More English Speakers Seek Help at Migrants’ Clinics

Charish Bailey was doubled up in pain in an exam room at La Clinica del Carino, a medical clinic originally created for Latinos who work in the orchards dotting the Columbia River Gorge.

Bailey has never been a farmworker; she has a $17,000-a-year office job. But with coverage for state residents under the Oregon Health Plan slashed because of budget cuts, she has been forced to turn to the low-cost medical care at La Clinica del Carino.

“They don’t make you feel uncomfortable here,” said Bailey, 36. “They give you a bill, but they let you make small payments.”

Bailey is among thousands of Oregonians using federally subsidized migrant worker clinics because they have lost benefits provided by the Oregon Health Plan, the state’s health insurance plan for low-income residents.

The influx of Anglos has tipped the 20 such clinics in Oregon to treating a majority of English-speaking patients, although they retain their Spanish names and still welcome undocumented workers, no questions asked.

In 2000, 49% of the clinics’ patients spoke English. By 2002, the last year statistics are available throughout the state, 70% spoke English.

At the same time, the number of patients using the clinics increased dramatically -- from 55,000 to 68,000, according to the Oregon Primary Care Assn.

The growth coincided with the recession in Oregon that brought one of the highest jobless rates in the nation and cuts to state-paid care, including dropping roughly 42,000 patients from the Oregon Health Plan last year.

That sent thousands of low-income residents scrambling for alternatives.

Some went to emergency rooms for basic care, running up huge bills that went unpaid. Others subsisted on free samples from drug companies.

“A lot of people are finding out about the services we offer,” said Daniel Ward, La Clinica’s director. “A lot of our patients have lost the Oregon Health Plan.”

The signs in La Clinica’s waiting room are in Spanish and English. A notice promises patients that they will not be reported to immigration authorities.

The nonprofit clinic charges on a sliding scale. Those with incomes well below the federal poverty level pay $25 to see a doctor, $35 for a dentist. Patients must show a pay stub or tax return. The staff of family doctors treats cuts, broken bones and other urgent needs, but refers patients to a hospital for X-rays, and to specialists for some problems.

The clinics’ outreach workers visit migrant camps, where they find patients with undiagnosed diabetes, complications of pregnancy and even gangrenous limbs in one case. The care is no-frills, low cost and accessible -- and although tailored to migrants, popular with all patients who pay out of pocket.

The trend toward Anglo patients is more dramatic at some clinics than others.

La Clinica del Valle in Medford had been narrowly focused on helping the migrant population, but this year began serving an English-speaking majority.

The Virginia Garcia network of clinics in Washington County was named after the daughter of a farmworker who died after her foot infection went untreated. These clinics too are seeing large numbers of Anglo patients.

The federal subsidy makes the service affordable.

La Clinica, founded to treat migrant workers in cherry, apple and pear orchards in Oregon and southwest Washington, receives federal grants that pay 44% of expenses, such as salaries for bilingual doctors and a dentist. A mix of state money and patient fees covers the balance.

Bailey, who is single with one child, is typical of the Anglos who come to La Clinica.

The last time she saw a doctor, in 1999, she qualified for the Oregon Health Plan. That changed when she got a job as an office manager, which pushed her salary slightly above the threshold for public health insurance.

Bailey said she would prefer a personal doctor and cannot afford dental work, but has no complaints about service at La Clinica.

“There are quite a few of us who know it’s well worth it to support this place,” Bailey said.