July 2, 2004
A Southeast Portland clinic, which offers interpreters and services for low-income patients, is hit by a budget squeeze
When Amparo Mendenhall arrives at her job as a health assistant and an interpreter at Multnomah County's Southeast Health Center clinic, she wraps a stethoscope around her neck and makes the rounds.
She offers medical advice to patients for a variety of maladies: a baby with a raspy cough, a young mother with anemia, an older man with high-blood pressure.
The clients are mostly low-income or non-English-speaking patients, so Mendenhall takes on an equally important job as the clinic's resident den mother. It's not uncommon for her to help patients with their daily bills or walk a client to a nearby store to make sure that he or she is buying healthy food.
"We don't just provide health care here," says Mendenhall, who has worked at the clinic for eight years. "These aren't just our patients. They are like family."
But within a month, the clinic -- which serves about 8,500 patients -- will shutter its doors. County officials decided last month to cut the clinic's $3.2 million budget as a cost-saving measure. They said keeping the clinic open would cost too much money, given that the county will lose about $10 million in the next fiscal year in state and federal money.
The closure goes into effect July 29, a little more than a month after county officials put the finishing touches on their general fund budget. Patients will have to find somewhere else to receive health care and most of the clinic's 30 staff members will move to other county jobs.
Finding enough money to keep the clinic open has been problematic, county officials say. The building -- at 3653 S.E. 34th Ave. -- has structural problems, and it would cost too much to repair. Money is tight, officials say, because of cuts made to the Oregon Health Plan and Medicaid.
The county's Health Department has a complex budget that operates on a combination of local, state and federal tax dollars. Much of the federal money flows to the county but must be combined with matching state and local dollars. If those dollars are cut, federal funds shrink, too.
Officials say there isn't enough money to keep the clinic running. When the board heard public testimony on the possible cuts to the Health Department, few people spoke on behalf of the Southeast Health Center.
"It's really heartbreaking to have to close this clinic," said Multnomah County Commissioner Lisa Naito. "With all the cuts in the Oregon Health Plan, there are going to be thousands of people without the means to pay for health care.
The clinic's manager, Deborah Cockrell, said most of the patients will have the option of having their medical records transferred to one of four other county-run clinics in the metro area.
Need for interpreters
About 60 percent of the patients at the Southeast clinic need interpreters and many have used the facility because of its services for low-income people.
"This has been an anchor for a lot of people," Cockrell says. "It's something that is stable in their lives and has always been here for them. It's hard to just pick things up and move on without them."
Shirley Davies has been a patient at the Southeast clinic since the late 1980s. She suffers from Graves' disease -- a thyroid condition -- osteoporosis and emphysema. She considers the staff to be "more like family and friends" than medical practitioners.
"They are well organized there," says the 69-year-old Lents neighborhood resident. "It's like you're visiting your close friends because they make you feel so comfortable. It's that closeness I'm going to miss."
Davies says she'll have to visit the Gresham clinic to get treatment, which will mean a longer trip to see a doctor. She worries that with all the changes for the Southeast clinic patients, her new clinic will be "a crowded mess."
"I hope it's not too much to bear," she says.
These are the kinds of complaints that get under the skin of Mendenhall, the clinic's health assistant. She says she's particularly worried about patients who are senior citizens and those have language barriers.
Mendenhall came to the United States from Colombia about 30 years ago and English was her second language. She worked hard doing domestic work and later went to Clackamas Community College to study to become an interpreter.
A Southeast Portland resident, Mendenhall says she loved working near her home because the patients were her neighbors.
One time, a pregnant Vietnamese woman who spoke little English came to the clinic for a checkup,and she looked lethargic. Mendenhall remembers talking to the woman about a booklet of unused food stamps that was in her purse.
Because of the language barrier, the woman didn't realize that she could use the food stamps at any store. Mendenhall used her lunch hour to walk the woman to a nearby store and help her shop for groceries. Eight years later, the woman still brings her child in to the clinic to visit.
"I know what it was like to be in a place where you can't communicate," Mendenhall says. "That's why I will always look for ways to help people. Sometimes, these last few days, I'll be upset and cry because we are closing.
"But sometimes I say to myself: 'We can do it. We can stay open.' I want that to happen. But things don't look good."
David Austin: 503-294-5910; firstname.lastname@example.org