It's a cramped space set below street level. Faded purple carpets and narrow hallways branch off into small examination rooms, office space and labs. Classical music plays in the halls. For now.
But they'll soon be empty.
Aradia Women's Health Center, a First Hill nonprofit organization with a feminist point of view, has faced protesters, debt, several moves and a lot of change over the years. Recently it confronted an even more potent threat: a lack of funding coupled with rising costs. This financial crisis will soon take its toll. In January, after 34 years of service, one of Seattle's first abortion clinics and women's health centers will close its doors permanently.
"We're calling it the perfect storm," says Karen Besserman, vice president of the board of directors. Over the last two years Aradia's insurance provider tripled the cost of malpractice coverage. Most of the clinic's clients are low-income women -70 percent up from 50 percent five years ago - and Medicaid subsidies simply did not cover costs. Donations from local individuals have stayed consistent and account for 10 percent of the clinic's funding. The rest comes directly from clinic services.
Aradia was created in 1972 by a group of women at the University of Washington's YWCA. The Supreme Court's decision in Roe v. Wade legalized abortion a year later, and in 1977 Aradia incorporated the procedure into its general gynecological care program. It has served 54,000 clients and stayed true to its original mission of care for women by women, together with reproductive advocacy and education. The clinic has been at its current site, 1300 Spring St., for 10 years.
Here the organization's eight health care advocates, a nurse, a physician's assistant and nine doctors, provide abortions, birth control counseling, annual exams and testing for sexually transmitted diseases.
Breaking the news
On Dec. 12, the staff gathered in the clinic's waiting room for their afternoon meeting. The board of directors was also present as Liz Vivian, interim executive director, made the announcement about the upcoming Jan. 31 closure.
"I think that everyone was kind of surprised," says Kale Rose, a health care advocate. "It was always in the back of our minds that it was a possibility. No one wanted it to be." The decision to close was part of a multi-year examination of the clinic's sustainability, says communications director Amie Newman.
But last year's $84,000 budget deficit was a red flag. Other recent signs hinted at closure. There was a freeze on employee raises and outgoing development workers were not replaced. Notably, no permanent executive director had been hired after Marcy Bloom, the former director, left in May.
"It's a loss to the community," says Bloom, but "organizations have life spans." Bloom served as Aradia's executive director for more than 18 years. During her tenure she increased the budget from $250,000 to more than $1 million, doubled the staff and added bilingual members.
She joined Aradia in 1987 at a time when the clinic was struggling with debt and the rising cost of malpractice insurance, "ironically enough" she says. When she left Aradia it wasn't decided that it would be closing. "I will say that the decision to close came independently of her leaving," says Besserman.
"That kind of compassionate model of health care simply wasn't sustainable in the long term," says Bloom.
At Aradia, health care advocates receive intensive training that takes three months. They screen and talk to clients, take their health care histories and also do some lab work. "It's quite intimate," says Rose. They stay with clients during abortions and afterward take them to the recovery room with its recliners, heating pads and scent of peppermint. "We're there so that they are not alone," says Rose. That kind of one-on-one care was one of the things no one at Aradia wanted to give up.
The only real choice
The board considered other options aside from closing, such as merging with a larger organization, becoming just an abortion clinic or purely an advocacy group. But, says Newman, none of the options would "retain the essence of Aradia." Roughly 20 employees are being laid off. Bloom feels certain they will go on to continue Aradia's mission, "with the brand of feminist health care on their souls."
"It's a sign of the times," says Bloom. The federal government does not fund abortion. Washington state subsidizes it through Medicaid but those reimbursements are too low, says Aradia staff. As fewer Americans have insurance, independent non-profit clinics like Aradia are unable to cover the rising costs of service. Abortion is on the decline nationwide, except among low-income women, something Bloom feels is due to their lack of insurance and access to birth control.
Yet Bloom, as well as the current staff and management at Aradia, are hopeful that their clientele will receive the necessary care elsewhere. Aradia is one of 13 feminist health care clinics left in the country, says Newman, but here in Seattle the community is well served and has access to other reproductive care. Aradia will send its client list to another provider, though a decision where hasn't been made yet. Aurora Medical Services is around the corner and a branch of Planned Parenthood is nearby.
"I'm not sorry for any choices that we made," says Bloom. "There was never enough thick and too much thin." "When you're not willing to cut programs or cut staff or do things that compromise the vision..." She drifts off. "Why stay open if you can't stay true to your mission?"
Capitol Hill-based freelance writer Tara Hayes can be reached at editor@capitolhilltimes.com.
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