Board of Directors

Jerry Sinn, President

Dr. Audrey Gift, Ph.D., RN, FAAN Vice-President

James (Jim) Jones Treasurer

Bill Green, Rev Secretary

Ralph Elston

Patty Lebowitz Chair,

Development Committee

Richard E. Newman

Dave Salmon

Staff

Kip Tulin, MD Medical Director

Rose Gibbs, RN MHA/MPA

Clinic Director

Sara Nicholls Executive Director

Larry Germain, ARNP

Chronic Healthcare Clinic

Marian Needham, Administrative Assist

Pennie Robinson, Wellness Program

Coordinator

Dian Woodle Prescription Assistant

Program

Sandy Hutter Volunteer Coordinator

2016 Annual Report

This last year was very interesting as we watched volume increase then wane. The last six months reflected what was to be our new norm. Volume was essentially flat from 2015 in both Chronic Care and Urgent Care. However, the number of those returning became the majority. While the numbers are very manageable, the complexities of some of our clients have presented new challenges. Our experience is similar to the other 32 free clinics in Washington State who are also coping

with and responding to new challenges presented from their communities in this changing health care landscape. Of interest, is the increase during the last few months of clients returning due to loss of health coverage, inability to pay premiums and co-pays and loss of employment. Also, many with coverage are unable to find an accepting Primary Care Provider.

Typically we provide the bridge between acceptance and being seen, which can take up to three months for our new clients who have obtained health coverage. Without a primary care provider, an urgent care clinic or emergency department has no place to send the person for follow up. Our clinic becomes the only viable option. The Olympic Medical Center sends us clients on a fairly regular basis for needed follow up. We serve as a safety net and create an access point for some of Washington’s most vulnerable populations.

In addition, we are being sought by those who received partial subsidies and can only afford to use their plan as ‘catastrophic’ and are now finding it prohibitive to afford copays and deductibles. The statewide free clinic association believes that “with decreasing reimbursement rates and a statewide healthcare provider shortage, particularly in rural communities, this is unlikely to improve”. Of course, there are also those who do not qualify for ACA, such as undocumented workers and non-citizens.

Dental care continues to be a real concern. Medicaid clients have coverage; however, most dentists do not accept Medicaid and the only local agency that does is overwhelmed. Other insurances, including Medicare, do not provide dental services without additional insurance coverage. The Port Angeles free clinic, VIMO, has been struggling to secure dentists for their state dental grant, thus, there may be two to three months before a client can be booked for an (continued on page 2)

Clinic Director’s Report By Rose Gibbs, RN, MHA/MPA

In 2016 Dungeness Valley Health & Wellness Clinic had 1036 Patient Visits.

The value of health services to the community was $239,471.

$137,394 cash revenue $146,808 cash expense

Annual Report for 2016

Clinic Director Report, continued appointment. Those coming to our clinic present with a dental emergency and require rapid intervention. We limit our dental support to those who qualify to be seen in our medical clinic and those who reside within the Sequim School District. Occasionally exceptions are made due to the severity and inability to obtain any assistance elsewhere. Through the generosity of our local dentists and support from the Olympic Medical Center and other grants and donations, we were able to help over 80 individuals obtain dental care for dental emergencies in 2016. The majority has no regular dental care and required the expertise of an oral surgeon.

Through the Prescription Assistance Program, we have been able to secure expensive medications for our chronic care clients directly from the manufacturer. Three volunteers coordinate this program for our clients in Chronic Care. Due to the overall decrease in Chronic Care and the extra documentation required to qualify, the volume in this program has decreased with the lower volume of eligible clients. Respiratory and diabetes medications are the most often required due to their prohibitively high expense. Approximately $23,000 of free medications was supplied to our clients in 2016.

Free Clinics base their services on the particular needs and resources of the local community. DVWHC could not be successful without the tremendous support of and partnering with the Olympic Medical Center. Low-cost facility use fees and a generous in-kind contribution for basic diagnostic lab tests and imaging services for clinic patients have allowed us to provide required treatment, medical management and needed care. Many patients who are seeking care at the Free Clinic have previously had to forego needed health care, some for several years, and often multiple health issues are revealed in their first visit.

The Kitsap Public Health District and its 16 partners were awarded a competitive four year grant from the Washington State Department of Health. We completed our second year and are

continuing in our current, third year. We provided a series of classes for our clients who want to improve their overall health and wellness, with a focus on diet and exercise. The target audience has been those who are pre-diabetic or pre-hypertensive. Two of our volunteer registered nurses, Kitty Dissing and Renee Jones, are leading this educational grant process. They were able to incorporate participants at the Community Gardens, as well as support and educational groups who meet at the Shipley Center. Shelley Stratton, RN has provided additional instruction in exercise and yoga.

Over 75 clinic volunteers donate their skills and expertise, including medical providers, nursing professionals, clerical and general support staff. Most have joined the clinic after completing their own careers and have brought their vast experience and life wisdom to support others in their community. They are the foundation of our clinic and a priceless resource to our community. Marianne Ude, MD will not continue as a volunteer provider in 2017. We were very fortunate to have her compassion, support and expertise over the last ten years.

Numerous specialty providers, many associated with the Olympic Medical Center, have generously provided consultation when referrals were needed for the expertise of their specialties. During 2016 there were over 60 formal referrals with ten requiring services not available on the Olympic Peninsula.

I am privileged to be part of such a marvelous community endeavor. 2017 will be another year of transition. One day these services may no longer be required. Until that day, Dungeness Valley Health & Wellness Clinic will continue to be ‘a beacon of health and a beacon of hope’ for the underserved in the Sequim Community.

Patient Demographics: 45% Male / 55% Female 82% Have no Local doctor 67% Have no Insurance 44% Are Employed 59% Are Under the Age of 50

Page 2

Sequim’s Free Clinic Page 3

Tips for Lowering Blood Pressure

An article found on-line from the Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974 recommends the following tips to lower blood pressure:

1. Lose extra pounds. Blood pressure increases as weight increases. This additional weight can increase your risk for sleep apnea too. Check with your Health Care Professional for a healthy way to reduce weight.

2. Exercise regularly. Try to get at least 30 minutes of exercise most days of the week. Try walking, cycling, swimming or dancing. Again, ask your Health Care Professional for a recommendation on an effective exercise plan.

3. Eat a healthy diet. Eat a diet rich in whole grains, fruits, vegetables and low-fat dairy products. The next newsletter will describe the DASH DIET, which stands for Dietary Approaches to Stop Hypertension.

4. Limit salt intake. In general, lower salt intake to less than 2,300 mg a day. Just 1 level teaspoon of salt has 2,300 mg of sodium. Start reading food labels and calculate the amount of salt in your diet. Use herbs or spices to flavor your food.

5. Limit the amount of alcohol you drink.

6. Quit smoking. According to the Mayo Clinic, each cigarette smoked increases blood pressure for many minutes after you finish the cigarette.

7. Cut back on caffeine. To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a caffeinated beverage. If your blood pressure increases by 5 to 10 points, you may be sensitive to the blood pressure raising effects of caffeine.

8. Reduce your stress. Take 15 to 20 minutes per day to sit quietly and breathe deeply.

9. Monitor your blood pressure at home. Maintain regular visits with your Health Care Provider.

10. Ask for support. Ask your family and friends to encourage you to take care of yourself.

Want to learn more about blood pressure and diabetics? Attend one of the health education classes at the Dungeness Valley Health & Wellness Clinic. Call (360) 582-0218 to sign up! Health Educators, Kitty Dissing, RN, CDE and Renee Jones, RN, MSN teach the classes. Both Educators have experience in teaching and have been involved in health education for many years. Renee Jones, RN, MSN Health Educator

Partners in Health— A Shout-Out To KSQM 91.5 FM!

As the volunteer medical director for the Dungeness Valley Health & Wellness Clinic I want to express my thanks to the staff of our

partner in community service, KSQM 91.5 FM, Sequim’s very own radio station. They have worked with us to help develop a series of short “Health Minutes” based on the idea that “Your Health Is Not A Spectator Sport”. These radio spots are broadcast several times each week and contain simple suggestions that have the potential to improve your health should you choose to incorporate them into your lifestyle. The emphasis is on encouraging you to take some active steps to improve your health and wellness. Change can only occur if you do it. Your health is not a spectator sport.

Kip Tulin, MD Medical Director Dungeness Valley Health & Wellness Clinic

*The Health Minute airs every Thursday afternoon at 12:30PM and Saturday Evening at 9:30PM. The program also airs at least once during the overnight hours (Midnight to 5AM-Pacific Time).

Annual Report for 2016 Page 4

In memory of…

John Baritelle by Katherine & Brian Hogan

Barry Mason by Myrna & Christopher Juergens

Get Growing!

Spring will be here before you know it so it’s time to ramp up again for GET GROWING! We are looking for 10 people with diabetes, pre-diabetes, or high blood pressure to join GET GROWING! our organic growing program. In addition to learning about organic gardening, the benefits of joining this group include exercise, healthy produce, and access to a certified diabetes educator, Kitty Dissing, RN for tips about making healthy food and lifestyle choices. This program was a great success last year, and this year we have 2 new raised planting beds! The group’s meeting dates will be determined

based upon the best match between partici-pant and leader schedules and will meet once a week. We expect the program to run late April through

late September. For more information or to join the GET GROWING! group, please contact Kitty Dissing at 582-2975 or getgrowing@dvhwc.org .

It’s Time to Talk about GiveBig 2017

Over the past 6 years, more than $78 Million has been raised for area non-profits through Seattle Foundation’s annual 24-hour online giving campaign GiveBig. Please mark your calendars for Wednesday, May 10th. Some new features that will be available this year: Early giving so you can schedule your gift in advance of May 10th, You will have the opportunity to opt to pay processing fees, increasing the impact of your gift and a reduced fee Echeck (electronic check) option will be available. Please check our

website and our Facebook page for information as it becomes available.

Thank you to

Olympic Theatre Arts Olympic Theatre Arts, as part of a community outreach campaign has been partnering with other area nonprofits for each of the theatres shows this season. The ob-jective is to bring awareness to the various needs in our community to the OTA theatre audiences and to introduce the amazing benefits that live theatre brings to the hearts and souls of the indi-viduals it touches. OTA was pleased to partner with Dungeness Valley Health and Wellness Clinic for their holiday show “It’s a Wonderful Life, A Radio Play”. The Wellness Clinic was presented with discount coupons to this popular holiday performance to distribute to patients.

Receive our Newsletter by Email

In an effort to reduce expenses, we are asking people for their email addresses if they are inter-ested in receiving our newsletter electronically instead of the mailed hard copy. We hope to create two email lists, one for only newsletters and one for community events such as our monthly WOW forums. We will not share your emails.

If you would be interested in helping us reduce costs but still keep you informed, please send an email to Sara Nicholls, Executive Director at admindir@dvhwc.org. In the body of the email please let us know if you are interested one or both of our email lists.

Sequim’s Free Clinic

Providers

Gary Henriksen, MD Ed Hopfner, MD John Joseph, ARNP Larri Ann Mishko, MD Kari Olsen, MD Kathy Shannon, ARNP Charles D. Sullivan, MD Kip Tulin, MD Marianne Ude, MD Carl Weber, MD

Nurse Managers (RNs) Suzanne Anaya Kitty Dissing Nancy Dolansky Ardis Erickson Brooke Fitzsimmons Billie Fonville Linda Fortney Lyell Fox Jamie Goodwin Mary Lenard Kelly McKillip Ale (Alexis) Rippe Wendy schultz Christine Straker Shelley Stratton Sally Wilson

Assessment Stefanie Anderson Sandra Boudrou Donna Cameron Atlanta Duncan Lorika Erbenich Steven McElroy Jessica McGinley JoAnn Munroe Monica Ostrom Barbara Parse Jean Pratschner Dottie Robertson Elizabeth Tomisato Vina Winters

Reception Betty Archer Joyce Bahrt Madelin Barclay Joy Beaver Linda Chapman Randi Cooper Ralph Elston Irene Greene Nicolle Ho Bev Horan Sonia Killian Jan Mitcham Susan Stinard Kristine Whitman Jolie Will

Interpreters Carrie Cobb Maria Dryke Lilia Dodd Michael Garcia Maria Hall Carmen Pitkin Prescription Assistance Program Dian Woodle, PAP Coordinator Eileen Collins, RN Arlene Cox, RN

Data Entry/Clerical Support Carol Babcock Hazel Blake Sue Brock Marilyn Freeman Eva Lundstrom Debi Maguire Jane Stewart

Specialty/Technical Kitty Dissing, CDE Renee Jones, RN Sue Sorenson, RN (Diabetes Educator) Grace Lambert, Social Media Matt Wilson, Social Media

Page 5

Financial Report

Contributions 17%

Patients 3%

Event 13%

Grants & Contracts 20%

Contributed Services & Facilities 47%

Revenue for 2016 - $261,422 Expense for 2016 - $297,211

Direct Care 83%

Administration 11%

Development 8%

Thank You to our 2016 Clinic Volunteers in recognition of the service of our 2016 volunteers

Cash Revenue $137,394 / Non-Cash Revenue $124,028 Cash Expense $146,808 / Non-Cash Expense $150,403

Page 6 2016 Annual Report

NONPROFIT ORG

US POSTAGE

PAID

Olympic Mailing

Services

P.O. Box 3434 Sequim, WA 98382 Phone:360.582.0218

Follow us: Sequimfreeclinic.org

Facebook.com/

Pages/Dungeness Valley Health and

Wellness Clinic

Reminders for 2017:

Monthly Forums

Second Wednesday of each month, 2:30 p.m. at Trinity United Methodist Church, 100 Blake Ave, Sequim

March to June 2017 Schedule: March 8

The “New” Miracle Drug: Exercise For All Ages Dr. Tim Guthrie, Jamestown Family Health Clinic April 12 Better Dental Health For You Dr. Richard (Bud) Davies and Errin Aidane, RDH, Sequim Smiles

May 10 The Mental Wellbeing Challenges of Living Longer Dr. Joshua Jones, CPO/Olympic Medical Physicians June 14 Fight The Fall: Strategies and Exercise to Improve Balance, Safety and Fitness Jason Wilwert, Pt, DPT, OCS

2017 Clinic Fun Walk

Saturday, September 9, 2017

9-12:30

at Trinity United Methodist Church,

100 Blake Ave, Sequim