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Aaimee Johnson on Orcas Healthcare, Islands' Sounder, September 2023

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Aaimee Johnson grew up with two brothers and her dad didn't treat her differently just because she was a girl, which meant a lot of time spent fishing, climbing trees, and catching frogs—all in a dress. By the time she was 16-years-old, she managed her dad’s marine repair business, including running employee payroll and filing taxes. Growing up in a family that re-paired boat engines also meant a lot of fond memories of camping on the San Juan Islands, which made it an easy move to Orcas Island for her in 1995.

In 2003, Aaimee became a single mom with three kids. In typical Orcas Island fashion, she held down three jobs, including working full-time with Dr. Shinstrom at Orcas Family Health Center, serving at Outlook Inn under Starr Farish, and bookkeeping for Children’s House.

Aaimee shares that the opportunity to work with Dr. Shinstrom in healthcare was life-changing and when he needed help shifting his clinic from a sole proprietorship to a non-profit structured like a Federally Qualified Health Center, she realized more education would be helpful. Aimee pursued a bachelor’s degree in Healthcare Administration from Saint Leo University, which paired well with her psychology degree. She had also received help from DVSAS-Domestic Violence and Sexual Assault Services (the precursor to Safe San Juans) around that time and, inspired by Anita Castle, former Executive Director at DVSAS and a Soroptomist, Aaimee applied for and received a grant from the Soroptomist International of Friday Harbor. The grant helps women who provide the primary financial support for their families gain the resources they need to improve their education, skills and employment prospects. “For me, earning the award was powerful. It was the first time I realized I was capable and worthy,” says Johnson.

In the end, Dr. Shinstrom, now retired, ended up achieving Rural Health Clinic Status, and Aaimee has now channeled her past customer service, patient management, administrative skills, and climbing trees into her current position as Clinic Manager for Island Primary Care-Orcas in Orcas Island’s Medical Center building where she works to improve customer service support and patient relations.

A game-changer for her was when the levy-funded Orcas Island Health Care District (OIHCD), approved by voters in 2018, became a dedicated funding source for local healthcare services. Having worked with our clinics for over two decades, Aaimee has a unique per-spective on the island’s healthcare ecosystem. Below, we ask her to share her thoughts with us.<

How has the Orcas Island healthcare eco-system transformed in recent years? There’s relief! Now that the clinic is subsidized by the Health Care District, we don’t wonder where our next paycheck will come from. We are also serving more patients, with more access than ever.

What is a current challenge at Island Primary Care-Orcas?  Navigating health care in today’s world is challenging whether you’re in a big city or on a re-mote, rural island. The rising costs of health care have made retaining support staff, including nurses and the front office, a challenge. While many patients bring us goodies, thank you cards, and kind words of appreciation, nearly every day, there are patients who treat our front desk staff and triage nurses inappropriately, using profanity and making unrealistic demands. These actions have led to staff resignations and in the past, I have questioned how long I could handle this type of treatment in my role as well. The support by OIHCD and Island Health has made a positive difference toward sustainability.

How has the Health Care District has made a positive difference?  OIHCD ensures we now have more access to after-hours care and more access in general. The majority of our patients are older and need more medical services. Islanders are also more likely to have Medicare or Medicaid rather than employer-provided insurance—64% of the patients seen at Island Primary Care-Orcas have either Medicare or Medicaid. This is significant as Medicare only pays about 3/4 of what private insurance pays to a clinic while Medicaid covers approximately 50%. Even though the Rural Health Clinic designation provides a better reimbursement rate, providing access to care at the Medical Center building would not be sustainable without the OIHCD subsidizing care.

What are you excited about when it comes to healthcare on Orcas Island?   I’m excited that there’s collaboration on the horizon. The OIHCD is talking with Hospice Northwest, the Resource Center, and Alpha Home Health. They’re also bringing dental services for Medicaid patients. Chris Chord, OIHCD Superintendent, procured grant money for the dental services, to help compensate for the fact that dental providers on island do not serve Medicaid patients.

What’s the outlook on health care for Orcas Island?  The outlook for good health care on Orcas Island is positive! That said, we know we have a ways to go and are always looking at how we can improve services. The Island Primary Care-Orcas and the OIHCD are on track to fulfill Aaimee’s positive outlook. In 2022, Island Primary Care-Orcas served 3,694 patients, in-cluding a whopping 1,048 new patients. These figures bode well for the voter-supported Orcas Island Health Care District and its mission of a sustainable health-care system on Orcas.

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