Thursday, June 20, 2024

Family Health Center addresses community health needs


FHC Excellence and leadership posture
Family Health Centers’ service area is primarily Okanogan County plus the Bridgeport Community in neighboring North Douglas County. We are committed to our mission of improving the health of our entire community. That is our bottom line. If in five years we have not seen measurable improvements in key health indicators in our county, we will not be meeting our bottom line. We see everyone and accept all payers such as private and public health insurance. We are the most affordable healthcare system in Okanogan County, especially when it comes to cost of medications via the 340B program in our pharmacies. With 220 people staffing FHC’s six medical clinics, five dental clinics, two pharmacies, a county-wide Women, Infant and Children (WIC) program, and embedded behavioral health access, Family Health Centers has the capacity to embrace the ambitious mission to improve the health of our entire community. Beyond this inhouse capacity, we are counting on meaningful contributions by our partners within the healthcare sector and from other sectors such as public schools and community coalitions. Maintaining our prestigious  Joint Commission accreditation for excellence is just one way to know we deliver “great care” to  our patients, but you only need to experience care with one of our providers to know how much we strive for “excellence.”
Whole Person Health and county health statistics
We have much work to do. For instance, Okanogan County has one of the highest suicide rates, teenage pregnancy rates, and dire diabetes and hypertension indicators compared to other counties in the state. In gearing up for these public health challenges, FHC is in its second year of introducing Whole Person Care approaches in every aspect of our services. What does this mean to our patients? It depends on the patient’s needs, but in general we seek to engage our patients meaningfully in their health with wrap around services customized to achieve the health goals of each patient.
This may mean primary care augmented with dental care, behavioral health, medications, naturopathic care and a host of facilitated connections to our partners like community based organizations that can help address other social determinants of health such as housing, job opportunities and local social services. It also means FHC collaborates closely with our hospitals and other healthcare systems to ensure smooth transitions from acute care to ongoing primary care with the patients’ primary care provider. The Wellness Wheel below helps visualize the concept of Whole Person Health and the second diagram highlights what impacts health in a community according to the US Institute of Medicine. With access to excellent healthcare services and patients’ commitment to behavior change guided by health professionals, we can affect 50% of what impacts the health of our patients.

Collaboration and Partnerships
As we consider how to improve the serious health statistics in our county, we must focus on upstream prevention initiatives while taking care of the downstream acute health problems our population is already facing. FHC is already partnering with at least ten school districts and three community coalitions to work on innovative prevention and whole person health efforts that head off future chronic health problems in our  younger generations. At the same time, we have also increased our clinical capacity to help our older generations already facing chronic health conditions that require a whole person care approach supported with a wide range of collaboration with institutional partners that can help support and stabilize conditions and people’s lives. It’s worth noting that FHC can’t do it alone, and we need to make health everyone’s business . We are grateful for the collaboration we enjoy with Worksource, our court systems, community coalitions, faith community, housing entities, transportation systems, public health, the business sector and of course our public schools.
OB care status and realities
Recruiting clinicians is a challenge for all health systems. We are proud of FHC’s success in the last two years in adding three MDs, two Naturopathic Doctors, two Nurse Midwives, four Advanced Registered Nurse Practitioners, five Dentists, a doctorate level Psychologist and two new Pharmacists. In addition, we create entry level job opportunities for local graduates in a host of support roles from dental assistants, medical assistants, billers and other business and customer focused roles. FHC is well staffed to ensure access to excellent outpatient whole person care. We have been able to recruit excellent providers to insure access to maternity care in our six medical clinics across our service area, but the challenge we still face along with our hospital partners is access to OB services in all three of our hospitals. This has become unattainable for three main reasons:
1) Decreasing OB patient census at each hospital means providers and staff struggle to maintain a high level of practice to retain their professional credentials; 2) Low census can also affect patient safety and quality without investments to compensate; and 3) At least three (ideally four) Physicians certified to perform C-sections are needed at each hospital to ensure adequate hospital call coverage. Without these Physicians’ labor and delivery care may not be possible in the future. Realistically, these three obstacles are not going to get any easier in the foreseeable future.
In response to these insurmountable obstacles, we must act with some urgency to save OB from disappearing from our county all together. If we don’t, we risk losing more providers and not creating a strong inpatient-outpatient health system that is attractive to future providers for OB and other needed services. FHC’s response is to immediately implement a plan to move our OB hospital services to one hospital and work with that hospital’s leadership to create an OB Center of Excellence to better serve Okanogan County. Working closely with our partner health systems it is possible to generate the innovative efforts needed to ensure their survival by improving collaboration and specialization in needed services. These collaborative services will address the county’s health needs at an affordable, sustainable level of excellence that is adaptable to current and future needs. These improvements in service delivery will attract local and regional residents and be an anchor for future families and community growth. The key is excellence! We have to consider, how much money will stay in the county when more local residents have confidence in what is offered locally.
Future opportunities
It’s time to lock arms among local healthcare systems and create sustainable business models that ensure our institutions not only survive but are able to thrive.
FHC is already contributing greatly to the sustainability of our hospitals and we want to do more. FHC providers have carried the entire burden for OB coverage in Brewster and shared that burden with other health systems in Omak and Tonasket for the last five years. With one of our hospitals specializing as the OB Center of Excellence, the other two hospitals can share opportunities to provide other needed services such as: surgical services, ancillary care services (such as lab, CT, MRI, X-ray & others); orthopedic services, palliative care; physical and stroke rehabilitative services; 24-7 inpatient medical surgical care; physical therapy; and towards the opioid epidemic there is a business case for a local residential substance use disorder center that, with a dedication to excellence, could care for patients from across the western states. Collaboration is no longer just’s a necessity. The current leadership from the board down at the three hospitals are showing us this is possible. With the recent announcement of two OB providers leaving Tonasket, it is critical that we act now on a sustainable long-term solution.



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