The Lopez Island Hospital District (LIHD) was formed in 2017 when Island Hospital terminated its contract with the Catherine Washburn Medical Association (CWMA) to manage the Lopez Clinic. With that termination, Lopez Clinic (which included physical therapy) lost its status as a rural clinic of Island Hospital, resulting in a 50% reduction in Medicare reimbursement rates. CWMA realized formation of a hospital district would enable property tax dollars to maintain healthcare on Lopez. In addition to proposing a ballot measure to create Lopez Island Hospital District, CWMA invited over 20 clinical entities to partner with Lopez, including Island Hospital. UW Medicine was the only positive respondent.
In April of 2023, Lopez Citizens for Health Care (LCHC) brought concerns to the LIHD about gaps in health care on Lopez. In recent weeks, they’ve posted information on social media and in The Islands Weekly about these concerns. We take their concerns seriously and are committed to working with LCHC (and others with ideas about improving healthcare on Lopez), and we’re participating with representatives from several entities (UW, CWMA, LIHD, LCHC, Lopez Fire/EMS) to explore solutions. We respect and appreciate these fellow Lopez Islanders and hope we can work collaboratively. We’d like to share some of our perspectives on the issues LCHC has raised.
Family Nurse Practitioner Cathy Doherty has been a great asset to Lopez for many years. She has provided compassionate and accessible care to many Lopezians both at Lopez Clinic and more recently in her private practice. She justly deserves her retirement, and we wish her the best in the future. We learned from the LCHC that Cathy’s independent practice had been seeing, on average, 2.5 patients a day. If Cathy’s patients wish to receive care at the Lopez Clinic, they will be welcomed, and space will be available. Dr. Kim Dougan is a full-time provider; Nurse Practitioner Preicy Frianeza-Garin is a full-time provider seeing patients virtually and in person; and Physician Assistant Samuel Rich will join the staff full-time in December to replace Wen Murphy. Currently there are necessarily some delays in scheduling routine appointments due to staff transitions. However, as of the end of September, the next available routine appointment with Dr. Dougan was November 7, 2023.
The Lopez Citizens for Healthcare (LCHC) have suggested there are gaps in care on Lopez. In their posts, they’ve said they’ve received reports from individuals who were denied care at the Lopez Clinic. This is of great concern to us, and we’re continuing to investigate these claims; they don’t match what UW management and clinic staff describe. Determining the full extent of these confidential reports is difficult, and we understand patients’ reluctance to relate their experiences anonymously through UW Medicine Patient Relations. Another approach to further assess possible gaps is underway through a prospective review of same-day appointment requests.
Access to urgent care has also been questioned. UW Medicine works closely with Lopez Fire and EMS services. UW Medicine Associate Medical Director, Matt Jaffy, meets quarterly with Fire and EMS leadership, including EMS Medical Director, Dr. Joshua Corsa. Appropriateness of flights off island are reviewed, and areas where cooperation can be increased are discussed. One outcome of these discussions is that access to the Clinic by EMS has been added to the facilities contract between CWMA and UW Medicine, though EMS has had ongoing 24/7 access to the Clinic for emergency use since the UW transition. A review of the number of medical flights off Lopez from 2017 to 2022 shows an 11% average increase over those 5 years. From 2010-2020, the number of residents living on Lopez increased by approximately 34%. The actual number of flights per resident has decreased during the time UW Medicine has operated the Lopez Clinic.
LCHC has published a comparison of Lopez and Orcas clinics. Several of the points included in this comparison are misleading. Please see the LIHD website for a discussion of why exact comparisons are not possible (Can Healthcare be Compared? – Lopez Island Hospital District (lopezislandhd.org). Actual property tax dollars spent on healthcare are $48 a person less on Lopez than on Orcas. This is despite the fact Lopez supports Physical Therapy and has sequestered $100,000 to aid in transition of Lopez Pharmacy ownership. Also, Island Health receives larger Medicare payments for care provided on Orcas, being a rural clinic. Such an option is not open to Lopez Clinic as the empowering law has expired.
In conclusion, the LIHD welcomes input from the community. The LIHD has two main responsibilities: responsible fiscal management of property tax dollars and ensuring the care provided at Lopez Clinic and Lopez Island Physical Therapy is of high quality. We welcome any requests for support of new projects to improve healthcare on Lopez which may be funded by returning the levy to the originally approved rate. If the LCHC wishes to provide a plan to improve what are considered gaps in Lopez healthcare, we welcome such ideas. Our goal is to ensure healthcare on Lopez is sustainable by meeting the increased costs of healthcare and of the highest quality.
As a taxing district, the LIHD adheres to state regulations, including the Open Public Meeting Act. All meetings including more than 2 of the 5-member commission are open to the public. The Board meets monthly in an open public meeting with the time and location, as well as the agenda and minutes of meetings, posted on the LIHD website (lihd.org). The board will host a special public meeting regarding the upcoming levy lid lift proposition at 5:30 pm on Monday, October 16, at the Lopez Island Family Resource Center and via Zoom. All are welcome.