According to The Public Hospital District Commissioner Guide, the Board and individual Commissioners are responsible for overseeing the hospital district’s policies and organization with respect to the operation of the District, including the delivery of quality patient care. In fulfilling its obligation, the Board’s role is to adopt the necessary general policies to achieve these ends and to delegate the day-to-day operational responsibility with respect to these policies to the District Administrator (aka District Superintendent).

Since 1974, Lopez Island has enjoyed the services of Lopez Island Clinic, a primary health care provider. For over 20 years, Lopez Island Clinic partnered with Island Hospital to serve as a remote clinic of the hospital. In September 2016, Island Hospital gave notice they would terminate their contract, explaining that operating a remote clinic in the current healthcare environment had become too challenging.

Island Hospital’s decision to end the operating agreement had significant financial implications. As a department of a critical access hospital, Medicare reimbursed Lopez Island Clinic at a rate close to the cost of services. Without the affiliation with a critical access hospital, that reimbursement rate would decrease by more than half of the current payment level and with an island population that is over 50% Medicare that change has a significant impact.

Immediately after receiving the notice from Island Hospital and understanding the implications, members of the Catherine Washburn Medical Association (CWMA), the non-profit volunteer board that owns the clinic building and much of the equipment, began working with Dr. Robert Wilson, clinic staff, and community members to find a new model of management that would meet the community’s health needs. Through this research, it soon became apparent that whether the clinic found a new partner or went independent, keeping it in operation would require ongoing financial support from the Lopez community.

After exploring many options, the CWMA concluded that a Public Hospital District would be an excellent mechanism to assure financially sound, fiscally responsible, fair, and equitable funding for the community’s primary health care needs. Public Hospital Districts successfully support many other rural, remote clinics around the state, including one on Orcas Island. The CWMA put forward a petition to place the measure on the ballot in a special election; while only 200 signatures were needed, more than 500 people signed, and the measure appeared on the April 25, 2017, ballot. It passed with 86% of voters saying “yes.”

The annual tax for property owners may vary, but is limited to $0.75 per $1,000 assessed property value.

The clear intent of establishing the Public Hospital District (PHD) was to provide funding to keep Lopez Island Clinic open. Necessary funding to also keep physical therapy services on island has also been allocated by LIHD. The District continues to collaborate with community partners to identify additional healthcare needs and is committed to providing solutions to those needs.

Under the clinical services operating agreement (CSA), UW Medicine will provide all clinical services and administrative tasks for the clinic including insurance billing, referrals, personnel management, and installation and training for a new electronic medical record system. UW Medicine will provide the Hospital District commissioners a quarterly report on their performance.

The best place to start is by contacting the Lopez Island Clinic manager, Crystal Rovente, at 360-438-2245 or email,

You may also contact UW Patient Relations: 206.520.4294 or

The Catherine Washburn Medical Association (CWMA) was established in 1971 in memory of Catherine Washburn, a Lopez resident. Its purpose then, and now, is to facilitate the primary medical care needs of the Lopez Island community through support of the Lopez Island Clinic. The CWMA began by raising funds for the original clinic building, completed in 1974, and has continued to provide financial support for facilities, several expansions, and equipment. It will continue to serve as the landlord for the clinic facility. To learn more about CWMA visit their website.

Regular meetings are scheduled for the fourth Wednesday of the month, 4:00 PM. All meetings of the commissioners are open to the public. Check upcoming meeting dates and locations on the website calendar.

The agenda typically includes time at the beginning for public comment. Although this is simply a time for the public to give comments to the commissioners (discussion and decision-making don’t occur at that point), the Commissioners appreciate hearing concerns and questions of the public and will consider them for possible further discussion.

The transition from a Clinical Services Agreement (CSA) with Island Hospital to UW Medicine is a complex process. These are some of the tasks that had to be completed before UW Medicine could begin providing services at Lopez Island Clinic:

  • Credentialing of the clinic practitioners in order for their services to be reimbursed by insurance providers. This process couldn’t begin until there was an agreement between UW Medicine and LIHD; it involved obtaining original source documents (i.e. educational institutions, licenses) for all insurance payers and reviewing providers’ past performance.
  • Privileging all practitioners as UW faculty.
  • Hiring process for all staff.
  • Installation of Information Technology equipment and training for all staff.
  • Transfer of medical records from Island Hospital to UW Medicine.
  • Establishing vendor relationships and contracts for supplies, services, etc.