clinics.jpg
More than 150 people, many carrying signs, showed up at a Washington County commissioners' board meeting Tuesday night to protest the planned closure of two publicly funded health clinics. Commissioners, after three hours of often-impassioned testimony, voted 4-0 to move ahead with the closures.
(Dana Tims/The Oregonian)
A large, sign-carrying crowd wasn't enough to persuade Washington County's commissioners Tuesday night to scrap or alter a plan to close two publicly funded health clinics that serve primarily low-income residents.
Commissioners, following three hours of often-impassioned testimony, voted 4-0 to end at least 25 years of county provision of direct clinical services.
The board endorsed a staff-drafted proposal to increase partnerships with existing medical providers in hopes of expanding the range of services offered.
"The goal is to provide folks a year from now with better service than they have today," Commissioner Greg Malinowski said. "We're hoping to get people in contact with those who can do a better job than we've been able to do."
The clinics, one on Main Street in Hillsboro and the other on Second Street in Beaverton, currently offer testing and treatment for sexually transmitted diseases, immunizations and contraceptive and women's health services.
They are now due to close at the end of June.
The plan adopted Tuesday night will provide other clinics and medical groups in the county with a total of $793,000 for each of the next five years. Of that total, $500,000 will come from the county's general fund, with the rest coming from federal money earmarked for contraceptive and family planning services.
The money will enable anywhere from 3,500 to 4,000 uninsured patients to start receiving primary medical care they have previously not gotten, said Marni Kuyl, director of county Health and Human Services.
Most of the nearly 25 people who testified weren't buying it.
"These clinics will close June 30 and new contracts aren't even in place yet," testified Lil Reitzel, a county Health Department nurse practitioner who works for Kuyl. After the meeting, she added, "This plan isn't even close to adequate."
Two translators were on hand to help the many Spanish-speaking residents in attendance follow the testimony.
"This will have an adverse affect on an already taxed healthcare system," Alberto Moreno, executive director of the Oregon Latino Health Coalition, told the board. "And the need for these services will not simply go away after five years."
Board members several times noted that Kuyl's plan includes periodic reviews to ensure that the transition from county specialty services to a more comprehensive primary care regimen is working as planned.
Manny Berman, CEO of Tuality Healthcare, called the plan "workable."
"This money is a good start for providing medical homes" to many low-income residents who currently lack comprehensive care, said Berman, whose organization expects to play a role in creating an enhanced network of care providers.
As drafted, the plan is also intended to provide family planning and contraceptive services to 3,000 women who previously did not qualify for such care. The money will also pay for 2,100 people who lack any insurance to receive immunizations, mainly through school-based clinics, Kuyl said.
The medical facilities expected to sign up to provide services formally offered by the county clinics include Virginia Garcia Memorial Health Center and Beaverton-based Neighborhood Health Center.
Unlike the county clinics, however, those facilities will charge co-pays, which are expected to average $15 per visit.
Gil Munoz, Virginia Garcia's executive director, said his organization will do its best to absorb county clinic clientele, but he added it wasn't Virginia Garcia's preference to see the closures.
Of the $500,000 flowing into the new plan from the county's general fund, Munoz added, "That won't provide access to the remaining uninsured population in the county. That's just being realistic and we need to understand that right off the bat."
County health officials said the proposed closures come in response to at least a decade of declines in patient visits. Much of that drop, they said, is attributable to the federal Affordable Care Act and Oregon's own expansion of Medicaid.
The roughly 12,000 visitors recorded in the early 2000s, they said, dropped to between 6,100 and 6,200 in 2014.
The county closed a third clinic last year in Tigard. It cited similarly declining numbers of patient visits for the closure.
In the end, commissioners said the closures will start moving the county to a better, more comprehensive model of health-care provision.
"We are dedicated to finding a status quo that's higher than we have in the current system," Malinowski said. "We want this to work."
-- Dana Tims
503-2294-7647; @DanaTims