A small woman wearing a cheap cotton coat and an ill-fitting wig pushed her way toward the woman she had been told was a reporter. She opened her mouth, manipulated a wad of chewing tobacco, pointed to a tooth and poured out her troubles.

"Miss reporter lady," she said in tinny voice, "I got a bad tooth and these people wouldn't treat me. I got Medicaid and everything, and they wouldn't pull my tooth. I had to go all the way to D.C. General," she said, waving accusingly at 14th Street's Upper Cardozo Neighborhood Health Center as she spoke.

Just then a man walked up to her and offered her a petition. "That's why we need community control of the facility," he said, and pressed her to sign.

For the past several weeks, a small group of dedicated community residents has kept vigil just outside the health center at 3020 14th St. NW, prodding passersby to sign petitions and to protest against what the group describes as the present board of trustees' insensitivity to community needs and wishes.

Founded in 1969 on the second floor of a renovated bank building, and moved five years later to the $4.5-million-dollar facility, the health center is the gleaming result of years of organizing by a group of six mothers who lived at the Park-Morton public housing project.

The protest effort was touched off this summer when the present board selected a white Virginia resident for the top adminstrative post over a black woman veteran of the agency who also wanted the job.

Protesters say they are angry about a decline in the quality of services, but mostly they seem to feel that the selection represents the latest in a series of betrayals.

The center was designed to provide free comprehensive health care to the low-income residents of the depressed Cardozo area, but also, say the protesters, the founders hoped it would provide training, jobs and an exercise in forming leadership skills for poor members of the community.

Formerly the board of trustees was selected through open elections in which all the patients were invited to vote; now, a committee of board members selects new members -- half of whom must be patients -- after soliciting resumes.

An in-house program that trained neighborhood residents to work as paraprofessional health aides has been discontinued. Now Howard medical students work as interns at the clinics during the school year.

"I think that if we could sit down and put our ideas on paper for something as monstrous as that, we should be able to control it," said Vivian Cherry, one of the six founders and now head of the Committee to Save the Upper Cardoza (sic) Health Center. "I feel I know what the community needs better than many people who are now on the board, but I have been told they don't want people like me on the board."

"We are in a conservative economy. We are in a hard fight to hold onto services. We are going to do what we can to provide quality health care . . . with the same amount as last year," answered Jolene Adams, a community activist and a member of the present board, at a recent board meeting.

"But a lot of the learning and acting out that was done when lots money was available is no longer going to be tolerated. tWe have to meet deadlines and come out of a meeting with something. [Members of Congress] do not care about community input any more; they care about dollars and services."

As an institution that has outlasted some of the agencies which provided its first trickle of funds, the health center is a successful monument both to grass-roots organizing and to neighborhood health care. With longevity, however, it has also localized many of 14th Street's long-developing growing pains.

When the center opened in temporary quarters at 3308 14th St. NW in 1969, the Office of Economic Opportunity (OEO) provided $1.8 million in operating funds. Construction on the new building at 3020 14th St. NW began in 1972 with a $1.4-million planning grant, making it the first sign of regeneration after the 1968 riots.

Last year, the Department of Health and Human Services gave the center $1.6 million -- which buys much less than in 1969 -- which the board supplemented with another $500,000 from other sources.

Thus the present directors must now weigh the demands of efficiency against the need to provide learning experiences for the disadvantaged. They operate in a political climate infused with different notions about the way federal money can and should be spent. And they must understand changing ideas in transitional neighborhoods.

Middle-class neighbors who in the past preferred not to consider themselves part of a depressed neighborhood are now joining new renovators and old residents in finding ways to improve the area, but they may be very much resented by the lower-income people who struggled to improve the quality of neighborhood life all along. Reginald Berry admits that he is as good an example as any.

"I first became aware of the need for health care when I had an accident and had to go all the way to George Washington [University] Hospital to get treated and the bill came to something like sixty-seven bucks. This is right down the street [from Berry's house on Irving Street], but I didn't come here because I thought this was an anti-poverty program set up for people who couldn't pay. I thought they wouldn't take a guy like me," said Berry, an independent roofing contractor who has been on the board since January.

"I know that people can say, 'Well, where were you when we were trying to get this thing started?'" he added. "And I have to admit I wasn't part of it. But that argument doesn't address management capablity . . . I have an expertise in finance . . .I've learned that health care is needed in this area and we're trying to make sure that this [facility] provides it."

Vivian Cherry, on the other hand, was there all along, pushing for the building which she still calls her "baby." She attended the first few meetings of the group of six women back in 1962.

The would sit for hours in the basement of 620 Morton St. NW, thrashing out their proposal, deciding who could polish it, who would know where to take it. The much-revised document finally found its way into the receptive hands of the OEO, and in 1969, the temporary center opened.

In 1972, Cherry watched then-mayor Walter Washington scoop the first schovelful of recently smoldering earth for the new building, which accepted its first patients at the end of 1975.

Since 1979, the health center has offered a full range of free services including gynecology, obstetrics psychiatry, nutrition, optometry and dentistry, and child care for parents undergoing treatment. Now the staff of twenty-two full-and part-time physicians offers the same range of services, but they are no longer free to all low-income residents of the Cardoza area. Service are offered on a sliding scale of fees depending on income, and the center accepts patients from all over the city.

For the last three months the staff has enrolled an average of ten new patients a day. The number of patient visits in Spetember 1980, an indicator of usage, jumped almost 100 percent over the previous September, and the number of visits in the first nine months of 1980 has already surpassed that of the whole of 1979. "And," said Jolene Adams, "this is the first year this place has not gone over the budget."

Still Vivian Cherry feels she has witnessed a breach of trust, which seems to be symbolized by the appointment of Elbert Hayes as project director, instead of home health program director Eloise Jones. Jones served as acting director until the board selected Hayes and asked him to begin work in September.

Said Cherry, "The hope and dream we had was that people in the community would be trained for jobs. And now outsiders get hired over the people who already work there. They never get recognition, and the whole point of the health center was to provide upward mobility."

"It's not just an insult to her," added committee member Nia Kuumba, "it's a threat to the economic enfranchisement of women."

But members of the board replied that race was not a criterion for selection. "Now, I'm prejudiced," replied James Washington, another consumer representative and, at 68, a longtime neighborhood resident. "And I don't like white people. When we voted, you know what I said? I said, 'I don't like him because he's white, but I'm going to vote for him because he's qualified.'"

Members of the Committee to Save the Upper Cardoza Health Center have vowed to fight the present board until members either resign or are dismissed by the Department of Health and Human Services. They have written letters of complaint to everyone from Cabinet Secretary Patricia Harris to the program analyst who oversees the health center's budget -- even though the health and human services agency has consistently returned votes of confidence to the board by renewing funding and staying out of the adminstrative affairs.

But the committee says it will do whatever it can think of -- including picket members at their own homes -- until the board submits. The odds are not in their favor, because, said board member Diane Amussen, "the idea that polite folks will run away if a mistake."