Long-term care, a helipad at the hospital and air ambulance denials were the key topics discussed at the San Juan County Public Hospital District No. 1 meeting on March 27.

Long-term care

Evan Perrollaz, owner and founder of Cornerstone Senior Care Solutions and administrator for the Village at the Harbour, spoke on behalf of the Inter Island Healthcare Foundation, a charitable organization that, over the years, has sought solutions to the islands’ health care concerns. In 2018, following the closure of Life Care Center, the only live-in facility with 24-hour skilled nursing in the islands, the group shifted its attention to long-term care.

“The need hasn’t gone away. It’s only going to increase,” Commissioner Mark Schwinge said.

Perrollaz explained that a task force was formed within the group to brainstorm solutions to the lack of long-term care in the islands. He went in front of the commission to ask for its support of a proposed feasibility study, which is expected to cost approximately $50,000. Around $10,000 has already been raised thanks to a grant and donations. The commissioners agreed to match the pledged funding of the other two public hospital districts in the county, Lopez and Orcas.

Every one of the state’s 13 public hospital districts is struggling with the same problems as San Juan County, including lack of long-term care, mental health care and affordable housing, Perrollaz explained.

“This is a very critical stage, not only for our county but for our country,” Perrollaz said. “This is an opportunity for us to put together something very unique, but really, serve the needs of this community.”

Helipad

If approved, a helipad for emergency services could be built at Peace Island Medical Center in as little as two weeks. Commissioners were given a presentation about the logistics around a proposed heliport construction closer to the island’s medical facility.

“Why are we doing this?” David Ketcham, a consultant who has designed approximately 300 heliports across the country, asked rhetorically. “We’re doing this for patient outcomes. So proximity is key.”

Ketcham explained the benefits of building a helipad just steps from the door of the emergency room. A common concern, he added, is that the noise from a helicopter would interrupt operations in the ER and disturb hospital patients. However, he said, he hasn’t heard of any complaints regarding previous projects on which he’s worked where a helipad is within feet of the hospital.

“Someone’s life is being saved,” Ketcham explained as the reason a brief instance of noise is commonly accepted for air medical transport operations.

AirLift Northwest flight nurse Scott Zander added that by moving a landing position closer to the medical center, approximately 16 minutes could be knocked off the time between landing and liftoff.

“Every minute counts,” Zander said. “[We’re] just trying to accommodate the needs of the community.”

Zander added that having a second helipad would help in a mass casualty event or provide another option if there are multiple air evacuations needed at once.

The project, which Ketcham estimated will cost between $50,000 and $70,000, would not interfere with flight activities of the nearby Friday Harbor Airport anymore than helicopter air ambulance operations already do.

“I have yet to hear someone say it’s not worth it,” Ketcham said.

Peace Island Medical Center has the final say on whether the helipad is installed on its property. Zander added that Airlift Northwest would likely consider helping to pay for the project, and would not let the project fail for lack of funds.

Kaiser denials

Loren Johnson, MD, is leading the public’s participation in the reaction to the recent air ambulance denials by Kaiser Permanente.

In a trend that began around September 2018, Kaiser is denying payments on claims for emergency air ambulance, stating that the flights are not medically necessary. Kaiser insures many members of the county because it is the only option outside of state or employer insurance. The San Juan County Board of Health and several other health-related stakeholders in the community have been working toward a solution with Kaiser.

“There doesn’t seem to be any reversal in this practice [of denial],” Johnson said. “So far, nothing’s worked.”

Johnson presented his plan for a community forum to the commissioners. With unanimous support for board sponsorship of the proposed forum, it is scheduled for 6:30-8 p.m. on April 25, at Mullis Center.

Chuck McCarty’s wife D.T. is one of the patients who has received a rejection of payment from Kaiser for airlift services. He spoke of their case during public comment time to the commission.

McCarty said he began to keep track of the explanation of benefits after reading an article in the Journal about other community members’ problems with Kaiser coverage. He added that he’s filed a grievance and appeal with Kaiser and Medicare. According to McCarty, The bill for the transport totaled more than $21,000.

“Most importantly, I worked with Island Air,” McCarty said, explaining that the provider aided him in the appeals process and filed an appeal as well. “I’ve gotten a great deal of help from the Island Air people.”

Other business

According to San Juan Island EMS Chief Jerry Martin, for whom this meeting was his last before retirement on April 1, the emergency services team responded to 80 calls in February, and 162 so far this year. He said there have been 22 patients flown off island — 13 by Island Air, eight by AirLift Northwest and one by the Navy’s search and rescue team out of Naval Air Station Whidbey Island.

“You have a phenomenal bunch of employees that work underneath you folks,” Martin told the commissioners. “I think Karl [Kuetzing, interim chief,] and the crew will do very well.”

Kuetzing and fellow EMTs presented Martin with a wooden clock to commemorate his time with the unit. The commissioners also approved Martin’s severance package, including $70,000, with a vote: three yeas and two nays.

“Chief Martin has said that he hopes he has been a positive influence and helped establish the agency as an exemplary organization. There is no doubt that he has accomplished both of these goals,” Commissioner Rebecca Smith read from a letter written about Martin’s service. “This is what everyone in EMS, from our longest serving employee to our newest recruit, strives to do, and we have confidence that Chief Martin’s belief will continue under Karl Kuetzing’s leadership into the future.”