Celebrating 50 Years: Gardner Fights for a Community Clinic

In the 1940s, the City of San Jose began a dramatic shift from agriculture to industrialization, at great cost for working-class communities. At the time, San Jose was globally recognized for its fruit exports, thanks to neighborhoods such as Gardner, which housed fruit companies and employees alike. However, Gardner became the poorest district in San Jose as economic expansion took place elsewhere. Faced with an unresponsive city government, Gardner residents worked autonomously to improve their quality of life, and opened their own health clinic.  
Gardner, the neighborhood, began as a separate community that bordered San Jose’s downtown district but was annexed in 1911. It was the first of many neighbors to be absorbed as the city rapidly expanded to invite more investment. Gardner quickly became the center for working-class Italians and other European immigrants who labored in the nearby canneries and orchards. A trickle of Mexican migrant workers began arriving in the 1930s for seasonal work, but remained largely transient. In the 1940s, manufacturing and defense industries drew European workers away from the low-paying agricultural jobs, leading many Italians to move to the more affluent community of Willow Glen. Migrant workers were thus able to find permanent work and housing they could afford to rent in Gardner. Mexican-Americans continued to displace the previous residents, and by 1970, more than half of Gardner’s residents were of Mexican descent.  
As new industries took hold in San Jose, the city grew and became more urbanized. Orchards were pushed out by suburban homes and new manufacturers, signaling the end of the packing industry. The population of San Jose jumped from 95,000 in 1950, to 437,000 in 1970. However, the Gardner community shrunk by 40% as homes were destroyed to make way for new freeway projects. Housing and job discrimination severely limited the opportunities for residents of Mexican descent, a problem that was compounded by the lack representation in local politics. Due to at-large elections for city council and other positions, it was practically impossible to elect a representative from Gardner, or any other low-income immigrant neighborhoods. The city government and local business interests were focused on economic expansion and so low-income communities went neglected.
In 1969, a Stanford neurologist, Dr. Skillicorn, had begun interviewing Gardner residents to identify the feasibility of a new health screening program. After conducting over 100 interviews, Dr. Skillicorn discovered a community in peril. Housing was deteriorating and overcrowded, with up to twelve people crammed into a two-bedroom home. Many homes had sinking foundations and cracks in their wooden frames, meaning residents had to run their heater 24 hours a day to stay warm. About 40% of homes had disabled or retired persons, most of which were lonely and depressed, about a third of the residents were unemployed, and the median income was $4,000. With all these findings, Dr. Skillicorn titled his research “A very, very depressing place.” It had become clear that a community health center was urgently needed. He and his team of Stanford medical students began contacting community members to establish a small clinic in the Gardner district.
Meanwhile, local residents had begun exploring the possibility of establishing a clinic as well. A clinic had opened across town in Alviso and Gardner residents wondered how they could receive similar funding. The civil rights movement had inspired some residents to get involved in local issues, and some were seasoned organizers who had participated in boycotts by the United Farmworkers Union. Community groups had also formed to advocate for change, such as the Mexican-American Community Organization, the Gardner Neighborhood Council, and the Mexican American Political Association. Another organization active in Gardner, and the Mexican community specifically, was the local Catholic Church, Sacred Heart on Willow Street. The church’s pastor, Father Cuchulain Moriarty, was a social justice minded priest, who had come to know the problems his Mexican neighbors faced. Many immigrants turned to the church for help finding a job, to locate a relative, to obtain food or shelter, or to translate an application. Many adults were uninsured or undocumented and so chose not to seek health care, but most troubling to Father Moriarity were the children who were in need of medical attention, some seriously ill.
Dr. Skillicorn and the Stanford students continued to search for a co-sponsor to fund a new Gardner clinic. He was referred by Stanford’s Regional Medical Programs to an organization operating in the Alum Rock district of San Jose, Community Health Unlimited (CHU). CHU was operating with funding from the Model Cities federal program, and was looking to expand into the other service areas of San Jose, Gardner being among them. The Stanford group met with Father Moriarity and Gardner residents to discuss how the clinic could be opened. Father Moriarty had recently closed down the parish school to save money. He offered a classroom for use as a clinic. Gardner community members and Stanford students renovated the classroom to house a clinic and obtained supplies and donated medical equipment.
In July, 1971, the Gardner Community Health Center (GCHC) officially opened. Initially, the clinic only operated twice a week since it was staffed by volunteer professionals, community residents, and students. The clinic was a great success for the community and all those involved in the planning. However, the celebration did not last long.
Conflict quickly arose between the clinic staff and CHU. Since CHU was a federally funded program through Model Cities, the clinic was to be managed by the CHU director, who had yet to visit the clinic during operating hours. Gardner residents disagreed that an outside organization like CHU should oversee the clinic, they believed the clinic should be controlled by the community. As much as possible, Gardner residents wanted to avoid federal money and retain total control of the clinic themselves. Eventually, CHU pulled their funding and the clinic closed.
The Gardner community responded by forming their own committee to run the clinic and 7 months later the clinic reopened under the direction of a new board of directors comprised of community members and volunteers. With help from Stanford, funding was obtained to hire part-time staff. The clinic was now operating two nights a week and Wednesday afternoons, but the clinic quickly outgrew the school classrooms. In response, Father Moriarity offered the church rectory for $1 a year.
At the time, patients were being seen on a sliding scale of $4 to $16 for initial visits, and $1.60 to $6.40 for a follow up. But, clinic staff were concerned this was too expensive for their patients and they wanted to find more sustainable funding. In 1972, the GCHC became the first free clinic in the county to receive a medical license, allowing the clinic to bill Medi-Cal. Equally impressive, in 1973, GCHC received a Country Revenue Sharing contract and hired its first full-time physician and support staff. The grant paid for the salaries for one physician, director, secretary, and medical assistant. One year later, a physician from the National Health Service Corps was assigned to GCHC, raising the staff to two full-time providers. By 1974, GCHC was open full-time, operating 5 days a week and one evening.
The revenue sharing contract with the County of Santa Clara came with a caveat, however. The County wanted GCHC to determine residency status of its patients and to keep records of non-citizens and the undocumented. The board of directors refused to comply and sought legal counsel to combat the County’s requirement. GCHC board members and supporters of the clinic alerted other community organizations about the County’s requirement to track patients and their citizenship status. Rights for the undocumented was an important issue in San José, and the Mexican/Chicano community coalesced to oppose any efforts by the city or county to target the undocumented. The County eventually rescinded the requirement.
The success of the Gardner clinic was the culmination of the community’s desire for autonomy and self-determination. The GCHC leadership remained steadfast in their belief that the clinic should be overseen and implemented by the community. Although this would make the road ahead difficult, this belief would solidify the clinic community when facing future challenges.
Content curated by Antonio Nunez, Jr.