— by Susan McBain, Orcas Issues reporter —
The main theme of the September 3 meeting of the Orcas Island Health Care District (OIHCD) commissioners was dollars and cents—that is, budgets and costs.
The commissioners began discussion of the District’s 2020 budget, based on Superintendent Anne Presson’s first draft. The biggest differences between this budget and last year’s are that 1) budgeted amounts for after-hours care by the UW Neighborhood Clinic (UWNC) were not paid because the District and UWNC did not reach agreement on that topic, and 2) reimbursements to Orcas Family Health Center (OFHC) were lower than budgeted. A public hearing on the District’s 2020 budget, required by law, is scheduled for November 5, so discussions will continue through October.
The District received a draft budget from OFHC for its fiscal year beginning October 1. The budget projects OFHC’s operating loss at just over $468,000. Subsidies to the two major Orcas clinics are a substantial part of the District’s annual expenses, and thus its budget process.
The commissioners discussed a proposal from Hargis Engineering to prepare a requirements document for the mechanical, plumbing, and electrical work needed for the UWNC building, which the District owns. That document is intended to provide sufficient detail to allow building contractors to submit proposals for doing the work, which Hargis will also review. The commissioners approved Hargis’s $19,500 bid; they expect the document in October or early November.
The District signed a contract with DZA, a certified public accounting firm in Yakima, to compare the requirements, benefits, and drawbacks of various structures that could enhance clinic revenues and care options on Orcas Island. These include Rural Health Clinic status, Federally Qualified Health Center status, and partnership with a hospital of 50 beds or fewer; all these options can potentially increase the amounts of Medicare and/or Medicaid reimbursements. The DZA consultant expects to complete the work by the end of September.
To update the community on its current and projected finances and activities, the District has scheduled two Town Hall meetings, the first on October 5 and the second on October 28. The results of the DZA work may not be available at the first meeting but will definitely be covered in the second.
Presson reported on a call with LifeWise, the insurance provider that will be replacing Kaiser in 2020. She noted that LifeWise has established a foundation to provide money to help rural practices. She also noted that rather than hiring an employee for administrative help, District resources might be better used to contract for project management support as needed, such as for determining phasing for the building’s roofing and HVAC projects.
The District’s next meeting is Tuesday, October 17, at 5 p.m. at the Eastsound Fire Hall. The following meeting has been rescheduled as a special meeting on Wednesday, October 2, same time and place.
We are entering a sensitive phase in this the close of the premier season of the Orcas Public Health District. Many basic assumptions about how an Orcas-specific healthcare system will function have been tested. A decade of conflict-cum-modus-operandi is winding down with a bracing dose of transparency and sensitivity to underlying questions. And foundations are being laid for a new structural approach to our community healthcare.
So it seems especially important that this report was written two weeks after the fact by a reporter not on the scene, from a recording which fails to capture the nuances of what transpired. Further, it poorly prepares us for community participation appearing as it does unpredictably hours before the next meeting.
We are dealing with some pretty tricky issues and some actors with a long history of administrative .. er, complexity.. in their costly dealings with the fundamental issues of our healthcare. Not too long ago the principals of one clinic burst into the meeting claiming to be the “only ones providing after hours care”(!!) Dramatic. And recently another multilayered management team provided over an hour of show-&-tell in which virtually no datum provided could be taken at face value. Obfuscatory.
In the coming Town Hall meetings in which we have the chance to -FOR ONCE- be heard and to sort out our priorities, we need to -FOR ONCE- free our antennae of the entangling strands of past inappropriate management patterns, and find clarity.
And PLEASE, ask something more insightful than bla bla..
“One clinic or two” epitomizing the drama the obfuscation,
the pabulum of a lost decade of dysfunction.
Like: what are our needs?
What is our vision?