Sharon DeHart has been known to climb into her 4-wheel drive pickup and head out in even the worst winter weather to check on a patient.
One way or the other, she makes sure residents of South Wasco County get the care they need, even if they are not patients at the Deschutes Rim Clinic in Maupin, which she manages.
“I do home visits — if the patients can’t get to me, I’ll go to them,” said DeHart, a physician assistant.
The clinic at 1605 George Jackson Road is in a remote location, perched on the bluff above the Deschutes River. A black bull snake once took up residency under DeHart’s truck, and suturing lacerations from agriculture-related injuries is the most sought-after service.
The people who live in the White River Health District, which runs the clinic, have a fierce independence and pride themselves on self-sufficiency. One time a patient with an accidental gunshot wound drove himself to the clinic for treatment.
Despite its rural location, the services provided by the clinic are on par with urban medical centers. Primary care dispensed by DeHart and two doctors covers everything from blood draws to splinting broken bones, stabilizing heart patients for transport to a hospital and performing follow-up checks.
“Our job is to be the coach on that patient’s team,” said DeHart.
She brought a background to her current position that included work as a maid, firefighter and restaurateur.
One day, when she was in her 40s, DeHart decided to pursue education as a physician assistant from Oregon Health and Sciences University and Oregon State University.
“I knew everything I never wanted to do again, so I decided to go into medical because I wanted to help people,” she said.
She graduated from OSU in 2001 with the intent of practicing in a rural community because that’s where she was the most comfortable.
DeHart was raised in the Newport-Toledo area by a family who worked in the timber industry.
“Living in rural Oregon is a certain personal philosophy, it’s a way of life that moves at a slower pace and has a lot more camaraderie,” she said.
When she contacted the state Office of Rural Health to inquire about opportunities to practice her craft, DeHart got a photo of the Maupin site and started laughing.
“I thought they were joking because what I saw was a picture of a concrete slab on a bluff,” she said.
DeHart arrived in Maupin to help get the three modular units in place and open the clinic in 2007.
During the Sept. 4, 2007, open house, she said the first patient drove up, a man suffering from chest pains, and he later ended up in hospital undergoing bypass surgery.
Deschutes Rim sees more than 2,600 patients per year and visits can take more than a few minutes, depending upon the patient’s needs.
Giving everyone who comes through the door a high level of personal attention is something not readily available in larger medical centers, said DeHart.
The health district has the same boundaries as the South Wasco School District and serves people in and around Tygh Valley, Shaniko, Antelope, Wamic, Maupin, Pine Grove, Juniper Flat, Sportsman’s Park, and South Junction, an area of about 750 square miles.
DeHart is required by law to work under the supervision of a physician, and Dr. Stephen McLennon of Hood River fills that role.
The clinic is also staffed by part-time medical professionals — Dr. Judy Richardson and family nurse practitioner Lisa Nevara, both from The Dalles — and two administrative workers.
“We’re trying to bring full medical services to an area that has nothing,” said DeHart.
Demand has grown so much in the last 10 years that is it time to build a new facility, she said.
In January of 2017, Mike Wilson, senior partner at Westby Associates, Inc., of Vancouver started working with the Deschutes Rim Clinic Foundation, the fundraising arm for the district, launching a capital campaign to raise funding for a building of about 8,500 square feet.
Currently, medical services are dispensed from about 2,400 feet of space. There are three desks in one office space the size of an average bedroom that are shared with several people.
There are times, said DeHart, when desk space is not available, and she works on a laptop in a closet down the hallway.
Conceptual drawings for the new structure have already been designed and the district will be working with Pinnacle Architecture of Bend for further development.
DeHart said there are rooms for X-ray services and procedures, which are not currently available, and more patient exam rooms (there are now only two), as well as meeting space.
With room to grow, DeHart envisions an urgent care clinic that would provide 24/7 service. The current posted hours for the clinic are currently 9 a.m. to 6 p.m.
The old building will be converted into housing for part-time providers and medical students and storage space, something not currently available, and provide room for physical and occupational therapy services.
The existing lot is large enough to accommodate new construction and possibly a landing site for Life Flight, the helicopter that provides critical-care medical transport.
“The goal would be to look at what partnerships we can form,” said DeHart of growth plans. “Rural health care is never going to be a moneymaker, so we need to spread the word about what we can do.”
In 2001, voters in south county approved a permanent tax of 25 cents per $1,000 of assessed property value. Eight years later, voters were asked to approve an option tax level of 50 cents per $1,000 that expires in 2019.
“We have the smallest tax base for a health district in the state,” said DeHart. “Most have a base that is at least three times ours.”
For that reason, she said voters will be asked in 2018 to approve a 75 cent, instead of 50 cents, per $1,000 for an option tax levy so the district receives a full $1 investment.
DeHart and Wilson successfully lobbied for a $1 million grant from the Legislature this year for the new building, which is expected to cost $2.5 million.
They said thanks are owed to these state officials who went to bat for the funding: Sen. Ted Ferrioli, R-John Day; Rep. Greg Smith, R-Heppner; Sen. Bill Hansell, R-Athena and former Rep. John Huffman, a Republican who left his post in late October to pursue a job opportunity with the federal government.
Last January, Wilson began interviewing people in the district, both residents and officials, to learn what services are most important to them, and to brief them on those the clinic already provides.
“We are the only place to get medical assistance unless you can get to The Dalles or Madras, which is 40 to 50 miles for a one-way trip,” said DeHart of the need for immediate care.
She said construction costs have more than doubled since the district began planning for the new building, so the time to act is now.
“We can’t afford to sit on this for very long because it will soon become prohibitive to build,” she said.
In true country style, money for the building fund is being raised by raffling off quilts made by area groups and individuals. Tickets sell for $3 each or two for $5.
“Our hope is to sell them by Christmas because they make great gifts,” said DeHart.
A group of volunteers formed White River Health & Living in 1997 to provide housing for seniors and local health care services. The nonprofit separated into two boards, one to establish Canyon Rim Manor, an assisted living center, and the other to open the medical clinic.
The district is a taxing entity that operates under Oregon’s Special District regulations. All residents within the boundaries can utilize the clinic’s services, regardless of their ability to pay.
DeHart said all insurances are accepted and payment plans are set up for patients without coverage.
Dennis Beechler of Tygh Valley chairs the district’s five-member volunteer board. He is joined by Brian Manning of Wamic, vice-chair; Sue Knapp of Maupin, secretary; and Sandi Chamberlain of Wamic.
There is an open position on the board and DeHart said it would be good to get representation from Shaniko or Antelope.
In rural America, it’s all about relationships and connecting with people, so the clinic is about partnerships as much as providing services.
By having health care readily available, DeHart said it is easier to attract new businesses into the area, which is good for the local economy.
“We’re looking at the community at-large, not just our patient population,” she said.
In addition to managing the clinic, DeHart serves as president of the Central Oregon Independent Practice Association board and spent four years overseeing the Columbia Gorge Health Council.