By Chris Chord

OIHCD superintendent

In April of this year, voters approved Proposition 1, a temporary 10-year levy lid lift proposed by the Orcas Island Health Care District board. During our levy town hall meetings, the board committed to three key work areas as the basis for our levy request: long-term stability in clinic operations, clinic expansion and expanding primary care services. Since April, we’ve made significant progress on each of these areas, including signing a 10-plus year contract with Island Health to operate the clinic, finalizing a long-term strategic facilities plan, which will be the basis for architecture and design of a clinic expansion, and convening work groups with community organizations around primary care expansion. We are excited to share updates on those work areas and more, while providing an outlook on how the levy dollars will be utilized in 2026 and beyond.

Ensuring primary care access until 2045

OIHCD’s top priority this year has been to secure a long-term extension of the original five-year contract with Island Health to operate the Island Primary Care – Orcas clinic. Renegotiations began in the summer of 2024, and a term sheet was agreed to in January of 2025. Since then, the federal law passed on July 4, 2025, which included the largest proposed cuts to federal health care funding in our nation’s history. The impact of this law on health care providers, especially those that serve larger Medicaid populations (like Island Health), is profound.

We are grateful that, despite the uncertainty in the federal landscape, we have been able to agree to a 10-year contract renewal, with the option for two five-year renewals without renegotiation. This contract ensures a clinical partner for Orcas until 2035, and possibly until 2045. Island Health has been flexible, understanding and realistic in their contract terms, and continues to recognize that operations of the Orcas clinic differ in many ways from the operations of their clinics on the mainland.

Expanding our clinic to meet long-term island needs

The original board and staff of OIHCD faced a significant undertaking in 2018, when voters approved the existence of the San Juan County Public Hospital District #3, the formal name of OIHCD. They purchased the clinic at 7 Deye Lane from the previous medical center owners and invested in upgrading the building’s infrastructure. Island Health has brought on long-term staff to meet the growing population and health care needs of our community. They are also actively recruiting two additional medical providers to better serve our residents. The clinic building remains in excellent condition, but the available space is becoming increasingly constrained.

OIHCD engaged with a consultant in early spring to conduct a Strategic Facilities Planning Assessment. After input from community members serving on a committee, interactions with clinic staff, and a review by the OIHCD Board, we have collectively agreed to a long-term facilities expansion to serve our community far into the future. OIHCD will be engaging architects, engineers and capital planning consultants in 2026, and envisioning what the clinic expansion at 7 Deye Lane will conceptually look like. We look forward to community input and sharing visuals of a clinic that can serve the next generations of Orcas Islanders.

Expanding primary care access

OIHCD has been contracted with Island Health since 2021 to provide primary care services through our federally recognized Rural Health Clinic. Our clinic provides routine care, same-day care, urgent needs through collaboration between our triage nurses (RNs) and medical providers, and provides after-hours care through an on-call phone system available through the clinic’s main phone number. In recent years, Island Health has brought visiting OB/GYNs, pain interventionists and telehealth cardiology to the islands on a routine basis. Island Health hopes to continue to increase access for OB-prenatal care, diabetic education, orthopedics and other services in the future.

As with many other health jurisdictions serving rural (or island) residents, OIHCD recognizes our need to be a community resource outside of the traditional brick-and-mortar clinic. OIHCD has historically supported community health initiatives, including the launching of the Orcas Community Dental Clinic. The dental clinic has served roughly 400 Orcas residents since May of 2024, many of whom had not received dental care in years. Through our partnership with Orcas Island Community Foundation, OIHCD will continue to support that initiative in 2026 as we seek a sustainable clinical model. Additionally, OIHCD supported medical access funds administered through Orcas Community Resource Center in 2025, which will continue to be supported in 2026. These funds reduce barriers for islanders to access needed medical care, whether on or off island.

As resources at the federal level for our working-class, aging and at-risk community members are in jeopardy, OIHCD is committed to showing up as a community collaborator on the island and regionally, seeking creative solutions to build infrastructure and capacity to better take care of our islanders. In September, OIHCD received a grant on behalf of San Juan County to help develop a San Juan County Community Health Network in 2026. This collaboration helps identify areas where we can share resources across the islands. For Orcas collaboration specifically, this summer, OIHCD brought together community organizations to discuss “Out of Clinic Care.” This group met for several months, working to identify gaps in care and prioritize needs for serving our community members outside of the walls of a clinic. We look forward to exploring many of the initiatives identified from that work group in 2026.

Our commitment to community

As we explore ways to better serve our community, OIHCD has always been committed to utilizing taxpayer funds responsibly and strategically. With our increased levy dollars coming in 2026, OIHCD has developed additional financial management policies around reserves to allocate resources into our promised work areas. Additionally, OIHCD is holding a board retreat in January to both visualize our strategies around expanding primary care access and define our strategic plans for the coming years.

As we go into this new year, we thank you again for your ongoing support. In a U.S. health care landscape that seems mostly doom and gloom, we are overwhelmed to have such a bright future for health access on Orcas Island.