June 12, 2005
By BILL KETTLER
Mail Tribune

Jackson County’s health-care outlook brightened this week when federal grants of more than $3 million were announced.

The U.S. Department of Health and Human Services awarded La Clinica del Valle $2.33 million to provide medical care, dentistry and psychiatric counseling for low-income patients. A second HHS grant will provide $750,000 for the Health Care Coalition of Southern Oregon, a group of clinics in Jackson, Josephine and Douglas counties, to reduce infant mortality and improve the health of newborns.

Both organizations had received prior grants from HHS for the same programs. Federal grant administrators review successful applicants every four to five years to determine whether the programs deserve re-funding.

"It’s competitive," said Maria Ramos-Underwood, development director for La Clinica del Valle. "We have to make a case for our services, who we’re offering them to and for what we’re doing."

La Clinica will use the grant to subsidize patients who cannot afford the full cost of their doctor visits, Ramos- Underwood said.

It’s what we use to pay for subsidized care," she said. "That $2.3 million plugs that hole, and it’s a very big hole."

She noted that the grant represents nearly 32 percent of the clinic’s annual budget of $7.2 million. "It’s a big part of what makes these services available to our community."

La Clinica serves about 11,000 patients and provides about 45,000 patient visits annually.

Ramos-Underwood said Southern Oregon’s quality of health care has deteriorated since the last time the federal Bureau of Primary Health Care reviewed La Clinica’s grant. About 35,000 people have no health insurance and an additional 30,000 are underinsured, which means that their insurance would be inadequate if they faced a medical crisis.

She noted that the Oregon Health Plan has reduced its benefits and the number of people covered; that medical specialists such as neurosurgeons and obstetricians are in short supply in the region, and that visits to hospital emergency rooms have increased, in large part because hospitals cannot turn away patients who lack the ability to pay.

The Health Care Coalition grant comes from the Maternal and Child Health Bureau. HCCSO will use the money to help women have healthy pregnancies and deliver healthy babies, said Peg Crowley, director of the Community Health Center. CHC serves patients at clinics in Medford, Ashland and White City.

"Getting women into early prenatal care will continue to be a major focus," Crowley said.

The coalition includes county health departments in Jackson, Josephine and Douglas counties, each county’s "safety net" clinics (including the Community Health Center) and La Clinica. They created a regional organization to work together on problems they all encounter, such as women who use drugs during pregnancy.

Drug and alcohol abuse, tobacco use, domestic violence, poverty and late entry into prenatal care all contribute to infant mortality and low-birth-weight babies, said Viki Brown, who will manage the project for HCCSO.

Brown also is division manager for public health for Jackson County Health and Human Services.

Some parts of the three counties have disproportionately high infant-mortality rates compared to statewide and national averages.

Oregon’s infant-mortality rate has hovered around six deaths per 1,000 live births in recent years, and the national average is about seven deaths per 1,000 live births.

The infant-mortality rate was more than twice as high (14.39 per 1,000 live births) among Hispanic women in Roseburg, Grants Pass, White City, and Ashland during the three-year period from 1999 to 2001. The infant-mortality rate was also substantially higher (11.82 per 1,000 live births) in communities such as Glide, Riddle, Cave Junction, Wolf Creek, Myrtle Creek, and Talent.

"We’re making progress," Crowley said, "but we still need to do more."