Loud and clear.

Olympic Medical Center CEO Eric Lewis, OMC Chief Human Resource Officer/General Counsel Jennifer Burkhart and hospital commissioners Thom Hightower and John Nutter made their concerns about changes to Medicare and Medicaid reimbursements to state and national representatives in Washington D.C. late last month.

As it turns out, Nutter noted, similar concerns from Olympic Peninsula residents are being heard in D.C. as well.

After urging citizens to comment on a Centers for Medicare and Medicaid Services (CMS) proposal that would significantly cut reimbursements for the hospital’s off-site clinics — costing the public hospital $47 million over the next decade — CMS is getting a proverbial earful, OMC representatives said.

“I think the letters from Sequim patients and residents are very compelling,” Lewis said in a recap of the lobbying visit to hospital commissioners on Oct. 3 in Sequim.

“We did what we wanted to do; they probably (have) never heard from a community our size,” he said.

Lewis and Burkhart reviewed their efforts to let CMS, a federal agency that administers the Medicare program and works in partnership with state governments to administer Medicaid, understand the impact their proposed cuts would make to Olympic Medical Center and other rural hospitals.

In previous interviews, Lewis said the cuts OMC would see if the Centers for Medicare and Medicaid Services’ proposal moves forward would only worsen the area’s shortage of health care providers and could increase visits to the emergency room. The rules would reduce OMC’s expense reimbursement from $118.35 per visit to $47.34 per visit — a 60 percent cut — at its off-site clinics. That would be a $3.4 million loss in funding for next year.

“In my 30 years in health care, I’ve never seen a cut this big,” Lewis said previously.

In the nation’s capitol, Lewis spoke on a panel with the American Hospital Association — a national organization that represents and serves all types of hospitals, health care networks, and their patients and communities — and told commissioners in early October that if the CMS recommendations for the 60 percent cut are passed, the association would consider backing a bill to reverse those cuts.

CMS representatives were responsive and listening, Lewis noted. He said they had received about 3,000 letters and contacts from people across the nation. With the intent to make those comments public, CMS had released about 1,000 as of late last month, Lewis said — and 346 of those were from Sequim and Port Angeles residents.

In a previous interview, Lewis said cuts OMC would see if the CMS proposal moves forward would only worsen the area’s shortage of health care providers and could increase visits to the emergency room.

Burkhardt said OMC representatives are also working with the Washington State Hospital Association (WSHA) to lobby for fairer Medicare and Medicaid reimbursements.

“We were able to get Sequim and Port Angeles’ issues on the WSHA agenda,” she said.

Lewis and Burkhardt said they received support from Sen. Maria Cantwell, Sen. Patty Murray and U.S. Rep. Derek Kilmer.

“Rural health is bipartisan; we really made an effort to talk to Democrats and Republicans,” Burkhardt said.

Nutter added that Washington state’s legislators seemed to know the peninsula’s issues before they began to explain OMC’s concerns.

‘It feels like consistent visits (to D.C.) is paying of,” Nutter said.

Burkhart said OMC representatives also asked for support from legislators to help OMC keep discounts on pharmaceuticals similar to those given to Veterans Administration centers, along with support for discounts for some pharmaceuticals now labeled “orphan drugs” — drugs that at one time had a single purpose but are now being used in to treat cancer patients locally, Burkhardt said.

Re-bids for cancer, primary care centers

Olympic Medical Center is sending out bid proposals for a second time for about $15 million in construction for Sequim facilities.

Bids were considered in June and OMC officials hoped to have a proposal in hand by November, but a glut of projects across the region coupled with rising wood and steel costs left OMC with two bids.

Lewis said he hopes to see three to five bids for commissioners to consider at their next meeting, set for Oct. 17, with a possible construction start by February or March.

The proposed construction includes $9-10 million for the cancer care and primary care centers, plus $5 million for an outpatient center.

“We would like to do both of those projects,” Lewis said.

He said OMC is hoping to have three to five bids for commissioners, with a target construction start date in February or March.

Commissioners in June unanimously agreed to seek bids for the cancer center/primary care center project that would add about 4,000 square feet to the cancer care center and about 7,500 square feet for primary care service.

“It moves us to what we really need in Sequim,” Lewis said.

Commissioners to consider library endorsement

Hospital commissioners also agreed to consider an official endorsement of the North Olympic Library System’s proposal for a new Sequim Library in November’s general election.

The library system is asking voters to approve Proposition 1 and 2 in the Nov. 6 general election; Proposition No. 1 creates the Sequim Library Capital Facility Area tax district — roughly the same boundaries as the Sequim School District — while Proposition No. 2 finances the expansion of the Sequim Library by approving $12.4 million of voter approved bonds paid off over 21 years.

“We live in dramatically different times, technologically-speaking,” NOLS executive director Margaret Jakubcin told hospital commissioners. While libraries aren’t all about books anymore, she said, they have become technology learning centers and community gathering places.

If passed, the two propositions would expand the 1983 Sequim Library building from 6,050 square feet to 17,000 square feet.

“It (the cramped space) is not a new problem; it’s been a problem for probably twenty years,” Jakubcin said.

Paula Barnes, a campaign steering committee member, asked the commissioners to consider the endorsement at their next regular meeting.

“The building is too small, It’s old and it’s too small,” Barnes said. “The library needs to offer flexible and adaptable meeting spaces.”

Barnes noted that libraries are symbols of civic pride.

“It’s not political. It’s not partisan. It doesn’t cater to one demographic,” Barnes said.

“I remember (coming to the peninsula) and going to the Port Angeles Library, a brand new library, thinking, ‘This is awesome,’” Lewis said. “Libraries do matter.”