The one-time medical clinic for migrant workers now serves nearly as many English speakers as Hispanics

You don’t have to speak Spanish to see a doctor at La Clinica del Valle.

As the clinic marks its 15th birthday today, it serves nearly as many English speakers as Spanish speakers. Organized in 1988 to serve the Rogue Valley’s migrant and seasonal farmworkers and their families, the clinic has become a major health-care provider for all kinds of people who can’t afford care anywhere else.

"Poverty and difficult circumstances in health affect everyone," said the Rev. Josué Delgado, president of La Clinica’s board of directors. Delgado said 48 percent of La Clinica’s patients speak English when they visit their physician. That’s a far cry from the clinic’s formative days, when nearly everyone who came to the clinic described their ills in Spanish.

La Clinica’s patient population has grown steadily — from about 1,000 people in 1990 to more than 7,800 so far in 2003. If growth continues at its current pace, the clinic could serve 10,000 patients by the end of 2004 — nearly 1 in every 20 Jackson County residents, said Brenda Johnson, executive director.

"It’s a huge piece of our local health care community," said Hank Collins, director of Jackson County’s Department of Health and Human Services.

Collins noted that Jackson County does not provide primary health care because La Clinica and Community Health Center (another safety- net clinic) offer those services.

"We would be in a bad state of affairs if we didn’t have La Clinica del Valle and Community Health Center," he said.

The clinic’s expanding role reflects the changing face of health care in Jackson County, said Johnson. Rising health-care costs and soaring insurance premiums have pushed health care nearly out of reach for many people.

"As health insurance becomes more costly, businesses can’t afford the premiums," she said. "Employees can’t afford coverage for their spouse and children. We’re seeing more uninsured children."

Health care providers estimate that at least 35,000 Jackson County residents — one in five — have no health insurance of any kind. La Clinica’s sliding fee schedule has made it one of the few places where people without insurance can still afford to see a doctor. A doctor visit costs as little as $20 for people who meet federal income guidelines for poverty ($1,533 or less per month for a family of four).

In 2002, 78 percent of the clinic’s patients (4,969) had incomes that fell below the federal poverty line.

The clinic also provides an important point of entry into the mainstream culture for Spanish speakers, said Milo Salgado, who served on the clinic’s first board of directors in 1988.

"When people come to live here," he said, "it is their first step toward integrating into the community when they use health services at La Clinica del Valle. As they move on, they find other channels."

Recent reductions in state spending have forced the clinic to cut some services. The clinic lost about $800,000 of its anticipated budget of $5.1 million for this fiscal year when the Legislature cut back the Oregon Health Plan. The decision to drop dental care for adults forced the clinic to eliminate a dentist’s position and temporarily shut down dental care at its main clinic on South Pacific Highway.

Cutbacks also forced the clinic to operate four days a week at its new west Medford site instead of the five days that had been planned when it opened.

Uncertainties about future funding cuts may cast a shadow on today’s birthday party. If voters approve the initiative that’s being circulated to roll back the Legislature’s $800 million temporary tax hike, the clinic will see more cutbacks, Johnson said.

"We will see many members of our community without health care," she said.