— by Susan McBain, Orcas Issues reporter —

At their regular meeting on July 16, the commissioners of the Orcas Island Health Care District considered a number of topics of interest to the public.

Consultant. The commissioners have been exploring different clinic structures that could maximize reimbursement from payors such as Medicare and Medicaid. Alternatives could include designation as, or affiliation with, a Rural Health Clinic, a Federally Qualified Health Center, and/or a Critical Access Hospital. (Orcas Family Health Center [OFHC] is already a Rural Health Clinic.) Because of the complexity of the various alternatives, they decided to hire a consultant who could help analyze our current island health care delivery system and recommend the best approach. Factors in the decision could include short-term versus long-term benefits of each alternative; the advantages and disadvantages of consolidating island practices; the complexity and length of the application process; and any availability for grants.

The commissioners are preparing a scope of work to send to several consultants they have identified who appear to be best qualified to help. They hope to select a consultant and obtain cost estimates by their August 6 meeting.

Budget Schedule. It is already time to begin working on the District’s budget for 2020. Scheduling to meet required deadlines will begin in August; the first look at five-year projections and the draft 2020 budget will occur on September 3. The draft budget should be finalized in early October to be ready for consideration at the public hearing on November 5. Possible new expense categories include the consultant mentioned above and an administrative assistant for Superintendent Anne Presson.

Additional Funds for OFHC. OFHC had requested additional funding of approximately $50,000 for its fourth fiscal quarter, which ends September 30. The commissioners did not consider a mid-year change in funding to be feasible, but will consider the request at the start of negotiations for the new fiscal year. The Board had previously discussed making an adjustment to the July–September subsidy payment because Dr. Shinstrom was on disability leave for a month. Rather than apply the usual reduction for having less than a full time MD present, the Board approved the recommended adjustment, which kept funding close to the originally budgeted amount.

Communications. The next of a series of articles on District activities is in preparation, giving more detail on the issues the consultant will help to address. (An earlier article, “Health Care on Orcas at a Crossroads,” gave an outline of those issues.) Although the commissioners feel that keeping the public informed of potential changes is important, they also stressed that they “greatly respect the current practices and the people in them. The problem is costs.”

Replacement of Kaiser with LifeWise. Presson announced that under the new LifeWise insurance program (which for 2020 will replace Kaiser in the individual and small group markets), both the Orcas UW Neighborhood Clinic (UWNC) and OFHC will be considered to be in network. In addition, LifeWise has approved a benefit exception to allow UWNC patients to be referred to UW specialists and be covered in network.

The District’s next regular meeting will be August 6 at 5 p.m. at the Eastsound Fire Hall.

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