In 1968, a long-discussed merger finally took place between the county and the City of Portland, making the Multnomah County the sole public health authority in the area.

Shortly after, the Multnomah County Health Division expanded its services and reorganized nurses into geographical districts. By the late 1960s, the county had added five new clinics and began expanding prenatal and mental health care. The county also established a new walk-in clinic in 1973 at S.W. 5th Ave. and S. W. Ankeny.

Then, in 1974, in the midst of these successes, budget cuts forced a major cut in staff and services. The Health Department retrenched and sought, and won more federal funding. Less than two years after the cuts, virtually all staff and services were restored.

Yet the county hospital remained a crushing financial burden. Meanwhile, only half of the county’s residents needing care were actually receiving it.