Oregon Public Broadcasting

On the banks of the Columbia River, one of the Northwest's smallest counties is battling for survival. In the words of one commissioner, Wahkiakum County - in rural Southwest Washington - is being battered by a "perfect storm."

As a result, the county has had to borrow to meet payroll and the only health clinic for miles is at risk of closing. Correspondent Austin Jenkins reports from the eye of this fiscal storm.

At the Wahkiakum Family Practice Clinic, nurse Cynthia Faubion is preparing to give a saline drip to an elderly patient who's dehydrated.

Nurse Cynthia Faubion with a patient at Wahkiakum Family Practice Clinic.

Cynthia Faubion: "Because of her age and the co-existing health problems we're going to be giving it very slowly."

This is small town medicine in action.

Cynthia Faubion: "I've known Mrs. Golden and her family since I was an infant."

Faubion -- who doubles as the local volunteer paramedic -- says because the nearest hospital is nearly an hour away, this clinic provides a lot of services many doctors offices don't.

Cynthia Faubion: "And so giving IV hydration, doing X-rays, EKGs, stabilizing people for ambulance transport or helicopter transport is something that we do almost every day. Alright there's going to be a little bit of a needle stick."

But this busy place could soon close. You see Wahkiakum County took over the clinic a few years back -- in order to keep the doors open. But it's become a money drain -- costing the county nearly $300,000 a year.

Now that Wahkiakum County has fallen on hard economic times, the County Commissioners have decided they can no longer afford to be in the healthcare business.

They're trying to get a local network of Community Health Clinics to take over.

A decision's expected by the end of the month.

Nurse Faubion says this clinic is a lifeline for the roughly 3000 rural patients who come here.

Cynthia Faubion: "These are my friends, my family -- people that I've taken care of since I've been here which is 35 years. Sounds like an awfully long time. We've patients who are still coming here that have been coming to this practice since 1954 when the practice first started."

The plight of the Wahkiakum Family Practice Clinic is just one example of how the down economy is roiling this little county. This place is deeply dependent on fishing and timber.

In fact half the county's $5 million a year budget comes from the proceeds of logging. This year Wahkiakum will be lucky to net a million bucks from timber.

The price of logs dropped dramatically when the economy went south. That's put the county in the red.

Paula Holloway: "Remember we had to borrow at the beginning of the year for cash flow purposes? So I took 500,000."

At a recent finance meeting, Wahkiakum's Treasurer Paula Holloway updated the County Commissioners on the financial crisis.

Earlier this year, the county borrowed from its investment accounts just to meet payroll and keep the lights on.

There's enough money now to repay that loan, but the county still faces another half million dollar shortfall next year.

Already the Commissioners have laid-off nearly a third of the county's workforce -- including two of eight sheriff's deputies.

Now as they sit around the table crunching numbers, Commissioner Blair Brady wonders aloud what to cut next.

Blair Brady: "You know laying people is not looking like an option because we've already done all that. So there's only a couple of avenues left available to us -- do we cut benefits? I mean we pay almost $900,000 a year for healthcare. Do we cut that in half? I don't want to cut health benefits."

Wahkiakum County is hardly alone in its budget woes. Throughout the Northwest counties big and small, urban and rural are slashing services and laying people off.

For instance in Idaho, Boise's Ada County has experienced a dramatic decline in home construction. That's meant 15 lay-offs in the Development Services office.

In Oregon, counties got a temporary reprieve. That's because Congress extended the federal timber payments program. But the cash-infusion to counties will ratchet down over the next few years.

Eric Schmidt with the Association of Oregon Counties describes it as a ticking time bomb.

Eric Schmidt: "When Congress reauthorized the payments it just made the ticking time bomb move a little bit more slowly. So that bomb is still going to go off. It's just a question of when."

You might ask why don't counties just raise taxes? Easier said than done. Washington and Oregon both have caps on property tax increases and Idaho limits growth in government.

Plus, elected county commissioners are loathe to inflict higher taxes on voters at a time when the economy is in the tank and unemployment is high.

Back in Washington's Wahkiakum County the Commissioners are trying to get creative. One idea is to hand over a small county ferry to the state. Some people have even suggested the county dissolve.

Commissioner Brady dryly jokes the county would if it could.  

Blair Brady: "The state said they will not take our keys. I said even if I build you a pretty box and tie a bow around and I just hand it to you, trick you. They will not accept it."

Even though counties are struggling, you do hear strains of optimism. Talk that the economy may have bottomed out is giving county commissioners across the Northwest some hope.

Others say things can't get any worse, so they're bound to get better.