April 17, 2014

Ocracoke Health Center addresses islanders’
concerns about after-hours care

The Ocracoke Health Center staff and board members at a public meeting Monday night addressed islanders’ concerns about the discontinuation of after-hours care.

That is one of the changes in how the center will operate as of June 2. New expanded hours for the center will be from 8 a.m. to noon and 1 to 7 p.m. Monday through Friday and from 9 a.m. to 1 p.m. Saturdays. But there will be no on-call providers after clinic hours.

Cheryl Ballance, CEO of the nonprofit center, explained at the meeting attended by about 50 islanders how the loss of state funding, learning more about risk management, and the receipt of a federal grant last year prompted changes in its operation.

Although there will be limited after-hours coverage during the weekends, a triage nurse will advise patients after hours over the phone. That number is 252-928-SICK.  After someone calls this line, the nurse will send a report to the health center for next-day follow-up.

Many in the audience, while asking questions about center operations, were concerned about after-hours changes, but Ballance stressed that the health center is a private, family practice business. Persons with a medical emergency must call 911.

“None of us are trained or qualified for that,” Ballance said. “The Ocracoke Health Center is not an end point for any emergency issue.”

Health Center Board Chair Susan Pentz pointed out that were it not for having received a federal grant, the health center was looking at closing.

“The medicine world has changed,” she said. “We changed hours, but we added hours. We got a grant from the federal government and we have to go by their rules.”

Ballance explained that upon scrutinizing the statistics over the last three years, only seven percent of the total visits were for after-hours.  The price tag for having one of the two providers—Dr. Erin Baker and, formerly, Gail Covington, a nurse practitioner who now staffs the Hatteras Health Center--on-call was costing the center over $227,000 per year. 

Income from all sources—even a large grant from Hyde County Occupancy Tax--was not covering those and all of the other costs, she said.  So the decision was made to seek federal health center status, expand hours, and hire a nurse triage service for after-hours. 

In addition, and according to the federal grant requirements, the health center is planning to eventually have pharmacy and dental services.

As for emergency services, Justin Gibbs, the director of EMS services in Hyde County, who attended along with Bill Rich, county manager, said that there is one paramedic on the island and three EMTs at all times. A gap in service in the off-season arises when the paramedic has to accompany a patient to Nags Head via ambulance in a six-hour round trip, which leaves the island without a paramedic.  From Memorial Day to Labor Day, there is a second paramedic and ambulance on the island, Gibbs said.

Paramedics can administer oxygen and insert intravenous medicines, Gibbs said. Only physicians can do sutures or surgery. Currently, the island’s paramedic cannot administer the drugs used to stop heart attacks or strokes, but Gibbs said the island paramedic is working toward being able to do that by July 1.

Rich noted that if the health center is not asking the Occupancy Tax Board for as much as it has been, perhaps some of that money could go toward enhancing EMS services on the island.

“You can go to a hospital over on the mainland,” noted Martha Garrish. “We’re literally stuck on an island.”

And that is the next step, Pentz said--to coordinate with Hyde County for enhanced emergency medical services.

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