The work has never been easy for the nurses, physicians and others who have spent the past several years creating the Waterfall Clinic.

This month might be particularly poignant to the staff and volunteers who provide medical care for people who are uninsured or can't afford it. By April 30, they will have used the last dollar of a three-year, $500,000 federal grant that enabled the clinic to see patients full time.

Fashion show set as fund-raiser

The nonprofit Waterfall Clinic sponsors fund-raisers throughout the year to augment the medical clinic's revenues and grant funds. On April 5, the clinic will host a fashion show from 11 a.m. to 2 p.m. at the Ramada Inn on Virginia Avenue in North Bend. The luncheon will include a silent auction. Tickets are on sale. Several local businesses are participating in the show including Boat Basin Plaza, Weddings Etc., Fred Meyer and Highway 101 Harley-Davidson of Coos Bay. For ticket and other information, those interested can call Waterfall at 266-0620.

"We haven't been sitting still of course," said Kathy Laird, the clinic's executive director.

The clinic earns some revenue from sliding-scale fees paid by patients. Also, Waterfall's supporters have been fund-raising all along (see sidebar) and seeking grants to fill out the $200,000 annual budget. But those efforts won't ensure the clinic's long-term survival. They also won't cover the growing number of local uninsured children, women and men.

Now, Laird and the clinic's board members are applying to become a federally qualified health center, enabling it to receive federal reimbursement. As part of that, the clinic would provide dental and medical care as well.

"It's a very competitive process," Laird said. "It's very obvious that our little corner of the state is in great need."

First, the county must be designated as medically underserved. That declaration must be in place for Waterfall to win federal approval.

If successful, the designation would be a great achievement for the area. Even with Waterfall's current efforts, there are thousands of Coos County residents who still aren't receiving medical care, except in emergencies. Statistically, Waterfall has reported in its grant applications that more than 10,800 residents were uninsured here in 2002. That doesn't include people who were under-insured or people who paid out more than 10 percent of their incomes for medical care, Laird said. And the situation is worsening as the Oregon Health Plan cuts services and more businesses eliminate health insurance to save money.

The clinic is enlisting support in its federal appeal. Geoff Stuckart, spokesman for Sen. Ron Wyden, said Wyden and his staff have researched Waterfall's request and believe the center is doing good work.

Stuckart said an impressed Wyden intends to send a letter of support to federal health officials who will review Waterfall's request. Wyden hasn't sent very many of these types of letters.

"I'm not aware of us doing it very often at all," Stuckart said Tuesday.

If the clinic wins federal support, by its third subsequent year Waterfall would have to provide care to at least 4,300 patients.

Laird is apprehensive, but always outwardly optimistic. She can't imagine they won't succeed. It's that never-quit attitude of Laird's and other original volunteers that prevailed as the clinic grew from a one-night-a-week venture into a full-time practice now seeing 1,000 patients a year.

Though Waterfall's current federal grant is expiring, the clinic has pulled in a $100,000 grant from the Roseburg-based Ford Foundation - money critical in covering part of the clinic's expenses through the rest of the year.

For people tied to the medical profession, Waterfall is an instrumental component in community health.

"It's absolutely necessary to our community. There's a growing need because things aren't getting any better," said William Murray, chief executive officer of Doctors of the Oregon South Coast.

The physician-owned organization contracts with the state to provide medical care for Oregon Health Plan patients. This month, almost 1,800 area residents lost OHP coverage for prescriptions due to the state budget crisis. Thanks to a concerned Oregon Legislature, that coverage is being phased back in for all but 5 percent. OHP members still lost medical and dental benefits and Murray is skeptical the Health Plan can continue without cutting more coverage.

On a federal level, the Bush Administration hasn't let its preoccupation with the war on terrorism stall a goal of increasing medical care for uninsured and underinsured Americans. On Monday, Health and Human Services Secretary Tommy Thompson announced his department had awarded $16 million in grants to 31 health centers nationwide, although not a dime of the money is trickling into Oregon.

Should Waterfall become a federal health center, the clinic would be reimbursed for seeing Medicare and Medicaid patients, in addition to receiving funding for operating expenses.

"We are so needy here ... our area and the people here, we deserve the opportunity," Laird said.

The application process takes about a year to complete, according to Laird. Waterfall is seeking letters of support from the community and Waterfall patients. Those letters must be written by mid-April. Laird doesn't expect a decision from federal officials until 2004.