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Hospital Board agrees present site
likely to be unworkable for a hospital
posted 02/21/2008
San Juan County Hospital Board Commissioner Michael Edwards agreed with consultant Joe Kunkel's assessment that it would be unrealistic to use the current site of the Inter Island Medical Clinic as a site for a hospital. He suggested the board ask the committee researching the feasibility of building a critical access hospital to include a study of an alternative site.
The motion was approved by the board at the Feb. 20, 2008 meeting. Asked if this meant the current site was completely ruled out, Commissioner Bob Low said, "The short answer is no." The current site's location next to the convalescent center and closeness to town are pluses. The study of an alternative site will be borne by the committees not by the hospital district.
Edwards said the two hospitals operated by Peace Health which members of the committee visited are located on 10- and 22-acre sites. Ideally, according to Kunkel's report, the project would be located on at least 10 acres and preferably 15 acres which leaves room for growth in the future.
The reasons against the current location on Spring Street included having to operate the clinic and Emergency Medical Services (EMS) in a construction zone for 20 months, and needing to build on multiple levels rather than just one floor. The inability to locate a helipad onsite could cause delays which could be the difference between "life and death" according to Kunkel's report.
The cost and difficulty of buying up enough neighboring property to make the project possible in its current location was another drawback.
Hospital committee considering partnership with PeaceHealth
posted 01/17/2008
San Juan Community Hospital Committee and PeaceHealth, a not-for-profit healthcare system with hospitals and medical centers throughout the Northwest, will conduct feasibility studies during the next 120 days about possible partnership opportunities to expand the provision of healthcare services to the residents of San Juan Island.
The hospital committee has been researching the costs of creating a community access hospital. At the Jan. 16, 2008 Hosptial District Board meeting, SJCH Co-chair Tom Cable said if the partnership worked out he expected philanthropy would cover much of the building costs and the bond needed would be less. The hospital committee is an independent group and is not part of the hospital district board.
The SHCH committee and PeaceHealth will spend the next four months identifying and analyzing potential healthcare service expansion opportunities, including the addition of a small, state-of-the-art Critical Access Hospital that would be located in Friday Harbor.
The Committee will provide periodic updates to the San Juan County Public Hospital District #1 ) Board of Commissioners and to the community through public meetings, the committee's Web site and periodic news releases.
"By May 2008, we will provide an informed recommendation to the hospital board regarding the feasibility of this potential partnership," said Cable. "We welcome working with PeaceHealth on this assessment. They bring a strong reputation as a compassionate, community-based healthcare provider that delivers high-quality, patient-centric services and care. And that's our ultimate goal-expanding the range of and access to quality, on-island healthcare services."
Inter Island Medical Center currently offers basic diagnostic equipment and services, but must send many patients off-island for additional dianosis, testing and procedures. On-island services are provided in a 34-year-old facility with a diminishing ability to serve a rapidly growing population and no additional capacity for expansion or in-patient care.
"Improving access and serving communities is at the heart of who we are," said Peter Adler, PeaceHealth's senior vice-president for strategy, innovation and development. "We were happy to be contacted by the San Juan Hospital Committee and look forward to working with the committee and the San Juan community to explore opportunities to expand access and healthcare services on the island."
Background: The SJCH committee is a group of islanders working with consultants, residents and potential partners, in an advisory capacity to the hospital district board, to determine how the growing island population could sustain and expand on-island access in high quality, cost-effective medical care. More information is available on www.sjcommunityhospital.org
PeaceHealth is a Bellevue, Washington based not-for-profit healthcare system with hospitals, medical centers and physicians in Alaska, Washington and Oregon that serves urban, rural and remote communities with state-of-the-art care and healthcare services. Sponsored by the Sisters of St. Joseph of Peace, PeaceHealth has provided exceptional medicine and compassionate care to Northwest communities for more than a century. PeaceHealth annually receives national recognition for innovations in patient-centered care, patient safety and healthcare technology. PeaceHealth is frequently named as one of the region's best employers. For more information, visit www.peacehealth.org
Critical Access Hospital process continues
By Sharon Kivisto
According to the state Department of Health: "The Critical Access Hospital Program was created by the 1997 federal Balanced Budget Act as a safety net device, to assure Medicare beneficiaries access to health care services in rural areas. It was designed to allow more flexible staffing options relative to community need, simplify billing methods and create incentives to develop local integrated health delivery systems, including acute, primary, emergency and long-term care."
The San Juan County Hospital Board which oversees Inter Island Medical Center and SJ EMS heard an update at their Feb. 21. 2007 meeting on the progress of the feasibility studies underway about creating a CAH on San Juan Island. The results of the telephone survey showed the majority of islanders were in favor of having a CAH. Hospital District Commissioner Michael Edwards who also is a member of Inter Island Healthcare Foundation said, ":We (Inter Island Healthcare Foundation) committed $30,000 for studies, and another $40,000 for additional studies." There are a dozen subcommittees and steering committees working on various aspects of the project. No decision has been made yet on whether it is financially feasible to have a CAH on the island.
A CAH office has been opened in the Sustainable Technology Center. An open house is planned for mid-March. Public outreach and an educational campaign will begin soon.
During the audience participation period of the Feb. 21 meeting, Richard Babbitt questioned the board members for 20 minutes about the CAH project. He was skeptical about the validity of the telephone survey. "Why was the survey taken in the middle of the winter when the majority of the population has left for warmer climates?" he asked. "The wealthier residents, who pay the property taxes, are in Palm Springs."
He didn't believe the island could afford a CAH and suggested instead residents could just use Island Air's air ambulance to fly to a mainland hospital or take advantage of the newly reinstated subscription service for Airlift medevac helicopter service.
IIMC CEO Beth Geiger said the survey was taken when it was because "we wanted to get the people who lived here year round." She noted research showed $18 million in healthcare is leaving the islands every year. "If you took all the hospital admits and backed out all the ones we couldn't do, on any given day there would be five people in the hospital," she said." She emphasized whatever is done would be "island appropriate."
Inter Island Medical Center is supported by income from patient services and by local property taxes. One of the questions being researched is whether more tax support would be needed for a CAH. The increased revenue from being able to recover at a higher rate for costs already incurred may offset increased costs. In other words, services rendered at Inter Island Medical Center can only be billed as a doctor's visit for Medicare even when they are after hours and are more appropriately billed as emergency etc.
In the survey respondents who were in favor of the project were asked if they were still supportive of the project if a tax increase was deemed necessary. The majority were still in favor of the project.
At the end of his remarks to the board, Babbit again referenced the survey, he said, "You got the people who don't pay into the tax base. People who leave the island in the winter own bigger pieces of property. The ones that stay here don't have the wherewithal to go to southern California or Hawaii in the winter time."
Asked if he would like to join one of the subcommittees which is researching the project, Babbitt declined.
Results of telephone survey
indicate support for community hospital
posted 02/21/2007
PRESS RELEASE:
At the request of the Community Hospital Project Steering Committee, a phone survey of 560 San Juan County residents was taken by Health Facilities Planning Inc. in January. The survey explored the possibility of creating a small community hospital not only to replace the current Inter Island Medical Center but also to provide services for patients of all healthcare professionals in the county.
The survey explored the general feeling of residents as to the importance of health care improvements relative to other issues facing the community. Of a variety of local issues tested, the highest percentage of respondents (69%) ranked “Improving Health Care” first.
When asked directly whether they thought that Friday Harbor and San Juan Island need a new hospital, 84% of the respondents clearly indicated yes. Importantly, 87% of the residents also indicated they would use the new hospital for as much of their medical care as possible.
92% of the residents thought that this project would benefit the community.
Although the details of the project are yet to be defined, 72% of voters were willing to support construction of a new facility through additional taxes:
The hospital and its range of inpatient and outpatient services will be designed to be financially self-sustaining, but the survey further tested the strength of support by asking the difficult question of continued operational support through taxes in the event it is needed. 64% indicated their strong support.
In addition, the residents of Orcas and Lopez Islands would substantially support a new Friday Harbor hospital as follows:
- 45% believe that the county needs a new hospital in Friday Harbor.
- 55% would use the new hospital.
- 59% felt the hospital would benefit the Lopez and Orcas residents.
82% of responders indicated that local providers are doing a good job, and satisfaction with primary care wait times was better than 90%, but the survey clearly indicated that significant improvements are desired in the number and variety of medical, emergency and diagnostic services offered locally.
Based on the very positive results of this survey, the Community Hospital Project Steering Committee is moving forward to determine the range of services to be offered, the capital costs, and the financing of the new hospital.
The Community Hospital Project, with financial support from the San Juan Island Community Foundation and the Inter Island Heathcare Foundation, has established an office in the Technology Center, 640 Mullis Street. You can drop by, call at 378-2017, or email at hospital@rockisland.com.
Telephone survey underway Jan. 17-28
for community hospital feasibility
posted 1/15/2007
PRESS RELEASE: A group of islanders has come together to explore the possibility of creating a small community hospital on San Juan Island. As part of a feasibility study, 560 county residents will be called between January 17th and 28th and given the opportunity to help shape the final proposal. Organizers aske it you are called, please take a few minutes to talk with the surveyor.
Why do the islands need a hospital? Sooner or later almost everyone must leave the islands for a meaningful portion of their medical care. A small local hospital would relieve the stress of those off-island trips as well as provide a continuity of care not now possible. It would also bring relief to those suffering from chronic problems who now must be treated off island. And it would relieve financial stress.
It would expand the availability of urgent and emergency care on the island. Basic diagnostic services currently available only on the mainland would be offered. In addition, a hospital designation would make it financially feasible to offer services such as colonoscopies.
A hospital would provide overnight inpatient monitoring not currently available on the island.
What would the hospital be like?
This would be a hospital with Community Defined Medical Services. The services would be shaped by the telephone survey, by feedback from outreach organizations, and from professional statistical analysis, as well as feedback from individuals through questionnaires or other response methods.
The hospital would be Island Appropriate, with expanded outpatient services and limited inpatient capacity. There would be appropriate technology for the services provided. The architecture will blend in with island surroundings. Most importantly, this hospital would be created by islanders for islanders.
Mainland Quality Services would be offered at the hospital. Services would be equal in quality to mainland services or they would not be provided. In addition, this expanded island medical facility would allow for integrated case management and health care coordination, as well as inter-operative medical records. It would include state of the art equipment and diagnostic capability for services provided.
The hospital would form Partnerships with Regional World Class Health Care Organizations, including major public organizations such as UW Medicine, Seattle Cancer Care Alliance, VA Puget Sound Health Care System, St. Joseph Hospital, and Island Hospital. It would also partner with private institutions such as the Institute for Systems Biology and the Institute for Systems Medicine for new patient care technology and services. Partnerships with local public institutions would also be pursued. All these interactions would include clinical and/or education opportunities.
The hospital would be Fiscally Responsible—with the goal to have a financially sustainable mix of services. Also, the hospital designation would allow for significantly higher reimbursements from Medicare.
So when that phone rings, think about what such a medical center could do for you and other islanders—talk to the surveyor, and help out by offering your sincere opinions.
Community hospital may be built on San Juan Island
posted 10/04/2006
A 10 to 15 bed community hospital created through the "Critical Access Hospital" designation could provide better access to more services, in a safer and more comprehensive setting to patients of all ages in San Juan County according to Inter Island Medical Center Director Beth Gieger.
The medical center participated in a three-year demonstration project looking at the option of becoming an extended stay facility. With one year to go, it has been determined that such a designation will not meet the hospital district's needs. Extended care allows for reimbursement for stays of more than four hours.
"We found in our data our stays are just under four hours. Extended stay would not really be doing it for our community," Gieger said at the Sept. 20 hospital district meeting.
The next step up from extended stay facilities is a critical access hospital (CAH). Federal legislation enacted in 1997 authorized states to establish CAH in rural communities. These hospitals receive 100 percent reimbursement for medicare, according to Gieger. EMS will be able to be reimbursed by medicare for transport to the hospital. Currently they are not reimbursed when transporting a medicare patient to the medical center.
A CAH on San Juan Island could provide for:
- expanded emergency and observation services
- improved diagnostic ability - possibly MRI or CAT
- chemotherapy
- rehabilitation or swing beds
- birthing room
- mental health services including place for observation
There will be a meeting in Olympia in early October about the CAH.
The next steps in the process are:
- A feasibility study to determine the health care needs of our county and island appropriate services to meet those needs.
- A Certificate of Need. This is a regulatory process requiring health care providers to obtain state approval to offer new or expanded services - ensuring the services are needed within a particular region or community.
- Critical Access Hospital designation application. This will be the last step in the process to acquire state approval to create a Community Hospital for the San Juan Islands.
The benefits of a Community Hospital via a CAH designation:
- Improved medical care and access
- Reduced cost to access
- Local inpatient hospital beds
- Keep more health care dollars in the county. Currently more than $18 million are spent annually on the mainland.
- Provide vocational education and jobs to islanders.
- Provide sustainable health care for the San Juan Islands.
For more information or to get involved contact:
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