$100K loan approved for health clinic

THE DALLES — Wasco County commissioners approved a $100,000 loan Wednesday, May 13, to keep the Deschutes Rim Health Clinic afloat through a “projected cash flow gap” this fall, tiding the institution over until their first infusion of revenue from the new tax levy hits their bank account in November.

The unanimous vote at the May 6 board meeting underscored the increasingly precarious state of rural healthcare across Oregon, particularly in South Wasco County, where recruiting and retaining providers has become both expensive and uncertain.

White River Health District, which operates the Maupin-based clinic, serves two thirds of the county’s geographic area and one third of its total residents. The Oregon Office of Rural Health has consistently identified South Wasco County as an area of unmet healthcare need in the state.

The district listed several precipitating factors that led to the funding gap. Revenues, while increasing, are projected to fall short in September or October of this year, as debt obligations repaying the $1.4 million clinic building are increasing Feb. 2027 from $8,200 per month to nearly $13,000 per month due to an interest rate adjustment.

Regional support for the district has been strong, from the county’s $50,000 grant to the new clinic in 2019 to the local tax levy passed in 2025 to help sustain operations.

“This doesn’t get any stronger than that when the community taxes themselves to support their own clinic,” Commissioner Phil Brady said.

Acquiring and retaining practitioners

White River Health District Board Chair David Farris told commissioners the facility came close to collapse in recent years after repeated provider turnover eroded patient confidence and destabilized operations.

“Nobody wants to move to a primary care provider that may not be there,” Farris said. “People have to develop a faith that primary care provider that we have will still be there a year from now, two years from now.”

Farris said the district recently recruited a full-time nurse practitioner from Wyoming, a development he described as critical to the clinic’s survival.

“She called from Wyoming and said they want to move, and they’re bringing their drift boat and the raft and their three dogs,” Farris said. “People love her.”

“That’s a remarkable achievement, to get a steady provider in a rural community,” Commissioner Brady said.

The discussion touched on the broader crisis facing rural healthcare systems. Farris said even patients from The Dalles have begun driving to Maupin because of instability among primary care providers elsewhere in the region.

“We have one local person there who put on Facebook that she was looking for now her fifth primary care provider in six years in The Dalles,” Farris said.

But even with new staffing at the Deschutes Rim Health Clinic in place, clinic leadership said rebuilding patient volume and financial stability will take time. The requested loan is intended not simply to cover operations, but to fund marketing efforts and provider recruitment, Farris said.

Loan framed as a bridge, not a bailout

The loan carries a 4.5% interest rate deferred until June 30, 2027, when increased tax revenues approved by South County voters are expected to begin stabilizing district finances.

“I’m always hesitant to just be a granting agency,” County Administrator Tyler Stone said during discussion. “The reason that the county’s in a fiscally stable position is because we look at sustainability and long-term revenue.”

Brady said the structure of the agreement — a short-term repayable loan rather than direct aid — made the proposal more acceptable to the county.

Commissioners noted the district had already aggressively pursued outside grants and local funding before approaching the county for assistance.

Under the approved motion, Stone will finalize the formal loan agreement with the district.