To set the three priorities, the hospital and Wipfli LLP looked at how many people are affected by each issue, how significant that issue is and how much of an impact Island Health can make on the issue.

The report outlines why each issue was highlighted as well as what the hospital will about it. It also takes a look at the past three years and outlines the work that went into addressing those priorities.

“A majority (87%) of community stakeholders interviewed reported that access to behavioral health services is a significant health need in the community,” the report states. “Stakeholders reported the need for the full spectrum of behavioral health services, from outpatient therapy and counseling to inpatient psychiatric treatment.”

Those interviewed noted a lack of behavioral health professionals in this region, resulting in long wait times for people who are seeking care.

Portions of Skagit County are considered by state government to be Health Professional Shortage Areas for mental health care.

According to answers in County Health Rankings for 2022, as reported in the assessment, “mental health outcomes in the tri-county region served by Island Health have worsened over the past three years, (where) adults in Skagit, San Juan, and Island counties report a higher number of mentally unhealthy days each month compared to state and 90th percentile national benchmarks, as well as higher rates of excessive drinking and drug overdose deaths compared to state benchmarks.”

Stakeholders interviewed for the health needs assessment noted concern for mental and behavioral health care, especially for young people and for those who are homeless, low-income or frequently involved with law enforcement. A lack of beds for care, especially for young people, is a high concern, according to the assessment.

Because behavioral health was also a concern during the last assessment process, Island Health listed what it has done since 2019 to deal with this issue, including recruiting an additional mental health counselor in its behavioral health program and expanding the Mental Health Intervention Program offered in partnership with the Anacortes School District. For that youth program, more staff, services and hours meant the program saw roughly 100 new students in the 2021 school year, according to the assessment.

Island Health also moved from a part-time to a full-time child psychiatrist to improve access, according to the report.

Up next, it plans to implement several tactics, including integrating behavioral health interventions across primary and specialty care, providing group therapy sessions, continuing the program with the school district (funded in part through the Island Health Foundation) and coordinating telehealth services.

About 60% of the stakeholders interviewed also listed access to primary care as a concern for the newest assessment. The lack of primary care access is especially a concern for the senior population, the report states. New patients can see wait times of up to six months to establish care with a primary care doctor, according to the assessment.

Skagit County is a Health Professional Shortage Area for primary care, as are Island and San Juan counties. In fact, parts of the tri-county area have roughly 1,250 more people per single primary care physician than a state benchmark, according to the assessment.

“Stakeholders speculated that provider shortages may be exacerbated due to the high cost of living, lack of affordable housing, the rural nature of the community, and staffing shortages in the healthcare industry nationwide,” the report states.

More accessible primary care services can mean fewer serious problems for patients later, according to the report.

“Stakeholders stressed the importance of being able to access primary care and preventative services in a timely manner, especially given the predominately elderly population served by the hospital which tends to exhibit higher rates of chronic disease and more complex comorbidities in their health conditions,” the assessment states.

About a third of the stakeholders also expressed concern about a need for more access to specialty care.

“Stakeholders specifically reported a need for services to support the senior population, such as cardiology, gastroenterology, hematology/oncology, neurology, and pulmonary medicine,” the assessment states.

Often, patients who need this specialty care must travel to receive it, which means they are spending more than two or three hours round-trip each appointment to see the doctor, the assessment states.

Access to healthcare was a concern for the 2019 assessment, as well. In response, Island Health completed several of its goals.

It recruited 17 new providers to provide more opportunities for patients, including “family practice (8 providers), general surgery (2 providers), pediatrics (1 provider), obstetrics/gynecology (1 provider), wound care (1 provider), interventional pain management (1 provider), psychiatry (2 providers), and urology (1 provider),” the assessment states.

It also added specialty providers in sports medicine, urology, gastroenterology and telemedicine, as well as expanded its scheduling center, its Patient Portal and its website.

In the future, for primary care, the goal is to “make Island Health the first stop for all community patients in need of health services by improving access to primary care,” the assessment states.

Some ways it plans to do that are recruiting additional doctors, assess future growth space needs, increase education classes and invest in IT improvements to help with patient portals and online scheduling.

Much of those plans, like accessing space needs and recruiting more physicians will help with the access to specialty care, too, according to the assessment.