Health District facing uncertainties regarding costs, structure

— by Susan McBain, Orcas Issues Reporter —

January was a month of uncertainties for the commissioners of the Orcas Island Health Care District, specifically about costs and about possible models for the island health care system.

Final numbers concerning the costs of the recommended approach to the roofing and HVAC project are not yet available, but the preliminary numbers are “scary,” according to District Chair Richard Fralick—two to four times higher than the previously estimated $41 per square foot. The plan, which would have roofers and HVAC contractors working alternately to coordinate their different tasks, “sounds good, but can we afford it?,” asked Fralick. Once final numbers are in, the commissioners will work on possibilities for loans, grants, and County facilities funds.

The best model for the Orcas health care system continues to be difficult to pin down. Discussions with the District’s consultants and with leaders of various clinics in our area have produced mixed information and recommendations about the two likely affiliation possibilities:

• A Federally Qualified Health Center (FQHC) affiliated with an existing FQHC, or
• A Rural Health Clinic (RHC) affiliated with a critical access hospital or under 50-bed hospital, known as a provider-based RHC. (The Orcas Family Health Center is currently a stand-alone RHC.)

Stand-alone status for either designation is also a possibility, but commissioners Art Lange and Patty Miller are concerned that the difficulties and costs of launching a new clinic would be extreme.

Superintendent Anne Presson and project management consultant Pat Hunt are working on a formal project plan to help the commissioners identify and get answers to their remaining questions in an effective and timely manner. In the interim, the commissioners will work on identifying and planning how to contact a couple of FQHCs and several hospital candidates that might be good affiliate partners.

The commissioners agreed that in the end they would like to consolidate District funding to one clinic. They will be talking with the existing clinics, Orcas Family Health Center and the UW Neighborhood Clinic, and are open to the possibility of receiving proposals from them that would meet the District’s requirements. The District would strongly encourage the clinics to look for all ways they could collaborate to create a more cohesive system.

The January 21 regular meeting also included a presentation by OFHC staff Aaimee Johnson and Shila Wachtel on OFHC’s 2019 Program Evaluation, required annually by RHCs under federal regulations. The presentation gave extensive statistics on the clinic’s patients, services, costs, and patient satisfaction, providing the commissioners with a good example of RHC reporting requirements. The clinic received very high satisfaction ratings from patients.

The next regular meeting is scheduled for February 4 at 5 p.m. at the Eastsound Fire Hall. For readers interested in more detail about meetings, minutes of each meeting are posted soon after final approval by the commissioners, usually at their next meeting.