By Susanne Severeid
There are moments when you know you are sitting among people who do what they do because it is right, for the sense of service, and not–by a long shot–for the money. I felt this recently while meeting with Heidi Gottlieb and Glenda Rackleff, two nurses who, for years, have been major forces behind the low-income foot clinic at the Senior Center. They told me with shock and sadness about the recent demands by the City of Ashland that have shut down the foot care clinic program.
Some background: Twenty years ago, the community of Ashland came together when the Senior Center and Soroptimist International of Ashland (SIA) collaborated to set up the foot care clinic here. According to both Gottlieb and Rackleff, the foot clinic and Ashland Senior Center has always been a perfect fit, including, more recently, under the leadership of Christine Dodson (former senior program director).
Why, then, this February, did they suddenly receive a letter from the City and Ashland Parks and Recreation Commission stating that to continue the foot clinic through the Senior Center, they would have to double their insurance and include the City as an endorsement?
According to the City’s email: “We regret to inform you that APRC will no longer be able to operate the foot care program after the last clinic already scheduled on February 25. To continue to serve these high-risk clients, the foot care program must separate from APRC to become either a charity service of your private practice or go under the auspices of another community agency. The City and APRC have a responsibility to all citizens to protect the budget from the devastating cost of lawsuits, which could otherwise undermine other City and APRC services.”
The foot clinic is now suspended due to the City’s new requirements.
“Patients have been left high and dry,” says Gottlieb, “not because the service is unavailable but because the City has abruptly canceled a program that has been very successful in providing needed health care for more than 18 years. What we do is not at high risk for liability as the City claims. It does fulfill a health care need in the community. Such an uncalled-for erosion of service within the Senior Program is shameful.”
Gottlieb says that her own insurance company considered this new requirement “excessive” and would not grant such additional insurance without “a written statement from the City describing why the perceived risk necessitates excessive (by the insurance company’s determination) liability coverage.” She adds, “They understand that I work within my scope of practice and maintain national certification as a foot and nail care nurse.” In other words, her own insurance company requested further explanation, which the City has not provided. Rackleff adds, “It concerns us that for some unexplained reason we have been tagged by the City’s Risk Management team as ‘high risk’ and have been refused a waiver to provide our professional services.”
Both nurses point out that there are many other cities in Oregon with similar foot clinics operating out of their Senior Centers, using the same coverage of insurance that has been in place here up till now. They understand that Corvallis, for example, sees five times the number of people seen in Ashland’s foot clinic on a monthly basis with nurses carrying the exact same insurance, all under city auspices.
What then is the motivation of the City to shut down this program?
“We’ve never had an incident,” they tell me, “We are not ‘a dangerous liability,’; we have adequate malpractice insurance. It’s just inappropriate. As a matter of fact, we’ve detected life-threatening conditions that have saved people from medical and surgical complications.”
In Gottlieb’s email response to the City, she states: “The City of Ashland provides zero financial funding for this clinic/service. Soroptimist International of Ashland has provided an annual grant and Ashland Parks Foundation provided a ‘pass through’ for those funds, on a per patient basis. We are so proud of this community. When the SIA lost funding due to COVID and the closure of OSF, private donors stepped up to fund the grant. It’s truly a longstanding community commitment to the needs of a vulnerable population. Over the years, we have been thrilled to be part of the team effort.”
Such a foot care clinic provides easy access for seniors to fundamental care that often becomes more difficult with age due to alterations in balance, flexibility, eyesight, perception and sensation; feet are key to mobility and independence. It seems common sense that the Senior Center is a logical place for people to turn for this service, where certified healthcare professionals can provide low-cost preventative health care, education, and support for a fundamental aspect of care. It is unfortunate if the Senior Center is not being utilized fully as it can and should be, to serve the people, not merely as a referral agency.
When I asked both women what they see as the future of the foot care clinic, their response was simple. “All we want to do is continue to serve, there are so many people who need this care. We need to get beyond the isolation and ‘deferred health maintenance’ that COVID has brought. We’re in limbo for the future of the clinic and not exactly sure what’s next. We are working with Soroptimist International of Ashland; they have been totally supportive. We hope that the community will continue to value and support this important and fundamental senior program.”
If you have comments or questions for the decision makers, here are their emails:
Director of APRC, Michael Black, email: Michael.firstname.lastname@example.org
Ashland City Attorney, David H. Lohman, email: email@example.com
Mayor, City of Ashland, Julie Akins, email: firstname.lastname@example.org
City Council: email@example.com
Susanne Severeid is an award-winning author, public speaker and performer with a background in international journalism. www.susannesevereid.com