Clinical Depression

Hounded by budget crises, unflattering audits, and general gripes about management, the Economic Opportunity Family Health Center circles the wagons

Trice acknowledges that she has received other, similar complaints. "I have to say it's an area we spend an awful lot of time on," she declares. "Regardless of how limited our numbers are, it causes a lot of concern because I know how it is to depend on people like us. But," she adds, "the people who don't have complaints have not been as vocal as the ones who do."

A few months ago someone showed Trice a copy of Alton Clements's log, which he had submitted to city and federal authorities along with written grievances about the whole HOPWA program (not solely the Family Health Center's involvement). She called Clements and met with him and Frankie Swain, her vice president in charge of services to HIV patients. By then, though, Clements was no longer eligible for the HOPWA program because he'd begun receiving permanent disability income.

Alvin Moore, chairman of the center's board of directors, says the entire HOPWA snafu was "an oversight issue" that was worsened by alarmist AIDS activists. "If there have been any areas to criticize," says Moore, an administrator with the Metro-Dade Housing Agency, "it might be that those [Family Health Center] folk cared too much for what they were doing. I'd rather be criticized for that than not caring at all."

When it opened in 1969 in an abandoned elementary school, the Economic Opportunity Family Health Center was one of the first community health centers in the nation. Back then the idea of neighborhood medical services was practically unheard of, recalls Dr. George Simpson, the center's first medical director. "We had a health system, but no organized approach to the health of the community," says the bespectacled Simpson, a former surgeon who now directs Jackson Memorial Hospital's family medicine clinic and sits on the Family Health Center's board of directors. "The War on Poverty began to ask questions about what causes disadvantaged people to have bad health: One, they couldn't afford it. Two, the facilities weren't accessible. And three, the attitudes and approaches of the providers weren't acceptable. Poor people were looked down upon, scorned. Black people are kept waiting while all the white people are seen, and when he comes in the room the doctor sits down and says, 'What's the matter with you, nigger?' Think that didn't happen? That was the way of life and in many ways it still is, and as bad as it used to be."

Proceeding from the premise -- revolutionary, at the time -- that social, cultural, economic, and psychological conditions all affect one's physical health, the center hired social workers to go out into the community and learn from clients about their living conditions and lifestyles. Then-project director Dr. Lynn Carmichael recruited young doctors from a family-medicine residency program he'd started at the University of Miami -- the first such program in the nation, according to Simpson. An extensive training program helped neighborhood residents earn their high school equivalency diplomas and learn nursing and technical skills; often they too came to be employed at the center. "It gave jobs, it was a site for training, it was the largest employer in Liberty City," says Simpson, adding that Family Health was the first center of its kind in the state to include alcoholism treatment in its mental-health programs. "It offered a place for new black providers to start off. It was a force in the community."

Simpson expresses surprise at the current allegations of mistreatment of poor clients. "The general approach is one of support, respect, and concern as well as competency," he says.

When Simpson left the center in 1976, the board had begun looking for a site on which to construct new offices. In 1980 Family Health Center moved into its present headquarters, overseen by its newly hired president and CEO Jessie Trice, who previously had served as director of nursing for the Dade County Public Health Department.

Trice, now 66, works in a modest second-floor office whose jalousie windows overlook the baseball diamond at Olinda Elementary. Although she now makes a comfortable living, she has known abysmal poverty. Growing up near Pahokee, in the Everglades, she picked beans and potatoes and sorted sugar cane along with her family. Like many black women coming of age in the Forties in the Deep South, she found that the best of her limited educational and professional opportunities was the chance to attend Grady Memorial Hospital School of Nursing in Atlanta.

After graduating in 1951, Trice worked as a nurse at the segregated hospital. Ten years later, newly divorced, she came with her two children to Miami, where her mother and brother had already moved. Her first job here was as an R.N. with a county health clinic in South Miami. In 1966 she earned a bachelor's degree in nursing from the University of Miami. In 1975 she took a leave to study for a master's in public health at the University of Michigan; upon her return she was promoted to director of nursing for the health department. She was appointed to the White House Conference on Children during the Nixon administration and is a former vice president of the state board of nursing. A past president of the Washington-based National Association of Community Health Centers, she still makes frequent lobbying visits to the capital. Locally, she is as well connected as any citizen with a street named after her could be; she counts among her friends U.S. Rep. Carrie Meek and Dade County Commissioner James Burke.

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