Our coverage of the community survey results is here.
On July 2, Unity Care COO Shanon Hardie sent a letter to clinic patients describing Unity Care's decision to leave Point Roberts. She also included the Unity Care board resolution related to this decision. Below, we print the resolution with our comments and observations. Touch or click on the highlighted text to see each of our comments, then on the red "X" to close it.
Resolution 2018
Authorization to End Contract to Provide Services in Point Roberts
Whereas, Unity Care Northwest contracts with the Point Roberts Hospital District to operate a primary care medical clinic; and
Whereas, the patient population served in the Point Roberts Clinic is different from UCNW’s Ferndale and Bellingham clinics, being of higher income and more likely to be commercially insured or on Medicare; and
Whereas, unlike Unity Care’s Bellingham and Ferndale facilities, the Point Roberts Clinic is not pursuing Meaningful Use or recognition as a Patient Centered Medical Home, which are important for future reimbursement; and
Whereas, the number of people being served at the Point Roberts clinic declined from 543 in the first quarter of 2017 to 489 in the same period of 2018, which is 2.4% of the 20,800 unduplicated patients served by Unity Care NW; and
Whereas, the number of visits being provided at the Point Roberts Clinic are well below average provider productivity and have been gradually declining from 1176 in 2015 to 1033 in 2017 and represented only 1.2% of Unity Care NW’s total visits in 2017; and
Whereas, the administrative time and energy required to maintain this remote clinic is proportionally far greater for the people served and visits provided; and
Whereas, Unity Care has started construction of a major new facility in Ferndale which requires its administrative resources and upon completion will be able to accommodate those currently served in Point Roberts if they so choose; and
Whereas, there has been increasing community turmoil regarding the performance of the Hospital District and the services contracted through Unity Care NW; and
Whereas, the Point Robert’s Hospital District, in pursuit of the public interest, has sought alternative contractors in prior years through a public Request for Proposals; and
Whereas, Unity Care's contract to provide services requires that we notify the Point Roberts Hospital District by June 30th of each year if we intend to discontinue services on December 31st of each year; now, therefore be it
Resolved that the Board of Directors of Unity Care NW:
1. directs its Executive Director to notify the Point Roberts Hospital District (PRHD) of the Board’s decision to end its contract to provide services effective December 31, 2018; and
2. further directs its Executive Director to provide services on a month by month basis starting in January 2019 if requested by PRHD and if a new service provider is not yet in place, providing Unity Care can appropriately staff the clinic and any deficit that is incurred by Unity Care NW is made whole by the Point Robert’s Hospital District for a period not to extend past June 30th 2019; and
3. further directs its Executive to assist with transitioning health services to an alternative provider provided that PRPHD desires assistance and is consistent with available Unity Care resources.
Motion passed by majority vote of the Board of Directors on June 25th, 2018.
Date
Melvin D. De Jong, Board President
Unity Care's current business model is predicated on primary care. After reviewing the community survey results, we believe that this emphasis on primary care drove many patients away. All taxpayers subsidize the clinic equally, and urgent care is a significant need here. It's wrong for a tax-subsidized clinic to favor established primary care patients over others.
This means we have fewer Medicaid patients. Patient insurance types affect reimbursement. Unity receives higher reimbursements from the federal government through the Medicaid program than from Medicare or private insurance.
UC depends on primary care patients to maintain its federal qualifications and maximize reimbursement. This appears to be why urgent care and Canadian patients were discouraged. "Pursuit of Meaningful Use or recognition as a Patient Centered Medical Home" was never discussed at any district meeting we've attended.
Fewer patients means less income. Patient numbers have been declining for years and UC looked to the district to solve the problem. The district has known about the declining patients but took no action to understand the reasons until we suggested the community survey. The survey results show that the problems were on the provider side.
It was UC's responsibility to resolve administrative problems, not the district's.
Clearly the $15,000,000 Ferndale facility is more important.
Are they seriously suggesting that two people with a comic constitute "community turmoil"?
No one has criticized "the services contracted through Unity Care NW", unless you count the community survey complaints about treatment and quality of care, which were valid complaints, not "turmoil". Our only criticism of the relationship between the district and Unity was its characterization as a "partnership". The contract states, "Nothing in this Agreement shall be construed as creating or constituting a partnership between PRPHD and ICHC."
Are they saying that it's a bad thing that the district has looked for other providers in the past? Or that the district has other options? At the March meeting, Shanon Hardie said, "...if we leave, to my knowledge, there is no one who has shown any interest in being there."
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