To address the inefficiencies in the county’s services, the county developed a long-range plan to re-distribute the indigent sick to private, community hospitals. By 1973, the county contracted with four local hospitals to purchase beds to care for 350 patients.

About the same time, the Oregon State Legislature approved a transfer of ownership of the County Hospital to the state of Oregon. Millions in county funds were freed up by the change and the money was invested into primary care for those with low incomes and no health insurance. The series of developments in the 1970s was coined as “Project Health.” At its height, Project Health served 10,000 clients per month and worked in conjunction with a program for clients with heightened medical need. 

While Project Health slowly faded out due to a growing community and a smaller budget, the program left an important legacy: access clinics designed to provide care for clients displaced by system change. Despite initially being designated as one-time clinics, their use began to balloon and the program rapidly expanded. It soon became clear that primary care clinics would be the future of public health. By 1988, field visits had almost tripled and clinic visits had doubled, and the county was securing extra funding to offer care for clients receiving Medicaid and refugee clients.

That year, the county’s Health Division boasted a $21.5 million budget and served more than 70,000 clients, nearly all of which had incomes below the poverty level. Half of those clients were people of color, with many of them suffering from emotional distress or the burdens of young, single parenthood. 

Corrections Health: Nurse Julie Kosovich inspecting an inmate for the Corrections Health Program. April 1981