VIMO History—The Long Story
The following history was written by Jody Moss, Healthy Communities Coordinator, United Way of Clallam County.
United Way Responds
In 1999, Group Health had made a decision to leave the area, and US Representative Norm Dicks asked the United Way of Clallam County to arrange a meeting of stakeholders to talk about health care problems and gaps. Afterwards, the participants asked to keep meeting to talk about health care issues and out of this, the Access to Health Care Coalition (AHCC) was born. This was really the first time all the different groups had started to have regular dialogues about the different struggles they were each facing and how they were working to address problems. The group asked United Way to continue as a neutral facilitator. The coalition identified several avenues for increasing access to health care including establishing a federally qualified health center, tribal and non-tribal partnerships, and rural health clinic status for existing practices and free clinics. Exploring these options helped to develop important relationships with several members of the Washington Health Foundation. The committee began exploring the possibility of a establishing a community clinic, and talked with the Barbara Malich at the Bremerton Peninsula Community Health Services about establishing a satellite clinic here. From this, the committee learned that Clallam County would need to be designated a Health Provider Shortage Area. With the help of the state department of health and OMC the committee participated in a year long survey and application and unfortunately learned that Clallam did not qualify for a HPSA designation1. Instead, the AHCC helped the Peninsula Children’s Clinic and Port Angeles Family Medicine become designated as Rural Health Clinics to help stabilize their practices with the goal of expanding capacity. The Olympic Medical Center and Jamestown Family Health Clinic formed a partnership, again to obtain higher reimbursement and expand capacity.
Unfortunately all these efforts did not address health access for the uninsured. After much discussion, a subcommittee was created to begin work on developing a free clinic. Following in-depth research into different free clinic models, the Volunteers in Medicine2 model was selected and, in January, 2003 the Volunteers in Medicine (VIM) Committee was given its name and Dr. Sam Baker, a semi retired Orthopedic physician assumed chairmanship of the committee.
The PAARC Clinic
At the same time, in August 2001, Dr. Ed and Phyllis Hopfner, who were participating in AHCC meetings, opened the PAARC3 Clinic, in the basement of St. Andrews Episcopal Church to serve those in our community with no access to primary care medical services. Within one and a half years, it became apparent that the need was much greater than PAARC Clinic volunteers (essentially, 2 providers and a nurse and various reception volunteers) or the clinic space could hope to serve. Within two years the need became critical and Dr. Hopfner came to the United Way asking for immediate help. He joined the Volunteers in Medicine Committee and began working to expand the PAARC Clinic into the VIM project.
Planning with Volunteers in Medicine
The committee met on a monthly basis, moving forward with plans. In late 2002, the VIM Committee signed a contract with the Volunteers in Medicine Institute to obtain assessment help and development assistance (at no cost) towards developing a VIM Clinic. A VIMI consultant (Amy Hamlin) visited in March 2003 and began helping the committee go through the steps to establish a VIM Clinic. The committee along with AHCC met with Representatives Lynn Kessler and Jim Buck to discuss barriers to development of a volunteer clinic; at their recommendations a Legislative Committee formed and crafted immunity legislation which resulted in the March 2004 passage of ESHB2787 and SHB 2788, Good Samaritan legislation and increased funding of volunteer provider insurance pool. The Committee also met with State Secretary of Health, Mary Selecky, Dr. Maxine Hayes and Marie Flake, regarding licensing and malpractice issues.
In January 2004, United Way of Washington provided a grant for a consultant to develop a business plan. The consultant also began working as a paid Project Coordinator to galvanize and manage development efforts. This contract was continued with funding from 2003-2004 designated Access to Health Care funds. Market analysis was done demonstrating the need. An employer health insurance survey was developed, administered and data compiled on medically underserved in Clallam County which sowed that 47% of businesses surveyed do not offer any sort of insurance to their employees - 20% of those surveyed have considered dropping insurance due to cost. The number of uninsured is conservatively estimated at 5500 adults in Clallam County between the ages of 19 and 65. Nationally, 8 out of 10 people who are uninsured are employed – based on PAARC Clinic patient survey data, 45% of patients seen in the free clinic are employed. A PAARC Clinic Survey was developed to provide baseline data about the patient population.
Finding a Home
Around the same time, Tim Hockett, Deputy Director of Olympic Community Action Programs (OlyCAP) spoke with the committee regarding partnering at a space recently vacated in Armory Square Mall. Olympic Medical Center committed to helping with a large portion of remodeling costs. Over a period of months it became apparent that the remodeling costs would be prohibitively expensive, especially when considering the community’s willingness to donate to dual campaigns: a capital fund raising campaign along with fund raising for operations. By the fall, the VIM Committee determined that the Armory Square Mall space would not work for the clinic4.
VIMO is Conceived
The process of looking at the space and working on architectural plans helped the VIM Committee to identify space needs. It also focused attention on the need to formally create a board that was legally able to make decisions, sign leases, etc. In September 2004, the PAARC Clinic 501(c)(3) was amended to become the Volunteers in Medicine of the Olympics and a new board was formed comprised of VIM Committee members, PAARC Clinic Board members and other community volunteers. Also in September 2004, the Olympic Medical Center “offered” the VIMO Board access to a house to “lease” for $1.00 per year. The house is located at 909 Georgiana Street, Port Angeles WA 98362, and is approximately 1500 square feet with 1 waiting room, 3 exam rooms, a work room, one handicap ready bathroom and two office/supply rooms on the second floor. A local Sequim contractor volunteered his time and worked closely with the Olympic Medical Center Facilities Department to completely remodel of the first floor of the house. The interior was painted by Virginia Mason employees as a United Way Day of Caring project and VIMO Board members.
Sallie Neillie of the Washington Health Foundation visited in October 2004 to facilitate a planning retreat, a series of work groups were formed and began working on very specific tasks including Policy and Procedures, Medical Provider Recruitment, Volunteer Management, Facilities and Equipment, Legal & Regulatory, Public Relations & Marketing, Recruitment of Board Members and Officers, and Fund Development. These groups worked diligently throughout the fall, winter and spring of 2004-2005. In March 2005 two volunteer clinic managers were recruited and began working with the VIMO Board.
Between January and July, with the help of Scott Kennedy, MD, a VIMO Board member and the Chief Medical Officer at Olympic Medical Center and Christine Lindquist, the Program Coordinator, Volunteer/Retired Provider Program of Western Washington Area Health Education Center, worked to recruit providers and get them signed up with the volunteer malpractice insurance.
In December 2004 the Fund Raising committee applied for a Washington State Department of Health and the Higher Education Coordinating Board – Health Systems Resources Program grant and in May 2005, the VIMO Board was notified they had been awarded this two year $57,500 grant to fund a Clinic Manager, an Administrative Assistant and purchase of clinic management software. In March 2005 the VIMO Board applied for and in June was awarded United Way Partner Agency status. In May, the Fund Raising Committee applied for a Rotary District matching grant which was awarded along with a Rotary Club commitment to paint the exterior of the building. The exterior of the house was painted by the Rotary Club of Port Angeles and by another PAARC Clinic patient who worked industriously to make certain the front of the building was painted prior to the Governor’s visit (see below).
VIMO Opens its Doors
On July 7th the VIMO Clinic officially opened its doors and was able to celebrate with a ribbon cutting ceremony on July 8th at which Governor Christine Gregoire officiated. Approximately 100 community members attended this celebration. Because the ribbon cutting ceremony was planned at the very last minute the VIMO Board chose to host a Community Open House on September 16, 2005. Also on that date, the project was officially launched and no longer a Healthy Communities Initiative. At the September 2005 United Way Board Meeting, the Board voted to distribute the 2004-5 designated Access to Health Care funds to the VIMO Clinic.
In the first quarter of operations, the VIMO Clinic has seen 510 patients in the clinic and has handled approximately 150 patient calls for other assistance. There are over 20 medical providers and another 20 nurses and receptions volunteering so far and growing.
2 The Volunteers in Medicine Clinics are a successful, free clinic model, promoting a “Culture of Caring” while emphasizing the use of retired health care professionals and lay volunteers. In Port Angeles, both retired and active providers are volunteers. VIM Clinics’ “Culture of Caring” recognizes the strengths of those in need and respects their dignity. The manner in which people are treated during a visit to a VIM clinic is as important as the medical care they receive. The sustainability of the Volunteers in Medicine clinic model is based on building a foundation of broad community support, and Volunteers in Medicine Institute consultation. Since the early 1990’s, the Institute has helped open 40 clinics; not one has failed. [Go back to text]
4 Note: In the Access to Health Care meeting immediately after this decision, OlyCAP learned of a new partnership opportunity which eventually was developed into the Dental Clinic / Dental Hygienist training program with Pierce College and Peninsula College opened in September 2005. [Go back to text]