Feeling their pain
Nurses and South King County city officials say closing four public health clinics would imperil the health of low-income and immigrant women
King County Public Health nurse Christina Enriquez, 62, spends most days driving through the outskirts of Auburn to meet pregnant women and new mothers outside, in trailer homes and on their friends’ couches.
But on a recent Monday, she added another stop to her list: the Auburn City Council chambers. Wearing a red shirt with the words “These Cuts Can Kill,” Enriquez asked the council for help opposing the planned closure of four clinics that serve primarily low-income women in South King County.
Enriquez and a group of other nurses have been testifying at bimonthly city council meetings in Auburn and Federal Way since Public Health — King County & Seattle proposed in July closing the clinics due to a $15 million budget shortfall. They were speaking on behalf of themselves, not their employer.
The nurses, along with patients and community activists, want King County and city governments to make the clinics their top funding priorities. City and county officials say that while keeping some of the clinics open is possible, meeting that goal would be tough.
“There is not a realistic chance that all cuts can be avoided,” King County Budget Director Dwight Dively said.
Spreading the word
Public Health’s budget has been in decline for the past decade, director Patty Hayes said.
The problem was compounded when several short-term grants expired and, at the same time, it became harder to qualify for Medicaid funding, spokesperson Hilary Karasz said.
Public Health currently operates 12 clinics throughout King County. To qualify for federal funding, the department needed to maintain two primary care centers, Hayes said. Clinics that offered dental care were spared because they earn enough revenue to cover operating costs. That left four clinics that didn’t make the cut: Auburn; Federal Way; White Center and Northshore in Bothell.
Closing the clinics will save Public Health about $10 million, director Hayes said.
After Public Health submitted its proposal July 9, the Washington State Nurses Association, which represents 16,000 registered nurses, organized informational meetings for nurses at several clinics and passed out “These Cuts Can Kill” T-shirts and bumper stickers, spokesperson Lillie Cridland said.
Members of El Comité and the May 1
Coalition, which advocate for immigrant rights, have been active in organizing patients, said Juan Bocanegra, a member of both groups.
Enriquez said that on Friday afternoons, a group of nurses at the Auburn clinic spend their lunch breaks holding signs and handing out pamphlets on the sidewalk. Calling themselves the Communities for Public Health, the group has collected nearly 2,000 signatures requesting the clinic remain open, she added.
Nadia Bucio, a mother of four and a patient at the Auburn clinic since 2001, has also participated in the weekly rallies. She said her friends, who don’t know about the planned cuts, prefer the Auburn clinic because the majority of nurses there speak Spanish.
One in 10 patients at the Federal Way clinic requires an interpreter, according to a City of Federal Way memorandum.
The patients and nurses have won support from city officials. After weeks of testimony by nurses, the Federal Way City Council passed a resolution Aug. 13 asking the county to rethink the cuts.
The mayor of Auburn plans to propose a similar resolution to the Auburn City Council, Director of Administration Michael Hursh said.
“It’s not equitable,” Hursh said of the proposed closures.
A ‘valuable’ service
So far, the cities don’t have a solution for Public Health’s budget shortfall.
The City of Federal Way has an annual budget of $516,000 for all social services, spokesperson Chris Carrel said. That’s about half the $1.15 million Public Health estimates is needed to run the Federal Way clinic.
Officials from Federal Way and Auburn said they’re looking for ways to accommodate the 30,000 people who now depend on South King County clinics, such as helping private clinics expand capacity.
County Budget Director Dively said since the county’s budget proposal is still in the works, funds may be found to keep some of the four clinics open. County Executive Dow Constantine will hand off the county’s full budget proposal to the county council in late September.
Dively said saving the clinics is a high priority for the county. “These are some of the most valuable things we do as a government,” he said.