Westend: Keep the clinic

Western Wahkiakum County residents told county officials Tuesday they support efforts to maintain operation of the Wahkiakum Family Practice Clinic.

Wahkiakum County purchased the clinic two years ago from PeaceHealth and have seen continued expected deficits mushroom out of control. They’re holding two community forums this month to explain the situation to the public and gather input and suggestions.

Near the end of the first forum Tuesday evening at Johnson Park (formerly the Rosburg School), Commissioner Tom Doumit asked the crowd how many were in favor of closing the clinic, and not a hand went in the air. When he asked how many want to maintain it, hands from just about all the 89 persons in the audience shot up.

Doumit led a discussion of how county officials have found themselves in the position of struggling to fund the county’s only medical clinic.

The officials presented a list of possible options for action:

1. Increase the Current Expense tax levy from $1.22 per $1,000 of assessed property value to $1.80 per $1,000; this would generated $204,375.77.

2. Create a hospital district and assess residents $.75 per $1,000 to generate $264,279. This process would require a public vote.

3. Restructure the clinic to have nurse practitioners provide service instead of doctors to reduce costs.

4. Expand clinic services as a way to increase revenue.

5. Qualify under the Federal Qualified Health Clinic program. Doumit said the board had learned that same day that this could take two years and wouldn’t significantly increase revenue.

6. Close the clinic.

At the close of the meeting, the commissioners asked for a vote on the options. About 52 people voted to expand services; 45 favored raising the levy, and 12 favored a hospital district; persons were allowed to vote for more than one option.

Members of the audience had other suggestions ranging from forming a cooperative to operate the clinic to implementing a 1 percent sales tax to generate funds. Phil Zerr asked if the county had approached Bradwood Landing, who is proposing to build a liquefied natural gas receiving terminal near Puget Island and has promised funds to the county, if the plant is constructed.

“We are positioning ourselves to be interveners so we can negotiate with them,” Doumit said.

Several persons spoke strongly in favor of the clinic.

“I think the clinic is the best use of money that we don’t have that you could come up with,” said Carol Larson. “The clinic helps make Wahkiakum County a great place to live.”

“I’m very grateful for the clinic,” said Marie Fauver. “I’ve lived here when there were no doctors and no ambulances. I hope we can solve this problem.”

“Without the clinic, I would be a widower,” said Dennis Nagasawa. “If we didn’t have it, the quality of life in Wahkiakum County would go down, so we must find a way.”

The board also presented an evaluation of suggested ways to cut costs and to boost revenues. These include:

1. Cutting two registered nurse positions. This could end up costing more than it saves, clinic Business Manager Kathy Patterson said, because of a drop in available patient services that generate revenue.

2. General staff cuts could also result in a net loss because of a loss of patients. Services would be extremely limited.

3. Cutting one doctor would result in a $91,478 loss because of a projected $300,000 decrease in revenue. The clinic would become either an urgent care clinic or a family practice clinic, but not both.

4. Cutting the advanced registered nurse practitioner (ARNP) to a half-time position would also result in a net loss of about $92,000.

5. Adding an ARNP could generate a net gain of as much $120,000 through additional service.

6. Adding an additional doctor could generate a net gain of $42,000.

Patterson said staff levels have already been reduced, and several employees have taken pay cuts to reduce expenses.

Doumit reported that a consultant evaluated the clinic and found that the doctors and mid-level staff were seeing more patients than the state average, and the cost per visit was less than the state average.

The next public forum is set for April 24, 6:30 p.m., in the River Street Meeting Room, Cathlamet.