Health Care District shares what it’s like in the weeds

Second in OIHCD weekly series

— from Anne Presson for Orcas Island Health Care District —

As reported in the first article in our newly launched series that began last week, in early January 2020 the Orcas Island Health Care District (OIHCD) communicated the decision that it was in the best interest of all parties to consolidate funding and support a single clinic model in 2021.

This decision was supported by leadership at both UW Medicine and OFHC and led to the development of a Request for Proposal (RFP). The RFP is a document that a business, non-profit, or government agency creates to outline the requirements for a specific project. The RFP process is designed to be a fair and equitable method of soliciting bids from qualified responders and be able to identify which responder is the best-qualified to deliver the service.

The Board has been clear in their objective to have both existing clinic operators participate in the RFP process. As previously reported, Orcas Family Health Center is planning to respond and UW Neighborhood Clinics (UWNC) let the District know they would not respond yet would be, “happy to continue managing the clinic under our current practice model, with an agreement that provides funding for any losses incurred”.

The current Clinical Services Agreement (CSA) with UWNC provides for
preparation of an Annual Budget which determines the Maximum funding level.

Subsequent to their written response that referred to funding for all losses
incurred, the OIHCD sought clarification and received verbal assurance that
UWNC was not anticipating asking for changes to the current CSA for the next fiscal year.

Another factor that played into UWNC’s response is the impending January 1, 2021 integration of UWNC into the larger UW Medicine (UWM) system. In
conjunction with the integration, UWM has stated that there are to be no new programs that would require a change or expansion of what is presently being done. This position contributes to UWNC’s decision to not participate in the RFP process. When asked if they would submit a proposal if OIHCD extended the deadline, UWNC responded that they would not submit a proposal for at least a year, and maybe not even then.

Furthermore, when asked if UWNC would be willing to manage a practice using their existing model with an expanded capacity to include OFHC patients, they have thus far declined to respond.

Although OIHCD has been working with UWNC leadership for two years to come to agreement about the practice model that is needed in our community, they have not been able to modify workflows, processes or the provider mix in a way that meets the service and financial needs for all members of our community. We respect that in an environment that requires standardized practices, it is understandably difficult and costly to change protocols to adapt to the needs of one small entity. UWNC’s experience since taking over the Orcas Clinic in 2017 indicates that developing a viable financial model is challenging in a small, remote
location.

At this time, it remains to be determined what the clinic structure will look like, and the OIHCD looks forward to seeing what responders to the RFP propose. The OIHCD will be reviewing all proposals in our Regular Board meetings, and we have scheduled two Special Board meetings in July to focus on the RFP analysis. We will also be asking the organizations who submitted a proposal to present their vision and answer questions in July (dates TBD).

We hope everyone is understanding of the restrictions faced during the COVID-19 era, and we are doing our best to enable as many people as possible to participate in these discussions. We will continue to use multiple channels to share and publish information.

Your Commissioners and our Superintendent remain accessible, and we
encourage you to contact us with your questions or comments. Contact
information can be found at www.orcashealth.org.

We are committed to having the best possible primary and urgent care delivery system for our rural community. We are confident that with your help and engagement, together, we will achieve that goal.