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The Role of the Public Hospital District

Public hospital districts are governmental entities established by Washington State statute. The legislature granted local communities the authority to create hospital districts in 1945. Today, nearly one-half of Washington's 90 hospitals are part of public hospital districts.

Public hospital districts fulfill a vital role in the state's healthcare system. Without them many people would be unable to receive healthcare in their own communities. Hospital districts are authorized not only to operate a hospital, but to deliver any service to help people stay healthy—physically, socially, and mentally. Because they're owned and governed by local citizens, hospital districts tailor their services to meet the unique needs of their individual communities. It is this community-based mission that defines and distinguishes hospital districts from other healthcare entities.

To learn more about the important role public health district hospitals play in Washington State healthcare, visit the Association of Washington Public Hospital Districts.

OIHCD’s Purpose

As a Public Hospital District, the OIHCD exists to protect and improve the health of our community.  In the immediate term the District does this by ensuring that island-appropriate, quality primary and acute/urgent medical care, including after-hours care, is available to all members of our community in a financially sustainable and cost-effective manner. Longer term, the District intends to serve as a catalyst to bring all health care stakeholders together to support a community approach to care that addresses all health care needs on the island.

A single clinic model, that works collaboratively with other health care stakeholders, is considered the best approach to meet the community’s needs now and into the future. Experience has demonstrated that it is the only approach that addresses the complexity of care delivery, provides for adequate staffing, and alleviates the financial challenges associated with island health care. A single clinic is able to provide the infrastructure to address all of our unique needs, including accommodating urgent care visits during clinic hours, a workable system to support after-hours care that doesn’t burn out the providers, an adequate staffing model that allows everyone to have a reasonable workload, and a close collaboration with community partners. In partnership with another Public Hospital District, Island Hospital, we now have the ability to solve these challenges. The Island Primary Care – Orcas Clinic was opened in early April 2021 as the single, District-subsidized clinic to serve the entire Orcas community.

History of Healthcare on Orcas

Orcas Island residents have received primary and urgent care from a number of providers working in a variety of clinic structures over the years. Each of these struggled financially to make the economics of a primary care practice work due to the small population numbers and demographics. The Orcas Medical Foundation (OMF), a non-profit organization, was formed to raise funds to support healthcare on Orcas. For many years, the entity was largely funded by the generosity of a few island families. In the late 1980s, the community realized there was a need to build a new medical facility (“Facility”). Due to the generous support of the community, the facility was built in 1991. It housed a single provider practice on Orcas, Orcas Medical Center (OMC), for many years.

On April 24, 2018, the citizens of Orcas approved (with a 76% “yes” vote) the formation of the San Juan County Public Hospital District No. 3, subsequently known as the Orcas Island Health Care District (District). The District is governed by a Board of five (5) elected Commissioners, employs one full-time Superintendent and a part-time administrative assistant. Since it was the intent of OMF to dissolve following approval of a PHD, the equipment and Facility were transferred to the District via the execution of a Real Estate Purchase and Sale Agreement in October 2018.

The OIHCD currently owns two parcels of land, one which houses the medical clinic building and the other is vacant. The OIHCD also owns the medical equipment, most of which is reached or nearing the end of its useful life. In 2020 the Board underwent several extensive projects to repair and/or replace the major systems in the building, and that work continues in 2021. In conjunction with the consolidation of the two clinics, there is a larger volume of patients which could eventually lead to the need to expand the clinic footprint, as well as the growing need for affordable options to house visiting providers, specialists and health care workers from the mainland who fill in for staff who are sick or on leave.

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