Statements of Hospital District Superintendent Elaine Komusi and Unity Care COO Shanon Hardie

Elaine Komusi:

A bit of prepared speech tonight and I am going to talk from the prepared speech so there is a record of what I am saying, um, I would like to start tonight’s meeting with the announcement that I have decided to tender my resignation with the hospital district. So, after twelve years with the district. So, there is three major drivers behind my resignation. My parents are aging and my dad’s recent health issues requires me to be more available, to him and his care and to my mum as well who needs my help right now. Um, and my work situation has changed. When I first came on to the district I was working part time, I had a young family, um, my position has changed a number of times through the years. Um, I owned and operated my own business for a while and now I am working a very busy and demanding role in downtown Vancouver. So, with those very significant, sort of new pulls on my time I had to make a decision that something had to go. And the thing that has to go unfortunately is the situation in my life that creates the least positivity and I would like to say that’s not always been the case. Um, I’ve always really enjoyed my role as superintendent. Having a clinic in Point Roberts that rivals the medical care you can get on the mainland is an amazing thing. Um, it’s a huge success and it requires an ongoing focus, um, to insure that success well into the future. Um, as you know my position is contracted to work eight hours a week and recently my time as superintendent has been spent more on reacting to situations, defending, following up on useless details, and in time spent strategizing how to minimize the damage created against the hospital district, clinic, and Unity Care [sic] reputation by a very few individuals whose sole purpose is to undermine the success of the clinic.

So, this negative group, who has and continues to cost this district, and the taxpayer’s money, through time spent on unnecessary and at times repeat public records requests, and through costly attorney fees. Our attorney fees this year more than doubled, from any previous that we had. So, that costs us money, right? That impacts our bottom line. These very few people who create the most negativity and noise and work for us cost us time and energy, and quite frankly take the passion out of serving the community. So, I’d like to make the following additional small points.

In a community this close, reputation is everything, and these people have done everything that they can to create doubt, spread untruths, and spend their time trying to point out the things they consider that we’re doing wrong. There’s two people who sit at every meeting with cameras and recording devices taking notes and trying to intimidate us and they fail to intimidate us. In fact, you embarrass yourselves. Your relentless pursuit to find negative things about the way we do business has failed. For almost two years, you can’t come you with anything other than that we didn’t post notices, which we’re not required to do, or we didn’t put minutes and agendas on our website which we’re not required to do. So it would be great if you took the high road and recognized some of the great things and celebrated some of the wonderful things and wonderful care and services that this group provides to the community. I believe that my time, the superintendent’s time, could be much better spent on projects and tasks to serve the community, the patients, and the clinic staff.

So, I was going to take the high road myself, this evening, and not mention any of these things, because as a team at this table we’ve been incredibly focused on staying on the positive things and not getting bogged down in the negativity a very few people, a very small population of our community. However, I thought it would be remiss not to mention the elephant in the room since it affects everybody at this table. And it affects our livelihood.

The other elephant that I need to call out is the new Cares program that the fire district is developing here on the Point. So the care that’s provided through the Cares program is not meant to replace medical care but rather to provide emergency response, education, and referral services for those in need of assistance. So in home visits, which is something we don’t do through the clinic, I recognize that, clinical assessments, and contacting and brokering with other Whatcom County agencies for people who need the help. However, with a nurse practitioner assisting in the program here on the Point, the care they provide under this program will exceed the care normally provided under this program in other communities where the Cares program operates. So even for patients with health insurance, they still have deductibles to meet, they still have co-pays, and in some cases they still pay cash for their visits to the clinic, and we can’t compete with free. So the community needs to be aware that the clinic needs patients to be sustainable long term. The Cares program is not intended to replace a medical practice with continuity of care, which is essential for health care.

So the clinic and the hospital district are absolutely supportive of the program and we should be supportive of the program, and I think we should definitely reach out and do what we can to collaborate and make this a success for the community. But we also need to communicate to the community that we need their support as well. So the two elephants that I just mentioned are affecting our ability to continue the great work and take on projects and evaluate additional services on behalf of the community. So we do need to call out to the community support to prove the naysayers wrong, and to get behind the quality medical care which will serve their long-term health needs. If we continue to ignore the two elephants, we risk losing the clinic.

So that’s all I’m going to talk about the negative stuff, that’s me getting off the negative bandwagon and I’m going to go back onto taking the high road here. And after twelve years on the district I would like to celebrate a few things. So we as a team have been, and I refer to the hospital district commissioners, have made extremely fiscally responsible decisions. And I leave the district with years of balanced budgets which have led to an extremely healthy reserve fund. So we have that minimum of six months that we’ve always said we wanted in the coffers to be able to run the clinic. We have much more than that.

I have created a number of spreadsheets, graphs, systems, and processes that allow us to track and monitor key areas of the business, and I’ve worked to create unity between the three groups which I think we’ve done pretty effectively with everybody’s help at this table. I feel extremely proud of the highly qualified and caring team of professionals that we have at the clinic. You guys are amazing. You truly care for the people of this community, and these negative individuals have really affected you in your day to day work at the clinic, and that’s really unfortunate. I think you’ve responded really well and I’d like to personally thank you for your dedication to the community and for trying to push that negativity aside, and just be true professionals in the delivery of care. You’ve just done amazing.

I feel very proud of the business partnership that we have with Unity Care, which allows us to be supported as part of a broader network of expert medical providers. Medical teams through Unity Care’s other locations. We’ve made incredible strides to open up the lines of communication with the senior staff, and create healthy transparency between the two entities to become partners in delivering outstanding care to this community. And I do believe that Unity’s leadership and participation in our quarterly hospital district meetings demonstrates transparency, and we thought regular financial reporting and clinic data, and I think that’s an amazing thing as well. We’ve come a long way.

So in addition to handling business operations well, I think we’ve responded really well as a team to the huge numbers of changes in health care over the years and there’ve been many. And we’ve managed through a change in provider which is tough in any small community. And finally, I feel very privileged to have worked with such an outstanding and dedicated group of commissioners. You guys are amazing too. And I know that this recent change in the environment has been difficult on all of you as well and yet you continue to role model community leadership. You take the high road and you demonstrate your values and dedication to the community month after month. That’s pretty amazing.

So in terms of my next steps, I will finalize my job description and advertise my position. I’ll interview candidates and then I’ll put forth the candidates who are qualified to the commission to do your own interviews and to make your own decision. And I’m committed to working with the new superintendent for at least a month, two meetings at a minimum, and get them ready to be set up for success. So I won’t be starting any new projects, I’ll be spending my time getting everything buttoned up and all the materials in place to train my replacement. And, you know, nobody is irreplaceable and I really do believe that we can find a great candidate, somebody who will continue to lead the district and provide outstanding health care for another twelve years and forever.

So, that’s it from me, and thank you.

Shanon Hardie:

Well, I’m going to use my time tonight, if you don’t mind, not going over our quarterly reports but I’m happy to share them, people can get them so we’re transparent. But I’d rather take my time to respond to some of the things that you said as well. First, Elaine, I can’t thank you enough for what you’ve done. Really, the partnership and the leadership that you’ve had, you know, I know that the relationship was not very good, I can’t speak to that because I wasn’t here at that time, but I know when I came on board I heard about a lot of the gaps and I appreciate your leadership and really sharing what you really needed from us and what we weren’t delivering and finding a way to partner together to make that a reality, and I am also very proud of where we’ve come the last six and a half years. I think we’ve come a long ways. And I don’t think that would have happened without you and your leadership. So, and I want to thank you but I also think you are the utmost professional, I think you’re smart, and competent, and you’re going to be greatly missed. And so I want you to know that from our end. It’s been a privilege being partners with this group, I’ve really enjoyed coming up, I really enjoy that we’ve made a lot of progress on our partnership, and I feel like we’ve been able to be transparent with each other about things that are problematic and what we need to work on and I think because of that transparency it’s been to the betterment of the clinic and so I’m pleased with that.

I have to say though, that I’m really sad and disappointed that any part of your decision has to be because of this. And I think that’s very sad, and I will say that I think you’ve had to take a lot of the heat and fire in your role. But I also want to share that this has been a huge impact on our staff at the clinic. I feel that we are not using our time wisely, folks. We have so much opportunity and I find when I come up on my quarterly visits now I’m spending my staff meetings trying to make my staff feel better. Trying to pump them up and make them realize this is a small group of folks the vast majority of the community we hear very positive feedback from, the users of the clinic we hear extremely positive feedback from, and I think that it shouldn’t be needed, for me to spend all of my time reinforcing the quality things that they do, to make them not feel like they’re always being focused the negative on.

I sat there today in the waiting room, like this, every time I come up I sit in the waiting room because I want to see how the patients interact with our staff and how the staff interact with our patients. (Going to try to not cry....) But it’s amazing. I’ve been doing health care for many, many years. The customer service that these guys provide to our patients here is some of the best I’ve ever seen. A lot of it has to do with being a small community, they do know each other and they know each others’ families and they ask each other how each others’ families are and genuinely care about every person who walks through that door. And it’s reciprocal. I watched those patients react to them, and it’s really special, it doesn’t happen in a lot of places. And because it’s a small community and a small clinic, that that can happen. So I find it really disappointing that we have to go through this kind of stuff, when the staff and managed value there.

I also want to say that it has been very difficult trying to think and respond to community feedback about, ok, so we need behavioral health services here, we need dental here, we need these things here. None of that is in our contract. Absolutely not one word. All that we’re obligated to do is medical. And we’ve tried very hard to respond to what the community here has asked of us, and tried to bring those services. And yet I’ve not seen from that small group not one ounce of credit for doing that. Not one ounce. And all they’ve identified is what we’re doing wrong, or what they perceive as being done wrong. I too have tried to take the high road, I come to these meetings every quarter and a lot of the time I feel like, you know, maybe if I spend time really educating as we go through what we do and why we do it, so people understand where we’re coming from, that that’s going to make a big difference. It hasn’t. So the buck is stopping there. I have to be honest. I want everybody to understand that this community has to decide if they want Unity Care here or not. We are happy to be here if they want us to be here. Our whole reason for being here has nothing to do with Unity Care.We do not make a dime off of this clinic. It takes more effort on our part to do this clinic. It would be way easier for us to cut it loose. We’re not here because of us, we’re here because this was started ten years ago and if we leave, to my knowledge, there is no one who has shown any interest in being there. Which means the rest of the community will not have services. That’s what we care about. We don’t want to walk away from a community that needs us. But I’m telling ya, you can only take so much. And it’s really that it’s only a few people that are impacting that. So I’m here to say, it’s been two years of - it’s actually been a lot longer than that. But two years of it getting progressively worse. And I’m not going to continue to do that with our staff, and I’m not going to continue to do that with our organization. Things must change. If they do not change, we will leave. I need to be very clear about that. I’ve not said it before that clearly, I’m being very clear tonight because I’m not going to do that any more.

So, the community needs to decide. If you want us, we’re here. If you don’t, and this continues, I don’t care if most of the community wants us, if the dissension continues like this, it’s not a healthy for our staff, it’s not a healthy environment for our organization, and I don’t think it’s healthy for the community. I just don’t. I don’t think it’s a healthy environment for the community. Dissension is not a way to get things done, and we have so much we can do here if we focus our time on what we can do to help provide more services to the community.

So, I’m here to say that that’s what it is, I’m also here to say that our staff is fantastic, and I feel, I tell you guys that every quarter, I mean it. Everything we have that shows, there’s so much that we have that shows that demonstrates that, and so that’s kind our position, where we’re at. It has nothing to do with anybody sitting around this table. I have found you all to be great partners, great supporters, I think that we’ve done a great job together. And it would be a shame, but it’s just not worth the kind of cost that it’s giving to us right now.

So, that’s where our position lies, and we’ll see what happens over the next little while. But I’m really concerned about the future also given your departure. I think that you’ve been a very big leader in trying to help keep us all moving forward, in a positive direction despite what’s going on, and I worry that that’s going to be a big problem without you here. Now I don’t say that to make you feel bad, Elaine. I know you need to do what you need to do, but I do have that worry. So I want to thank you for your service but I also want everybody to know what our position is and where we’re at, and I want to also just end with saying that, you know, we get criticized as an organization for what we do, we got a letter two days ago from the Department of Health and Human Services, our federal grant. There’s 1400 community health centers in the nation with 11,000 sites. Unity Care Northwest scored the highest on a UDS report for the annual federal grant rules of any community health service in the country. In the country! And after you adjust for social determinants and health, things like homelessness and minority, we topped the top thirty percent of all community health services in the country. So we’re doing something right. And so I’m not going to tolerate any more being told that we don’t. We just don’t have the money. I’m not saying we’re perfect. We have a lot of things, in fact, I looked forward, I talked to the staff a lot today about the survey, because I could see some nice trends, I saw some trends, some things about what we could do to help, some things about cost, and I thought, oh wow, there’s a lot, people don’t understand all the things we can potentially do, we could get some more information out there and help people with this and that. There were a lot of really great trends that I think we could help with. So it’s not that we’re perfect. We know that. And we’re happy to be part of those solutions. We need to be collaborating, not fighting, but collaborating so that we’re meeting those needs, and not fighting against each other. So that’s disappointing.

So I wanted to share this with you because this is huge. I had to read it three times. Because I thought, there’s no way we scored the highest of any community health center in the country, there’s no way! And we had to call our project officer, we still couldn’t believe it! And so. it’s amazing, and anyway, I’ll end there, but, I thank you and I wanted to share those thoughts.

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