Editorial | Public Input to Health Care District

— by Susan McBain–

The five commissioners of the new Orcas Island Health Care District have been working practically around the clock since they were sworn in in May. The tasks they have completed in five months have constituted nearly full-time jobs for several of them. Their work has saved the taxpayers on Orcas Island at least $60,000, the approximate amount that similar work performed by an interim superintendent cost the Lopez Island Hospital District.

The commissioners knew from the start that their job was way too big to complete in a year, much less the six months they had to estimate 2019 budget needs, hold public hearings, and approve that budget. So they elected to focus on what they saw as the most urgent tasks: keeping the two major Orcas clinics afloat, and ensuring 24/7 access to some form of medical services for everyone on the island. An excellent summary of their work to date is available on the District website; click here.

But the public has brought up other concerns at District meetings. Major threads among public comments have been:

• How community input is being obtained. The commissioners have held two Town Hall meetings and helped design an online survey seeking community input into their work. But community members, especially Lief, a former District commissioner candidate, have noted the weaknesses in both these methods, specifically that the most vulnerable members of our community—including those without the money, transportation, or capabilities to obtain services, or even ask for them; those without online access to express their opinions; those without understanding of even how to take an online survey—aren’t being heard from and aren’t being served.

• Support for providers other than the two major clinics. Orcas Island has other doctors besides those at the clinics; for example, Dr. Vincent Shu, a board-certified specialist in cardiovascular disease and internal medicine as well as a practitioner of acupuncture and Chinese medicine, has been mentioned by several people and has commented at District meetings. And there are many other providers of related medical services, such as physical therapy, massage therapy, and alternative medical practices, that community members might like to have supported.

• Whether 24/7 care is the island’s greatest medical need. Former District commissioner candidate Bill Bangs has done considerable research on acute care standards and requirements. He notes that different medical organizations have different standards for “timely care,” ranging from 14 to 24 hours in his examples. He also questions whether Orcas clinics, which do not have extensive diagnostic capabilities, could qualify as certified “urgent care facilities” either during or after hours. As an alternative to spending funds on 24/7 care, he recommends studies of current practices and outcomes, and pilot projects for improvements. (Note, however, that the recent survey by Madrona Voices of community health concerns showed strong support for 24/7 care.)

The commissioners have two public comment periods at each meeting, and meeting minutes include the public’s comments along with the commissioners’ discussions and actions. The commissioners take those comments into consideration along with all other sources of community input. Members of the community are always invited to comment at any District meeting, to make a comment on the District’s “Contact Us” web page at https://orcashealth.org/contact-us/, or to send comments to individual commissioners, listed on that same page.