How the BIRHC Board determined the need for a new Facility
The BIRHC Board of Directors is proceeding to build a new health care facility that will provide the space to more efficiently deliver currently available health care and wellness services and to house possible future services. The design is based on the physical inadequacies of the current space, limitations on our ability to offer additional medical services that are cost effective, and input from the entire community.
Long before the BIRHC Board had any inkling that someday funding would be provided to build a new facility, it undertook a strategic planning process. That was driven by the realization that Beaver Island was growing, the population characteristics were changing, and our one care provider was near exhaustion. The Board concluded that the health care strategic plan should be based on the desires of Beaver Island residents. The following is a summary of the planning process which actually occurred and can be documented by reading the BIRHC Planning Task Force Final Report (published August 2000) and issues of The Beaver Beacon and The Northern Islander–April 1999 through the present, which are on file at the Library.
April 1999: BIRHC Planning Task Force Convened. The 17 Island-resident members were carefully selected to reflect a true cross section of the community. This membership included businessmen and retired people, new and long-time residents, a township official, and the care provider at the time, Penny Kiss, and was chaired by B J Wyckoff. “Health Center's Current operations and facility capacity” was one of eight topics of investigation that were identified.
July 1999 and July 2000: Presentations to Beaver Island Property Owners Association. Representatives of the Planning Task Force introduced their mission and encouraged members to attend community forums to give their input.
August 1999: BIRHC Planning Task Force holds Community Forum. 78 people attended and had an opportunity to give their input on Island health care interests and concerns.
October 1999: Parent Focus Group Survey at BICS Parent Teacher Conference. Parents of school age children were surveyed about numerous health-related issues.
October 1999: Issues on Aging Focus Group. Panel discussion held to solicit senior citizen health concerns.
March 2000: Survey. 1200 copies of the BIRHC Survey were mailed directly to all taxpayers, including full- and part-time residents. In addition, 1100 copies were mailed out with the Beaver Beacon. A total of 350 surveys were returned. Its purpose was to gather data about the demographics of Beaver Island residents, current health care needs, and perceived future health care needs. The Task Force felt this kind of background data would enable them to draw an educated conclusion concerning the need for current and future services.
August 2000: BIRHC Planning Task Force Reports to the Community. One of the recommendations was that the current facility is inadequate. The Report makes public data from the survey that suggests the strong likelihood of increased patient numbers in the future and thus the need for a larger building. Examples of this data include: age profile–38% respondents identified themselves as age 60 or over; Future Residency–over the next five years 80% of respondents said they planned to be in residence for 6 months or more during the year; Chronic Diseases–significant numbers of respondents reported they suffered from chronic diseases. The need for more space was also supported by individual interviews conducted by the Task Force with BIRHC medical and clerical staff.
Spring 2001: Assessment. A “Medical Assessment” prepared by BIRHC Board and staff making the case for the need of a new and expanded center was presented to key state legislators.
Fall 2001: Funding. Through intensive lobbying by BIRHC and many individual community members led by Bill McDonough, $1.5 million was awarded by the State for the new facility.
December 2001: Limitations of present facility. Using a $30,000 anonymous gift, the BIRHC Board commissioned a professional sizing study performed by Community Health Associates to determine the appropriate size of the new facility. The firm interviewed medical center staff,
Dr. Wendy White, and BIEMS, and compiled the following list of space deficiencies in the current building:
- Inadequate space for two health care providers;
- No space for additional specialist and services;
- No space to expand current dental practice;
- Lack of space to accommodate modern telemedicine, laboratory, radiology, or emergency care equipment;
- Limited space for EMS operations;
- No space and limited equipment to care for emergency patients awaiting evacuation (sometimes up to 24 hours);
- No space for drug storage or dispensary;
- No space for community education;
- Cramped business offices without space for office equipment;
- No private areas for providers to consult with patients;
- Inadequate waiting area to separate sick and well patients;
Waiting area too small to provide patient confidentiality about purpose of visit;
- Inadequate space for storage of supplies, medical waste, and equipment;
- No adjacent property for expansion;
Inadequate parking; and
- Inadequate space for patient privacy between dental waiting area and health center exam areas.
January 2002: First Recommendation. Community Health Associates presented a report to the BIRHC Board recommending a facility of 7,855 square feet, which would include EMS and dental space.
Spring-Summer 2002: A gift of land. Jeff and Nancy Traudt and Harry Gill donated 5.5 acres of land in a prime location off King's Highway to the BIRHC for the new medical center and adjacent senior housing. Most costs of the land transfer were donated.
Early Summer 2002: Design Modifications. It became clear that including dental and EMS space specified in sizing study will put the project over the grant money. Both townships were approached about housing both dental and BIEMS space in the vacated health center building, which is owned jointly by St. James and Peaine Townships. The Townships' response was that they will continue to house one BIEMS vehicle and to provide office space to the organization, and that dental space belongs in the new health center.
August 2002: Draft of Plans. First draft of building plan with reduced dental space and no BIEMS space was presented by the architectural firm Hobbes + Black at a Joint Township public meeting. Community and staff input resulted in revisions to the plan.
November 2002: Final Plan. The fourth and final building plan was presented to the community at a public meeting. Further revisions were made after extensive staff input concerning traffic and workflow.
Looking at the time frame outlined above, one can see that this process included community member involvement, and active research, analysis, and planning over nearly four years. The information gathered through this process has been a major factor in the BIRHC Board's understanding of community health care and wellness needs for the immediate and near term (5 years.)
The medical and related services that are desired and practical to provide on Beaver Island, the additional regulatory requirements we must meet, and the available funding were all key considerations in defining the size, function, and design of the new facility.
It should be noted that some of the Task Force research and publishing required funding. Due to the importance of the objectives, private donors and foundations came forward with one hundred percent of these costs.
The BIRHC Board recognizes the importance of receiving community input and the importance of keeping the community informed. For those who could not attend the numerous meetings noted above, or the regular monthly meetings of the BIRHC Board of Directors, or could not participate in the 2000 survey, numerous articles have appeared in the Northern Islander and the Beaver Beacon throughout the process. The BIRHC Board of Directors invites those interested to attend our meetings on the third Tuesday of the month at the St. James Township Hall. It is at these meetings that the reasons behind our decisions concerning the Health Center can best be learned.
–Connie Wojan and Don Spencer
BIRHC News
At the March 18th meeting Arlene Brennan discussed the progress made straightening out the billing. Over half of the 885 patient ledgers have now been reviewed. Accounts receivable, which had been increasing, was reduced by 16% because of this inspection and rebilling. She also said they are now in agreement about who's in charge when the EMS is called: since the BIRHC is not a licensed health care facility (it's more like a doctor's office), the EMS medical director (an emergency room doctor in Charlevoix) has authority.
There has been an offer to work at the BIRHC by a doctor who has a summer home here. There are several details to work out about billing, staff, hours, and the chain of command before this can move forward. Also a physician doing her residency in emergency medicine has asked about working here.
The Care providers' Report prepared by Chris and Susan was distributed. Chris was there to talk about the progress being made with Tele-health. Using this technology, in some cases X-rays can be shown to a distant doctor with enough clarity for him to determine a course of action without having to wait for the actual X-rays to arrive. Chris and Sue were applauded for contributing their off-days to working on a variety of projects, such as weeding the X-rays of the deceased out of the files.
Letters to the Editor: The new BIRH Center
This letter–long overdue–is written to give our heartfelt thanks to the Beaver Island Rural Health Center care-givers, EMS, and the Board of Directors, whose dedication, energy, and professionalism give us the care and comfort needed to enrich our lives on this beautiful Island. Without this assurance, many of us would not be able to remain here. (Although many patients must be moved to the mainland for special services, this same procedure must be followed in many cities.)
The comfort we feel comes from the respect that the Medical Center care-givers have earned through their thoughtfulness, professional knowledge, and dedication to our well-being. As a result, we're proud of our Health Center, and thankful to those who've made it as useful as it is; and we're looking forward to the larger and better facility now in final planning.
Thanks again, most sincerely, to all of you.
–JoAnne and Chuck Hooker
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