When Steve Racciato helped open a small clinic in Cleveland in 2006, he had no way of knowing just how much it would grow — or how many people would come to depend on it.
Now, more than two decades later, Racciato is preparing to retire as chief executive officer of the Health Center of Southeast Texas, leaving behind an organization that has become a lifeline for thousands of patients across Liberty, San Jacinto and Polk counties.
Back then, it was just a handful of people working out of a former flower shop, trying to meet a need that wasn’t fully understood yet.
“When we originally started, I never foresaw the need in the area and our ability to respond to it,” Racciato said.
What started with four employees has grown into a network of clinics providing primary care, pediatrics, behavioral health services and pharmacy access – all with a mission to serve patients regardless of their ability to pay.
Today, the Health Center of Southeast Texas operates clinics in Cleveland, Dayton, Liberty and Colony Ridge (Terrenos) in Liberty County, as well as Shepherd in San Jacinto County and Livingston in Polk County, along with a mobile clinic. Another location is set to open soon in Roman Forest, expanding services into Montgomery County.
The early days were uncertain. Before the clinic received federal funding, Racciato and his team were simply trying to keep the doors open.
“We managed to survive the first 20 months without any federal funding, and that’s part of the challenge you have in becoming a federally qualified health center. Because the government doesn’t give you the money to operate until you can prove that you can operate on a very limited budget. That was a very definitely a challenge, those first 20 months, and then we had finally submitted our application to become a federally qualified health center (FQHC). We were awarded that on September 2007,” Racciato said.
Reflecting back on those early days before being approved as a FQHC, Racciato said there was a lot of uncertainty.
“There were times when it was like, how are we going to make it to the next payroll?” he said.
Over time, the focus shifted from whether the clinic would survive to where it was needed most. As the organization began to thrive, the mission remained unchanged. Whether deciding where to open the next clinic or how to serve a region that stretches across thousands of square miles, Racciato said the guiding principle was always the same – go where the need is.
In those early days, Racciato, a native of Pennsylvania and a resident of Kingwood, Texas, relied on a massive, eight-foot map mounted in his office to get a handle on the region he was serving. New to the area, he used it to study how communities were spread out and what challenges people faced in reaching care. Colored pins marked different features — green indicating forested areas surrounding small communities, while others tracked existing clinic locations and areas where expansion was needed. As new clinics opened, the map evolved alongside the organization, with pins changing to reflect growth. Over time, it became more than just a reference tool — it served as a visual roadmap for how the Health Center of Southeast Texas would expand to meet the needs of the communities it serves.
“The biggest decisions… were when to expand and where to expand,” he said.
In a place like Southeast Texas, where towns are spread out and doctors aren’t always close by, those decisions mattered.
“If we didn’t exist, you’d have to go to Beaumont, Conroe or Kingwood,” Racciato said, referring to federally qualified health care. Other clinics exist in the communities, but not all provided a sliding scale payment system for care based on the individual’s income level.
Finding doctors willing to work in smaller communities remains a challenge. Racciato explained that after years of training, many choose to practice in larger cities where there are more opportunities, higher pay and better amenities.
Even with those challenges, the health center has kept growing. Under the leadership of medical director Dr. Jasmine Sulaiman, it’s been able to build a solid team and expand services.
Care there goes beyond treating patients when they’re sick. Staff help people figure out insurance, connect them with programs they qualify for, and make sure they can actually get the care they need.
The in-house pharmacy in Cleveland has also made a big difference for many. It allows patients to get medications at a much lower cost, which sometimes makes the difference between filling a prescription or going without.
Racciato says none of this would have happened without partnerships with local governments, hospitals and nonprofit organizations, which have been key to the center’s success.
As he prepares to step away, he said he’s confident the organization will continue to grow under new leadership. Chief Operating Officer Maggie Estrada, who has been with the clinic since its early days, will take over as CEO.
After years of long days and constant decision-making, he’s looking forward to a slower pace — at least for a while — with plans to tackle projects at home before eventually traveling with his wife, Sue, who also recently retired from her job as an accountant.
For Racciato, his legacy will be measured in the people who continue to be served by the clinics he helped to start.
“Having been able to do something for a community that needed it is what I am most grateful for,” he said.
To hear the full interview with Racciato for the Bluebonnet News Headlines and Heartlines podcast, click the link below: