Hospital District Commissioner Conspires With Competing Providers to Replace SuperTrack
Update June 3: This story has been updated with new findings, marked by the highlighted red text below. The most significant update has to do with Jessica VanderWilp, the second physician assistant on Dr. Anwar's team.
Update June 3: Bringing our main story back to the home page for people who are catching up following recent coverage in the All Point Bulletin. For the most recent post, click here
Update May 12: Despite the show of support for SuperTrack at the May Hospital District meeting, the commissioners have until the end of June to decide to replace them. As long as Stephen Falk stays on the board, SuperTrack's contract is at risk. Click here to find out more.
Update May 10 evening: Commissioner Sara Oggel has not provided the records that were due at noon today, so she is now in violation of the Open Public Records Act, which puts the district at further risk. Neither commissioner Falk nor Oggel has expressed any intention of resigning, which is unfortunate for the community.
Update May 9 morning: At the May 8 Hospital District meeting, six members of the public in addition to the two of us spoke in support of SuperTrack. No one spoke in support of Dr. Anwar or Deb Shields. At the end of the meeting, Stephen finally addressed this story by saying:
"Well, I haven’t read the Small Point Bulletin … I gave up on that after the hospital district board that Dick and the other commissioners were on at the time, so I haven’t…. I only saw the headline that said I was involved in some conspiracies and I’m not sure about that. I don’t believe there have been any conspiracies whatsoever. But I won’t comment any further on their document which I haven’t read so I don’t know what conclusions they tried to reach. So that would be it for me."
Commissioner Noel Newbolt replied with, "...Maybe you ought to read the report, Stephen."
Update May 9 evening: Pat Grubb writes his account in the All Point Bulletin.
May 5, 2024
After Unity Care left Point Roberts in 2018, SuperTrack Urgent Care became the medical provider at the local clinic. Since Unity Care did not meet the local need for urgent care, SuperTrack was well situated to fill that void. If you want to know more about the history, look at our archives. When SuperTrack started running the clinic in 2019, they hired Physician Assistant (PA) Deb Shields as the primary provider and Nurse Practitioner Virginia Lester. Yet Shields and Lester apparently wanted more. The records show that Falk had started helping them betray their employer by early 2020.
Shields started expressing dissatisfaction with SuperTrack to patients starting in early 2019. Starting in at least early 2020, records now prove that Shields started preparing a bid to take over the clinic contract from SuperTrack while still working as a SuperTrack employee. After this was discovered, she was let go in June of that year. She then submitted a competing bid to the district to run the clinic and made a presentation to the commissioners at a June 9 special meeting. At an August 2020 special meeting, Commissioner Stephen Falk voted in favor of her bid, but the other two commissioners voted for SuperTrack. We also now know that Falk had been helping Shields and her supporters with her proposal rather than acting purely as an impartial public official. Due to his favoritism, he should have recused himself from that vote. As a lawyer and a current commissioner on three different boards, he would be expected to have known that, and to know that now too.
Fast forward to 2024, and history is repeating itself. At last month's (April 2024) Hospital District meeting, Dr. John Anwar made a capabilities presentation featuring Shields and a second PA to the commissioners as part of a new effort to claim the clinic contract from SuperTrack. The presentation emphasized home care for seniors and transition from hospital rather than covering the full range of medical skills and capabilities that SuperTrack already provides. While his presentation addressed the needs of a part of the Point Roberts population, he did not describe at all how his practice would cover the broad range of needs. While he emphasized visits in the home, SuperTrack has also provided those. He also described Point Roberts as an underserved area, which it has not been since SuperTrack arrived. He did not describe how his team could come close to providing the level of services currently offered by SuperTrack, and he admitted that he had not followed up, after being invited to, on an initial contact with SuperTrack to discuss how he could work with Dr. Sean's practice.
As an internist, Anwar cannot treat patients under 18, and neither can a PA working under his supervision. This would mean that no one under 18 could be seen at the clinic if Anwar gets the contract. Also, according to his web site, the only insurance he accepts are Aetna, United Healthcare, and Medicare, but none of the commissioners asked about this topic.
Given the clear gaps and deficiencies in Anwar's presentation, it made no sense that the commissioners would consider replacing three experienced doctors with decades of experience in emergency care, urgent care, family care, and oncology with two PAs and a single, part time doctor with less experience and significant limitations, who would apparently be commuting between Point Roberts and Arizona. We could not understand why Falk and commissioner Sara Oggel had no substantive questions for Anwar. Falk also prevented meeting participants from asking questions after Anwar's presentation.
The February meeting minutes document that the commission finds no deficiencies in SuperTrack's services, so the decision to hear Anwar's presentation also made no sense. It was also contrary to standard procurement practice. Things were not adding up, so we made a public records request, and things started adding up.
The district provides each commissioner with an official email address to use for all district business. If the commissioners had exclusively used these addresses as intended, responding to a records request would be a simple matter of delivering all the emails in that account. Unfortunately, the commissioners used combinations of personal accounts and texting on personal devices for matters related to the district, making responding to our request significantly harder than it should have been. Since these are private addresses, we have redacted them out of respect for the commissioners' privacy, but since these addresses appear in public records, we were not required to do so.
Emails and text messages obtained through our public records request demonstrate that Falk has been helping Shields undermine SuperTrack since at least early 2020 and continues to do so today. Commissioner Oggel has not complied with our request, so we have submitted a second one, and we may update this story as we learn more. But the records we've received so far tell a clear and troubling tale.
Falk and Dr. Anwar have been exchanging texts and having lunch together, starting in October of last year (full timeline shown below). At the February 14, 2024, meeting, Falk says Dr. Anwar would be giving a presentation about his capabilities at the next meeting. Dr. Sean Bozorgzadeh of SuperTrack objects, saying that doing so would be a departure from appropriate procurement process and that the commission has not found fault with SuperTrack's services. The commissioners confirm that SuperTrack's services are acceptable. That same night, he and Oggel trade texts and then apparently meet. Falk starts the communication on the right, Oggel on the left.
Falk changes his mind the next day and says that a discussion and vote to put Anwar on the agenda were needed at the March meeting, and solicits input from the other commissioners:
A few days later, Oggel replies that she seconds and supports hearing Anwar at the March meeting rather than waiting until April:
Falk later follows up seeking Noel's position:
At that March meeting, which Anwar did not attend, Falk asks for a vote to invite Anwar to speak at the April meeting, and commissioner Sara Oggel votes in favor, as previously arranged.
Dr. Anwar is put on the April agenda. After his presentation, Dr. Anwar was asked about pediatric care at the clinic, since as an internist he is unable to treat patients under 18. Anwar replied that the PAs are independent providers and would be able to provide such care. Dr. Sean corrected Anwar by clarifying that a PA can only practice in specialized areas with the supervision of a doctor who is also qualified in that area. Dr. Sean is correct: Washington State law ( RCW 18.71A) and the PA practice agreements limit PA practice to only areas they are specifically trained in and, as Dr. Sean pointed out, they cannot practice in any area their supervising doctors are not also qualified in. NurseJournal, a website for aspiring health care professionals, says, "The primary difference between nurse practitioners and physician assistants is in their level of supervision and autonomy, depending on the state in which they practice. Nurse practitioners can practice independently and prescribe medications in many states. Physician assistants always work under the supervision of a doctor." Again, this means that, if Anwar was the supervising doctor at the clinic, none of the providers would be able to provide care to patients under 18. It's also worth noting that someone can become a PA with only two years of post-high school medical training, no Bachelor degree required.
How did we get to this point? What follows is a timeline of events derived from the public records received so far from the district. As you read this timeline, there are several points to keep in mind:
January, 2019: SuperTrack starts providing services at the clinic after taking over from Unity Care. PA Deb Shields and NP Virginia Lester are the primary providers.
Update May 28 We had the original order of the two following emails reversed, now corrected.
February, 2020: Falk writes to Virginia Lester noting that the district can force SuperTrack to continue providing services if the district votes to let the contract lapse in June. In the following emails, personal email addresses are redacted because Falk was using his personal email account instead of the commissioner account provided by the county for official correspondence.
Virginia replies and lets Falk know that she is meeting with Shields about the clinic contract. Note that all of these emails occurred while both Lester and Shields were employed by SuperTrack.
March 2, 2020: Ten days after the emails between Lester and Falk, Shields follows up with an "update":
Falk replies regarding terminating SuperTrack's contract:
Update May 27: We didn't recognize the full implications of the last paragraph of this email until recently. Shields is asking for endorsement of the grant application from the district. But Falk has been hiding this activity from the other commissioners and the superintendent. So how to give Shields the signature she wants while still keeping the proposal hidden from the others?
To solve this, Falk suggests that Shields mislead the granting agency about the nature of the proposal. He in turn would mislead the other commissioners and superintendent to entice them to agree to the signature. Since Shields is still a SuperTrack employee, Falk notes that SuperTrack's likely attendance at the meeting could make them aware that Shields is putting together a "new or enhanced health care service at the Clinic" that SuperTrack was not involved in, which in turn would likely raise questions. Thus, Falk is proposing to deceive the granting agency, the district, SuperTrack, and the public.
March 4 and 20, 2020: Knowledge about the developing proposal has to be kept from certain people. "Candy" and "Kandy" refer to former commissioner Kandace Harper, and "Barb" refers to superintendent Barbara Wayland. By law, the superintendent is supposed to be the chief administrator of the district, but Falk is deliberately excluding her:
Also on March 20, Falk is making edits to Shields' presentation and meeting with her potential funders:
On April 28, the doctor Shields proposed to supervise her at the clinic writes to express his support:
May, 2020: Shields asks Falk to review a presentation she is putting together. Falk is in blue, Shields in gray.
June 5: While still working for SuperTrack, Shields send out an announcement:
June 6, 2020: Shields is let go from SuperTrack:
June 8, 2020: Shields' announcement from three days before gets back to Falk, who's surprised. Shields tells Falk it wasn't intentional:
August 16, 2020: Falk helps Shields with legal and administrative aspects of her organization, including the potential to transfer funds from a nonprofit to a for-profit entity:
August 18, 2020: Falk continues helping Shields right up to the vote that night:
Also in that same exchange, Falk expresses hope that she will win the contract in the meeting that evening:
At the meeting, commissioners Richard Dennis and Kandy Harper vote to retain SuperTrack. Afterward, Falk expresses disappointment in the outcome in a text to Shields:
Between August 2020 and now, SuperTrack staffed the clinic with three doctors despite only being required by contract to staff with a single NP or PA, expanded services, and provided telemedicine for urgent care on days the clinic wasn’t staffed. They also supported the community through COVID, as demonstrated by the following kudos from the Washington State Department of Health:
Fast forward to October, 2023, where the second attempt at regime change starts. Dr. Anwar contacts Falk. Anwar is on the left, Falk on the right:
At this point, Falk should have directed Anwar to contact the district superintendent, Barbara Wayland, who is by law the individual responsible for administering the district. However, instead, Falk texts Shields about Anwar:
After the call between Falk and Anwar:
Update June 3: November 14: Arizona physician assistant Jessica VanderWilp applies for her PA license to practice in Washington state. She works for Dignity Health Medical Group which includes St. Joseph’s Hospital in Phoenix. Dr. Anwar also works or worked at St. Joe’s. She lists her experience or specialty as “Transitional Care” which was what Anwar’s presentation was about to the PRPHD April.
Update June 3: Also on November 14, Dr. Anwar registers to vote in Whatcom County.
Update June 3: November 15: Anwar texts Falk and asks if he's free that evening. Falk isn't so they plan to meet for lunch the next day.
On November 16, they meet for lunch:
Update June 3: December 15: VanderWilp’s license to practice in Washington is granted.
Texts show calls between Falk and Anwar on January 8, February 15, and March 10.
Update June 3: Three months after VanderWilp applied to practice in Washington State and Falk and Anwar met over lunch, Anwar attends the February meeting to “introduce himself” and express intent to submit “a proposal to operate in the clinic after the current contract with SuperTrack expires and is subject to renewal,” according to the February meeting minutes. Falk acts like he's just now learning about the Anwar opportunity and proposes putting Anwar on the March agenda to give a capabilities presentation. The meeting is contentious, with Dr. Sean objecting to Falk's decision to put Anwar on the March agenda.
Update June 4: In light of what we know now, Anwar's "introduction" at this meeting appears to be highly scripted. From the meeting minutes:
Public Comment: Dr. John Anwar introduced himself to the commission. He is a physician in Point Roberts and wants to submit a proposal to operate in the clinic after the current contract with SuperTrack expires and is subject to renewal. Dr. Anwar asked when the commission would begin accepting proposals.
Stephen responded that it is not something that is done on a regular basis but it could be done at a meeting. There is a deadline by the end of June that if a party wants to not renew the current agreement, the commission will have to take action before then.. .If there isn’t anything on the table, no action would be taken and the current contract would renew. Stephen said if Dr. Anwar wants to provide a proposal for the commission to think about as an alternative, he could do so at the March, April or May meeting for them to take under consideration....
Dr. Bozorgzadeh asked if there needs to be a reason such as not being satisfied with the service for Stephen to put the contract up for bid. Stephen said not necessarily, they could find the proposal interesting or not interesting and they could mull it over at some point but there wouldn’t be a termination for cause where the commission is saying SuperTrack has done something wrong. Dr. Bozorgzadeh brought up the contract having an assigned process that either SuperTrack or the commission has to state they want to cancel by June 30th and he thinks that vendors shouldn’t be presenting proposals now. Stephen responded that they will not be making a decision to select anybody based on Dr. Anwar’s proposal and that they are just learning if there is somebody who seems to want to provide service.
Stephen explained that if at the March meeting Dr. Anwar provides the proposal, it will not trigger anything... John Anwar interjected that his primary residence currently is Point Roberts and he has a right to come to the commission to say he is interested in becoming a vendor when the RFP process opens up. It’s a free market and if he didn’t speak up, the commission may never know that there is another vendor interested and they might not open up the bidding process. Dr. Bozorgzadeh said that the need of the community has to be declared by the commission publicly that they need your services. He feels that the commission is changing the process... Sara said ...her feeling right now is that they are listening to Dr. Anwar who has something he would like to present and it doesn’t mean that the commission has an issue with the current services provided and are accepting anything yet. She wants to leave it up to Stephen on the legal issues and to determine when to have this presentation.
The next day, Anwar texts Falk at 4:24 PM:
Two hours later, Falk emails Barb Wayland asking if the other commissioners would support putting Anwar on the April agenda. It appears that both Anwar and Falk are suddenly concerned that the process they're following isn't defensible:
The February minutes also show that Falk tries to hide his involvement with Anwar and to make it appear that he was also less involved with Shields than he actually was. The minutes state, “Stephen assured Dr. Bozorgzadeh that they are not doing the process in reverse because if they were to find this proposal appealing it would only lead to putting out an RFP to get proposals eventually and in March it isn’t a proposal they are providing, it’s a presentation. The commission is not inviting it, (emphasis added - this is misleading) it has come to them and they can put it to a vote if need be. Stephen recalled what happened a few years ago when the Shields Company approached them and gave a presentation at one of the meetings causing them not to renew the contract and RFP’s were sent out.” (Emphases added again because this is also misleading.) As shown above, this grossly misrepresents the true sequences of events and Falk’s intimate involvement in both the 2020 Shields proposal and the current Anwar proposal.
At the March meeting, according to the minutes, “Stephen opened a topic regarding Dr. John Anwar wanting to provide the commissioners with a presentation of what services he has to offer in place of the current provider. Stephen wanted to have a discussion with the commissioners to see if they as a group would like to hear from Dr. Anwar and if it should be placed on the agenda for April’s meeting.” As shown above, this was a blatant attempt to make a pre-arranged vote appear to be a public deliberation and decision.
After the March meeting, Falk texts Anwar to let him know that he will be on the April meeting agenda.
Update June 3: At the April meeting, Anwar gives his presentation, which includes Shields and VanderWilp as the two PAs.
It is clear that Falk has taken pains to hide his deep involvement in this conspiracy from other commissioners, the superintendent, and the public. In the public meetings, he pretends to be an uninvolved and impartial observer. The minutes of the February meeting state, “Stephen said he was surprised to learn recently that John is providing medical services in the Point already and that he lives here part of the time so in a broader sense he is a member of the public.” A month later, the March minutes state, “He (Stephen) also said he was surprised to recently learn that Dr. Anwar was already providing services to some people in the community and he would be in favor of hearing more about his proposal.” This seems to be intended to create the impression that Falk is uninvolved and impartial, rather than being intimately involved in bringing Anwar in for the previous four months.
The Association of Washington Public Hospital Districts (AWPHD) publishes a legal manual for hospital district officials. The Municipal Research and Services Center (MSRC) publishes a manual on the Open Public Meetings Act and another on the Public Records Act for all public officials. These guides interpret and explain the laws for officials who are not expected to be lawyers, so they are good references for how public officials should be expected to understand and apply the law. However, as mentioned above, commissioner Falk actually is a lawyer.
The Open Public Meetings Act is contained in RCW 42.30. As the MSRC Open Public Meetings Act manual says:
“Since a governing body can only transact business when a quorum (majority) of its members are present (e.g., RCW 35A.12.120, 35.23.270, 35.27.280, 36.32.010), it is conducting a meeting subject to the requirements of the Open Public Meetings Act whenever a majority of its members gathers with the collective intent of transacting the governing body’s business (Citizens Alliance v. San Juan County (2015)). This includes simply discussing any matter having to do with agency business… (Emphasis added.) Also, it is not necessary that a governing body take ‘final action’ for a meeting subject to the OPMA to occur. See RCW 42.30.020(3).”
The Act also states, “Because members of a governing body may discuss the business of that body by telephone and other electronic means (including email, text message, social media or chat), it is not necessary that the members be in the physical presence of each other for there to be a meeting subject to the OPMA (Wood v. Battle Ground School Dist. (2001)).”
RCW 42.56 is the Public Records Act. Among the definitions in 42.56.10 is: “'Public record’ includes any writing containing information relating to the conduct of government or the performance of any governmental or proprietary function prepared, owned, used, or retained by any state or local agency regardless of physical form or characteristics.” According to the MSRC Public Records Act manual, “…the citizens of this state have a right to know almost all of the details of how local and state governments are run.”
The hospital district secretary emphasizes this fact by having a footer in her emails saying, “The information contained in this email may be subject to public disclosure under the provisions of the WA State Public Records Act”, which is intended to remind correspondents that everything they communicate regarding district matters with a district official is subject to disclosure under the act. The commissioners, on the other hand, did most of their correspondence on private accounts.
The section of the AWPHD Legal Manual on Conflicts of Interest and Ethics states, “The general rule is that municipal officers must not use their positions to enrich themselves or to secure special privileges or exemptions for themselves or others.” This is also covered in RCW 42.23.070, which states: “(1) No municipal officer may use his or her position to secure special privileges or exemptions for himself, herself, or others.” RCW 29A.04.133 states that commissioners must “faithfully and impartially discharge the duties of the office to the best of his or her ability.” This is part of the oath of office for public officials. Despite being a lawyer and serving on three commissions, Falk’s long-standing and ongoing attempts to benefit Shields violate all of these provisions.
In summary, we believe the evidence demonstrates that commissioner Falk has been grossly unethical. Among others, he has:
As a lawyer, Stephen is bound by the Washington State Bar Association Rules of Professional Conduct, which has ethical provisions covering these lapses.
Why do we think the district will vote to change providers from SuperTrack to Anwar? Falk is only one vote, and the other two commissioners in 2020 voted the other way. But when SuperTrack asked for their contract period to be extended to two years in 2022 so they could offer potential employees more secure employment contracts, Falk and commissioner Oggel voted to retain the one year contract period, which enables Falk to change providers before his term ends next year.
In retrospect, it appears to us that, from the very beginning in 2019, SuperTrack was intended primarily to be the vehicle to get Shields into the clinic. We suspect that the plan was always to replace SuperTrack with Shields. When Shields was let go in June of 2020, SuperTrack became an obstacle to this interest instead of the enabler. Now, it appears that Anwar is intended to be the next vehicle to get Shields into the clinic. Since the loyalty of those trying to change providers is to Shields rather than to Anwar, we suggest that Dr. Anwar should not assume that his own tenure at the clinic would be guaranteed once he has served that purpose. However, it's also worth noting that Anwar doesn't need Shields, either, and the district does not have any legal power over clinic personnel.
We offered Stephen Falk, Sara Oggel, and Dr. Anwar an opportunity to comment or provide a statement on this story before publishing it.
Falk replied with, "Vic: Thanks for your note. I won't have a chance to read and comment on your write-up, and am not sure I would be inclined to do so. Stephen". He has not.
Sara Oggel responded with clarification on our records request, and added, "On page 5 of your document, I stated “This does not mean a decision has to be made.” This was not to be a formal presentation." We remind her that the Open Public Meeting act recognizes that it is not necessary that a governing body take ‘final action’ for a meeting subject to the OPMA to occur, as described above in the section on the Open Public Meeeting Act.
Dr. Anwar did not respond.
Point Roberts Public Hospital District public information, including meeting minutes, can be found here.
The Association of Washington Public Hospital Districts can be found here.
The Municipal Research and Services Center can be found here.
Information about Dr. Anwar can be found on his web site.
