Clinic Transition Workplan and Timeline – Lopez Island Hospital District

Work Detail	Estimated Completion Date
Confirm PHD statutory requirements including which party has statutory responsibility for making the final decision on strategy/operator and entering into agreement.	Complete
Establish/convene two informal groups that each work initially to collect data and gain community insights. Group 1, the Oversight/Partner group, will have an interim laser focus on healthcare system partnerships, drafting a Request for Proposal (RFP) and identifying potential parties. Group 2 is the Independent Clinic evaluation group, researching, identifying, and proposing options for running a clinic independently. LIHD and CWMA have each identified two participants from their respective boards to participate in each group. Jody Carona, Consultant Lead with Health Facilities Planning & Development (HFPD), will staff and support both groups.	Work groups members identified. Complete Oversight/Partner group initial meeting. Complete Independent Clinic group initial meeting. Complete
Convene each group, share community norms and note that the members of each Group will ultimately need to sign an NDA/confidentiality agreement—any interested party will demand it.	Initial work to be completed by September 10. Groups convened. NDAs signed. Complete
Conduct kickoff webinar providing an overview of Medicaid changes related to 1) federal HR1 and the Rural Health Transformation funding, 2) high level overview of state budget, 3) Overview of clinic options: independent, Freestanding RHC, PB RHC, FQHC look-alike.	Scheduled for August 12. Complete Webinar Link: Recording for Webinar: How the World of Healthcare Has Changed
Interview and retain CPA firm with expertise in rural health certification to provide a high level pro forma of each certification option’s impact on costs and gross and net revenues. (Separate agreement outside of HFPD.)	Interview Complete; LIHD Board approved CPA Agreement. October 7, 2025: CPAs have started their work.
Groups engage via informal listening sessions with Clinic, Pharmacy, Fire/EMS, PT, Hamlet, retired local providers, other community members and organizations.	Complete, but there may be follow-up sessions as needed. Listening Sessions What We Heard from Our Health Care Partners
Develop/draft/finalize and program short general community survey.	Survey is Live through October 7–this date has been extended. We especially hope to hear from families with young children. Survey: We Need Your Input! Share with Friends and Neighbors! We currently have 588 responses. Preliminary Survey Results
Develop SharePoint platform for members of the two groups to share information.	Complete
Prepare draft Information Memorandum/Request for Proposals (RFP) to be distributed to qualified and interested health care entities with expertise in rural primary care ideally with a knowledge of the service area. RFP to include: Partnership objectives Brief history and overview of LIHD, CWMA. local community group, EMS, and the current clinic. Current and desired medical services and staffing. LIHD demographics and health care trends. Volume/patient metrics and estimated market share. Financial overview and District subsidies. Process and timeline.	September 5 Complete: Lopez Clinic Information Packet
Identification and initial outreach to potential parties. Confidential	September 5 Complete Update October 7, 2025: Jody Carona received responses from six regional healthcare organizations following her initial outreach, all of which expressed interest in learning more about us.
Send confidentiality agreement, and if/when returned, send RFP and provide process for requesting supplemental information. Confidential	September 10 Complete: late October Update October 22, 2025: Outreach to six potential partners is complete, with all agreeing to initial conversations. Four organizations remain interested, and two are in the process of signing confidentiality agreements. Those who proceed will receive an information packet prepared by HFPD outlining the clinic’s history, performance, care model, and current healthcare resources on the island. Update December 3, 2025: Outreach to six potential partners is complete, with all agreeing to initial conversations. Two signed confidentiality agreements and received an information packet prepared by HFPD, one of which has asked for further information and a tour of the clinic. Two others expressed interest in providing support, but not operating the clinic. The Information Packet can be viewed here: Lopez Clinic Information Packet .
Oversight/Partner group to review initial responses and develop requests for supplemental information. Confidential	October 10 Complete: Mid-November
Outreach for supplemental information. Confidential	October 15 Complete: January
Return of supplemental information. Confidential	October 29 Complete: January
Simultaneously, independent group determines feasibility of operating the clinic locally (consider billing, EHR, HR, data and analytics, contracting, financial and cost reporting, etc.). Presents findings to Oversight group.	October 15 Complete: November 19 October 1, 2025: The Independent Group is currently making swift progress in analyzing the costs associated with various types of independent clinics. They are also creating an in-depth compilation of the necessary steps involved in opening and running an independent clinic. October 22, 2025: LIHD’s CPAs continue to support the Independent Group in developing a financial model for a community-owned clinic. The model—now being refined to reflect actual payer mix, staffing costs, and patient volumes—will include three scenarios (“Bare Bones,” “Mid-Point,” and “Gold”) expected in early November. The group is also evaluating reimbursement options (RHC, PBRHC, and FQHC Look-Alike) and learning from similar rural clinics, including outreach to 26 comparable sites and the Orcas Island clinic. Next steps include exploring structure, staffing, and technology requirements for an independent operation. Complete Presented findings to Oversight Group on November 19, 2025: After work with rural health CPAs, the Independent Group created a preliminary financial model for a community-owned clinic with reimbursement options including a Rural Health Clinic and a Federally Qualified Health Clinic Look-Alike. The analysis suggests that it is feasible. Work continues to research and understand the process of the development of an ownership, governance, legal, and operational framework for the model, including certification, accreditation, compliance, and human resources/employment.
Oversight/Partner group meets to review two paths and as desired, select partner finalists.	October 27 Complete: January
On site interviews and reverse trips to finalist facilities. Include community meetings.	Complete prior to November 15. Dec. 2: In Process w/ one potential partner. Jan 12: Conversations continue with this potential partner, with the hope that negotiations will be completed by January 31, 2026. Complete: February 16
Selection of preferred partner/operator or local independent option.	Complete by November 15 Complete: February 18, 2026 Announcement to the community that Sea Mar Community Health Centers is LIHD and CWMA’s preferred partner.
As appropriate begin negotiation and finalization of operator agreement or begin process of planning start-up of local operation.	Complete by January 15, 2026 Complete: February 18, 2026 with LIHD and Sea Mar counsel developing the Definitive Agreement (operator agreement) to be presented to the board and signed in early March.

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