Insurance Update

If you are a current Kaiser Permanente MedicareAdvantage member you will want to learn about the new options available to you as of January 1, 2020. Click on the link to read about the new Premera Blue Cross MedicareAdvantage plans. The brochure  contains contact information for the local health insurance agent on Lopez, and there will be various educational sessions taking place in the weeks ahead.

Please watch for upcoming posts with information about the options for individuals under 65 and small businesses.

Long-Term Care Survey

surveyIf you are at least age 70 OR caring for someone age 70 or older, the County wants to hear from you!

Long-term care needs in our County are growing, and the Inter Island Healthcare Foundation (IIHF) is sponsoring a feasibility study to plan for current and future long-term care needs.

Please visit the IIHF website to learn more and find a link to complete the survey. If you would like a paper copy of the survey, please visit the Lopez Island Senior Center. Survey collection is currently underway and will close in the middle of September.

Be a part of helping shape the future of health care in San Juan County.

Message from the Board

finance-clipart-cliparti1_finance-clipart_06The District just completed its second Accountability Audit with the Office of the WA State Auditor. The audit covers the period January 1, 2018, through December 31, 2018, which represents the District’s first full year of operations.  The Commissioners and Superintendent take our fiduciary role very seriously and are proud to share the audit results. Once again, the District received the best possible outcome for an audit.

The audit included reviewing ALL payroll, financial and accounts payable reports to assess how well the District is monitoring and managing cash flow. The results show the District as having strong internal controls over the safeguarding of public funds. The audit also found the District to demonstrate full compliance with applicable state laws, regulations, and our own policies.

You can view the full report by clicking this link.

Clinic Information

As we continue to read and respond to feedback captured from the 2019 Health Care Survey and June 19th Community Conversation, we’ve identified that many Lopezians aren’t aware of the services available at the UW Medicine Lopez Island Clinic.

In addition to the standard Primary Care services, there are new services being added on a regular basis. You can talk directly with the Clinic or visit UW Medicine Lopez Clinic to see the latest information. Please visit the FAQ page for answers to commonly asked questions.

For those who would like to print the Questions and Answers, click here to download the FAQ for printing.

 

Board Update

At their meeting on July 24th, the LIHD Board reviewed the substantial amount of data, input, feedback and suggestions provided in the 2019 Community Survey on Health Care. The Board Meeting Materials contained some highlights from the survey itself.

Over 150 participants completed a paper version of the survey at the June 19th meeting, and almost 60 Lopezians completed the online version. A summary report can be viewed by clicking on this link:  2019 Health Care Survey: Summary report.

In addition to the charts, there are hundreds of comments that are not part of the posted  report. This information will be shared with the other healthcare stakeholders including: UW Medicine Lopez Clinic, Lopez Island Pharmacy, Lopez Island Family Resource Center, Cathy Doherty, Lopez Island Physical Therapy, and CWMA. Together with Lopez Island Fire & EMS, we will be reviewing the feedback with the various stakeholders to determine how it impacts each other’s plans and strategies. The information that comes from those discussions will be shared in future posts.

In response to a few questions asking why the LIHD embarked on the Community Meeting and Health Care survey, it’s helpful to understand a little bit about Public Hospital Districts and the work of the LIHD.

One of the major goals the Lopez Island Hospital District set out to accomplish this year was to gather feedback from the community to help inform the District’s short- and long-term planning. The Commissioners felt it was important to solicit feedback to make sure health care services continue to meet the needs of the population served, especially as the Board approaches the September 2020 contract renewal with UW Medicine. Understanding the types of services the community values will help inform discussions, and will be taken into consideration as both parties determine appropriate services and subsidies for the next three-year contract term.

In addition to the work with UW Medicine, the Board is bound to exercise their powers as spelled out in the Revised Code of WA (RCW) for Public Hospital Districts (PHD). One of those powers, as stated in RCW 70.44.060(1), is to “survey existing hospital and other health facilities to determine the health care needs of the District residents”. Based on results of the survey, the RWC goes on to state that “Commissioners adopt a plan to meet those health care needs”. While these activities are part of the PHD’s powers, the manner in which a PHD is to conduct such activities is not spelled out in much detail in the statutes.

In early 2019, the LIHD Board began to think about the best way to approach the survey process. This included engaging various organizations to gather feedback and suggestions. At the same time, Lopez Island Fire and EMS (LIFE) was approaching the end of their current 10-year plan and beginning their strategic planning process for the next 10 years. The LIHD and LIFE Boards had already begun working together on several key initiatives to address changes in health care that had an impact on the community. Building on that work, the Boards decided to work together to gain community feedback on the overall state of health care services and support on Lopez Island.

Please look for the next edition of HealthMatters 2.0 that will be published in the August 6th issue of the Islands’ Weekly. The Commissioners and Superintendent continue to appreciate the active and ongoing engagement of the community in these important health care conversations.

Board Meeting Notice

Board Meeting colorThe meeting materials for the July 24th Regular meeting of the LIHD Board of Commissioners have been posted. Details on the meeting time and location are listed on the Agenda. There are also links within the Agenda to access materials that will be discussed.

Please visit the Agendas tab of the website to access these items.

Insurance Update

As a follow-up to our last post on changes in the individual and small group health insurance markets, the Commissioners are very excited to share this news that is hot off the press. Following her outreach, the Superintendent received communication this morning from the Senior Network Executive at Premera Blue Cross (parent of LifeWise) expressing the company’s commitment to work together to ensure residents of San Juan County experience minimal disruption with the changes taking place in January 2020.

We now know that the new LifeWise network specific to Individual exchange plans will include ALL San Juan County providers who are currently contracted with Premera. The network will also include the UW Medicine Lopez and Orcas Island Clinics as an in-network provider.

There is more good news!

While the new LifeWise specialty network is slightly more narrow than their traditional Premera network, an exception was made to enable patients receiving care from the UW Medicine Lopez or Orcas Island Clinics to be referred into UW Medicine for specialty or hospital care, and be handled as in-network. This is very positive and will allow for improved continuity and coordination for patients needing higher levels of care.

As far as the rest of the network, Providence/St Joseph, Swedish, PeaceHealth, Seattle Children’s and Skagit Regional Hospital will all be in-network for LifeWise. Those facilities that will not be in the new LifeWise network are some of the larger hospital systems and providers, primarily in King, Snohomish and Pierce Counties. They include: Multicare, Virginia Mason, Overlake Hospital, The Everett Clinic, Evergreen Hospital, UW Medicine (except for patients receiving care from the UW Medicine Lopez or Orcas Island Clinics) and Seattle Cancer Care Alliance.

We are awaiting more details on the Medicare offerings and will share information as it becomes available. As always, please feel free to contact the Superintendent at apresson@lopezislandhd.org with questions or concerns. You can also provide feedback directly on the website by visiting the form on the Community Engagement tab.

 

News from the Board

Thank you word bubble. Message in pop art comic style.The LIHD Board of Commissioners wants to thank the more than 200 Lopezians who took part in the 2019 Health Care Survey. Results are being tabulated and an analysis will be presented at the July 24th Regular Board meeting. A summary report will be posted on the website by the end of July.

In addition to this work, we know insurance concerns are top of mind for Lopezians. The LIHD Superintendent has been staying in close contact with the Office of the WA Insurance Commissioner (OIC), as well as the contracting teams at LifeWise (Premera) and UW Medicine. We are optimistic that through her diligence and advocacy, supported strongly by the three SJC Public Hospital District Boards, the OIC has recognized the unique challenges of our rural, remote community, and has requested more information from LifeWise on both air ambulance services and network access.

In response to concerns raised, LifeWise is revisiting their Access Plan to ensure they will be able to provide access to all medically necessary covered services within time and distance standards required by the OIC. As of this morning, the contracting team at UW Medicine confirmed that LifeWise is now willing to consider the UW Medicine Lopez Island Clinic as in-network. While the contracting process is not completed, this is welcome news.

It’s important to note that all of the information reported is specific to individual and small group plans. We are continuing to seek out details from the appropriate parties to determine what Medicare plans will be available in the coming year. It’s likely there will not be an individual Medicare Advantage option; however, nothing is confirmed to-date.

We recognize this is a stressful time, and Lopezians are anxious about the health care offerings in 2020. We will continue to share information as soon as it becomes available. For now, we hope that the community can rest a little easier knowing that your interests are being very well represented.