Rushing to try to save 2 county health clinics

The proposed closure of two county health clinics in Northgate and Bothell has doctors, nurses and patients organizing and agonizing over the possible loss of health care for people who have few other options.

Jill Hoffman, a public health nurse who said she was speaking as a citizen, not a representative of Public Health -- Seattle & King County, said the sites targeted for closure accounted for 80,000 visits in 2005, and other clinics that handle underinsured and uninsured clients couldn't handle the overflow if they closed.


		Gilbert W. Arias / P-I
	At the North Seattle Public Health Center, employees Dr. Michael Lippman, left, and registered nurse Nozipho Bujela, right, talk with nearby resident Jim Davis about Saturday's rally as he signed a petition Tuesday to keep the health clinic open.

"People will be taking themselves and their children to emergency rooms for treatment. That will cost everyone money," Hoffman said.

"It's a big deal and nobody really knows about it," Hoffman said. "This is going to impact a lot of people." She said the moves could also leave about 120 people unemployed.

Public Health centers are part of the community safety net that includes community clinics and Harborview Medical Center -- places that provide care for the uninsured, under-insured and Medicaid recipients.

The proposed closures became known in July when Dorothy Teeter, interim director and health officer for the joint city-county health agency, sent a letter to public health employees explaining that flat funding, higher basic costs of doing business and more uninsured residents were going to affect the area's public health clinics.

"Because of this difficult fiscal environment, and in order to balance our budget, we will need to propose significant cuts in Public Health administrative overhead, substantial reductions in client services and other programmatic reductions across the department," Teeter wrote.

County officials subsequently proposed closing the North Clinic, at 10501 Meridian Ave. N in the Northgate neighborhood, and the Northshore Clinic, at 10808 N.E. 145th St. in Bothell.

David Gallaher, a Northgate resident, became a client at the North clinic two years ago when his primary-care physician was about to move away. "I took it upon myself to call all the clinics around to find a new doctor. And no one was taking Medicare patients," he said.

His physician called the clinic and talked to Dr. Michael Lippman about Gallaher. Lippman called Gallaher and said he was welcome at North Clinic, Gallaher said.

"The staff makes you feel like you're going to be taken care of. It's not an assembly line, like some doctor's offices," said Gallaher, who has arthritis of the spine. He said closure of the clinic wouldn't leave him with many alternatives.

Gallaher said Harborview is "saturated" with an emergency room that's busy 24 hours a day. "Northwest Hospital's emergency room is the only thing around and I wouldn't have a doctor there. Their emergency room will accept Medicare, but services may have to be paid for,' he said.

Like several North clinic clients contacted, Gallaher relies on public transportation or rides from friends. If the clinic closed, he said he would spend hours on buses getting to another facility.

Bob Cowan, budget director for King County, said all Public Health -- Seattle & King County clinics were assessed when the budget was being assembled, using criteria ranging from number of homeless visits, visits per full-time employee, the percentage of patients with income less than twice the federal poverty limit and the percentage of non-Caucasian clients, for example.

After the criteria were applied to all 10 clinics, the North and Northshore clinics were earmarked for closure. Cowan said consolidation was "looked at," but it wouldn't save money and reduce costs, and there isn't enough room in existing clinics to house and serve double the clients.

Catherine Sauerzopf was a client of the North Clinic in the 1970s, and became a Northshore client when it opened in 1993. She said she's always been treated with kindness, dignity and respect, with insurance or without it.

When she was working and insured through her workplace, she still used the clinic. "I didn't want to start all over with someone who didn't know me. I was happy to hand over my insurance card," Sauerzopf said.

Dr. Gregory Schroedl, a vice president at Northwest Hospital & Medical Center and an emergency physician, said closure of the North clinic "may have a significant impact on our volume here at the emergency department. We already see many patients who are unable to be seen in primary-care offices or public health facilities in a timely manner. There can be a three- to four-week wait for an appointment."

Lippman has been at North since 1981. He is currently co-chairman of the Communities for Public Health, an advocacy group formed by staffs at the facilities faced with possible closures.

"Myself, the staff and patients are devastated. Patients are very scared. Half have no health insurance. They're a sick population and there's nowhere else to go. They're going to be staying home and getting sicker or flooding the ERs," Lippman said.

King County Executive Ron Sims will give his budget recommendations to the County Council on Oct. 16. There will be public hearings before the council announces the final budget Nov. 20.

Financing for public health clinics has been erratic since repeal of motor vehicle excise taxes, said Sandy Duncan, spokeswoman for Sims. "Every year we've had to pay the funding gap. The state has given some money, but less than in 1998-99."

Washington ranks 44th in public health funding, she said.

RALLY PLANNED

Opponents of the proposed closure of public health clinics in Northgate and Bothell have planned a rally for 10 a.m. to noon Saturday outside the North clinic, 10501 Meridian Ave. N.

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