Sequim community members rally at city against addiction-treatment facility | Peninsula Daily News

It’s sad to see such opposition to a possible plan to bring a much needed treatment center for our addicted neighbors on the Olympic Peninsula. The MAT project was not well clarified in this article, which tended to simply focus on public reaction to the project at this meeting. The MAT project itself has been part of an overarching set of money that the Governor and legislature, along with the Congress at the end of the Obama administration, is distributing over a five year period to address opioid addiction. The project includes monies for a three county area, Kitsap, Jefferson and Clallam. This money, designed to put a central treatment facility on the Peninsula, is being looked at for Sequim because it is central to both sides of the Peninsula. It makes sense to put it in Sequim, and the Jamestown S’Klallam have offered up their expertise and land to make this possible.

It has nothing to do with the Trump Administration changing the hospital rules that will possibly force the Olympic Medical Center to close it’s facilities in Sequim. Representative Kilmer is working with other House and Senate members to see if they can reverse the ill advised rule from the Trump Administration, that has put our community clinics in Sequim in jeopardy. And while we all say we want to see treatment for the growing opioid and meth addicts that are in our communities, what are you willing to actually support rather than just say no to?

Read the whole story at the PDN:

Staff: Proposal not yet before council, planning commission
— Read on

Residents, officials to state: Don’t close community’s hospital – Kitsap Sun

The controversial move by CHI Franciscan to close Bremerton’s hospital and move to Silverdale continues to draw angry citizens out worrying about the poor’s ability to have hospital and emergency room service locally.

BREMERTON — Residents of Bremerton and nearby communities made their voices heard loud and clear: do not close the community’s hospital.

Approximately 200 people, some of whom had to wait outside due to overcrowding, were on hand in the Bremerton School District Office board room on Sept. 8 to voice their opposition to the closure of Harrison Medical Center in Bremerton as part of a proposal to move medical care to an expanded Silverdale campus. The hearing was conducted by the state Department of Health as part of its reconsideration process.

Read the rest of the story here:

Health care mergers often driven by patient access – Kitsap Sun

Good short article detailing the problems facing independent medical practitioners today. This is the state of medicine we are in. Jennifer Hanscom is the CEO and executive director of the Washington State Medical Association.

When I began my career at the Washington State Medical Association in 1996, 38 percent of physicians were in solo practice; today that number has plummeted to less than four percent. For comparison, during that same period only 18 percent of physicians were in practices of 100 or more physicians and a good percent of those practices were large independent clinics. Today, over 61 percent of physicians practice in groups of more than 100 physicians, with most employed by integrated systems.

Kitsap County: Hearing to discuss Harrison Hospital Expansion and religious doctrine issues

As more of our hospitals, and especially our rural hospitals, have been taken over by Catholic and other religious orders that seek to ban women’s access to reproductive health care, along with end of life decisions for all of us, many of us are very  concerned about maintaining long standing legal choices.  Harrison Hospital is the only hospital between Port Townsend and Seattle, and many of our local patients get transferred there, or seek care on their own, due to the perception of a larger hospital being more capable.

We are at a crossroads as Harrison is moved, quietly and behind the scenes, into the Catholic sphere of influence, having been bought by them. Because of their state license, they are not allowed to openly ban healthcare based on religious beliefs. But citizens have the right to demand that the hospital follow the laws explicitly. Here is your opportunity to demand that. Please make it a priority if you have concerns.


Barry Peters
Resident: Bainbridge Island, Washington (and former City Council member, 2008-11)
(206) 317-6150

February 21st Hearing: We Seek To Improve Access to Lawful Healthcare Options in Kitsap

At the 11am February 21st hearing at Poulsbo City Hall, a member of the public may make a 3-minute comment.

Some forms of healthcare are lawful and valued by many, but may be becoming less accessible here in Kitsap County and elsewhere in the multi-county area served by Franciscan Harrison.

A February 21st public hearing by Washington State Department of Health will give local residents a chance to address patients’ rights and the need for access to care – including types of care which may be contrary to the “Religious Directives” of the church-associated healthcare system that owns and operates our only hospital in Kitsap.

One local resident is encouraging other concerned area residents to attend the hearing and express their preferences about the need for access to hard-to-find healthcare options.

Residents of Kitsap (and extended service area) who care about the importance of access to certain lawful health care services and options – including women’s reproductive rights care and end-of-life options – have an opportunity to voice their concerns at the Washington Department of Health’s hearing at Poulsbo City Hall on February 21st, starting at 11am.

One of the issues for the hearing to address is whether a large proposed project by CHI Franciscan Harrison will lessen access to certain forms of healthcare – including by women, the elderly, the handicapped, or others.  The project has an estimated cost of nearly $500 million dollars – nearly half a billion dollars. CHI Franciscan Harrison in Kitsap is now a part of a national religious hospital chain that includes seven hospitals in this region.

The hearing is the result of an approved request by at least one local Kitsap resident for a Department of Health hearing. The request was based on the resident’s desire for the public to ask the State whether the Religious Directives of CHI Franciscan and the Catholic church – when combined with the major expansion of the proposed project – will impose an obstacle to access by our community members to a full range of lawful healthcare services relating to women’s reproductive rights and end-of-life options.

The hearing gives the local public a chance to ask whether Religious Directives which are currently being attached to contracts with Kitsap area providers are increasingly becoming a barrier for patients to access lawful and needed forms of health care and end-of-life options. This question becomes crucial to access to care now that CHI Franciscan (according to its website) controls healthcare practices of nearly 200 physicians and other providers in Kitsap.

The hearing arises in connection with an application for State Health Department approval of a Certificate of Need to relocate CHI Franciscan’s Bremerton hospital beds to Silverdale. That is already the only hospital in Kitsap County. The Kitsap community’s hospital campuses in Bremerton and Silverdale were previously owned by Harrison Medical Center. Harrison was a secular community hospital with no religious affiliation until 2013 when the takeover of ownership by the CHI Franciscan system was finalized.

According to its website and the State Department of Health, Harrison maintains a published policy regarding patients seeking options under the Death with Dignity Act. That policy document states that it is subject to review in December 2016, which has passed. At the hearing, there would be an opportunity for the public to ask the Department of Health to have the applicant submit its proposed policy stating to what it extent it will accommodate patient requests for Death with Dignity Act options.

Also, for example, in the area of women’s reproductive healthcare, Harrison Hospital currently publishes a policy that appears to defer to a doctor’s individual professional judgment where it says: “In circumstances wherein a woman’s life is in danger, providers at Harrison are expected to follow best practices of surgical and non-surgical treatment options even if it results in termination of the pregnancy.”

In connection with the large proposed project, the hearing will present an opportunity to ask whether CHI Franciscan will retain those Harrison policies – or change them to conform to its more sweeping Religious Directives that exclude certain lawful healthcare options.

Members of the public may ask at the hearing what the new CHI Franciscan project, and its increasing use of Religious Directives, will mean for access of patients to lawful types of healthcare and end-of-life options.

One resident who plans to ask questions like that at the hearing is Barry Peters, a 70-year-old resident of Bainbridge Island. He is a member of a local Unitarian Universalist church where many fellow members sought to legalize “death with dignity” options for Washington. He was an active participant in the 2008 public campaign in which a majority of Washingtonian’s voters approved a ballot measure resulting in Washington’s Death with Dignity Act. That Act legalizes medical aid in dying, subject to certain legal limitations for a willing person who wants that option and who physicians find to be close to the end of life. A similar act has long existed in Oregon and another was recently approved by voters in Colorado.

Courts, legislatures, and even our new president, are increasingly standing at the crossroads of religious beliefs colliding with patients’ rights. For example, a Federal appellate court ruled in 2015 that a pharmacist in Washington State with a religious objection to dispensing a medication could decline to dispense it himself, but his pharmacy had a duty to fill a lawful prescription. By analogy, the February 21st hearing might be an opportunity to recognize and accommodate religious beliefs of individual physicians, but ask that an entire corporate health system and its community-wide network of medical practices not be allowed to use Religious Directives to regionally block a patient’s access to lawful treatment options.

At the February 21st hearing, as Barry Peters commented: “We in the Kitsap community may want to ask the Department of Health an important question. Should a health system with the only hospital in the county – one that imposes its religion’s prohibitions on the community’s physicians and other healthcare providers — be allowed to unconditionally grow to the point of effectively monopolizing limitations on access to care. At what point does such unconditional growth improperly limit a patient’s access to lawful care and personal health options?”

He added: “This religiously-affiliated hospital will continue to be financially supported by the taxpayers’ public dollars, from public programs like Medicare, Medicaid, CHIPS for children, Veterans medical programs, and so on. Patients supported by public dollars deserve better access in Kitsap County to lawful treatment options.”

At the 11am February 21st hearing at Poulsbo City Hall, a member of the public may make a 3-minute comment.

Written comments are encouraged by the Dept of Health. The deadline for written comments to be received by the Dept of Health is 5pm February 21st.

Faxed comments will not be accepted.  

Mailing address is:

Department of Health
Certificate of Need Program
Mail Stop 47852
Olympia, WA 98504-7852

Email address for the Department of Health Analyst managing this Certificate of Need process is Karen Nidermayer:

Update on the Governor’s new State-Federal Partnership

The announcement last week from the Governor.

OLYMPIA –Gov. Jay Inslee and the Washington State Health Care Authority (HCA) announced today a new state-federal partnership that will bolster state efforts to improve the physical and mental health of Washington families and transform the state’s Apple Health (Medicaid) program to control costs.

After months of detailed negotiations, the HCA—in partnership with the Department of Social and Health Services (DSHS)—and the federal Centers for Medicare & Medicaid Services (CMS) reached an agreement in-principle, on a five-year Medicaid demonstration waiver to continue implementing the governor’s Healthier Washington plan.

To get more input on this, I talked to Dr. Elya Moore, who is the Executive Director of the Olympic Community of Health, which is the Accountable Community of Health (ACH) that will help implement this new project on the Olympic Peninsula, and in Kitsap County.  There are eight similar ACH’s in various districts around the State.

Dr. Moore described the new program as a very positive step towards focusing on prevention and proactive management for conditions like diabetes and mental illness, along with addressing opiate dependency. To help illustrate the scope of this federal grant, the figure is 1/2 of the NFL budget, so it’s a large number. The breakdown of need  for our three counties are illustrative: In 2015 24% of people in our three counties were on Medicaid (27% is the statewide average); 30% of the health care recipients have been  prescribed opiates. Opiate use also often can lead to opiate abuse. The problem is very large in our counties. This grant will be used to address those and other issues.

The program, as described by the Governor, will also fund supported employment and housing services and long term care services along with supports for unpaid family caregivers so they are able to keep caring for their loved ones. The hoped for result will be less use of high-cost services  and better health outcomes.

The ACH in our district is comprised of a 22-member Governing Board including  15 sectors and seven tribes. There is also an Executive Committee and Regional Health Assessment and Planning Committee to review health assessments and advise board on regional priorities.

Dr. Moore said she hopes that  the money will be spent on programs to do the following:

  • Address chronic disease management and prevention.
  • Help with access of dental, behavioral  health,chronic disease, aging in place, integration of care and early childhood health.

The money from the Federal government will flow through two different paths. Approx $65 million will go towards the Healthier Washington program, and then into programs that the ACHs help coordinate that are the focus of that program. An additional new $1.25 Billion will flow through State programs  and also into State ACHs, for the programs that will help in healthcare transformation. Another $375M will be used on programs for in place housing programs for care maintenance and services that delay or divert the need for intensive interventions such as support for people who need long-term services. . (That money will not flow through the ACH’s but a different state program).

Once the funding has arrived, which is supposed to be very soon, the ACH for the Olympic Peninsula will then kick off projects to use that money effectively and on priorities. Opioid prevention and response is a major priority project to kick off. It is to be determined how much money will be used on this project, as the project has not yet been scoped. Other projects that address the other issues will follow soon.

We will continue to track this program in the future.