SEATTLE — The King County executive's office says "most" of its health clinics are at risk of closing in 2025 due to budget issues, unless significant additional funding is secured.
Executive Dow Constantine and King County council members are searching for solutions as healthcare workers' unions launch a petition to raise awareness and seek action.
The Public Health - Seattle & King County clinics at risk offer primary care, maternal and children's health services, health care for people experiencing homelessness and dental care for around 80,000 patients. Advocates say more than 60% of patients identify as Black, Indigenous or people of color; 40% speak a language other than English, and a substantial population are uninsured or homeless.
"These clinics span from downtown to the Eastside to Federal Way and Renton, they're all across the county and provide care for our community's most vulnerable," said Karen Estevenin, executive director of PROTEC17, which represents some of the workers inside at-risk clinics. The organization, among others, signed a petition to call for action on the issue. So far it has secured more than 1,000 signatures.
"To gain education, to build community support," Estevenin said. "We're hoping this gets the word out, that people can talk about it, that people can have some facts and figures in front of them and know that this is [a real possibility]."
King County Executive Constantine warned the community about the potential for these cuts in fall of 2023. At the time, county leaders asked state lawmakers to consider several measures to give the county more flexibility in raising money. Lawmakers chose not to change a revenue growth limit that could have brought in some more funding, but did pass two other bills that could help. One allows health clinics connected to Harborview Medical Center to get funding through a public hospital property tax; the other allows the county to put a levy measure to voters to fund the General Fund programs that would otherwise be cut.
King County Council Health & Human Services Committee Chair Teresa Mosqueda said she wants it to be clear: the centers are still open right now and people should not be afraid to seek care.
"Your public health clinics are still open and my goal is to make sure we're working in conjunction with the executive, congressional members and state partners to keep those open at least through 2025 so we can have a conversation with voters and community members over the course of the next six months," Councilmember Mosqueda said. "But please know your public health clinics remain open, the workers are still there; do not self-select out of the care you need."
Mosqueda said in addition to providing care to thousands of patients, the clinics also served as geographic roots in different communities, helping to provide care during the COVID-19 pandemic.
"There's an ongoing shadow pandemic right now and that is one of depression and isolation, often seen in the form of addiction and behavioral health, mental health crises," Mosqueda said. "We need to have a similar response to keep our community healthy and cared for by investing in that workforce and investing in that infrastructure."
Mosqueda said it's important to look at ways to increase reimbursement for services, and that actions by the state legislature will help. An additional tool could be congressional funding to cover temporary costs while discussing options with voters and the community for funding future care.
The Washington State Nurses Association represents nurses in some of the clinics and says they have built special relationships with their patients over the years - bonds that would be disrupted by clinic closures.
"They're building relationships. The community members trust the nurses, they build a rapport; its not just one generation, it's multiple generations, in different settings," said Linda Burbank with the Nurses Association. "This [petition] is a cry to say, the public health nurses are instrumental in bringing the community to a healthier space, they were there through the pandemic, so its alarming we're talking about cutting those services."
The county executive's office said if clinics do close, it will happen in the first six to nine months of 2025 and no decisions have been made about specific clinics. Executive Constantine is working on options for discussion with council and may have a proposal in early May.
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