To see the way forward for health care, islanders should look back

The current conflict between Sea Mar and Vashon Health Care District should be placed in the context of the work that community members have undertaken for more than a decade to bolster local control over the delivery of health care.

Another week, another bombshell in the weeks-long rollout of news about the impasse between Vashon Health Care District and Sea Mar Community Health Centers.

But in conveying this news to islanders, it’s important to also step back, and detail the efforts of local advocates who have long worked to help Vashon determine its own path for providing health care on the island.

The District’s recent purchase of 2.3 acres of prime real estate on which to build a community-owned health care clinic is, in fact, a direct result of that work, led in recent years by John Jenkel and Tag Gornall.

In 2013, Jenkel and Gornall were instrumental in establishing the Vashon-Maury Health Care Collaborative (VMHC) a nonprofit established to address the topic of primary care on the island.

At that time, the era of a simple clinic, operated by island doctors, sustained by donations and accountable to the community had clearly passed.

It was an obsolete financial model, considering the increasing costs and complexity of our country’s contorted approach to medical care and public health.

It was not hard to envision off-island entities such as Highline, which was gobbled up by CHI Franciscan, making decisions that reflected their own business interests rather than the interests of the community.

So, VMHC was formed in the anticipation that Franciscan, which operated the clinic at the time, would leave because they were hemorrhaging money, providing services to an island that could not sustain the costs of its own care.

And indeed, CHI Franciscan did leave.

But VMHC made sure that they did not leave before downloading important financial and population data (not personal data), so the community could have a basis for a new provider’s inquiry.

That new provider — Neighborcare — was obtained primarily through the efforts of Dr. Gary Koch, who was assisted in this effort by VMHC as well as Dow Constantine, Sharon Nelson, and many others.

But sadly, during Neighborcare’s tenure, the financial unsustainability of the clinic became even more evident. It confirmed what Jenkel, Gornall, and others already knew — that without a mechanism for Vashon to subsidize operations of a clinic, Vashon would forever be dependent on the charity of an off-island source.

What’s more, the island would never be able to form and mold services to those best suited to the island, rather than those best suited to the business/economic interests of a provider.

This was the basis for the Vashon Health Care District campaign: to create a legal framework to establish standards of performance and obligation to the community in exchange for public dollars.

In 2019, Vashon accomplished this, with a 70% approval vote to establish the Health Care District.

The basis for the District’s recent land acquisition was on a separate, years-long track — pursued under Gornall’s initiative and leadership.

In 2016, Gornall began to broker the sale of the property, with the aim of having it retained as a site for a badly-needed new clinic.

He began early discussions with the Brockman family, who then owned the property. Next, he and other VMHC members then located a community-minded buyer who was willing to purchase and hold the property for the eventual development of a clinic by an entity that could oversee it.

This was three years before Vashon’s Health Care District existed, but the transaction was a beautiful example of community citizens working together to fix a revolving door of medical service providers guided by the decision-making of off-island managers.

All of this work is now being threatened by the recent decision of Sea Mar to terminate its contract with the Vashon Health Care District and build its own independent clinic on Vashon.

For Jenkel, who said he is grateful for Sea Mar’s agreement to come to the island in 2020, the situation is a stark warning that Vashon may be at yet another crossroads in terms of its ability to retain local input into health care.

Sea Mar’s recent actions, including its method of negotiating through the press in the current crisis, seem to smack of predatory practice, according to Jenkel.

“We see before us a highly competitive medical services organization demonstrating a clear intent to avoid public input and act in pursuit of its own goals,” he said. “At times, those goals may be favorable to island interests. At times they will not be. It has been that way for the last 10 or 12 years and for each organization that has passed across the Island.”

In speaking to The Beachcomber, Jenkel said he hopes Vashon has learned its lesson.

“I hope that a company which chooses to ignore island voices and disrespects the community’s struggle to take some measure of control over public health services is not given a free pass to disregard the elected representatives of the island,” he said.

Gornall, when also asked for comment by The Beachcomber, also spoke about community.

“A lot of people worked to provide the island with the opportunity to take control of its health care again,” he said. “People put their time and money into securing land to construct a replacement facility. The actions of the current health care contractor seem to suggest that they do not understand the idea of a community working together.”