History of Health Care Conference PPT

History of the Beaver Island History of the Beaver Island Rural Health CenterRural Health Center

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Donna KubicDonna Kubic

Managing DirectorManaging Director

ChallengesChallenges

Beaver Island’s extreme geographic Beaver Island’s extreme geographic isolation and transportation challenges isolation and transportation challenges result in service limitations and result in service limitations and obstacles to connections with larger obstacles to connections with larger medical care resources such as hospital, medical care resources such as hospital, surgical centers and radiology facilities.surgical centers and radiology facilities.

We have extreme fluctuations in utilization We have extreme fluctuations in utilization that vary from moderate in late fall and that vary from moderate in late fall and winter to overcrowded in summer.winter to overcrowded in summer.

Beaver Island Beaver Island

GeographyGeography

Population Year Round Population Year Round 600600

6 Miles x 13 miles6 Miles x 13 milesLargest, most remote Largest, most remote

inhabited island in the inhabited island in the Great LakesGreat Lakes

32 miles from the 32 miles from the nearest point of nearest point of access on the access on the Michigan mainland.Michigan mainland.

Before the Mormon Era (1847-Before the Mormon Era (1847-1856) there is no record of 1856) there is no record of medical help available on medical help available on Beaver Island.Beaver Island.

Feodor Protar (1893-1925) a Feodor Protar (1893-1925) a refugee from Russia, had no refugee from Russia, had no medical training but his best medical training but his best friend, Dr. Berhardi, practiced friend, Dr. Berhardi, practiced medicine in Chicago, and he medicine in Chicago, and he was willing to look up was willing to look up remedies and order cures remedies and order cures through the mail.through the mail.

History of Health Care on Beaver Island

• After Protar’s death, After Protar’s death, people had to be taken people had to be taken to the mainland in a to the mainland in a fish boat or a doctor fish boat or a doctor had to be flown in.had to be flown in.

1923 Dr. Palmer set up shop1923 Dr. Palmer set up shop

• In 1923 Beaver Island were lucky In 1923 Beaver Island were lucky enough to be discovered by enough to be discovered by Canadian Dr. Palmer, who set up Canadian Dr. Palmer, who set up shop. When Dr Palmer left once shop. When Dr Palmer left once again the island had no doctor. The again the island had no doctor. The state was willing to help if we could state was willing to help if we could meet their requirements, but they meet their requirements, but they were completely beyond us. were completely beyond us.

Requirements for the DoctorRequirements for the DoctorIn 1952 a doctor was found in Bay City In 1952 a doctor was found in Bay City

who was willing to come, if he couldwho was willing to come, if he could

1) 1) find a home, find a home,

2) 2) if there would be some kind of if there would be some kind of state state subsidysubsidy

3) 3) if the Island would provide some if the Island would provide some kind kind of modest hospitalof modest hospital..

What to do?What to do?

• Call a meeting??Call a meeting??

Community pulls Community pulls togethertogether

January 16, 1953 January 16, 1953 a general a general meeting was meeting was called for all called for all Island residents. Island residents. 100 people 100 people showed up at showed up at the Parish Hall.the Parish Hall.

Getting the job doneGetting the job done

May 9May 9thth with with volunteer volunteer

labor, it was labor, it was thought the thought the

building would building would cost around cost around

$12,000.$12,000.

Proposed constitution and Proposed constitution and bylaws approvedbylaws approvedFather JoeFather Joe Art Johnston, PresidentArt Johnston, President

Jewell GillespieJewell Gillespie Mrs. George RicksgersMrs. George Ricksgers

Roger CarlisleRoger Carlisle Lloyd McDonoughLloyd McDonough

Frank NackermanFrank Nackerman Mrs. John GallagherMrs. John Gallagher

Mrs. Frank O'DonnellMrs. Frank O'Donnell

Were elected to the board of theWere elected to the board of the

Beaver Island Civic ClubBeaver Island Civic Club

19531953Beginning of the Medical Beginning of the Medical

CenterCenter

Open for BusinessOpen for Business

In the first year, eight maternity cases In the first year, eight maternity cases were handled, and people spent were handled, and people spent seven nights in bed there for various seven nights in bed there for various ailments. 36 x rays taken that first ailments. 36 x rays taken that first year, a number of strains were year, a number of strains were diagnosed as fractures and given diagnosed as fractures and given proper treatment.proper treatment.

In 1955 a surgical table from In 1955 a surgical table from Butterworth Hospital in Grand Rapids Butterworth Hospital in Grand Rapids was procured.was procured.

In 1956 island births were increasing In 1956 island births were increasing despite a decreasing population of despite a decreasing population of 210.210.

Serious Problem on the Serious Problem on the HorizonHorizonDr. Vail gave notice on May 1, 1956.Dr. Vail gave notice on May 1, 1956.

Distraught the Medical Center Distraught the Medical Center Committee asked the State Health Committee asked the State Health Commissioner for help.Commissioner for help.

Doctor for HireDoctor for Hire

With the help of Health Commissioner With the help of Health Commissioner Albert Heustis, Dr. Luton became the Albert Heustis, Dr. Luton became the doctor in 1956. doctor in 1956.

He was 77 when he took up his duties.He was 77 when he took up his duties.

Dr. Howard Haynes 1962-1967 Dr. Howard Haynes 1962-1967 provided servicesprovided services

Dr. Joseph Christie 1968-1979 providedDr. Joseph Christie 1968-1979 provided

servicesservices

Doctors continued to serve Island Residents

Board appointed to oversee Board appointed to oversee Medical CenterMedical Center

Bylaws were adopted and Bud Bylaws were adopted and Bud McDonough served as the first McDonough served as the first PresidentPresident

GoalsGoals

1975 a Medical Center Board was 1975 a Medical Center Board was appointed to oversee the Medical appointed to oversee the Medical Center,Center,

and bylaws were adopted.and bylaws were adopted.

Their goal was to have a contract with Their goal was to have a contract with the doctor (being paid $7,500 a year).the doctor (being paid $7,500 a year).

ExpansionExpansion

1976 an addition was designed and 1976 an addition was designed and put out on bids.put out on bids.

Dr. Christie followed (1968-1979), Dr. Christie followed (1968-1979), then Dr. Siudara who retired in 1985, then Dr. Siudara who retired in 1985, giving way to the post being manned giving way to the post being manned by Mike McGinnity, RN.by Mike McGinnity, RN.

Rural Health DesignationRural Health Designation

Rural Health Status designation was Rural Health Status designation was approved in 1976.approved in 1976.

Dr. Philip Lange was instrumental in Dr. Philip Lange was instrumental in accomplishing this.accomplishing this.

The Funding of the Health The Funding of the Health CenterCenter Since 1985 Medical and Health care needs have been Since 1985 Medical and Health care needs have been

met by Mid Level Practitioners overseen by a physician met by Mid Level Practitioners overseen by a physician practicing in Charlevoix.practicing in Charlevoix.

From it’s beginning in approximately 1927 until 1985, From it’s beginning in approximately 1927 until 1985, state of Michigan support of health care on Beaver state of Michigan support of health care on Beaver Island was done by paying the salary and benefits of a Island was done by paying the salary and benefits of a resident physician. When the last physician retired in resident physician. When the last physician retired in 1985, application was made for state support of a 1985, application was made for state support of a Physician Assistant.Physician Assistant.

This was approved but was “trickled” This was approved but was “trickled” down through the 3down through the 3rdrd District Health District Health Department, until that ceased in 1991. Department, until that ceased in 1991.

In an effort to become self-sufficient in In an effort to become self-sufficient in the face of the loss of state funding, the face of the loss of state funding, Island voters passed a two mil property Island voters passed a two mil property tax. Since those revenues would be tax. Since those revenues would be delayed for some months, interim state delayed for some months, interim state assistance was asked for and received assistance was asked for and received to fill the gap until the new tax to fill the gap until the new tax revenues could be collected and revenues could be collected and dispersed.dispersed.

Between 1991 and 1996Between 1991 and 1996

1) local tax dollars, 1) local tax dollars,

2) patient fees2) patient fees

3) and contributions 3) and contributions

barely kept the Center’s door open.barely kept the Center’s door open.

Following a successful appeal for state Following a successful appeal for state assistance in 1996 and from that date assistance in 1996 and from that date through 2002 the state of Michigan again through 2002 the state of Michigan again helped by sending $75,000 annually to helped by sending $75,000 annually to help cover operating expenses. help cover operating expenses.

However, in the decade of the 90’s the However, in the decade of the 90’s the island’s population grew 40% and the island’s population grew 40% and the patient visits to the BIRHC grew 434% patient visits to the BIRHC grew 434% which created the need to add a second which created the need to add a second care giver thus increasing operating costs.care giver thus increasing operating costs.

The new Rural Health The new Rural Health CenterCenterIn 1998 the Medical Center Board began to In 1998 the Medical Center Board began to

seriously explore the possibility of seriously explore the possibility of upgrading it’s facility. Everyone had a upgrading it’s facility. Everyone had a chance to give their opinion during a two chance to give their opinion during a two year period.year period.

Jeff Traudt offered to donate property on the Jeff Traudt offered to donate property on the NE corner of King’s Highway and Carlyle NE corner of King’s Highway and Carlyle Road –no strings attached.Road –no strings attached.

How do we pay for it?How do we pay for it?Bill made it through State Congress for Bill made it through State Congress for

two million dollars.two million dollars.

Governor Engler vetoed it.Governor Engler vetoed it.

The same energetic team went back to The same energetic team went back to work and their diligence paid off a 1.5 work and their diligence paid off a 1.5 million dollar grant was awarded. million dollar grant was awarded.

March 2003 ground was broken with a March 2003 ground was broken with a completion date of date of December completion date of date of December 2003.2003.

The Current StatusThe Current Status

A new plateau of competent service A new plateau of competent service has evolved due to the diligent work has evolved due to the diligent work of the Beaver Island Board of of the Beaver Island Board of Directors.Directors.

New FacilityNew Facility

One Major Problem One Major Problem RemainsRemains

How to we pay for the operation of our How to we pay for the operation of our new Rural Health Center?new Rural Health Center?

The government has let us know in no The government has let us know in no uncertain terms that we have to look uncertain terms that we have to look elsewhere for help.elsewhere for help.

How to we pay for it’s How to we pay for it’s Operation?Operation?

Objective: Objective: Secure funding Secure funding

so there isn’t a so there isn’t a worry about worry about whether or not whether or not the doors will the doors will stay open.stay open.

In the last decade the population of In the last decade the population of Beaver Island has increased nearly Beaver Island has increased nearly 40%, and the patients served by the 40%, and the patients served by the Rural Health Center have risen from Rural Health Center have risen from less than 600 in 1990 to over 2600 in less than 600 in 1990 to over 2600 in 2002 and 2745 in 2005 and 3050 in 2002 and 2745 in 2005 and 3050 in 20092009

Local tax collections plus patient fees Local tax collections plus patient fees are just able to cover personnel costs are just able to cover personnel costs and the annual stipend for a and the annual stipend for a physician’s visit every two weeks.physician’s visit every two weeks.

• Despite the best efforts of the Health Despite the best efforts of the Health Center Board, its staff, its patients, Center Board, its staff, its patients, and taxpayers to be financially self-and taxpayers to be financially self-sufficient, it can’t be done without sufficient, it can’t be done without outside support. outside support.

• Few health facilities, if any, rural or Few health facilities, if any, rural or urban can survive without county, urban can survive without county, state or federal dollars, especially, if state or federal dollars, especially, if they are as isolated as Beaver Island.they are as isolated as Beaver Island.

Capital CampaignCapital CampaignThe BIRHC Board of Directors has determined The BIRHC Board of Directors has determined

that a Capitol Campaign is necessary to ensure that a Capitol Campaign is necessary to ensure the future financial stability of the Health the future financial stability of the Health Center.Center.

The goal of the campaign is to build the Center’s The goal of the campaign is to build the Center’s Endowment to $1.5 million. Interest from the Endowment to $1.5 million. Interest from the Endowment will be used to make up the Endowment will be used to make up the difference between operating revenues and difference between operating revenues and expenses, a gap created by the elimination of expenses, a gap created by the elimination of the state of Michigan’s annual subsidy to the the state of Michigan’s annual subsidy to the BIRHC. The current operating revenues of the BIRHC. The current operating revenues of the health center come from patient billings (26%), health center come from patient billings (26%), property tax levies (49%) and donations from property tax levies (49%) and donations from outside sources (25%). It is hopeful the final outside sources (25%). It is hopeful the final 25% portion of the revenue stream the 25% portion of the revenue stream the Endowment interest is expected to contribute.Endowment interest is expected to contribute.

BIRHC LEGACY TREEBIRHC LEGACY TREE

Support of the TownshipsSupport of the Townships

The only Health The only Health Center in the Center in the state state substantially substantially funded by local funded by local tax millage.tax millage.

Two significant componentsTwo significant componentsto Health Care on Beaver Islandto Health Care on Beaver Island

The ability to obtain high quality basic The ability to obtain high quality basic health services.health services.

The ability to get the best, coordinated The ability to get the best, coordinated emergency care and transportation emergency care and transportation to leave the island as expeditiously to leave the island as expeditiously as possible when needed.as possible when needed.

Mode of transportationMode of transportationPatients in need of extended services which Patients in need of extended services which

cannot be provided by the BIRHC need to be cannot be provided by the BIRHC need to be evacuated by the local air taxi service, North evacuated by the local air taxi service, North Flight or the US Coast Guard.Flight or the US Coast Guard.

Evacuation is dependent on weather Evacuation is dependent on weather conditions.conditions.

North Flight EMSNorth Flight EMSSubsidiary of Munson Healthcare, Inc.Subsidiary of Munson Healthcare, Inc.Traverse CityTraverse City

Beaver Island Emerald IsleBeaver Island Emerald Isle

Ferry boat to Charlevoix – 2 hour 10 minute Ferry boat to Charlevoix – 2 hour 10 minute triptripWeather permittingWeather permitting

US Coast GuardUS Coast Guard

Health Care Delivery Health Care Delivery TodayToday

Nurse Practitioner and Physician AssistantNurse Practitioner and Physician Assistant

ChiropractorChiropractor

Eye doctorEye doctor

Mental health providerMental health provider

Dermatologist beginning April 2010Dermatologist beginning April 2010

Collaborating Physicians who provides Collaborating Physicians who provides services 2 days/month.services 2 days/month.

SummarySummary

Beaver Island Rural Health Clinic has Beaver Island Rural Health Clinic has developed from a two room hospital to a developed from a two room hospital to a modern medical facility.modern medical facility.

Our dedicated volunteer Board Members have Our dedicated volunteer Board Members have worked cooperatively with the staff to worked cooperatively with the staff to ensure the success of the Beaver Island ensure the success of the Beaver Island Medical Center.Medical Center.

Thank you for all the volunteer hours these Thank you for all the volunteer hours these dedicated islanders have provided to dedicated islanders have provided to accomplish these tremendous endeavor.accomplish these tremendous endeavor.