–by Susan McBain, Orcas Issues reporter —
Candidates in the election for Public Hospital District Commissioners, from left, Patty Miller, Richard Fralick, Leif, Art Lange, Diane Boteler, Bill Bangs. Candidates John Dann, Pegi Groundwater and RJ Myers were not present
On Feb. 24, seven of the 11 official candidates for commissioner of the proposed Orcas Public Hospital District described their positions and qualifications for office to more than 100 Orcas community members. The candidates also answered questions formulated by the Coalition for Orcas Health Care (COHC), followed by questions asked by audience members.
The candidates running for each of the five positions are
• Position 1: Richard Fralick (unopposed)
• Position 2: Pegi Groundwater (unopposed)
• Position 3: Art Lange and Leif
• Position 4: Bill Bangs, John Dann, Diane Boteler, and R.J. Myers
• Position 5: Patty Miller (unopposed).
A fifth candidate for Position 4, Steve Hulley, has withdrawn from the race. His name cannot be removed from the ballot at this point, but his statement will indicate that he will not serve if elected. John Dann, Pegi Groundwater, and R.J. Myers were unable to attend this Town Hall but are expected at the next, on March 14.
A full house at the Senior Center’s Lundeen Room listened to the Public Hospital District candidates’ responses
In brief opening statements, the candidates described themselves by answering the questions: why are you running for district commissioner, what do you think Orcas residents want, and why do you think so? The candidates briefly highlighted their individual backgrounds and skills, then referred those in attendance to their printed position statements at the entrance to the meeting. Full position statements for all candidates are posted on the COHC website at https://www.coalitionfororcashealthcare.com, along with frequently asked questions, resources for research, and more.
Moderator Lisa Byers read a number of questions put together by the COHC based on comments and questions it has received since the first Town Hall in January. In general, the candidates responded to the questions as favoring:
• Keeping current medical practices afloat.
• Working with Orcas Island Fire & Rescue to coordinate services between the clinics and OIFR’s Emergency Medical Services.
• Minimizing district and clinic overhead expenses, but not at the cost of patient choice.
• Awarding contracts fairly and impartially.
• Setting policies for funding services, but not trying to micromanage the operation of either clinic. The district’s tool for requiring and measuring performance is its contracts with providers. Day-to-day communications between the practices and the district will be the responsibility of the district superintendent, who will be employed by the district, as required by law.
• Ensuring that each contract includes metrics to measure performance in the areas of quality of care, patient satisfaction, accessibility of care, and cost efficiency at a minimum. Performance results should be publicly available, perhaps quarterly.
• Immediately addressing the critical first task of assessing community needs, identifying gaps in services, and determining how those gaps can best be filled.
• Once basic service gaps are filled, considering services beyond basic primary, urgent, and after-hours care if the community wants and is willing to pay for them.
Byers invited all candidates to post on the COHC website their answers to a final question: How could the district encourage cost efficiencies and coordination between the two current practices, and what would you see as an ideal outcome?
Questions from the audience addressed the following topics:
• Possibilities for collaboration with the Lopez district
• Conflict resolution among commissioners
• Differences between the roles of the commissioners and the superintendent
• How the scope of primary care is defined
• How the district could influence a provider’s policies
• After-hours cooperation between Orcas clinics
• Ensuring a physically accessible provider for after-hours care
• Funding for psychological and psychiatric services
• Courtesy lab work
• Involvement of younger islanders
• Commissioner recall possibilities
• Specific questions to be asked in the commissioners’ needs assessment and methods of analysis
• Keeping care local and getting rapid response to medical problems
The final Town Hall will also focus on the commissioner candidates. It is scheduled for March 14, 5:30-7:00 p.m. at the Eastsound Fire Hall.
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Creation of a hospital district historically has been the path for isolated or rural areas to develop local heathcare facilities. But the current financial and regulatory environment for healthcare delivery is far different than in the past, and many districts fail. Creation of a district can lead to a taxpayer liability that cannot be supported by the resident community. Lawsuits over governance are not uncommon,malpractice and medical liability lawsuits are very common. It is often said in healthcare that no good deed goes unpunished, so I hope your candidates truly understand what they getting themselves and the residents of Orcas involved in by creating a district. I hope that the good intentions of all are the outcome you recieve.
One question that has arisen for me is does any other hospital district simply subsidize existing medical practices without any relationship to individual patients’ claims?
Another question is whether the candidates will waive the per diem as the Commissioners in Lopez reportedly have done. In addition, the law allows the Commissioners to vote themselves full health insurance, life, disability, etc., even for what should settle into a small commitment of time after the district is established. Insurance costs are one of the biggest drivers of government costs rises Will the candidates not to take insurance?
In response to Peg’s last question, are Port Commissioners, Fire Commissioners (both public) and OPALCO Board members also asked to forego those perks?
For those who could not attend the above-mentioned meeting, I’ve been working on a transcription. It takes a fair bit of time, but we hope to have it ready and published on the COHC website in the next couple of days. CoalitioForOrcasHealthCare.com
Thank you for your efforts Alison. I look forward to reading the transcript.
Mr Reed. Thank you for these reminders.
I agree that we should let the realities of the marketplace along with our legal framework (with all the rights, obligations and fuss this usually entails) settle into our thinking now, not after the fact.
Whatever system we adopt, it must be consistent with how our society functions today, both practically and legally, or it runs smack into a wall and ends in a bust at great expense to islanders.
We can only do what’s possible; more often than not this means “what is most probable” given “actual and potential” resources available.