After 39 Years, End Of a Health Institution

Washington Free Clinic Bids City Farewell

Nearly 40 years after its founding, the Washington Free Clinic will see its final patients Friday and then close the doors forever on its once pioneering work. Yet the center's staff will carry on without pause, joining the Whitman-Walker Clinic as it expands its medical services in the District.

The times, they were a-changing in 1968 when the Washington Free Clinic became the first of its kind on the East Coast, an immediate leader in the nascent movement to offer low- or no-cost health care. From the basement of a Georgetown Lutheran church, a motley crew of volunteers initially treated street people, dope addicts, teenage runaways and other at-risk youths, plus draft resisters on their way to Canada.

Changing times now are responsible for its passing. Financial struggles and what board Chair Gardiner Lapham calls "today's administratively burdensome health-care environment" repeatedly threatened the clinic's viability in recent years. In mid-2005, it nearly shut down after a sudden, major loss of federal HIV-AIDS funding. The crisis ebbed when donors stepped up, but it initiated a board-led soul-searching that culminated last week.

"We realized we couldn't go it alone," said Lapham, who conceded bittersweet feelings as the news was announced. The unique "collaboration" between the two clinics will provide more security for the smaller operation's paid staff members as well as continued medical services for its 1,800 patients who transfer to Whitman-Walker.

In 2007, these men and women tend to be the working poor or recent immigrants from Central America or Africa, who frequently lack insurance and have few places to turn. A contingent of 50 volunteer doctors and nurses have helped keep them healthy.

"It's really painful, but it's the right thing for the community," Lapham said.

Whitman-Walker, the largest provider of HIV-AIDS services in the region, benefits. For different reasons it, too, suffered a fiscal emergency in 2005 that forced its leaders to reconsider its long-term future. "We had to bring some stability to the clinic," said Donald Blanchon, chief executive since spring. One key decision was to offer comprehensive primary care to Whitman-Walker's largely gay or HIV-positive clientele as well as to the city's medically underserved neighborhoods. But the organization needed a major investment in staff and infrastructure to accomplish that.

"The market doesn't allow for any survival for staying in place," Sharon Baskerville said Friday. As executive director of the D.C. Primary Care Association, she helped prompt discussions between the two parties. "It took courage on both sides to take on that challenge."

D.C. Council member Jim Graham (D-Ward 1), who once led Whitman-Walker, applauded the outcome as "a historic step in the evolution of Whitman-Walker Clinic and health care in our city."

Evolution was in fact how Whitman-Walker began. It was launched by the Washington Free Clinic as the Gay Men's VD Clinic. Five years later, in 1978, it became a separate entity and was renamed Whitman-Walker. Today Whitman-Walker has 7,000 patients, facilities in the District and Northern Virginia and a $22 million budget -- 22 times that of the Washington Free Clinic.

"It does come full circle," Lapham said. "They're now taking care of us."

Every day this week will bring hugs and goodbyes at the Washington Free Clinic, which for a quarter-century has seen patients in the worn-but-homey balcony alcove of St. Stephen and the Incarnation Episcopal Church in Mount Pleasant. After the last pediatric appointment Friday, the final obstetrician visit and HIV test, staff members will begin moving several blocks over to Whitman-Walker's 14th Street NW center.

By Jan. 29, they'll be treating Whitman-Walker clients, and, they hope, welcoming nearly all the familiar faces from their former home.