Two proposals leave many Health District questions still to be answered

— by Susan McBain, Orcas Issues reporter —

One thing became very clear at both the Orcas Island Health Care District’s regular meeting on July 7 and its public Town Hall on July 9: The commissioners still need many detailed answers from both groups
proposing to open a consolidated medical clinic on Orcas. And until they get answers, they cannot determine which of the proposals, if either, will meet the needs they laid out in their request for proposals (RFP).

The two proposals, from Island Hospital and the Orcas Community Integrative Medicine Clinic, can be reached from this link. Go to the bottom of the page and click the RFP 2020-03 Responses link. The Island Hospital proposal is #2, and the OCIMC proposal is #6.

To help them formulate their questions and get answers, the commissioners formed three “clarification teams” of two commissioners each, who will meet with representatives from both proposers. A Financial/Staffing team will look at cost considerations, including the effects of staffing choices. A Scope of Services/After-Hours team will discuss the services to be offered, including alignment with EMS. And a Legal/Governance team will consider questions related to the contract, how the governing boards will interact, and the degree of local control.

The tentative schedule for what happens next:

• At their special meeting on the 14th, the commissioners will discuss the answers the teams have received and determine if they have more questions.
• On the 21st, they will hold a short meeting to discuss any further answers received. The rest of their meeting time will be a Town Hall, at which members of the public can ask questions.
• A finalist presentation to the public via Zoom will be scheduled for either the 30th or 31st.
• The scheduled date for award of the contract is the District’s August 4 regular meeting.

The meeting began with a quick summary of the factors that led to the RFP, the current situation, and next steps. Commissioner Patty Miller presented financial projections for the existing two-clinic model, which showed the District moving from a $56,000 financial surplus in 2023 to a negative balance of $429,000 by 2025.

Also presented were significant points from each proposal. Island Hospital stated that it will provide the full scope of services outlined in the RFP, including the costs of transition and of extended and after- hours care; that it intends to hire current providers and staff; that current salaries will be grandfathered; and that its requested annual subsidy will be $1.2 million per year for five years, slightly lower than the current combined subsidy for Orcas Family Health Center and UW Medicine.

The OCIMC proposal stated that the proposer, Dr. Vincent Shu, would create a new entity offering integrated Eastern/Western medicine, at an estimated annual subsidy of $904,000. OICMC would plan to offer expanded services such as mental and behavioral health and dietitian services. It would apply
for Rural Health Clinic (RHC) status initially, with the goal of achieving Federally Qualified Health Center (FQHC) status at a later time; would plan to retain some current providers and staff; and would hope to utilize volunteers more broadly.

Community questions included these topics:

• How would Island Hospital cover its costs when it projects that revenues will drop sharply? The commissioners will be discussing that with Island Hospital representatives.
• Why did the Family Care Network not submit a proposal? Their model is too different; they are a partnership of physician-owned practices.
• Can’t UW Medicine remain on island and serve all island patients? UW Medicine has stated that it does not have the capacity to serve all patients.

The Zoom link for each meeting will be available on the District calendar shortly before the meeting. Click the title of the meeting to find the link and connect. All meetings begin at 5 p.m.