Health District prepares to seek potential partners for medical services

— by Susan McBain, Orcas Issues Reporter —

On Tuesday, April 22, the Orcas Island Health Care District met via Zoom, bringing the commissioners together for the first time in nearly a month. There was plenty of information to report but, frustratingly, no action on the most pressing need.

Because of uncertainty about the current restrictions of the Open Public Meetings Act, the commissioners chose not to issue their Request for Proposal (RFP) to potential medical service partners until a legal opinion, or clearer guidance from the governor’s office, is available. They hope to be able to move ahead at their next meeting on May 5.

But they did make some progress. They decided to eliminate Federally Qualified Health Centers (FQHCs) from the proposer list, since no viable FQHC candidates have been found. They discussed revisions to the draft of the RFP, which spells out the District’s needs and requirements for a potential partner. The RFP will be accompanied by the District prospectus, which describes the District demographics, the current medical system, and the commissioners’ preferred single-clinic model of care. The final drafts of
both documents should be available for the May 5 meeting.

Both Orcas Family Health Center (OFHC) and the UW Medicine Orcas Island Clinic (UW) presented reports on their recent operations under COVID-19 conditions. OFHC saw a decline in visits of about 60% for March 19–April 12 compared with 2019. The clinic went to half-day open hours on March 18 and is doing many appointments by telehealth. Income has so far dropped only about 7%, but a much steeper decline is expected for the second quarter as lower revenues are recorded.

Statewide, the UW system has seen a decline in visits of about 50% since this time last year, although numbers have recently increased somewhat. The UW Orcas clinic had 110 patient encounters the week of April 14–18, mostly via telehealth. COVID testing for symptomatic patients referred by a provider is available Monday through Friday outside the clinic building. At the request of San Juan County’s Health Officer, Dr. Frank James, testing for essential workers (such as health care, grocery store, and pharmacy
workers) without symptoms began on April 24. Because of its recent staff shortages, the UW Orcas clinic has not needed to lay off anyone, but the statewide UWNC system has instituted numerous layoffs and reduced hours.

The case count in the San Juans remains at 14: eight people on Orcas, five on San Juan, and one on Lopez. There have been no deaths and no one has been flown off, although some of the 14 have elected to travel to the mainland for care. As a result, preparations for a “medical surge” in cases have been discontinued for the moment by the County Emergency Operations Center (EOC) effort.

Regionally, 28 deaths have been recorded in Whatcom County, but the curve seems to be flattening.

Both Island Hospital and PeaceHealth have empty beds and are considering admitting patients for other serious conditions. Testing is still a problem: the accuracy and sensitivity of tests for positive identification of the COVID-19 virus are good, but negative tests results are only 70–75% accurate. The
sensitivity of current antibody tests is also problematic. UW’s Clinic Chief, Dr. Camille Fleming, noted “We haven’t experienced having this little data about something in my entire career.”

The commissioners then moved on to more routine matters. They narrowed the options for replacing the HVAC system in the clinic building, voting to put out an RFP for a system design estimated to cost $240,000 (versus well over $1 million for earlier options). The design would qualify for rebates from OPALCO and perhaps other grants or loans. An RFP for the roofing system has already been issued, and after firm bids have been received for both RFPs, the commissioners can consider the functionality and costs of the whole package of building improvements.

Finally, Superintendent Anne Presson reported that property tax collections have reached about 72% of what would normally be expected for the first half of the year. As of April 21, the District received $616,225 of its budgeted $842,640 for the first half, and it expects to receive more in the coming weeks.

Presson also noted that the District’s first-quarter 2020 financial report showed nothing unusual through March. She will make the May 1 interest payment on the General Obligation Bond, move the usual semiannual amount of $50,000 into the Reserve Fund, and pay the subsidy to UW for July through December.

The District’s next regular meeting will be May 5 at 5 p.m. via Zoom. The Zoom link will be available on the Meetings Calendar page; to attend, click the May 5 “OIHCD Regular Meeting” link, then click the Zoom link. If you have not used Zoom before, the app will automatically download before opening.