In the early 1990s, Our Lady of Guadalupe Church, a large Catholic parish in Denver’s Northside that’s a hub for local Latinos, faced a crisis. Nearly every day, people come to the office asking for help with medical or mental health, the pastor at the time told the parish council, and we don’t have anything to offer. Is anyone willing to take the lead on this issue? Jim Garcia, attending his first meeting of the church’s leadership group, raised his hand.

Back then, Garcia worked for Tim Wirth, a Democratic U.S. senator from Colorado. “It wasn’t like I had a health care background,” Garcia says. “But I did have an understanding of the issue from the policy level…. It turned out to be a lot more than I imagined.”

The church owned a run-down two-bedroom, 800-square-foot bungalow in the Highland neighborhood that could potentially serve as a free clinic, but bids to renovate the century-old house came in around $150,000. Garcia’s budget was $10,000. So, he stood up at a Sunday service and asked for volunteers. “More than 100 people showed up,” Garcia says. And they kept showing up, often working construction jobs by day and laboring at the clinic into the night.

Meanwhile, Wirth decided not to run for re-election in 1992. Garcia took it as a sign and poured himself into the project for a year, getting by on savings and financial support from his then fiancé, now wife, Gloria Padilla de Garcia. An accountant, Padilla de Garcia managed the clinic’s finances for free for the first five or so years. “I consider her a co-founder,” Garcia says.

But what to call the clinic? Inspiration struck when the couple attended a Latin American folk art exhibit at the Denver Art Museum. A video told the story of how Our Lady of Guadalupe, an incarnation of Jesus’ mother, appeared before a poor man on Tepeyac Hill outside of Mexico City in the mid-16th century, bringing the promise of love, protection, and healing. Tepeyac has become one of the most visited Catholic shrines in the world. Garcia turned to his wife: “What a great name.”

In January 1995, the Tepeyac Community Health Center opened its doors to patients. Since then, it has evolved into an essential resource for the nearby neighborhoods of Globeville and Elyria-Swansea (GES), offering primary care (from annual exams to mammograms); behavioral health counseling for individuals, couples, and families; and dental care (including cleanings and more advanced procedures, such as extractions and fillings). Garcia has been there every step of the way. Even after getting a day job at the Denver Housing Authority, he served on Tepeyac’s board of directors; he never received a dime for his time until he became Tepeyac’s full-time CEO in 2011.

Jim Garcia has helped lead Tepeyac since the clinic’s founding in a Highland home. Photo by Amanda López

This month, Garcia will lead Tepeyac through its most significant transition yet: a move to a new 24,500-square-foot facility at the corner of 48th Avenue and Vine Street in Elyria-Swansea, part of an ambitious development project that also includes affordable housing units, a fresh food shop called Noir Market, and the restaurant Tacos El Huequito. Garcia’s challenge? To stay true, in the face of gentrification, to the original vision of the clinic as a welcoming place that values patients and their cultures. “It’s appropriate that our first clinic was a very modest home,” Garcia says. “Our driving philosophy was—and is—that we want our patients to feel as though they are honored guests in our home as opposed to a number that needs to be dealt with.”

During a tour this past fall, Tepeyac’s new high-ceilinged, light-filled clinic was in the last stages of construction, but Garcia talked about the empty rooms as if they were already bustling. The 60-year-old pointed out the areas for family medicine, mental health, dentistry, labs, X-rays, and pharmacy. Big windows in the community room overlooked a landscaped courtyard and playground. He described the brightly colored walls and couches that would soon line the main corridor. “It’s meant to feel like home,” Garcia says.

Tepeyac may strive to keep the spirit of its original location alive, but the clinic itself has become much larger. The turning point came in 2016. Before then, Tepeyac had moved into a bigger, nearly 6,000-square-foot facility in Globeville thanks to fundraising and a grant from the Office of Economic Development. Then, seven years ago, the clinic became a Federally Qualified Health Center (FQHC), making it eligible for reimbursement from Medicare and Medicaid, as well as other perks. At the same time, Tepeyac started to take private insurance too. (Even today, however, about 65 percent of its patients are uninsured.) The injection of insurance revenue fueled bigger dreams. Garcia began talking to community partners about a facility with expanded services that would still take all comers.

Tepeyac follows an integrated health model, where people can access most health services under one roof. “It’s a whole body, whole person approach,” chief health officer Dr. Pamela Valenza says, “where maybe instead of starting a medication, we can treat someone with therapy.” Staff members call patients who have gaps in care or miss preventive screenings. “There have been patients that have come in with the idea that community health centers are less than or don’t provide as good of care as private practices or big-name health centers,” Valenza says. But Tepeyac ranks in the top 30 percent of all FQHCs in the country, based on 14 federal quality measures—such as childhood immunization status and control of high blood pressure—that focus on prevention.

Tepeyac’s facility features a mural painted by Jeremy Silas Ulibarri, aka Jolt. Photo by Amanda López

Nola Miguel, co-director of the nonprofit GES Coalition Organizing for Health and Housing Justice, has her choice of providers through private insurance, but she goes to Tepeyac. The clinic is convenient to where she lives and works, and she says Tepeyac has a higher quality of care than other options nearby. “The interactions with the care providers are just so much better than I was getting at other places,” Miguel says. “It’s more personal.”

Tepeyac has managed to achieve that success despite serving one of the most polluted zip codes in the country. The area is part of the Vasquez Boulevard and I-70 Superfund site, which is contaminated by toxic chemicals such as lead and arsenic left behind by smelting and refining plants, and it suffers from poor air quality due to its proximity to major highways. In addition, the GES neighborhoods are a food desert: U.S. Department of Agriculture data show that a significant number of low-income residents lack access to fresh and affordable foods.

Tepeyac currently employs around 70 staff members. That includes 11 medical providers who care for almost 4,000 patients each year; within two years, Valenza expects those numbers to double. By 2027, she predicts the clinic will serve 12,000 patients. The expanded reach won’t only benefit GES. A Tepeyac analysis shows that by reducing emergency department visits and hospitalizations as well as warding off complications from chronic conditions, Tepeyac already saves the health care system $6 million each year. Those savings are projected to grow with the expanded clinic—as will, hopefully, the overall wellness of GES residents, who have some of the highest rates of cardiovascular disease, obesity, diabetes, and asthma in Denver. A resident of the affluent Hilltop neighborhood is expected to live 13 years longer than one from Globeville, according to the Colorado Department of Public Health & Environment.

As Garcia and I walk along 48th Avenue toward the new development, he talks about the community the clinic serves, which is mostly working class and Hispanic. “This is a traditionally underserved community, and I mean that literally,” Garcia says. “We just got these sidewalks last year.”

A tight Denver housing market combined with two major infrastructure projects—the $1.3 billion Central 70 project and the $1 billion expansion of the National Western Center—have made the GES neighborhoods especially attractive to real estate investors over the past few years, resulting in “massive displacement,” Miguel says. Families who have lived there for generations just can’t afford it anymore. The development Tepeyac is joining intends to bring stability to the area.

The project dates to 2014, when the city approached the Urban Land Conservancy (ULC), a Denver-based nonprofit focused on creating equitable communities through affordable real estate, about buying the six-acre industrial site with the proviso that at least 51 percent of future development go toward affordable housing. (The two-acre development that includes Tepeyac represents the first phase of the project.) ULC brought in Atlanta real estate developer Columbia Ventures to help.

One of the most important aspects of the deal, ULC president and CEO Aaron Miripol says, is that ULC is renting the land to Tepeyac and Columbia Ventures through a 99-year lease that ensures the property will remain affordable, no matter how high real estate prices rise. “It’s about stewardship,” Miripol says. “Because we own the land, we’re protecting not just the city’s investment, but also the community’s investment in what they wanted to see here.”

Garcia is also thinking about stewardship. He realizes that at some point in the not-too-distant future, it will become someone else’s turn to shepherd Tepeyac. But the larger facility will entail higher operational costs, and Garcia doesn’t plan to leave until he’s sure that the center is financially sustainable. Part of the additional revenue will come from helping more eligible people sign up for Medicaid and OmniSalud, a new program from the Colorado health insurance marketplace that provides plans for immigrants lacking permanent legal status. The staff will also have to maintain its grant writing and philanthropic outreach. “It’s a challenge,” Garcia says. Especially as the larger facility—located near the intersection of I-70 and I-25, a light-rail station, and two bus routes—is poised to serve even more Denver residents in need.

On the exterior of the new clinic, a kaleidoscope of butterflies painted by Denver graffiti artist Jeremy Silas Ulibarri, aka Jolt, arcs along the side of the building. The mural, Garcia says, “is emblematic of this community that has so much cultural beauty and strength and resiliency.” It seems to celebrate enduring life. Says Garcia: “We have to be around for the long term.”