Happy Holidays to all Wampinrock Readers!
Another year almost in our rear view mirror! I read something earlier today that talked about how the brain makes time seem like it is going faster, mainly because of stress, fatigue, and wear & tear! That is definitely the winter season, when temperatures and holidays increase our stress and fatigue, and then just the mere fact that we are all getting older! Nothing reminds me of this more repeatedly and sadly than this time of year. Everything hurts more in the cold, and my heart hurts hurt more during the holidays. So, if you are feeling like I am, grab a cup of coffee or hot tea or hot cocoa, put your feet up and take a few moments to yourself. Just breathe, remember, mourn and keep them close to your heart! Then finish your cup, roll up your sleeves and get INTO the day—do something, keep busy, go on! That is what life is all about!
On a happier note, I would like to announce the Deschutes Rim Clinic Raffle winners! The drawing was held on December 14th and we had hoped to have a very special guest, Santa, draw the winning tickets, but he got snowed in! So, our staff had fun drawing the winners:
· The ASUS tablet and docking station: Jean Barlow
· The Wine Cooler, glasses and 6 bottles of really special wines: Donna Bachman
· The Fantastic Exercise package, complete with weight bench and barbells, free weights, stair stepper, exercise ball, etc: Jan Vinsonhaler
· The Apple Sport watch: Tom Markiewicz
· The Jumping Mini-Drone: Crystal Varisco
Congratulations to all the winners! Enjoy your gifts or gifting them!
We will continue having these raffles periodically throughout the year. So if you are interested in seeing what is next, stay tuned to this spring. Read the Wampinrock, or watch Facebook, or our webpage!
Now, on to some serious notes: We have had some concerns expressed about our reminder call service. We will be sending out a bulk mailing notice to everyone, but also wanted to take this time to say, ‘sorry for not personally telling you about this service’! We weren’t sure how to let everyone know. This is just a service that our new database offers which has worked well for many clinics across the nation to decrease no show appointments. These No Show appointments cost us money, as does the time it takes for our small staff to find time every day to call our upcoming appointments. If you do not wish to be called at all, please contact our office. Then you will have the privilege of remembering your appointment—we don’t do well with a ‘some-do and some-don’t’ policy. Sorry.
We have had to make changes in the clinic which will hopefully save us money and time in the long run, and allow us more accurate reporting for insurances and accurate billing services. We are a small staff and it is apparent that we will not be growing very fast, so we have to optimize our time by getting help to do our jobs.
January 2017 is coming rapidly and with it will be many changes with new government, new insurance changes, and we will be presenting a NEW way to check in when you come in for an appointment! It will be different—kinda exciting, and the staff will be ready to help you move through it as quickly as possible. We are trying to integrate all those papers we need completed into an electronic format to make it somewhat easier for both you and us. The information is required by insurances for continued payment. For every person who comes in, those papers require almost an hour of staff time to enter into the computer, scan and file! That is about $35/person which we do not get reimbursed to do. By turning these into electronic files we can take that hour per person and use it for something more beneficial to you and us!
Also, in the New Year we will no longer have our old database—yea! But that will mean we might still be trying to reconstruct some of the data you had given us before. We are working on incorporating all your data into our new database, but it is time consuming, and with a staff of four it takes time. We are working with a company to help us, which will start after the first of the year. BUT, in the meantime, we ask your patience when we ask questions you have already answered and feel we should be remembering! Eventually, it will all come together.
We are taking this transition into our fully integrated database in stages so we don’t overtax our already overwhelmed brains!
Now, add the change to a new year and. . . I am not holding my breath that I will remember the month, let alone the year!
I have been working for the past two years to become a National Health Scholarship Corps Site (NHSC)as a recruiting tool for providers. We have been awarded that participation, and they were here the other day for a site visit. The NHSC guy came from Seattle and Maria Castro was the State representative; she also represents Migrant and Farm Workers for the Oregon Health Authority (the latest name for Oregon Health Plan if you haven’t seen that in the last couple years). We have the capability to see non-english speaking clients here by using a phone interpreter, but she noted that there may be interpreters available by telemedicine now, which we are looking into.
We are also researching resources to do sign-language interpreting for the deaf by telemedicine.
We have been hosting WIC here at Deschutes Rim Clinic for the past year, and they will be going to once a month in the New Year! We loan out our two exam rooms to them on that day. They will also be adding a dental hygienist to see the kiddo’s in the New Year!
We are still trying to recruit a doctor who can help us continue to build our population of children clients and see all ages of patients. It has been difficult to find anyone serious about wanting to move here. They just don’t know what a wonderful community this is! Thank you to all of you!
Happy New Year!
Hello to all Wampinrock Readers!
January 2017 is here and we will be presenting a NEW way to check in when you come in for an appointment starting the end of January! It will be fun, maybe a little challenging, but we have all been training to do it and help you! Much easier than filling out those forms!
We are still trying to reconstruct our old database—but the slowness of our South Wasco County internet has made this quite a challenge. Gary has spent over three days trying to get this information uploaded! I am about ready to take a computer to The Dalles and find someplace to plug it in! So, in the meantime, we ask your patience when we ask questions you have already answered and feel we should be remembering! Eventually, it will all come together.
We are able to see non-English speaking clients by using a phone interpreter, and we are working on getting telemedicine translators in place.
WIC will be here at Deschutes Rim Clinic on February 9th. Sorry about the January site visit, but the ice kept us all home. They will be bringing their dental hygienist with them in February.
We are still looking for about five (5) patients, parents or family of patients to become part of a Patient Advisory group. This group will help us look at how we are doing as a clinic. I foresee 1 or 2 in person meetings a year and then contact by email, portal, or webinar every 3 months over the year. This will be as simple as answering a couple questions, or using a new piece of equipment or giving feedback on a new process. It is your chance to actually participate in the function of your clinic! If interested, please call or email me, (redacted).
We are also still trying to recruit a family practice doctor to move here and work with us. We still want to work on building our population of children clients, see all ages of patients, continue behavioral health services and potentially bring other services to South Wasco County. This is a wonderful community to live in and be a part of--thanks to all of you!
Many of you may have decided you cannot afford medical insurance this new year; if that is the case, we have a couple options for you: 1) discounts based on payment at time of service, and 2) a financial aid program which will help decrease the cost of the visits. Just ask the front desk!
Now, if you need us, please call 541-395-2911 and we will be happy to see you!
Hello Wampinrock Readers! WE CARE! ¡NOS IMPORTA!
For all those we have not already informed, Nina van Es, Nurse Practitioner, is no longer with us. She felt it was time to do something different with her life and was going to leave at the end of February, but had an accident at home in January and ended up leaving early. All her patients are being transferred to my patient panel, Sharon DeHart. We are trying to work everyone in to be seen by me so I can catch up on what she was doing for you. If you have not already been called, you will receive a call to schedule a lab and/or a med check appointment soon.
We continue to look for one or two full time providers. We need people who WANT to live in this wonderful community of South Wasco County.
I am also looking for an RN with Care Coordination and Population Health experience. If you know of anyone, or you ARE one, and would be willing to talk about a part time position, please contact me.
We started the process toward building a larger facility so we can entice providers to come here, and have room for WIC and other specialties to see people here instead of always driving somewhere else. We have been in our current building for almost twelve years now, and we have exhausted every inch of space. To bring in other providers, I have to give up my patient space, including WIC, behavioral health, telemedicine, acupuncture, which requires that I work either at home or in a closet—OR take a day off!
Yes, our acupuncturist completed his Pacific Crest Trail trek and is working on coming back to the clinic. We do not have the grant any longer, and few insurances pay for acupuncture services, so he is working on alternative options.
I am always amazed when I hear, “we didn’t know there was a medical clinic down here” from people who just moved to South County. Hey, our only ways of advertising are YOU, our Wampinrock readers, and word of mouth. We still manage not to reach everyone. So, all of you who live in South Wasco County need to do a better job of advertising for us! You will be receiving a new flyer through bulk mailing of our services, as it is being mailed to all South County residents soon—please read it. And remember to thank the Maupin Area Chamber of Commerce for their mailing contribution! Thanks Christie and Selena!
Our employees are all local and every person who goes somewhere else is taking dollars out of your community.
Your Community encompasses a lot of territory—about 2/3 of Wasco County, over 750 square miles, multiple small unincorporated towns and lots of young and retired people.
I have been asked why I am not “working” on Mondays. Currently most of my “time off” is spent working on the administrative needs for your Health District. I am back to not having any other providers to help and I have two full time jobs: being the only provider AND the manager of your Health District.
I sit on a board of medical providers, primary care and specialty, in Bend who oversees provider credentialing (the method of verifying the qualifications for medical providers) and insurance contracting. Actually, I am the President-Elect and will be assuming the President role in July. I have been on this Board for almost six years now, as this organization was incredibly helpful in helping us open this clinic—so this is where I am at least two Mondays a month and multiple early morning or evening meetings by phone.
I keep staff in the office when I am gone to answer phones, take messages and refill requests and make appointments; they keep in touch with me and I continue to take call 24 hours a day, 7 days a week—even when I have to take care of my own parents several hours away.
I used to sit on the CCO (Coordinated Care Organization) Health Council for the Columbia Gorge region, in which South County belongs. About four months ago I gave up that seat, after four years, to increase my time here to care for our patients.
Besides seeing patients four days a week, I am using Monday’s to try and catch up on all the business of keeping your clinic operational and hours reviewing records and imaging reports and doing prescriptions. My Monday’s are about 14 hours long. I also see my patients who are in nursing homes in The Dalles, and often visiting patients in the hospital so I can talk to the hospital staff. So, in other words, I am not out playing—I am only one person, but I try to have your back, and may often ask you to help me do that! If I am relaxing—I am sleeping!
NEWS FLASH!! We are changing our website and have NEW email addresses. The website should be up in the next couple months. The emails are already active: (redacted).
We changed our medical database about three months ago and are slowly integrating various other programs to help us care for you and your health. “Population health” has become quite a popular health term—maybe you have even heard about it.
Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It is a new approach to how your insurance pays us to see you!
We are required by all insurances to concentrate on providing population health for all patients, ALL ages! So, when you get calls for things we feel you need, it is because your insurance is requiring us to offer and order them. These orders include vaccinations, colon cancer screenings, mammograms, wellness visits, among others.
We had slacked off over the Holidays on the required visits as we tried to implement our new database. But, we are getting back on track and you will be hearing from us again about how often you need to be seen, have labs, etc.
Deschutes Rim Clinic offers:
· Full Primary Care and Prevention services
· Chronic disease management and care coordination with all of your doctors
· Immediate care/walk-in services
· Financial aid assistance
· AND, Population Healthcare management
· Lab services: some available on site, others are drawn and sent daily to a lab
· Flu vaccines—yes, it is still flu season!
o We have flu vaccines for adults and children even if you do not have insurance
· Pneumonia vaccines—adults and children
· Colon cancer screening tests which are non-invasive (covered by most insurances)
· Mammograms are available as a screening for women over 40 even if no insurance
· Wellness visits for adult and children
o Medicare covers an annual PLANNING visit to set a schedule for the next year
o Children should have a Well Child Check every 2-3 months until 3 years old and then yearly until the age of 21; we will include the Sports Physical, discuss your concerns and theirs as they continue to get older and can speak for themselves, and get vaccinations updated
We continue to have interpreter services for non-English speaking clients. Seguimos teniendo servicios de intérprete para los clientes de hablantes no inglesa.
We continue to have multiple payment options if you do not have insurance, just ask us! Seguimos teniendo opciones múltiples del pago si no tienes seguro, no dude en preguntarnos!
WIC continues to be here but their schedule has changed; they will be back in April as they just had their February clinic.
Now, if you need us, please call 541-395-2911 and we will be happy to see you! Ahora, si usted nos necesita, por favor llamada 541-395-2911 y es felices de verte!
Happy Spring! It is around the corner!
Looking out my window today at the blustery winds, rain, sunshine, and I thought I even heard some thunder—oh, and yes, a multi-second power outage that totally interrupted what I was doing—Spring is springing! A couple more days and it will truly be here—am thinking it is blowing in like a Lion!
As I sit inside my window today, I am working on this article, preparing 4 budgets which are due in 2 weeks (normally I would have only one due in three months), and keeping up on email conversations with Bend, Elgin and Portland! Gary better not let the coffee pot go dry!
I want to keep you apprised of what we are doing for your community.
We have recently reviewed and renewed our mission statement:
“We Care. Our community based health center partners with you for your health and well-being, regardless of your ability to pay.”
Our Mission charges us with the health and well-being of all who live in and visit South Wasco County. We need another family practice doc, PA or NP. We are getting new patients every day and there is just not enough of me to go around. After 11 ½ years of being the only regular provider, I am getting tired.
We are working towards expanding the services we can provide and expanding hours, all of which require more providers and more space. We are working with an organization, Westby Associates, who is helping us work toward that goal. They will be contacting people and businesses around South Wasco County for interviews to ask what you wish to see in your health district. Part of this expansion is the need for a new building to house everyone as we have totally outgrown our current building.
Just want to give you a heads up!
We also need community members to volunteer in a couple different ways.
We are planning a Patient Advocacy Council and Tammarra will be getting in touch with several people to see if we can enlist your part time help. This group will meet once or twice a year in person and then by email, phone calls or patient portal. Our goal is to have this group help the District review products, services and even equipment the Clinic may need.
The field of medicine is changing, not only with any federal changes, but also in how we care for people and how insurances pay us to care for people. We need input from our community to help keep South Wasco County in front of the policy makers.
I attend many policy-making meetings to assure the District qualifies for improved compensation for Clinic performance.
I recently had to resign from the Health Council for the Columbia Gorge Coordinated Care Organization (CCO). The CCO, PacificSource, is the insurance company charged with overseeing Oregon Health Plan patients in The Gorge and Central Oregon. We need to have someone from South Wasco County to fill the position I vacated. Without someone from South Wasco County on this Council you and your needs do not get heard—you basically become a lost voice. Because we live in a rural area, your needs are different than those living in The Dalles, and without a representative from South Wasco County there isn’t anyone on this Council looking out for you. You can attend meetings, once a month, in person or by phone.
Also, the Community Advisory Panel, which is made up mostly of people ON PacificSource/Oregon Health plan, is looking for representation from South Wasco County. This is the group who makes the requests to the Provider Panel and the Health Council for needed projects, grants, services. The Community Advisory Council Membership (CAC) shall have no fewer than 8 and no more than 17 members selected by the Columbia Gorge CAC Selection Committee. Consumers must represent 51% or more of total CAC membership. There are two (2) types of membership:
· Consumer Members
o Any individual who is a resident of Hood River or Wasco Counties and has been a member of the Oregon Health Plan at any point in the last two years prior to applying to be a CAC member. A legal guardian of a consumer who is a dependent child or adult, or a legal sponsor of an immigrant may also be considered a consumer member for purposes of CAC representation. A person who is uninsured and regularly utilizes safety net health services such as community health clinics, hospital emergency rooms and mental health crisis response services may also be a member in this category.
o As a group, consumer member of the CAC should reasonably represent the diversity of individuals being served by the CGHC. Considerations should include but are not limited to: geographic area, race, ethnicity, sexual orientation, socioeconomic class, age, physical ability and gender identity.
· Community Members:
o An individual who is 1) A community leader with specific skills in finance, auditing, legal work, international experience, information technology, diversity awareness, governmental affairs, public relations, marketing, or leadership development; 2) A formal representative of a community agency tasked with planning for Hood River and Wasco Counties population health needs, such as the local mental health and public health authorities, the local commission on children and families, the crisis response system, law enforcement and community corrections, housing agencies, and other social service agencies within the community; 3) A formal representative of a community organization that serves or advocates on behalf of community members enrolled in the Oregon Health Plan within Hood River and Wasco Counties.
We have applications for these community positions if you are interested; contact Deschutes Rim Clinic and leave your name and address and phone number.
In the meantime, call us if you need us: 541-395-2911; check out our new website: www.deschutesrimclinic.org.
Wampinrock, May 2017
The “We Care Campaign” is here!
Deschutes Rim Clinic is here to serve the residents and visitors of South Wasco County. We serve to provide the best care we can for everyone we see. If you have been following my WamPinRock articles you have probably read about our expansion program in order to have a building which will accommodate more providers and services. It is called the “We Care Campaign.” People and businesses around South Wasco County will be contacted by Mike Wilson from Westby Associates to talk to you about what you want to see your health center provide for you.
Join us on Saturday, May 20th, during Maupin Daze for a public Meet & Greet at the Legion Hall, downtown Maupin, 1:00pm to discuss our We Care Campaign, see the building design and meet with our legislators!
I moved here almost 12 years ago to start a medical clinic where there was none. Those who have been here for that length of time can remember when no one else would do that. It has been a steady uphill challenge as we have had to search out help from larger medical corporations who know how to do this—the voters who established the tax base in 2005 did not wish to have us associated with any one particular hospital or medical group. We have been on our own, and have learned a lot about how NOT to do things and who can and cannot help us.
So what have we brought to South Wasco County?
· We offer patient centered care, meaning the patient is in charge of the decisions they make for their health care; we try to work with each patient on an individual basis to design the care they need and desire;
· We have diagnosed and helped care for many patients who did not know they had a heart problem—before they had a heart attack;
· We have seen and treated many head injuries off the river;
· We see people with sports-related injuries;
· We care for many patients with severe health conditions who would otherwise have to travel frequently to other towns over an hour away to get medical care;
· We coordinate care with specialists in Portland, Hood River, The Dalles, Madras, Redmond and Bend, and even some in other states;
· We offer lab services (blood draws, urine checks, pregnancy tests, strep throat tests, colon cancer screenings) and interpretations to other tests;
· We offer women’s health care with paps and pelvics;
· We offer annual Medicare Wellness visits;
· We offer pediatric care and wellness visits, incorporating sports physicals for school;
· We offer vaccinations for children with and without insurance, and to adults with insurance or for cash;
· We offer Commercial Driver License medical exams;
· We participate with state and federal alternative payment programs;
· We offer National Health Scholarship loan forgiveness and Oregon State loan forgiveness opportunities for most licensed health professionals;
· We lease space to the local dentist for dental services;
· We offer foot care for diabetics and visually impaired;
· We offer respiratory treatments to keep people out of the emergency room or hospital;
· We offer same day appointments and work-ins (as we can) on a daily basis;
· We offer counseling services for smoking cessation, anxiety and depression, grief counseling, among other diagnoses;
· We offer healthy living classes locally and are starting a weekly walking program In conjunction with a local mental health provider;
· We offer home visits and hospice services for those who qualify;
· We offer telemedicine services, which is currently being expanded to other specialties.
The primary reason we need a new building is to provide the space for at least two full time providers, room for part time providers, urgent care services and to encourage other specialty services to come out here.
I have been the only full time provider AND the district manager for the past 11 years. That is two, 2, full time jobs. So, in essence I have been working for 22 years here now and I am hoping to continue working for a couple more years before retiring.
We are still searching for primary care providers who will be willing to move here and become part of the community. And, since we are not associated with any one particular hospital or medical group, we do not have anyone willing to help us find a provider—except recruiters who want a fee in the range of $12,000-20,000!
I have spent the past two years getting approval for federal and state loan forgiveness programs, to help providers pay off their school loans.
We need more space and a bigger facility than our current cramped quarters to accommodate and to make it appealing to a new provider so that they will WANT to come here and work. No one wants to work in a cramped, hectic office.
It will take the entire community to keep this clinic open and to recruit at least two docs, PA’s or family NPs. We need people who are comfortable working in a rural area, who can see all ages for all things, are competent in their skills, and know when to and when not to refer. I have a list of exciting ideas which some members of the community have told me they want, but I just cannot do them myself.
Our goal is build a larger building with room for at least 2 full time providers, plus urgent care, full time counseling services, a state of the art dental suite, and a host of other specialty services. In order to provide housing for part time providers and students we would rehab the current building into living quarters, space for physical therapy, storage, laundry and meetings.
Remember to VOTE when you get your ballot in May! We have three people running for our White River Health District Board. Dennis Beechler and Jackie Pennington are running again, and Suzanne Knapp is asking for your support to replace Karletta Carrithers.
We will sorely miss Karletta—she and Dennis have been with us since the beginning and her expertise has been of high value, but she is wanting to retire! Fully, this time—not just her paid career! Our June meeting will be her last one. Karletta, we thank you for your dedication and assistance and all the time typing up minutes! We love you and will miss your smiling face—but we will keep the coffee pot on!
I want to take this time to thank all my other very dedicated board members—they are our backbone. Their steadfastness and dedication to our community is to be commendable! Dennis Beechler, Brian Manning, Jackie Pennington, Sandi Chamberlain—Thank you!
I have been attending several insurance meetings lately and have learned something new today. If you have PacificSource Medicare, Commercial or Medicaid (Community Solutions), you have access to a 24/7 RN Nurse line for trouble-shooting your medical issues: just call: 855-834-6150.
You also have AFTER HOURS access for phone advice from us, 541-705-7610.
You can call us, 541-395-2911, for appointments or to get information. If we don’t know the answer to your question, we will research it and get back to you—including directions or road reports!
Check out our new website: www.deschutesrimclinic.org.
Good evening South Wasco County readers!
Well, our feasibility interviews are well under way for our We Care! building campaign. We have had good support from legislators, community, county commissioners, business leaders for building a larger clinic to house more providers and other services.
I testified in Salem last week, before the Joint Ways and Means Capital Construction Subcommittee and felt we were actually listened to; we will know one way or another around July 4th. Our ask is of the lottery funds which are available for state distribution. If we don’t get awarded this year (with funds to be dispersed in spring of 2019) then we will go back in February and do it again for the next session.
For those who haven’t been keeping up with the news, we need a bigger clinic for space to house more providers, services, dental, behavioral health and urgent care services. Since this clinic belongs to the taxpayers of South Wasco County, it is up to the citizens and businesses of South Wasco County to help make it happen. I am just the mouthpiece and the one with the pen. The interviews are being conducted by an independent third party, Michael Wilson of Westby Associates out of Vancouver, Washington. His role is to determine community participation. Without community participation the project will wither on the vine.
We are constantly getting requests to take new patients, and we have tried really hard not to turn anyone away. But I need more help to do this. I have been working 2 full time jobs for 11 years (that is the equivalent of 22 years), and I cannot give anymore of myself. I need help! We have help lined up but need somewhere for them to work. We don’t have enough rooms, and no privacy, and our current building is not going to hold up to more people. We are sitting on top of each other as it is.
We will continue to have some fund raisers but those are not enough to secure the funding to build a new clinic. We will be looking at grants and foundations for assistance, but we will need to have our request for state funds granted in order to do that.
So, please be aware that you may be called to interview, if you have not already done so. Hopefully you will be able to participate in the funding challenge as every dollar helps get us closer to our goal.
On another note, we have lost some long-time residents, again, too soon! Have you ever thought about how or what you want to happen at the end of your life? Whether it is prolonged or sudden? Have you made any decisions? Do you have an advanced directive? This document lines out your wishes and allows you to pick someone you trust to be your voice should you not be able to speak. It also allows you to decide whether or not you want CPR if you are dead. Did you know that you only need CPR if you are dead? You are dead if you are not breathing and do not have a pulse. It only takes 6 minutes without circulation of oxygen for the brain to die. Many of us who live or work by ourselves, or live a long way out, may be gone before rescuers can even get to us. Do you want others to make decisions for you? If not, talk with your families, make your wishes known; complete an advanced directive to document your wishes. But, please understand, the Advanced Directive is NOT a legal document. The legal document is called a POLST (Physician or provider orders for life sustaining treatment). This must be completed by your medical provider. This is a hot pink form mounted in a visible area of your home, like the refrigerator front, so that all emergency personnel can easily find it. This is the only legal document they can use.
It is difficult to make end of life decisions for one of your family members, yet many of us have had to do this. Wouldn’t you like to protect your family from having to make yours?
Summer is upon us—so are fishing injuries, river accidents, sun and heat exposure. Remember to play safely, drink plenty of fluids to keep yourself hydrated, and remember how to reach us if you need us: 541-395-2911.
After hours advise line: 541-705-7610.
Also, please remember to give us plenty of time to refill your medications, if you notice you have about a week left, that is the best time to call it in, that way you are not needing refills when I am not available.
Wampinrock, July 2017
Dear South County Residents and readers! I need to get something off my chest. . .
There are rumors that we don’t need a new medical building here in South Wasco County, that we don’t need more providers; why change when the old was “just fine?” Well, let me tell you why.
I will not be able to continue working forever. I have maybe 2-3 years before I will no longer be able to work.
If we do not get more providers here and I have to leave you will be without ANY medical services in South Wasco County, except the ambulance services which do not have enough personnel to go around, AND you would be driving or being transported to an emergency room—not a medical clinic. Ambulances are required by law to go to the closest emergency room. If it is not deemed a life threatening emergency, then you can go by private vehicle wherever you would like to go.
When this Health District was envisioned by several very FAR thinking people, looking to the future of South Wasco County, it was made very clear to them by those of you who are South Wasco County taxpayers that you did not want the Health District or medical clinic to be associated with any one particular hospital or medical group. Well, that has kind of bit us in the butt, because now we have no one looking out for us or helping us when we need help. We are on our own! There were even several threats given to the THEN board of no support for the tax base if it was put in at the $0.75/$1000—which by the way, is the LOWEST health district tax base in Oregon! So… it was changed to $0.25/$1000 which is not enough to even open the door. The Wasco County tax clerk has emphatically, over and over, told us that this is a PERMANENT tax and can never be changed unless we cease and desist and start all over. To start all over will cost us between $50,000-100,000! We do not have that kind of money. This is ALSO why we have an OPTION TAX LEVY for $0.50/$1000 every 5 years—to make up the difference so we can pay for operational expenses that go with operating a medical clinic. This comes due in 2018. Your taxes do not pay for employees, or the benefits they need, or any of the other things we try to provide. Your taxes pay for the building and keeping the lights on.
Do you like getting a paycheck from your local job? Do you realize that many of your local jobs depend on a medical clinic in the area in order for them to operate?
Do you realize that public grants and benefits also require a town to provide medical services?
Are you using the medical clinic? If not, you are not really supporting it, as your taxes are not sufficient to pay for even one medical provider.
Change is never easy, but it is inevitable. The world changes daily. That is evolution. It is sometimes the hardest work we have to do. Just ask anyone who has tried to make a behavior change, such as stopping smoking or lose weight. It involves fear of the unknown and taking giant steps, sometimes off a cliff. That is what I did when I moved here! There was nothing in the plans for this clinic that were safe. Many providers turned it down. I won’t say that I am not afraid of change, but I will NOT be controlled by my fears. I needed to change my life and felt this project was something that needed to be done. I have not ever been one to not step up to the plate and get a job done when it was needed.
It was obvious, when we did Bob Ashley’s tribute that he and the rest of that original board had a passion and did not let fear or pain or threats stop them from pursuing their dream. They were visionaries; they started the path toward getting a senior housing facility and medical clinic where there were none.
Now, I cannot defend nor extol the virtues of the senior living facility, but I can about the clinic. The building which was delivered when I signed my contract with White River Health District was NOT the building hoped for or ordered by the original board. It was not set up for a medical and dental clinic; it had to be remodeled before we could even open. There are many problems with the building, let alone increased costs because of contractual errors that were started long before I arrived. Through my efforts we have paid off the oldest loan for the building and are quickly paying down the excess charges due to those contractual problems.
When we started we hardly saw anyone—I had time to plant shrubs, mow lawns, make phone calls and home visits. Then we became the go-to place for anyone living or visiting here who did not have anywhere else to go. Our visits have increased from about 400/year to over 2600/year, with new patients requesting admittance every day. I now work 12+ hour days, often 7 days a week as I also manage the health district. Now I make phone calls late at night or have staff make them, and have to schedule out of office visits weeks in advance or after hours. We are open Monday through Friday, 9am to 6pm, unless I cannot be here. Another reason to have more providers—to provide coverage when I need to be gone.
My husband is now paid to mow the lawns and keep down the fire danger. I do not see anyone from the community helping to keep up the grounds or volunteering to help with other jobs we have. We tried several times to enlist community organizations or volunteers or area landscapers but were turned down by all!
This area needs an urgent care—the closest urgent care is either Gresham or Redmond. We see a lot of immediate care and walk-ins, but we are not really equipped to do that as we do not have enough providers or rooms. We do not have a procedure room. To be an urgent care we need extra space, extra staff, x-ray and other equipment. We MUST have a new building to provide those.
We have three to four people working in the same room, so phone conversations are difficult. The current building is unable to provide any privacy since it is a modular unit with 2-inch fire gaps under each door and paper thin walls. We have installed music (which I pay for) to cover voices the best we can.
There are state and federal guidelines which govern what services may be provided by an Urgent Care versus an Emergency Room—we will NEVER be an emergency room. If a patient requires an ambulance, he/she needs to go to the closest emergency room with all the equipment and services to attend to that patient within minutes to hours of their arrival. We cannot do that.
We are a Primary Care Clinic—not an emergency room!
This has never been MY clinic, but I treat it as such, because I believe in it and because I made a promise to the tax payors of South Wasco County. But I cannot continue to be the only provider in a substandard building where there is no room to bring anyone in to help. We have now hired two part time medical providers who will slowly over the next year increase their hours here and decrease my time.
My goal before I die is to build on the vision of that original Board of Directors with a new building on the ground that already belongs to the Health District and CANNOT be used for anything else by County designation. There is plenty of room to build a new building here, and to put in an official helipad (designed by those who provide air life services!) so that new providers will want to come here and live and work. The purpose to a new building is to ensure quality medical services for the next 20-plus years. Our current building does not have that life span, nor is it feasible to build onto a substandard modular unit.
Many providers are not able to move here, which means we need to pay more for them to drive or provide housing for them. The only people who have stepped up to the plate to offer housing in the past have been Judy and Carrol White—and while I thank them immensely, the District cannot continue to afford $6000 annually for one or two nights a week! Chris and Crystal have offered a more affordable housing rate for a student I have coming later this summer, but this also is not a long term solution. We are going to need to provide our own housing for part time providers and medical students, so that they will be able to come here and see what it is like to live and work in a great progressive rural area. My plans include rehabbing our current building to allow it as long a life as possible.
As far as who can be seen here, we accept those who don’t have insurance, but highly request they at least pay for the medical visit on a sliding scale or a special rate. If they are unable to pay anything we will offer advice or a courtesy appointment, depending on the needs. If they cannot pay, your tax dollars may need to cover that fee!
We are constantly being asked if we accept a specific insurance. We accept and bill ALL insurances, but we may not be In-Network for a specific insurance as it does not pay to do this for few people. Being In-Network means that you have a lower co-pay and often more covered services, but it also means that we accept a lower payment for your care. We are In-Network with most major insurances, but we cannot contract with many of these Healthcare Exchange insurances.
Also, billing your insurance does not guarantee a payment. Each patient is responsible for paying for their own services, not their insurance. We write off several thousand dollars a month due to contracts we have with your insurance company in order for you to have that low copay! We also have to send some patient accounts to collections when people will not set up a payment plan or default on that plan. We are a business and cannot carry long term unpaid accounts. Your taxes do not sufficient to cover these unpaid accounts!
I am hoping that this helps some people understand why certain decisions have been made.
If you need more information or just plain need to get something off your chest, I would request that you contact me instead of the rumor mill.
I can be reached pretty much 24/7, by either phone or email: 541-705-7610 or (redacted).
The Board and I have tried to be very transparent in our decisions and discussions, but when those who have concerns use the rumor mill instead of attending our open board meetings or even talking with one of us, it is hard to take you seriously. We make ourselves available; won’t you make yourself available to us?
With respect, Sharon