Clinic Transition Workplan and Timeline

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.

In Process by Jody Carona, consultant, HFPD.

September 5

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.

Identification and initial outreach to potential parties. *Confidential*

September 5

Complete

Send confidentiality agreement, and if/when returned, send RFP and provide process for requesting supplemental information. *Confidential*

September 10

In Process

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.

Oversight/Partner group to review initial responses and develop requests for supplemental information. *Confidential*

October 10

Outreach for supplemental information. *Confidential*

October 15

Return of supplemental information. *Confidential*

October 29

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

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.

Oversight/Partner group meets to review two paths and as desired, select partner finalists.

October 27

On site interviews and reverse trips to finalist facilities. Include community meetings.

Complete prior to November 15.

Selection of preferred partner/operator or local independent option.

November 15

As appropriate begin negotiation and finalization of operator agreement or begin process of planning start-up of local operation.

January 15, 2026