Five months after the Franciscan Health System took ownership of the Vashon Health Center, Franciscan representatives say that clinic upgrades are planned and a patient advisory council has formed, while some islanders continue to be concerned about possible limits to care because of the Franciscan’s Catholic affiliation.

In April, the Tacoma-based Franciscan Health System purchased the financially ailing Highline system, which had administered the Vashon Health Center for more than a decade. It began running the Highline clinics  in July. The Franciscan-Highline merger has come at a time of increased attention to Catholic health care affiliations, especially in Washington, where a wave of partnerships between Catholic and secular health care institutions has taken place. Of particular concern to many is the possibility of limits placed on care, especially regarding women’s health choices and end-of-life issues.

On Vashon, Franciscan representatives have said that care at the island clinic would remain unchanged and that they planned to bring benefits to the island, specifically improvements to the outdated facility, electronic medical records and access to specialists in their system.

In a recent interview, Scott Thompson, a Franciscan spokesman, said appointments have increased at the clinic, now called the Franciscan Medical Clinic – Vashon Island, and promised that changes are still on track.

“We are looking at spending several hundred thousand dollars there for improvements,” he said.

In particular, Thompson said, the Franciscans plan to install a digital X-ray machine by March and have requested bids to make cosmetic improvements to the aging facility, including painting and flooring. That work will likely begin after the holidays, he said.

The transition to electronic medical records — required under the Affordable Care Act  —  is slated to begin on Vashon in May, he said. The Franciscan system started the process in its facilities in the spring of this year, with plans to continue that process throughout the system.

“It’s a big endeavor,” he said. “There is a lot of training and a lot of support that goes with it.”

The Franciscans also hope to have a new physician in place on Vashon after the first of the year, though Thompson said he is unaware of further details of the search process.

Since July, he said, 216 new patients have come to the clinic, a 19 percent increase over the previous six months, and patient visits are up 5 percent over the same time period.

“That is positive news for us,” he said.

When the Franciscan system first announced its plans to purchase Highline, several people familiar with Catholic-affiliated health care systems expressed concern about a range of women’s health care issues, including access to birth control, which is prohibited by the Ethical and Religious Directives, a document that governs Catholic health institutions.

However, Franciscan and clinic officials said that providers at the clinic would continue to prescribe birth control.

Tom Langland, one of the co-owners of the Vashon Pharmacy, said he has seen no changes in prescriptions since the Franciscans took ownership of the clinic, noting that he and the other pharmacists fill birth control prescriptions written by the clinic’s providers everyday.

“It’s business as usual,” Langland said.

Meanwhile, Granny’s Attic, which has supported the health center since its inception in the 1970s, is no longer doing so on a monthly basis, having changed its granting model to funding health-related programs at several island nonprofits. In the fall, Janet Kime, the president of the Granny’s board, said Granny’s hoped to partner with the clinic in the future, but it had turned down a clinic grant request, which had asked for funds to assist with transportation costs for off-island staff.

Recently, however, clinic and Franciscan representatives asked that Granny’s reconsider the request, which is for $22,000 for the year, Kime said. They made a good case, she said, and the Granny’s membership will vote on whether or not to provide the funding in early December.

In the fall of this year, the Franciscan system established a Patient and Family Advisory Council on the island, which Thompson said the Franciscans have created in all of its major hospital areas to get feedback from patients and improve the delivery of care.

Comprised of eight Vashon patients as well as several Franciscan staff members, the council experienced a turbulent beginning, according to some who were part of the process.

May Gerstle, one of the organizers of a public meeting with the Franciscan representatives last spring, had been in communication with Highline CEO Mark Bennedum about forming a local advisory council. Several community members stepped forward to join the group — to be called the Vashon Health Center Citizens’s Advisory Committee —  but shortly after the Franciscans began running the clinic, they announced they wanted to develop their own council. At first, Gerstle said, she was told members of her group would be grandfathered into the Franciscan group, but then they were told they would have to apply.

In the end, Gerstle said, just two members of her group elected to do so, and both are now serving on it. Gerstle declined to apply for a position, saying she did not believe it would not be a true advisory council.

“I could not in good conscience be on the board,” she said.

John Staczek, one of the people to move from the first group to the Franciscan council, said he, too, has questioned if the group will truly be an advisory council. The Franciscans set the agenda, he said, and it has seemed to him that the answers to the topics have been clear ahead of time.

So far, he said he felt that council members were only able to discuss the limited agenda, and he hopes that there will be more opportunity for questions and other observations so genuine communication would be possible.

“I would like to see that happen,” he said.

However, another member of the group, Arlene Schade, a retired school teacher, said she is pleased to be part of the group and has only praise for it.

“I am happy that they are even doing this,” she said. “How many groups ask citizens their opinion?”

Committee members are supposed to keep the meeting topics confidential, but Thompson said the subject of the first meeting was about what specialists patients go off-island to see. Staczek noted he felt the answer was clear — since we have no specialists on Vashon, islanders travel to see all specialists. Schade, however, said she appreciated the topic and privately conveyed to the group’s leader some of the difficulties seniors have in leaving the island for such appointments.

The purpose of the question, Thompson said, was to gather information to see if rotating specialists might serve the island. Franciscan representatives will look to see what is feasible to do in that regard, he said.

Finally, Thompson shared the Franciscan policies for uninsured patients and charity care, which many hoped would improve under Franciscan leadership. The clinic no longer requires that self-paying patients pay $75 at the time of service, which is a departure from a policy Highline created some years ago. Patients experiencing financial difficulty are invited to apply for financial help for their care before or after service, including if they have outstanding bills, Thompson said. If approved, they — and anyone in their families — are eligible for assistance for 90 days, with no limits on the number of visits in that time.

While changes continue at the health center, several islanders, including Gerstle and Kate Hunter, who was also instrumental in setting up the initial public meeting with Franciscan representatives, say they continue to be concerned that people will not have access to a full range of care at the island clinic and the larger Franciscan system. They’re continuing a group called Vashon HealthWatch, which they say is currently in a transitional phase. Hunter has also formed a splinter group, which has petitioned the Group Health Cooperative board to educate its physicians and patients about the potential limits of Catholic-sponsored care, including restrictions on participating in the Death with Dignity Act. She took this action, she said, because in some areas, Group Health members are sent to Franciscan hospitals.

Gerstle added that several members of her initial group are working on assisting with other types of health matters, such as signing up for health insurance through the state exchange. For now, she said, Vashon HealthWatch is still focused on keeping aware of health changes on the island and informing the public of them.

In the next few months, she said, the group may call another meeting to talk about what is going on in the health care arena on Vashon.

“I … feel an obligation to do that,” she said.