— from Susan McBain, Orcas Issues reporter —
The May 7 meeting of the Orcas Island Health Care District (OIHCD) took place one day after the first anniversary of its establishment in 2018. The commissioners took a few minutes to review their accomplishments, which they have also summarized in an article here.
Major topics discussed at the meeting:
- Commissioner Patty Miller and Diane Boteler met with Dr. Matt Jaffy, Assistant Medical Director of UW Neighborhood Clinics’ (UWNC’s) North Region, to discuss UWNC’s proposal for providing after-hours care at the clinic. The proposal budget was about $250,000, and the commissioners wanted to explore whether any of the proposal’s elements were negotiable. They felt that continued negotiations are possible, but resulting cost reductions might bring the budget total down to around $150,000 at best. Dr. Jaffy will be seeking more information from UWNC senior management on some of those elements.
The remainder of the proposed contract between UWNC and OIHCD is acceptable to both parties.
- The amount of funding that OIHCD contracts to pay each year to each of the two clinics—UWNC and Orcas Family Health Center—is based on each clinic’s proposed budget for its fiscal year. UWNC’s proposed total budget for its 2019–2020 fiscal year is about $90,000 more than OIHCD expected based on the five-year financial model it developed last year. This substantial increase is due in large part to organizational changes at UW Medicine, which will bring provider salaries in line with faculty salaries. The proposed UWNC budget does not include the costs of the after-hours care proposal.
- The commissioners heard a presentation from representatives of the Inter-Island Healthcare Foundation concerning the need for long-term care in San Juan County. The Foundation is proposing a feasibility study to determine care needs and options, including the possibility of one or more “micro-nursing-homes” offering care to 8–10 people on the biggest islands. Another possibility is establishment of home health and home care services across the islands. The Foundation is requesting $10,000 from OIHCD, and also from the Lopez and San Juan health districts, toward the $50,000 cost of the study.
The next regular OIHCD meeting is scheduled for May 21 at 4 p.m. at the Eastsound Fire Hall.
I believe the new numbers from UW for their projected cost of services has just gone from $539 to $754 thousand in the next FY. This is a 40% rise and includes a 12% raise to their physicians. This is exclusive of the $150 thousand they want to continue -and formalize- the tradition of after-hours care available on Orcas.
This so beggars comment that I have had to delete all exclamation points as insulting to the intelligence of the reader.
This presentation by the so-called “Inter-Island Healthcare Foundation” had *some* of the right buzzwords, but it shows just how easy it is to conflate words:
“healthcare” and “cash cow.”
A simple mistake,
though generally one considers “Foundation” to imply “an organization that has been established to provide financial support for activities and groups that are useful or helpful.”* Not one that requests ten thousand dollars to produce a ‘study’ without any defined outcome or methodology. dUH!OH! this is Orcas.
It is not entirely dissimilar to asking $215,000 without promising, well, -any- improvements. So, overall, a busy time for our OIHCD commissioners.
[buy stock in collar stays]
_________
* Cambridge Business English Dictionary ©Cambridge University Press.
The “Inter-Island Healthcare Foundation,” whatever that is, wants $50,000 just to study the possibility of offering long-term care to “8—10 people on the biggest [sic] islands.”
Wow! Talk about a cash cow. I’m not sure which islands qualify as “biggest,” but we’re talking about a maximum of, maybe, 30 people served…eventually.
So the mere feasibility study is going to cost about $1,700 per proposed patient. And that’s just for a study, to see if the idea will fly.
Nice racket: You want to open a business, so you get public money to cover your research costs…and, probably, also pay your salary all the while.
Sorry. Nope. Our OIHCD needs that $10,000 you want, to pay for clinical service to its patients.
If you want to open a business, pay out of your own pocket for your research, and for your own start-up costs, too.
Keep your hands off of our tax money.
Long-term care is the third-rail of healthcare economics, and for good reasons. It is a black hole into which endless amounts of money are poured to provide care that often rises merely to the level of warehousing. If the District has any thought of funding that care–which even the Medicare program will not touch–then we need to know and have a new vote on the District’s existence. Once such funding begins, it cannot be easily withdrawn and could easily bankrupt the District. (I realize that the “Inter-Island Healthcare Foundation” is seeking money just for a study. But we all know what that portends.) Moreover, experience has established that it is very difficult, if not impossible to satisfy the burdensome certification requirements for any type of institutional long-term care in the islands.
Far better that attention be devoted to the provision of home health and hospice care. That doesn’t leave residents who require long-term nursing home care but have no funds or have spent all funds on medical costs without support; such patients are eligible for Medicaid, which does cover that care, though only in licensed and certified institutions that practically speaking must be on the mainland.
As for the IIHF notion that “micro-nursing homes” could accept Medicare and Medicaid reimbursement, I suggest that they find an expert in federal healthcare reimbursement and certification, and soon. The environment they describe would never satisfy the current conditions for payment by Medicare (which does NOT pay for true long-term care, but rather only for a maximum of 100 days per illness, at fully-licensed institutions) or Medicaid. The costs would be paid by the health districts.
Why do physicians who are family practitioners here on a beautiful island have to have salaries that match FACULTY salaries in Seattle? Just one of many questions that arise in any analysis of UW’s subsidy demands. Another is their budget and what proportion of it results from the costs of the huge bureaucracy in Seattle.