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On-site clinic provider to leave Cascade County health department; screenings and specialty care ending
Summary
The countyrun clinic's on-site provider will depart and the department will end or refer out specialty services including diabetes care, some STI/HIV care and retinopathy screening; staff said patient letters are being sent and partners will be asked to absorb care where possible.
The Cascade County health department told the Board of Health on May 7 that it will end its on-site provider clinic, affecting diabetes care, some sexually transmitted infection treatment and specialized screenings.
Abigail (Family Health Services and Prevention Services staff) said the department determined the clinic model was not financially sustainable: "It was determined that it's just not sustainable at our health department." She said the programwhich provided diabetes care and some STI/HIV serviceswill end June 30 and that staff have begun notifying patients.
Why it matters: the providermodel had included chronic disease management (Abigail said the diabetes panel numbered in the hundreds) and on-site capacity to diagnose and treat STIs; losing the provider reduces the departmentcapacity to perform some exams and in-person treatment.
Services affected and alternatives: Abigail said diabetes care, STI treatment and Hep C/HIV care capacity will be reduced. Some aspects of screening will continue through referral partners; for example, the department will route patients to community providers such as Benefits clinic and other partner organizations. A state-funded retinopathy screening contract will be terminated because the department no longer has a provider to operate the camera-based clinic.
Medical director and standing orders: staff said the health department must operate under a medical director. Abigail said an interim medical director exists through the Department of Emergency Services if needed, but the county must complete credentialing and standing orders for that arrangement.
Board questions: Board members asked about the size of the diabetes patient panel and what would happen to STI exams that formerly were treated on-site. Abigail said she would follow up with precise patient counts and that core communicable disease functions (reporting, partner tracing, medication ordering under public health authority) would continue through the department even if clinical services shift to partners.
Ending: The department will send patient notices, refer patients to other providers and seek credentialing for interim medical oversight while it works to ensure continuity of care.
