Healthcare District edges closer to urgent care contract

District has yet to ink any major agreements for urgent care or behavioral healthcare on island.

The Vashon Health Care District is edging closer but hasn’t yet inked any major agreements for urgent care or behavioral healthcare on the island.

District Superintendent Tim Johnson will speak to the Vashon-Maury Community Council at its June 20 meeting, and speak to the board of Vashon Island School District on June 27.

Urgent Care

The Vashon Health Care District (VHCD) set three main responsibilities for itself after its split from Sea Mar Community Health Centers: Keeping cash on hand in the event of a sudden, urgent need for primary care; supporting urgent care on the island; and boosting behavioral healthcare on the island.

Of those, Johnson said, urgent care topped 80% of the responses when VHCD reached out to the community for its priorities and desires from the district, Johnson said.

After the district’s split from Sea Mar, it began talking to Indigo Urgent Care, a division of the local healthcare organization MultiCare, roughly a year ago. There was “strong interest” in using VHCD’s property near Kathy’s Corner for an Indigo facility, but around late fall last year, Indigo decided to pass on the opportunity for now, Johnson said.

But they did raise DispatchHealth — another MultiCare partner that offers urgent care on wheels — as another option.

“I think a [brick and mortar location] just wasn’t in the cards in the short term,” Johnson said. “MultiCare, working with Dispatch, I think, gave them the idea that this might be a good interim step.”

Mobile care is faster to implement and has a lower upfront cost than a physical location, is advantageous for elderly or mobility-challenged patients who have difficulty leaving home, and can be convenient for families with young children, Johnson said.

The DispatchHealth program sends a practitioner and nurse team to deliver urgent care to people’s homes. The program, while fairly new, now operates across the country, including in Seattle, Tacoma, Olympia, and Spokane.

The district met with DispatchHealth in May to review a first draft of a contract to bring the service to Vashon. That agreement is now under legal review by the district, and the district is set to talk with DispatchHealth again this week.

That’s one option on the table for VHCD. But one remaining question is how it, or any of the district’s mobile urgent care plans, would co-exist with the Mobile Integrated Health (MIH) program offered by Vashon Island Fire & Rescue (VIFR), which has been in a state of expansion.

VIFR Fire Chief Matt Vinci favors expanding MIH so that a third-party service wouldn’t be needed at all.

“I look forward to working with (VHCD) and our MIH partners to expand MIH from a referral-based model to a response model,” Vinci said. “We’re looking for every aspect possible to expand our scope so that we don’t need a third party, MultiCare (entity) on Vashon.”

Now, VHCD and VIFR leaders are working together to try to hammer out a shared vision for urgent care on the island.

It won’t be easy. The healthcare district is under pressure to make a decision soon that will serve islanders, who pay taxes to the district, and remain compatible with the island’s other government bodies, such as VIFR.

“The arrangement between a government body and (another) organization is fraught with a lot of technical details,” Johnson said. “If it also involves working with the fire department, that’s an interagency detail. There’s an awful lot of moving pieces. … So we haven’t put a lot out publicly because it is probably unhelpful. … And neither (Vinci) nor I want there to be the sense that we are disagreeing. We are working really hard to make sure that we both do the right thing for the people of Vashon. … So it’s moving quickly, but it’s very complex.”

In the meantime, Johnson said, VHCD will continue to maintain its currently vacant property on Vashon Highway: “We need to find the best and highest use for it, and just selling it doesn’t seem like a feasible thing to do, especially when there could be future multiple uses for it,” he said.

Behavioral health

After a roundtable discussion with behavioral health providers on Vashon, VHCD is looking at boosting counselors and adding a social worker in the school district.

Island stakeholders said that some of the greatest need, Johnson said, is at the elementary level at Chautauqua Elementary. It’s also a more productive time to intervene, because it’s easier to help a child earlier in their life while their brain is developing.

Also critical is acute care. The Neighborcare clinic at Vashon High School closes during the summer, and kids need continuity of care when school is out.

So a proposal on the table for VHCD would see the district fund a single social worker at the schools through VYFS; half of a full-time equivalent (FTE) VYFS therapist at Chautauqua (making the current half-time therapist there full-time); and another half FTE at the high school, through the DOVE project, which would make the half-time therapist there full-time and allow them to provide services through the summer.

DOVE, Neighborcare and VYFS would meet monthly with VISD to track student needs and report back to VHCD under the plan, which would also fund VISD staff to pilot a survey to learn about student and family needs, and fund workshop sessions for families and teachers on behavioral and mental health.

“VISD students and families are currently underserved through existing mental health and case management supports,” the proposal states. “VISD counseling staff are at or beyond capacity and estimate that dozens of students in need of counseling are not receiving mental health care. Students/families are also often in need of case management support to connect with resources and services beyond the scope and/or capacity of what school staff can provide.

The social worker position is key, Johnson said, “because it not only reduces the need for the therapist to do case management, navigation and wrap-around services … it also starts to bring in families and develop that need assessment.”

The partnership would likely cost VHCD about a quarter of a million dollars yearly, Johnson said, and could be reshaped as the partnership continues.

“It’s really a pilot project with no end date,” he said.

A VHCD committee meets this week to further detail the agreement, and a finished proposal could go to the district’s board as early as their next meeting on June 19. Johnson said that getting the project started soon would mean the therapist at VHS could be working with kids this summer, soon after graduation.

In the meantime, VHCD has asked for and received a proposal from VYFS to have the district help plug a shortfall in VYFS’ medical voucher program, which is a collaboration with Granny’s Attic. VHCD could take action on the request “in a meeting or two,” Johnson said.

“They’ve come to us because this is a very key program (for) access for people of low means to healthcare,” Johnson said.