Skagway, Bartlett near completion of clinic deal

Posted: Friday, April 25, 2003

Bartlett Regional Hospital would manage the Skagway Medical Clinic starting in July, under an agreement that is nearly final.

The clinic, which serves Skagway's 862 residents, had been run by the financially beleaguered Skagway Medical Corp. The city of Skagway didn't renew the corporation's lease earlier this month, in effect taking over operations.

Under the agreement, the city of Skagway would pay Bartlett $30,000 annually to manage the clinic for two years, said Skagway City Manager Bob Ward. The Skagway City Council would appoint a board to provide policy direction for the clinic, he said.

"The clinic employees will be employees of the city of Skagway and Bartlett will provide management support," Ward said. "There may be other services we would get from Bartlett that will be billed independently from the contract."

New clinic administrator Shaun Keef will be a Bartlett employee, with the city of Skagway paying his salary. The Skagway Medical Clinic has about seven employees and a Bartlett physician visits monthly. One of Bartlett's physicians will be the medical director for the clinic, Valliant said.

"It's a commitment to our regional perspective and of course, we get referrals out of the Skagway area," he said. "We're just glad to be out there."

It is the first time Bartlett has taken a management role in a nearby community's health clinic, he said.

The arrangement is similar to the relationship between the city of Juneau and Bartlett, Ward said. Bartlett is owned by the city of Juneau, but is managed by Texas-based QHR, formerly Quorum Health Resources.

Ward said the arrangement will mean better management at the small clinic. The city has filled budget gaps in recent years and paid $190,000 for uncollected bills at one point, he said.

"We've never really had an issue with the quality of medical service the community has enjoyed. The issues have been management," Ward said. "People will come in and get treatment and pay according to their ability to pay; there won't be quite so many people who skate on things. ... We're not trying to get out of subsidizing the clinic, we just want to make sure the money is used most effectively."

Meanwhile, the future of Skagway Medical Corp. is unclear. Board Chairman Hillyard Enloe said the membership will vote whether to dissolve the corporation or keep it going. About 80 residents are SMC members, he said.

"It's kind of pointless to have a governing body with nothing to govern," he said. "We feel we did do our best, but it wasn't good enough or fast enough."

Enloe said the board was making strides in turning the clinic around, but faced an uphill battle. Some people in town are disappointed the corporation was cut out of the loop, he said.

On the other hand, the corporation's board members liked the idea of bringing in Bartlett's expertise, and helped select the new administrator, he said.

"Everybody wants quality health care and we were no exception," he said. "As for the way to go about that, there were differing opinions as to who had the best idea and manner to make this thing happen. For quite some time, the board members would have to go to the city requesting funds for our shortfalls. How many times can you do that?"

Candice Wallace, a Skagway resident who served on a SMC board-appointed internal audit committee, said the results of the work should be released to the public.

Enloe said SMC's internal audit and a city audit of the clinic turned up similar issues.

"It didn't have anything to do with malfeasance," he said. "One of the issues was payments made for administrative duties and in our communication with grant people. ... With the grant, there were too many people in control and they didn't communicate."

Other Skagway residents have expressed concern that the Bartlett contract should have been put out to bid. Ward said the agreement is a professional services contract, and didn't need to go out to bid. The SouthEast Alaska Regional Health Consortium was contacted about the clinic early on, and deferred to Bartlett, he said.

But Lance Twitchell, president of the Skagway Traditional Council and the Skagway representative to the SEARHC board of directors, said SEARHC would be interested in submitting a management proposal if the option is available.

"The responsible thing to do is explore all the options because we need significant improvement in the way things are managed," he said.

Skagway tribal members can use the Skagway Medical Clinic, but because the billing agreement with SEARHC is limited, many people go to the Haines clinic or to the Alaska Native Medical Center in Anchorage, Twitchell said.

• Joanna Markell can be reached at joannam@juneauempire.com.



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