Jefferson Healthcare is looking to increase its capacity to see more people but does not have the same crisis to access that has been reported elsewhere in the state, including in Port Angeles.

"Access to primary care in rural communities is a crisis in this state and it is not in Jefferson County," Jefferson Healthcare Chief Executive Officer Mike Glenn told commissioners Sept. 3 after board chair Marie Dressier asked Chief Nursing Executive Joyce Cardinal about a story in the Seattle Times on Sept. 1 that reported a clinic in Port Angles had turned away 250 callers.

The thrust of the Seattle Times story was an influx of people seeking care as more become insured through the federal Affordable Care Act (also known as Obamacare), and the shortage of doctors in rural areas of the state.

Cardinal said that Jefferson Healthcare is seeing some Clallam County residents, and that Jefferson's system does have capacity to see more patients. She also noted that the system is recruiting one new primary care physician after the

departures ot Dr. Kichard Meadows and Dr. Carrie Day.

"I'll take our challenges over any other community in the state," Glenn told the board. "We need to be mindful of access and it's something we are constantly monitoring, but we are in a good place and continue to work hard to make sure we stay there."

Glenn also said that a new clinic optimization initiative is aimed at better understanding wait times and how clinics are used in an effort to be efficient and leverage the resources the hospital does have.

"If I called for Dr. (Joe) Mattern, I might have to wait for 90 days, but other providers might have green space (availability) at the end of the week," Glenn said.

ACTIVELY RECRUITING

That said, Glenn acknowledged that the system is actively recruiting for one new physician and doing an analysis on what to recruit for in the future.

"As we look into the future, we anticipate growing demand for primary care services and a shrinking supply of primary care providers," he said, adding that there is interest in learning what other clinics have done to create an environment that meets both the needs of patients and the needs of providers.

In an aging community with increasing needs and a shrinking supply of providers Glenn said that kind of evaluation needs to be done.

"The doctors just aren't out there. There needs to be different solutions," he said. "Is there a way that provides a highly satisfied patient experience and a satisfying provider experience and allows Jefferson Healthcare as an organization to meet the need?"

Hilary Whittington, chief financial officer, said Jefferson Healthcare started taking in more new patients last October and has been looking at where the bottlenecks are "to keep patients moving through the system."

MENTAL HEALTH

The discussion about access followed a report by Cardinal on what services the hospital has offered in 2014 and what services might be new in 2015.

Current services include inpatient and outpatient care, oncology and chemotherapy, orthopedic care, surgical services, intensive care unit, health prevention and wellness, cardiology, physical therapy, orthopedic rehabilitation, emergency care, women and children, walk-in care, diagnostic imaging, home health services and hospice services.

For 2015, the goals are to continue to grow cardiology services, add outpatient neurology, continue to optimize orthopedics and primary care clinics and develop a woman's clinic, she said.

Stephen Workman, who has raised concerns about Jefferson Healthcare's commitment to serving people who need mental health services, noted that there was no mention in Cardinal's report of mental health services being added. He noted that at the last hospital board meeting in August, a crisis in caring for patients presenting mental health issues was discussed.

"We provide the services as best we can. It's not adequate. Right now our goal is to work with Jefferson Mental Health and try to increase the availability of outpatient" services, Cardinal said.

Glenn did not agree with Workman's characterization of the system not providing care. Glenn said he has heard Dr. Joe Mattern, chief of staff at the hospital, say that up to 30 percent of the care provided by doctors is related to mental health issues.

Glenn said there are challenges in dealing with underfunded health issues.

"Given those challenges, we are doing an admirable job. We're trying to see if we can leverage our scarce resources to do a better job. To be clear about the level of health care, it's going on every day and I think you would be impressed," Glenn said.

In an earlier email regarding mental health, Glenn said he thinks there is a misconception regarding the complexity of providing psychiatric care.

"If a hospital is going to provide psych care, it must have all the resources required by the Department of Health and necessary to provide a safe, high quality care experience," Glenn wrote, adding that the doctors see patients with mental-health issues daily.

"In fact, we are working on a plan to embed a mental health professional in our clinics and working side by side with our providers," Glenn added in that Aug. 29 email.