In September, the boards of Vashon Island Fire & Rescue (VIFR) and Vashon Island Health Care District (VHCD) both voted to develop a contractual partnership between the two agencies to expand operations of VIFR’s Mobile Integrated Health program (MIH).

An agreement, outlined by VHCD superintendent Tim Johnson at a Sept. 17 joint board meeting of the two taxing districts, would annually provide MIH with up to $715,000 from VHCD for the program’s operations in 2026-2028.

An additional amount, $250,000, will be immediately disbursed to the fire district to fund the remainder of the program’s 2025 operations, prior to finalizing the contract.

Christina Bosch, VIFR’s financial director, said in a phone interview that funding from the health care district would free up tax revenue collected by VIFR to sustain and fund its core operations, staff and equipment needs, which have significantly expanded in recent years to better serve islanders.

VHCD’s proposed funding, she said, would be augmented by approximately $70,000 per year in funding from King County’s Emergency Medical Services (EMS) levy as well as $50,000 annually from VIFR’s general fund.

Fire board chair Brigitte Shran Brown applauded the impending partnership, calling it a “win-win” for the community.

”The funding from the health care district now allows us to re-direct funds allocated for MIH back into the emergency equipment needs for VIFR,” she said. “As health care services are increasingly threatened through the actions of our current national administration, VIFR and its partners — VashonBePrepared, its Medical Reserve Corps and Vashon Health Care District — are stepping up together to meet the growing needs of our community.”

Mobile Intergrated Health (MIH)

The MIH program, launched by VIFR in February of 2024, provides non-emergency health and social services to islanders in their homes and in the examination room of VIFR’s newly renovated Fire Station 55 on Bank Road.

As of August, MIH has had 1076 encounters with 413 different patients, averaging about three appointments for each patient, said Lilie Corroon, manager of the program.

In early September, VIFR added Paul McGown, a full-time physician assistant, to MIH’s already-existing staff: three part-time registered nurses, a licensed social worker and a rotating roster of firefighter/EMTs who staff the program five days a week.

MIH — a King County EMS program designed to provide preventative care, reducing the need for emergency medical care and transport — assists islanders in the transition from hospital to home and checks in patients with both one-off illnesses and chronic conditions.

Depending on their patients’ needs, VIFR’s MIH team performs tasks such as catheter cleaning, wound care, immunizations, medication management, fall prevention assessments, and nutrition and wellness checks. The program also provides assistance in navigating social services and accessing other health care providers.

McGown’s recent hire has allowed MIH to expand these services to include all that a PA is authorized to do — including but not limited to diagnosing and treating illnesses, ordering tests, prescribing medications, developing treatment plans and performing a variety of procedures including suturing of deep cuts.

MIH and DispatchHealth

The decision for VHCD to support MIH is a turnabout from just over one year ago, when then-VIFR fire chief Matt Vinci, upon VHCD’s request, presented a proposal to VHCD to fund MIH’s expansion on Vashon with $350,000 in its first year.

Vinci’s proposal — presented at an Aug. 21, 2024 VHCD board meeting — was positioned as an alternative to VHCD’s consideration, at the time, to work with DispatchHealth, a for-profit mobile urgent care provider, to provide seven-day-a-week, eight-hour-a-day service on Vashon.

Later, at the same meeting, the VHCD board voted to proceed with subsidizing the costs of DispatchHealth on Vashon, with several members saying they did not believe MIH could ramp up quickly enough to immediately fill Vashon’s pressing and immediate need for urgent care. But their resolution also included a pledge to continue talks with VIFR about the possibility of also partnering to support MIH.

Talks between VIFR and VHCD stalled for a time, but restarted under the leadership of Interim Fire Chief Ben Davidson, after Vinci departed Vashon to serve as the fire chief of a larger district in eastern Spokane County.

VHCD’s two-year contract with DispatchHealth stipulates a subsidy to the company of approximately $560,000 per year for its Vashon’s operation, Johnson said.

In its first year, DispatchHealth has proved a popular service, said Johnson, with the company’s staff of registered nurses and physician assistants making approximately 1,200 visits to islanders’ homes to attend to urgent health care needs including colds and fever, infections, cuts requiring suturing, sprains and strains and other ailments.

Dispatch trims portfolio

But the company’s continued presence on Vashon is now uncertain.

Following a merger with another company, DispatchHealth last week announced that it was ceasing most of its other operations in Washington state — with the exception of its services on Vashon Island.

“DispatchHealth remains committed to serving the Vashon community and to increasing access to timely, high-quality care on the island,” said company spokesperson Ashley Henson, in a statement to The Beachcomber. “Our partnership with the Vashon Health Care District is important to us and there will be no disruption in the services we’ve agreed to deliver together.”

Via a community newsletter sent last week, VHCD also stated that DispatchHealth’s services on the island would continue as contracted — and that the company would also soon ink an agreement with Kaiser Permanente to ensure coverage for Kaiser’s Vashon patients who use the service.

But at VHCD’s September 25 meeting, prior to the board’s vote to develop a contract to support MIH, board president Tom Langland said that DispatchHealth’s exit of its other operations in Washington had weighed heavily into his decision to vote “yes” to support MIH at the level suggested in the resolution.

Noting that while DispatchHealth was contractually obligated to fill out its partnership on Vashon through 2026, he expressed doubts that the company would remain on Vashon after that time.

“I think they will disappear unless they find a new partner,” Langland said. “They can’t. The economy of scale is not such that they are going to stick around … And we better be ready with something we can fashion that’s more urgent care-related.”

In a phone call, Johnson said he was more hopeful than Langland that DispatchHealth would be able to continue its relationship with VHCD beyond its current contract.

“We’re really grateful to have DispatchHealth — they’ve been a great partner, and we hope that DispatchHealth and MIH will also develop a strong partnership in the year or years to come,” he said. “Right now, we have a lot of medical service on the island and the capability to sustain and even expand that, which is even more exciting.”

Both Langland and other VHCD commissioners said that they believed it is important for VIFR to receive accreditation to collect insurance payments from patients who receive MIH service, which is now offered free of additional change to islanders. Collecting insurance payments, the commissioners said, would not leave taxpayers on the hook for money that could be obtained elsewhere.

VIFR is already accredited to collect insurance payments for transporting islanders via ambulance, but under a policy adopted in late 2024, does not “balance bill” islanders for any amount not collected from those companies.

Strategic plan

At VHCD’s Sept. 26 meeting, commissioners approved an outline for the district’s new strategic plan, as developed by Johnson and outlined in a document that can be read at tinyurl.com/bddazm43.

The document contains a history of the district, which islanders voted to create in 2019.

The strategic plan emphasizes the district’s commitment to “expand local access to increasingly needed medical, social and behavioral health services” — a commitment board members and Johnson all described as being especially needed on Vashon in light of impending reductions in actual and projected funding for health care services.

The district currently, in addition to subsidizing DispatchHealth and its commitment to fund MIH, funds a youth behavioral health project supporting a school-based social worker and part-time therapist, a social worker who works with vulnerable seniors, and supports a medical voucher program operated by VYFS.