— by Susan McBain, Orcas Issues Reporter —
Negotiations on the contract between the Orcas Island Health Care District (OIHCD) and the UW Neighborhood Clinic (UWNC) on Orcas are continuing. But the proposal from the After-Hours Work Group, which has representatives from both organizations, on after-hours care and scope of services will not be included right away.
While the Work Group has made progress in agreeing on what services are appropriate for after-hours care on a remote rural island, the proposal continues to make its way through UWNC’s leadership and provider staff. The proposal would represent a change from the way UWNC currently operates and would increase scope for the providers, so UWNC needs more time to determine how much it can accommodate and in what time frame.
Commissioner Patty Miller, who is on the negotiating team along with Commissioner Art Lange, proposed that, rather than continuing
Clinical Services Agreement (CSA) negotiations, OIHCD continue the current Interim Funding Agreement (IFA) with UWNC through June 30, 2019. The IFA is comprehensive and covers the full scope of services that UWNC currently provides. The commissioners approved a motion asking Miller and Commissioner Pegi Groundwater to identify modifications needed in the IFA, and authorizing the negotiating team to renegotiate the modified IFA with UWNC.
The After-Hours Work Group will continue talks during that period. The Group includes Commissioners Lange and Diane Boteler, and UWNC regional staff members Mark Bresnick and Dr. Matt Jaffy. Bresnick and Jaffy have been willing to consider OIHCD’s view of services needed on Orcas, and they are working with their management and the providers on the issues.
In other provider updates, OIHCD Superintendent Anne Presson reported on recent denials of coverage for emergency air transport costs for people with Kaiser insurance. She has connected Dr. Michael Sullivan, the county’s EMS Medical Program Director, to the appropriate medical leaders at Kaiser for discussions of the special situation of emergency medical care in the islands. Once she has more information on the reasons for denials and actions by the air transport companies, Presson will advise the community. She also stressed the importance of signing up for transport service from both Island Air and Airlift Northwest.
Before purchasing the clinic building last year, OIHCD received informal proposals from several contractors to replace the roof. Because of OIHCD’s recent agreement with the Municipal Research and Services Center in Washington (MRSC) for creation of a Small Public Works Roster, Presson has suggested to those contractors that they sign up with MRSC Rosters, so they can participate in the formal bidding. Presson will also submit notices to the Orcas news organizations asking local vendors to sign up for the Roster.
Finally, the commissioners reviewed a draft communications strategy document, continued reviewing their financial management policy with a focus on categories of reserves, and re-elected Richard Fralick as OIHCD President and Miller as Secretary for 2019.
The next OIHCD meeting will be Tuesday, Jan. 22, at 4 p.m. at the Fire Hall.
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“Work Group has made progress in agreeing on what services are appropriate for after-hours care on a remote rural island…. ”
Susan’s reporting is factually correct of course. But here’s where we stand, by my weekly observation:
We are “making progress” by analogy to getting Johnny voluntarily into bed.
We are at the point in an “Interim” contract mandating a “cooling-off period” prior to finding new management which will respect our needs. “Progress” is relative to an endlessly obfuscatory list of costly, irrelevant or inefficient requirements not rationally pertaining to the goal of providing Primary Care, at times at odds with UW’s own legal team. Our only other option is apparently signing an “interim” Interim Funding Agreement. Honestly!
Interestingly, this matter has made its way from the campaign trail, to the Commission’s agenda, and onto the PHD’s community approved budget without supporting ..er, “metrics.”
By contrast, the consensus of qualified professionals in every healthcare setting except Orcas is explicit “Standards of Care” established by current practice. Yet we are at the mercy of a perverse pattern-of-longstanding limiting our access to healthcare, divorced from Best Practices, dependent on political whim and hidden agendas: ‘the process.’
Let me reiterate this shred of truth: to live and age on Orcas we rely on an unbroken lifeline called “continuity of care” or Access intelligently forged anew of the most reliable materials: Collaboration & Professionalism.