In addition to giving an update on Del Norte’s Health Professional Shortage Area status, Janie Clark says she will ask the Del Norte Healthcare District Board on Tuesday to weigh in on developing a formal process for renewing the federal designation.

Clark, owner of Downtown Business & Professional Services, has been renewing Del Norte County’s HPSA designation for about 10 years. But she said there has never been a formal policy or procedure in place from the county for making sure that status continues.

“I would like to help develop those policies and procedures,” she said. “I’m going to explain that to the healthcare district.”

The Health Professional Shortage Area designation is used as a tool to recruit doctors to the area and allows those who do come to Del Norte to enroll in a federal loan repayment program, according to Clark, HPSA consultant for Del Norte and Humboldt counties.

Local physicians in a geographic high needs HPSA are also eligible for a 10 percent MediCare bonus. Del Norte County is a geographic high needs HPSA, Clark said.

Under recent changes from the Federal Shortage Designation Branch, HPSA designations must be renewed every two years. Clark renewed Del Norte’s HPSA designation last year with help from Penny Figas, of the Humboldt-Del Norte County Medical Society. Clark’s efforts were also supported by funding from the Wild Rivers Community Foundation, the Humboldt Area Foundation and the Del Norte County Department of Health and Human Services.

On Monday, Clark said she was reaching out to the Office of Statewide Health Planning and Development to better understand the timeline so she can provide that information to the healthcare district board. She said she also found out that the federal loan repayment program is connected to the Affordable Care Act.

“That is another important bit of information I want to share with them when we talk about what these HPSA designations are, what they mean, what the impact is for the community and how they all tie together,” Clark said. “I’d like to be able to educate the community, the healthcare district and the county on the purpose of these designations and how they all interact with each other and how they interact with other programs.”

Following Clark’s report to him and his colleagues, healthcare district board member Dr. Greg Duncan said he will ask about whether a HPSA designation will help the community establish a cost-based specialty clinic.

In sparsely populated areas experiencing doctor shortages, a cost-based system is a billing methodology based on the costs to operate a clinic rather than billing based on the fixed amount of a service, Duncan said. He noted that Sutter Coast Hospital operates a cost-based clinic.

“As a matter of our population and demographics, we cannot support full time specialists,” Duncan said. “One of the ways I’m hoping to bring more visiting specialists is through a cost-based clinic. That (HPSA) designation may be helpful in getting the qualification for that.”

Duncan has been working with St. Joseph Health Medical Group to bring a cardiologist to Del Norte County. St. Joseph is also planning to add urology and pulmonology services to Crescent City, Duncan told the Triplicate in June.

Duncan said he’s hoping to bring additional services to Del Norte County that isn’t provided by St. Joseph to save residents from having to leave the community to seek them.

“We’re just hoping to do as much as we can within the county given the obvious limitations in terms of our population,” he said.

The healthcare district on Tuesday will also resume discussions regarding Envision Healthcare, formerly known as EmCare, the physician’s group that staff’s Sutter Coast Hospital’s emergency department. Since December 2016, the healthcare district board has urged hospital representatives to renegotiate its contract with EmCare due to the group’s out-of-network status with most Del Norte County insurance providers.

At the healthcare district board’s August meeting, Sutter Coast Administrator Carlos Priestly announced that CEO Mitch Hanna told EmCare representatives they need to demonstrate evidence that they are negotiating contracts with local insurance carriers by Jan. 1.

On Monday, Duncan’s colleague on the healthcare district board, Dr. Kevin Caldwell, said Sutter Coast Hospital’s response to EmCare’s billing practices is “completely inadequate.”

“We want to figure out some way to put more pressure on them to do something about (EmCare),” Caldwell said. “We were contemplating too maybe connecting directly with EmCare — if they even know this controversy is going on.”

The healthcare district board meets at 6:30 p.m. Tuesday in the conference room at the Del Norte Community Wellness Center, 550 E. Washington Blvd., Crescent City.

Reach Jessica Cejnar at jcejnar@triplicate.com.

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