Orcas Island Health Care District: Relationships are the cornerstone of community health

Orcas Island Health Care District (OIHCD), formally known as San Juan County Public Hospital District #3, was established in 2018 to ensure access to primary care and urgent healthcare needs for our island residents and visitors. Our clinic, now operated by Island Health, serves around 4,000 unique patients a year, with approximately 1,000 visits a month. The clinic has reached a stable staffing situation with front desk and administrative coordinators, medical assistants, triage nurses, two physician assistants, a part-time pediatrician and two full-time family medicine doctors.

Clinic Manager, Aaimee Johnson, has worked tirelessly to build a trusting relationship with the staff, and serves as an effective ambassador to the community on behalf of the clinic. As the most important part of our mission, OIHCD is proud of the progress the clinic has made and the collaborative partnership between Island Health and OIHCD.

The five elected board members and two administrative staff members of OIHCD are dedicated to advocating for increased health care access. Since entering our contract with Island Health in 2021, we have worked to ensure stable physician staffing through recruitment support, encouraged increased specialty access through Cardiology telehealth consults, visiting OB/GYN services and visiting pain clinicians.

In addition to providing primary care, our taxpayer supported clinic ensures same-day access through a dedicated provider each day while the nurse triage team prioritizes patients based on medical urgency. The clinic has a dedicated after-hours call line, with calls routed to on-island clinicians, who address a variety of non-emergency health issues after the clinic is closed. In cases where emergent care is required, the district and clinic have a close relationship with our Emergency Medical Services (EMS). Our small community is privileged to be able to have this level of access, by caring island residents who serve us at Island Primary Care – Orcas.

The first few years operating the district were financially demanding, taking over ownership of the clinic building. The  district invested in significant building improvements such as the roof, HVAC, generator, and buying new equipment that increases our ability to deliver health services, including an ultrasound. As of today, the clinic is in adequate operational condition to serve our current needs. 

In terms of long-term financial health, we have intentionally kept our requests for funding modest, the district has levied less than the legally eligible maximum, saving taxpayers over $850,000. While we have been strategic in building a reserve to support our future needs, at the same time, we have more work to do to secure our long-term financial health due to industry trends. In recent years healthcare expense inflation has far outpaced broader inflation. For example, labor costs rose more than 30% over the last four years and many providers’ total expenses are up 25-40%.

Our board, comprised of dedicated elected officials, has played an essential role in the district’s success. Previous board members Art Lange, Carolyn Fiscus, Marie Michnich, Patty Miller, Pegi Groundwater and Richard Fralick put in countless hours to establish and solidify the district. Our current board members Chelsie Guilford, Dave Zoeller, Diane Boteler, and Mark Salierno continue to provide strong support on behalf of our community. 

The district hired me as their first full-time permanent superintendent a little over two years ago, taking over from Tom Eversole who served as a productive interim superintendent. I’ve enjoyed the professional development from an experienced board serving as strategic advisors, and grateful for two administrative assistants who both have been more than proficient in their help in operating the district.This has left me with flexibility to think big picture, envisioning structural changes that can build up not only our clinic, but many other aspects of health within our community. 

During my first year, I went on what Lindsay Jennings at OICF recently referred to as a “listening tour,” meeting with hundreds of community members over coffee, meals, and one-on-one conversations. I’ve committed myself to meeting people authentically, and spending time in the community. I’ve met many of you, and hope you’d recognize my face. I recognize many of you.

Commitment to community is alive and well on Orcas. In 2023, OIHCD partnered with OCRC, OICF, Mercy Flights, and San Juan County to lead the development of the Orcas Community Dental Clinic. Through collaboration initiated by Hilary Canty at OICF, OIHCD was able to apply for a Washington Department of Health dental grant that helped to fund $150,000 of program development expenses. OIHCD has also contributed taxpayer dollars towards legal support, equipment and furniture expenses for the newly leased dental clinic space at the Airport Center with the aim of finding sustainable long-term funding solutions.

I’m convinced that community relationships are the cornerstone of improving our collective health. My door is always open, and I encourage community members to stop by or reach out to discuss ideas, concerns, or just to connect. The lyrics of a song from a recent community gathering remind me of each of our responsibilities as community members, “I’ll show up at the table, again and again and again – I’ll close my mouth and learn to listen.” I feel fortunate to be part of a community where so many continue to show up, share their stories, and work together for the greater good.