As a long-time Vashon Island resident with over 40 years’ experience with nonprofit medical clinics and health care systems, I am opposed to the hospital district. Adding another taxing body will only take more money from Islanders while the health care issues being raised can be addressed in other ways.

I have worked with Community Health Centers (CHCs) extensively and was happy when Neighborcare Health opened here — it meant a return to the roots of island medicine, as our first major health facility was also a CHC. The federal government agency funding these programs notes their purpose as “provid[ing] health care to people who are geographically isolated, economically or medically vulnerable.” Vashon is both isolated and medically needy, as recognized in 2017 when we were declared a health professions shortage area lacking enough physicians to serve our population.

The Beachcomber’s past articles covering Neighborcare and discussions about the proposed hospital district highlighted some issues regarding our health care: Islanders want urgent care/same-day assistance, a helpful/responsive person answering the phone, not to wait a long time for appointments, call-backs when appropriate or promised and after-hours care.

Neighborcare is concerned it does not see enough patients, particularly those on Medicaid which, as a CHC, offers their greatest reimbursement. Because of medical staff turnover, the health center is only open four days a week/nine hours a day, variable hours on Wednesdays, and has no weekend hours.

Now, I have some questions around Neighborcare’s on-island services: When they look at the number of Vashon patients, do they include their second “successful” school-based clinic serving island children? Is the health center open enough hours to allow for seeing more islanders? Does Neighborcare think of Vashon as part of their health system of 31 clinics or as a separate community?

There are some solutions we can consider that do not require a taxing hospital district. To increase Medicaid patients, islanders could work with Neighborcare to find ways to employ staff whose job would be community outreach to help people use clinic services. In particular, they could target island Medicaid recipients encouraging the use of the health center. They might also send some of their bilingual/bicultural staff to Vashon to help Spanish-speaking islanders feel more comfortable seeking on-island health care while using their native language.

The benefit of being a health professions shortage area is these are locations where physicians can practice to receive forgiveness on their federal loans. The Neighborcare system uses these medical providers and could send one to Vashon part-time to increase services. Neighborcare could also offer remote medicine, allowing a doctor to see patients through video-conferencing. Many isolated communities use this system to expand health care.

It is not practical to consider using money raised through a hospital district to finance a new island medical practice. In today’s world, a health operation needs electronic medical records, physician malpractice and other insurance, health aides and staff just to do the paperwork, as well as a physical office. All of this costs a lot of money. Hiring a doctor for only after-hours calls is also unrealistic, and expecting the two Neighborcare doctors to be on-call all the time is unworkable. Neighborcare and other insurance carriers currently offer physician/nurse call assistance for after-hours, and urgent care clinics are available off-island. Acute emergencies should always be referred to Vashon Island Fire and Rescue.

Past health care providers did not care about us, only how much money they could make. Neighborcare’s mission is to assist communities like ours. That is why we should hold Neighborcare accountable for the services they provide and to think of Vashon as part of their large healthcare network, making all of their system resources available to us. Islanders should not have to possibly pay Neighborcare to stay. Neighborcare’s CEO, Michael Erickson, has said he wants to pursue “any and all avenues to be a solid and good partner” to provide health care in our community.

We need to jointly work with Neighborcare to improve their services and encourage more Vashon residents to seek health care on the island. Maybe those running for health commissioner could instead form a group to work with Neighborcare to look at some of my suggestions and other ideas. These solutions do not need tax money from a formal hospital district — only the commitment of dedicated islanders and Neighborcare administrators to work together for the benefit of all.

—Alice Larson, Ph.D., is a social services researcher with extensive experience assisting nonprofit health systems, government agencies and disadvantaged populations.