'A decade process' – Group begins talks about improving health care in Kitsap

PORT ORCHARD – The first meeting of a new group of local elected officials, community representatives and health care officials took place Wednesday afternoon to discuss the holes in the fabric of Kitsap’s health care system generated a daunting list of needs, problems and challenges.

The large group, gathered by Kitsap County Commissioner Rob Gelder and now set to meet every few months, opened with discussion ranging across a variety of local and broader health care topics like the need for more staff and services.

Said Dr. Gib Morrow, health officer for the Kitsap Public Health District: “What’s become apparent to me is that there isn’t any one single entity that’s responsible for ensuring that the complete continuum of health care works in any given community and that we’ve really kind of left this up really to market forces in a marketplace that doesn’t play by any of the market rules that most other marketplaces use.”

In December, the health district opened up a request for proposals with the goal of finding a consultant to study Kitsap’s health care landscape, identify problems and recommend fixes. Responses to that process are due on Tuesday.

Mentioned on Wednesday: the lack of obstetrical services, secular health care choices, primary care, urgent care and emergency room options, as well as the need for more care facilities, hospice care and dialysis options. One topic that has garnered some interest in the community is the formation of a public hospital district, a taxing district that can be used to subsidize or operate a range of health care services, and Gelder broached the idea as one topic of conversation.

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An exam room at St. Michael Medical Center's Medical Pavilion for expanded on-campus specialty care, in Silverdale on Wednesday, April 21, 2021.
An exam room at St. Michael Medical Center's Medical Pavilion for expanded on-campus specialty care, in Silverdale on Wednesday, April 21, 2021.

Poulsbo Mayor Becky Erickson described the work ahead as a decade-long process: “In my mind, it’s almost like rebuilding an ecosystem,” she said. “Funding is always important, but there’s so many layers to it. We’re talking about labor shortages, we’re talking about reimbursement rates, we’re talking about regulatory barriers. The list is really huge, and it’s one of the reasons why the survey is so important, it gives us a place to start.”

Bremerton Mayor Greg Wheeler noted the respite center Peninsula Community Health Services is developing on Sixth Street in Bremerton: “I don’t know of another one like that, that’ll help people folks discharge (from the hospital) who don’t have homes to be discharged to,” he said. “It’s a gap and a need.”

Randy Hartman, Kaiser Permanente’s district director of operations for the Kitsap Peninsula, noted the challenges of hiring physicians, pointing to a national shortage.

“Some physicians are just done and tired,” he said. “Really looking at alternative methodologies with advanced practice clinicians and other modes of caring for patients and utilizing teams and coordination, it is just the future. The cost of physicians is going up, they can pick their choice of wherever they want to go, so you’ve gotta try to compete on a price range, and you price yourself out of the market if you do that kind of stuff.”

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Morrow noted the complexity of navigating the world of insurance reimbursement for independent health care providers and “...private equity companies buying up specialty practices and then trying to put the productivity screws on physicians and then docs appreciating that all this money is getting sucked out of the system and they’re getting overworked and burned out and dropping out and retiring at an early age.”

Said Erickson: “I’m really grateful for (St. Michael Medical Center), we have a state-of-the-art hospital that’s landed at our doorstep, that’s a step in the right direction. But it still doesn’t solve our labor shortages. We’ve got huge issues with labor right now and part of the situation with labor shortages is because they don’t have any place to live. We have housing shortages.”

St. Michael Medical Center president Chad Melton pointed to the high cost of living in the community as a barrier to recruiting staff from other parts of the country.

He also noted the need for more openings in educational health care programs: “There are students out there that want to get into the profession, but there is not enough seats in our schools, nor enough programs,” he said, pointing to what he said was an about 100% vacancy rate the facility has for surgical technicians. “There’s only one school within the region and that’s in Tacoma, and they only generate 6-10 candidates a year. There’s not nearly enough programs that are out there today.”

Some at the meeting noted the shrinking of local health care services provided by the Navy.

Said Steve Kutz, director of the Suquamish Tribe’s health clinic: “That’s bringing huge stress to the system and never mind that Tricare (the Department of Defense’s health insurance program) is one of the worst payors out there, so a lot of people don’t want to accept it. That’s a real problem too.”

Morrow noted that Kitsap finds itself in a unique situation, while it contends with the same issues the rest of the country is dealing with: “I think that there are workforce shortage issues, there are in Kitsap unique issues like the Naval presence, which has been a historical importance to Kitsap and is a really important thing, but some of the way things have played out locally as health care has consolidated more and more, the Naval medical presence has withdrawn to a certain extent while the population’s growing, and throw a pandemic into the mix, and it’s all a morass at this point.”

This article originally appeared on Kitsap Sun: Group begins talks about improving health care in Kitsap