Health care district lays out next steps for provider search

Neighborcare Health will keep its doors open at the clinic on Vashon through October.

Neighborcare Health will keep its doors open at the clinic on Vashon through October.

Commissioners of the Vashon Health Care District have approved an agreement to provide enough operating expenses to cover the clinic’s projected losses over the next several months and will pay out a total of $440,000 to help keep Neighborcare afloat until October 31.

The commissioners are using money that was budgeted for supporting Neighborcare as part of an interfund loan obtained from King County last winter. The funds will be spent in monthly installments, and the first, for $110,000, will be paid to Neighborcare on July 31.

The district’s new clinic services agreement stipulates that all current services offered at Sunrise Ridge are to continue unless prior notice of any changes or disruptions is given to the commissioners first. Neighborcare, which has operated the Vashon clinic since 2016, has also committed to keeping its staffing in place at Sunrise Ridge as part of the agreement. Commissioners say officials have offered, in some capacity, to assist with the island’s transition to a new provider once one is chosen.

Neighborcare Health and district commissioners will issue a joint press release about the agreement before the end of the month, spokesperson Mary Schilder said. She noted that the school-based health center will not be affected by the transition of the primary care clinic at Sunrise Ridge and will continue to serve students on the island who need medical, dental and mental health services.

At their meeting last Wednesday, commissioner Eric Pryne said the clinic services agreement is a significant milestone for the young board, adding that the district has been at work hammering out the details with Neighborcare for months.

The board was unanimous in approving the contract, though commissioner Don Wolczko commented that he believes the subsidy Neighborcare requested is significantly higher than the investment comparable public hospital districts make in their own health care provider systems.

The board also acknowledged the short time frame and sense of urgency to find a new provider to take the helm at the clinic before Neighborcare pulls out.

Commissioners circulated a request for proposal in May to identify a new health care provider to operate the clinic by the summer. Despite some preliminary interest, Pryne and commissioner Wendy Noble wrote in a June commentary for The Beachcomber, the deadline the district set passed with no responses, citing impacts from the coronavirus pandemic.

The district has been researching other practice models that could be brought together to offer islanders care until a new provider could serve Vashon on a permanent basis — commissioners are exploring everything from bringing in retail mini-clinics to urgent care or an independent clinic, more telemedicine and facilitating collaboration between existing local practices. But some in the community have been under the impression that Neighborcare would stay put until the district found another provider to replace it, commissioner LeeAnn Brown said, though no such arrangement has been made, despite some conversation with Neighborcare about digging in at the island clinic for the foreseeable future.

Pryne responded, saying Neighborcare “made it pretty clear to us a good time ago that they did not intend to stay here past this fall.”

Inside Neighborcare, conversations are taking place about what the future holds for primary care on Vashon, as well as what may happen to the clinic staff who serve islanders, according to two employees who attended the meeting.

Remony Henry, an islander and licensed independent clinical social worker employed at the island clinic, said the impression she and staff were given is that Neighborcare is open to the possibilities.

“It may be that Neighborcare is saying something behind the scenes that they’re not saying to the employees,” she said. “I think they would need to be subsidized [to continue operating the Vashon clinic], but if we don’t have another provider, it seems preferable to have Neighborcare stay on rather than have no clinic at all for a time,” she said.

Tom Langland, president of the board, said the clinic services agreement doesn’t necessarily preclude another short-term deal like it in the future. But echoing other commissioners, he stressed that given the board’s communication with Neighborcare officials there is no indication of interest in such an arrangement after October.

Susan Pitiger, a registered nurse, drew on Henry’s remark in a question of her own that many have wondered at themselves.

“What happens to the island if we don’t have a primary care clinic?” She asked, recalling when CHI Franciscan Health withdrew from the clinic at Sunrise Ridge in 2016, also because of financial reasons, leaving the island without primary care for three months.

And that at a time free from a global pandemic when the West Seattle Bridge was open, she noted.

Moreover, Pitiger said she was looking for some measure of reassurance from the commissioners that she could take back to her coworkers, telling them they will still have jobs between now and the fall.

“I’m sure I’m not saying anything new to you now, I’m sure both of these things weigh heavily on [you all], but I’m concerned,” she said.

Commissioners were adamant that from the start they, too, have not wanted the island to be without a primary care clinic. And district superintendent Eric Jensen shared his hope that some encouraging news is on the way, saying the district is closing in on identifying a new provider.

Consultant Joe Kunkel, leader of a healthcare firm in Portland, Oregon, was on hand to elaborate on some of the progress made on that front, with two candidates emerging as front-runners for taking over operations at Sunrise Ridge. One is a federally qualified health center similar to Neighborcare Health, and the other is a hospital-based provider with a partnership with Kaiser Permanente. Both are based in the Puget Sound area, but bringing either to Vashon could play out in two very different scenarios based on their needs and how each is positioned, from how much they would likely need to be subsidized to Medicaid reimbursements, plans for best utilizing the island clinic, expanding service hours and more. Both also expressed their willingness and interest in maintaining current staff now working out of the clinic.

“So we’re gaining some traction here, which is very encouraging, and it’s very encouraging that we’re having conversations with groups of two and three people at a time at the senior level with each of these organizations,” Kunkel said. “They all know the time frame within which we’re working.”

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