Pain in the Budget

[May 19th, 2004] A proposal to cut back services at Portland's only Latino-oriented public-health clinic is drawing criticism from Hispanic activists and members of the Multnomah County Commission.

La Clínica de Buena Salud (the Good Health Clinic) is an integral part of Northeast Portland's Ortiz Community Center, providing some of the city's poorest patients with culturally relevant health care. Of the 5,200 visits per year at the facility, 98 percent of patients are Hispanic, the majority women and children.

When County Chair Diane Linn posted her budget earlier this year, the clinic's $1.1 million budget was gone.

"It was strictly a business decision," explains John Ball, Linn's chief of staff. With only enough room for a single health practitioner, La Clínica can't generate as much revenue as larger clinics. In addition, the clinic is without a lab, onsite pharmacy and X-ray services. For these needs, patients are referred to other clinics.

What may make financial sense might come off as cultural insensitivity. "It's part of a community that many have worked on for the last 15 years," say Commissioner Maria Rojo de Steffey. "If it goes, it will start unraveling what's been built."

Both Rojo de Steffey and Commissioner Serena Cruz are fighting to restore the clinic's funds. The most recent budget proposal puts $600,000 back into La Clínica's budget. That may be enough to keep key services alive, but some damage may already have been done.

"These are not folks who've had a comfortable relationship with bureaucracy," says Joel Dippold, foundation director of the Virginia Garcia Memorial Health Center in Cornelius, which also serves a Latino population. "In our system we have faith in our technologies. In traditional systems, it hinges more on a level of trust between patient and healer."