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Last of low-cost county clinics near closure

Vote on proposal by commission due in mid-December


Photo Credit: PAMPLIN MEDIA GROUP PHOTO: CHASE ALLGOOD - Nurse Practitioner Lil Reitzel checks Elizabeth Rubio-Alfaro's blood pressure at the Hillsboro clinic. A plan is underway to close Washington County’s two remaining clinics for high-risk, low-income clients.

Stakeholders and the county Board of Commissioners are already taking a hard look at the rapidly dwindling number of patients at its Beaverton and Hillsboro locations. A public hearing will be held; the date hasn’t yet been determined.

If all goes according to the recommendations made by the county’s Department of Health and Human Services, commissioners will vote on the proposal in mid-December. If approved, the clinics would close in July 2015.

The county’s Tigard clinic closed in October 2013. Beaverton’s clinic at 12550 S.W. Second Ave. and Hillsboro’s at 266 W. Main St. served 8,856 patients in 2013, a huge slide from the more than 25,000 treated in 2002.

“We think of this as a transition rather than closures,” said Marni Kuyl, director of the Washington County Department of Health and Human Services.

Kuyl stressed that the county clinics offer limited services rather than full-service care, including:

• Reproductive health such as family planning, contraceptive distribution and cervical cancer screenings;

• Sexually Transmitted Infection screenings, treatment and partner follow-up;

• Adult and childhood vaccinations; and

• Tuberculosis screenings and latent TB infection treatment.

“We do not and never have provided primary care,” said Kuyl.

“As health care changes, and the (Affordable Care Act) transformation takes place, our numbers are going down,” she added, with more county residents now covered by Medicaid or Medicaid expansion. “That’s a good thing,” said Kuyl.

County officials have written up a policy brief that proposes moving the care it provides over to local, Federally Qualified Health Care clinics such as the Virginia Garcia Memorial Health Center, the Beaverton-based Neighborhood Health Center and Southwest Community Health Center.

“We have limited resources, and we have a strong value that every patient should have a health-care home,” Kuyl said.

The proposal asks the Washington County Board of Commissioners to reinvest its $1.3 million county general-fund savings to qualifying health clinics to provide the care.

Jeri Weeks, CEO of Neighborhood Health Center in Beaverton and a FQHC provider, said her clinic is prepared to take on additional patients.

“We provide primary care to 10,000-plus patients per year in Washington and Clackamas counties,” said Weeks. “While we have seen an increase in patients since the ACA implementation, we continue to have capacity to serve new patients. We recently hired two nurse practitioners, both of whom are bilingual in English and Spanish.

“The potential impact is the ability for patients to connect with a primary care provider to serve all of their health-care needs,” she added. “Primary care provides immunization, STD services and family planning within our scope of practice.”

Those are the same services now provided by county clinics.

County leaders and the Neighborhood Health Center admit this will not be good news for everyone.

“Drawbacks for those who want a very specific service, such as family planning and STD services only, might not want to establish and receive comprehensive care,” Weeks said.

“The greatest risk of stopping these clinic services is decreased access to the specialty services for teens, immigrants, men who have sex with other men or other high-risk, underserved populations,” stated the Health and Human Services transition plan. “If we decide to transition the services to a local FQHC, we will need to ensure that we are able to monitor access to care for the high-risk populations.”

However, “The benefits of having public health expertise more readily available to community health centers far outweigh any drawbacks,” Weeks said.

Kuyl added that, “We are concerned about the population of people that do not yet have legal status, but we have a good safety net through the FQHC’s connections with the Latino community.”

The 25 employees currently working at the two existing county clinics would be “re-routed elsewhere,” said Kuyl.

That would be a huge benefit to full-service clinics that would take on the county’s workload, “for example, administering the vaccine-for-children program is incredibly complex and having public health nurses available to train our staff to maximize the benefit of this program is a win-win,” said Weeks. “Public health nurses and staff can ‘upskill’ our staff to assist in communicable disease outreach and response.

“This model strengthens our existing public health model and ability to carry out all of our missions.”

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