coming in once a month, giving us five bucks,” Van Pelt-Ramirez said. “All of these grassroots-level ideas is really what saved us.”
Dr. Tyler Sams, right, talks with Gabriela Flores during a checkup with her 7-month-old daughter, Elliana Montano, at a La Familia Health clinic on Thursday.
Schmidt, now La Familia’s chief medical officer, said the past few years have been “a time of rebuilding” — repairing trust with providers who had stuck with La Familia through the challenges while recruiting new workers.
“I don’t want to say we’re 100% because there’s always things that we can improve on and work on,” Van Pelt-Ramirez said. “The good news is, we’re doing business, and we’re using our business sense.”
New at La Familia
La Familia has brought on several new providers in recent years and has expanded clinical services in the process.
Dr. Jeff Humberson is one such provider.
Humberson completed specialized training in pediatric dentistry, education he said helps dentists become “masters of behavior management.” They’re trained to encourage kids to cooperate in the dental chair, while working with two patients — parent and child — at once.
While La Familia’s general dentists served children prior to Humberson’s arrival, his expertise allows the clinic to extend its services to children in need of dental care who might otherwise have a hard time receiving it.
“We are now emerging into pediatrics,” said La Familia Dental Director Dr. Brendan Vahey. “I’m really, really hopeful that you’re going to see a tremendous demand from the community, that the alternative that La Familia provides for pediatric patients resonates with what their interests are and what they want for their kids.”
Dr. Tyler Sams is another new provider at La Familia. A family medicine doctor with specialized training in obstetrics, Sams doubled the clinic’s capacity for delivering babies via cesarean section upon joining the organization in October 2024.
Sams said one of his favorite parts of providing pregnancy care as a family medicine doctor is connecting with parents and babies — before, during and after delivery.
“We get to build relationships not just with mom for the nine months of her pregnancy, but really with the whole family,” he said.
Currently, Sams said La Familia’s obstetric providers are waiting for a new grant-funded ultrasound machine, which will allow for more detailed anatomy scans during the second trimester. Those scans are a crucial step in monitoring fetal development, screening for congenital abnormalities, and ensuring proper placement of the placenta and umbilical cord.
“That’s really going to expand the services that we’re able to provide for patients,” he said, noting patients currently have to pay out of pocket for the anatomy scan or get in line for precious few appointments with other providers.
As La Familia brought new providers on board, another major change has occurred in the Alto Street clinic’s pharmacy, said Pharmacy Director Maya Hardman.
When Hardman started working at La Familia in December 2023, the clinic’s pharmacy was cash-only, serving existing patients without processing insurance.
In the past few years, La Familia officials have converted the clinic’s pharmacy into a retail pharmacy, meaning it can accept and process insurance to help clients pay for prescription drugs. Hardman said it’s “one of the biggest changes that they’ve had in the last few years.”
Dr. Matt Schmidt, chief medical officer at La Familia Health, talks with Dr. Diana Cardero, one of the organization’s attending physicians, about patient scheduling Thursday.
And it created a new revenue stream for La Familia, which in turn supports the clinic’s care for uninsured patients, Hardman said.
“That’s really made a world of difference for them in terms of being able to stay afloat financially,” she said.
Looking to the future
Van Pelt-Ramirez has ideas for the future of La Familia.
She said she’d like to add a transportation program to make it easier for patients to travel to their appointments.
She’s also looking at expanding La Familia’s clinic on the south side of Santa Fe, where thousands of new apartments will mean new residents and new demands for care, including pharmacy services.
And La Familia’s new foray into pediatric dentistry might create opportunities to partner with local schools to teach parents and kids how to take good care of their teeth.
“We have to think outside the box and think of ways to be innovative,” Van Pelt-Ramirez said.
She noted, however, all of this is happening at a time of great uncertainty at the federal level. The New Mexico Health Care Authority has estimated the 2025 federal budget reconciliation bill will result in at least 88,530 New Mexicans permanently losing Medicaid coverage through 2034. La Familia will likely be one of a few local clinics to absorb those uninsured patients.
Meanwhile, a major reorganization at the U.S. Department of Health and Human Services has affected the Health Research and Services Administration, which administers the Federally Qualified Health Center program.
Van Pelt-Ramirez said she’s keeping a close eye on national news — and keeping her staff abreast of any changes.
“It’s my job and responsibility to make sure that the staff know what’s going on, what things are going to impact La Familia and trying to prepare for an unknown, an uncertain future,” Van Pelt-Ramirez said.
She added, “We have to create contingency plans. We have to look at everything. … We always have to have a plan B, C, D, E, F, all the way through the alphabet to figure things out.”