History of the Beaver Island Rural Health Center

1. History of the Beaver Island Rural Health Center Donna Kubic Managing Director

2. Challenges Beaver Island’s extreme geographic isolation and transportation challenges result in service limitations and obstacles to connections with larger medical care resources such as hospital, surgical centers and radiology facilities. We have extreme fluctuations in utilization that vary from moderate in late fall and winter to overcrowded in summer.

3. Beaver Island Geography Population Year Round 600 6 Miles x 13 miles Largest, most remote inhabited island in the Great Lakes 32 miles from the nearest point of access on the Michigan mainland.

4. History of Health Care on Beaver Island Before the Mormon Era (1847-1856) there is no record of medical help available on Beaver Island. Feodor Protar (1893-1925) a refugee from Russia, had no medical training but his best friend, Dr. Berhardi, practiced medicine in Chicago, and he was willing to look up remedies and order cures through the mail.

5. After Protar’s death, people had to be taken to the mainland in a fish boat or a doctor had to be flown in.

6. 1923 Dr. Palmer set up shop • In 1923 Beaver Island were lucky enough to be discovered by Canadian Dr. Palmer, who set up shop. When Dr Palmer left once again the island had no doctor. The state was willing to help if we could meet their requirements, but they were completely beyond us.

7. Requirements for the Doctor In 1952 a doctor was found in Bay City who was willing to come, if he could 1) find a home, 2) if there would be some kind of state subsidy 3) if the Island would provide some kind of modest hospital.

8. What to do? • Call a meeting??

9. Community pulls together January 16, 1953 a general meeting was called for all Island residents. 100 people showed up at the Parish Hall.

10. Getting the job done May 9th with volunteer labor, it was thought the building would cost around $12,000.

11. Proposed constitution and bylaws approved Father Joe Art Johnston, President Jewell Gillespie Mrs. George Ricksgers Roger Carlisle Lloyd McDonough Frank Nackerman Mrs. John Gallagher Mrs. Frank O'Donnell Were elected to the board of the Beaver Island Civic Club

12. 1953Beginning of the Medical Center

13. Open for Business In the first year, eight maternity cases were handled, and people spent seven nights in bed there for various ailments. 36 x rays taken that first year, a number of strains were diagnosed as fractures and given proper treatment.

14. In 1955 a surgical table from Butterworth Hospital in Grand Rapids was procured. In 1956 island births were increasing despite a decreasing population of 210.

15. Serious Problem on the Horizon Dr. Vail gave notice on May 1, 1956. Distraught the Medical Center Committee asked the State Health Commissioner for help.

16. Doctor for Hire With the help of Health Commissioner Albert Heustis, Dr. Luton became the doctor in 1956. He was 77 when he took up his duties.

17. Doctors continued to serve Island Residents Dr. Howard Haynes 1962-1967 provided services Dr. Joseph Christie 1968-1979 provided services

18. Board appointed to oversee Medical Center Bylaws were adopted and Bud McDonough served as the first President

19. Goals 1975 a Medical Center Board was appointed to oversee the Medical Center, and bylaws were adopted. Their goal was to have a contract with the doctor (being paid $7,500 a year).

20. Expansion 1976 an addition was designed and put out on bids. Dr. Christie followed (1968-1979), then Dr. Siudara who retired in 1985, giving way to the post being manned by Mike McGinnity, RN.

21. Rural Health Designation Rural Health Status designation was approved in 1976. Dr. Philip Lange was instrumental in accomplishing this.

22. The Funding of the Health Center Since 1985 Medical and Health care needs have been met by Mid Level Practitioners overseen by a physician practicing in Charlevoix. From it’s beginning in approximately 1927 until 1985, state of Michigan support of health care on Beaver Island was done by paying the salary and benefits of a resident physician. When the last physician retired in 1985, application was made for state support of a Physician Assistant.

23. This was approved but was “trickled” down through the 3rd District Health Department, until that ceased in 1991. In an effort to become self-sufficient in the face of the loss of state funding, Island voters passed a two mil property tax. Since those revenues would be delayed for some months, interim state assistance was asked for and received to fill the gap until the new tax revenues could be collected and dispersed.

24. Between 1991 and 1996 1) local tax dollars, 2) patient fees 3) and contributions barely kept the Center’s door open.

25. Following a successful appeal for state assistance in 1996 and from that date through 2002 the state of Michigan again helped by sending $75,000 annually to help cover operating expenses. However, in the decade of the 90’s the island’s population grew 40% and the patient visits to the BIRHC grew 434% which created the need to add a second care giver thus increasing operating costs.

26. The new Rural Health Center In 1998 the Medical Center Board began to seriously explore the possibility of upgrading it’s facility. Everyone had a chance to give their opinion during a two year period. Jeff Traudt offered to donate property on the NE corner of King’s Highway and Carlyle Road –no strings attached.

27. How do we pay for it? Bill made it through State Congress for two million dollars. Governor Engler vetoed it. The same energetic team went back to work and their diligence paid off a 1.5 million dollar grant was awarded. March 2003 ground was broken with a completion date of date of December 2003.

28. The Current Status A new plateau of competent service has evolved due to the diligent work of the Beaver Island Board of Directors.

29. New Facility

30. One Major Problem Remains How to we pay for the operation of our new Rural Health Center? The government has let us know in no uncertain terms that we have to look elsewhere for help.

31. How to we pay for it’s Operation? Objective: Secure funding so there isn’t a worry about whether or not the doors will stay open.

32. In the last decade the population of Beaver Island has increased nearly 40%, and the patients served by the Rural Health Center have risen from less than 600 in 1990 to over 2600 in 2002 and 2745 in 2005 and 3050 in 2009 Local tax collections plus patient fees are just able to cover personnel costs and the annual stipend for a physician’s visit every two weeks.

33. Despite the best efforts of the Health Center Board, its staff, its patients, and taxpayers to be financially self-sufficient, it can’t be done without outside support. • Few health facilities, if any, rural or urban can survive without county, state or federal dollars, especially, if they are as isolated as Beaver Island.

34. Capital Campaign The BIRHC Board of Directors has determined that a Capitol Campaign is necessary to ensure the future financial stability of the Health Center. The goal of the campaign is to build the Center’s Endowment to $1.5 million. Interest from the Endowment will be used to make up the difference between operating revenues and expenses, a gap created by the elimination of the state of Michigan’s annual subsidy to the BIRHC. The current operating revenues of the health center come from patient billings (26%), property tax levies (49%) and donations from outside sources (25%). It is hopeful the final 25% portion of the revenue stream the Endowment interest is expected to contribute.

35. BIRHC LEGACY TREE

36. Support of the Townships The only Health Center in the state substantially funded by local tax millage.

37. Two significant componentsto Health Care on Beaver Island The ability to obtain high quality basic health services. The ability to get the best, coordinated emergency care and transportation to leave the island as expeditiously as possible when needed.

38. Mode of transportation Patients in need of extended services which cannot be provided by the BIRHC need to be evacuated by the local air taxi service, North Flight or the US Coast Guard. Evacuation is dependent on weather conditions.

39. North Flight EMSSubsidiary of Munson Healthcare, Inc.Traverse City

40. Beaver Island Emerald IsleFerry boat to Charlevoix – 2 hour 10 minute tripWeather permitting

41. US Coast Guard

42. Health Care Delivery Today Nurse Practitioner and Physician Assistant Chiropractor Eye doctor Mental health provider Dermatologist beginning April 2010 Collaborating Physicians who provides services 2 days/month.

43. Summary Beaver Island Rural Health Clinic has developed from a two room hospital to a modern medical facility. Our dedicated volunteer Board Members have worked cooperatively with the staff to ensure the success of the Beaver Island Medical Center. Thank you for all the volunteer hours these dedicated islanders have provided to accomplish these tremendous endeavor.