The city of Ocean Shores hosted a town hall with Harbor Regional Health (HRH) officials Wednesday evening at the Ocean Shores Convention Center that turned contentious in a hurry.

Residents were under the impression the City was teaming up with HRH to open a walk-in health clinic, however HRH officials indicated the new facility would be an appointment only Family Medicine Clinic, which blindsided those in attendance.

The town hall started positively enough, with HRH Chief Executive Officer Tom Jensen, Chief Medical Officer Anne Marie Wong, M.D., Executive Director Harbor Medical Group Elizabeth Tschimperle, Director of Marketing and Public Relations Chris Majors, and Grays Harbor County Public Hospital District #2 District 3 Commissioner Lynn Csernotta delivering a comprehensive presentation detailing HRH’s services, successes, challenges and concerns.

City Administrator Scott Andersen, Finance Director Sara Logan and Fire Chief Brian Ritter represented the city of Ocean Shores. Mayor Frank Elduen was unable to attend.

After a 45-minute presentation and a few general clarifying questions and answers about HRH’s services, the discussion turned to the health clinic planned for Ocean Sunset Plaza located at 171 E Chance a La Mer NE Unit 1, formerly Beach Bum Fitness, in Ocean Shores.

The Ocean Shores City Council held a special meeting on Dec. 30, 2024, to award a contract to Tumwater-based general contractor Christensen Inc., to transform the former fitness facility into a health clinic.

Elduen told The Daily World at the time, “We’re starting off with a walk-in clinic type care, if people use it, and I believe they will, (HRH) will expand their types of care, and they’ve said that, they just need people showing up and using the facility. I think people north of us, up the north coast, will be stopping here instead of driving into Aberdeen.”

American Rescue Plan Act (ARPA) funds awarded to the city of Ocean Shores by the United States federal government are being used to finance the construction of the clinic, which is budgeted for roughly $470,000.

The agenda summary for the city council’s special meeting reads: “ARPA funds will be used for this project. The city of Ocean Shores plans to build a Health Clinic at 171 East Chance a La Mer NE, in Ocean Shores. Council has agreed that the remaining ARPA funds can be used toward the Clinic construction. The City will partner with Harbor Regional Health (HRH) to run the Clinic. HRH will be responsible for staffing the clinic, the supplies and all equipment for the Clinic. HRH will sublease the space from the City, who is leasing the space from Ocean Sunset, LLC.”

The construction documents conveyed between the city of Ocean Shores and Christensen, Inc., all read “City of Ocean Shores Walk-in Clinic,” while the lease agreement between the City and Ocean Sunset LLC, under Use of Premises, reads, “Tenant or Tenant’s sublessee shall use the Premises for walk-in or urgent care medical services and other ancillary use (such as related office space) (the “Permitted Use”) and shall not use them for any other purpose without the prior written consent of Lessor, which will not be unreasonably withheld, provided, however, in no event shall the Premises be used as a behavioral health service, methadone or other drug recovery or substance abuse weaning type of clinic.”

Under Sublease; Assignment, the lease reads, “The Tenant shall have the right to sublease, assign, or license the Leased Premises to any sublessee, assignee, or licensee who agrees to operate the facility as a walk-in medical clinic, subject to the Landlord’s prior written consent, which will not be unreasonably withheld; PROVIDED, however, a sublease to Grays Harbor Regional Health is permitted outright.”

However, the Harbor Regional Health sublease agreement’s Use of Premises section reads, “Tenant shall use the premises for medical services and other related purposes and shall not use them for any other purpose without the advance written consent of City. Tenant shall continuously use the entire premises for the conduct of business during clinic hours for the term of this Lease with the exception of temporary closures caused by reason of wars, interruption in labor, riots, civil commotion, acts of the public enemy, acts of God, or temporary shutdown because of economic necessity.”

After a description of the HRH Family Medicine location in Westport, which offers appointment only services two days per week, the “Coming Soon” Ocean Shores clinic was mentioned in the initial presentation and the slide called it “HRH Family Medicine.” The presentation indicated a similar facility was in the offing for Pacific Beach.

“And then this is the location of the Family Medicine Clinic we are working with the city to open here in Ocean Shores,” said HRH’s Tschimperle. “We are working with architects in the city to get all of those things squared away so we can provide services here to Ocean Shores. We are also working to put a clinic of similar size at Pacific Beach.”

After a question was asked about emergency room challenges, Ocean Shores Fire Chief Brian Ritter indicated that he believes the clinic will help alleviate some of the pressure placed on local authorities for medical services.

“(Emergency rooms) are facing recruitment/retention issues, high turnover, just like everywhere else, but one of the biggest issues I see in the ED (emergency department), and I think in the majority of community hospitals, is people using the ED for their primary care,” Chief Ritter said. “Primary care has now fallen in the lap of a local community hospital,the fire department and the emergency room, and I think the benefit of having this walk-in clinic … having this opportunity for Harbor Regional Health, the city of Ocean Shores and the Fire Department work together to reduce some of that lower acuity of patient care will be extremely beneficial for not only the city but the hospital as well.”

The citizens of Ocean Shores in attendance at Wednesday evening’s town hall were aghast to hear “Primary Care” and “Family Medicine” instead of “walk-in clinic” from HRH officials.

A resident asked, “Earlier Elizabeth referred to the facility that’s coming here to Ocean Shores as a family medicine clinic, is that accurate?”

“Yes, that’s accurate,” said Tschimperle. “It will be providing primary care services initially. If there is an opportunity for us to recruit enough clinicians, we do have space to provide additional services like a walk-in service, but ultimately as a rural health clinic the initial services we need to provide are primary care. Urgent care is not the same. It’s a different classification of services.”

Jensen echoed Chief Ritter’s sentiments when it comes to alleviating pressure on emergency rooms if and when the HRH Family Medicine Clinic in Ocean Shores becomes a fully walk-in facility. He also tried to clarify the nomenclature.

“That’s the best part about a walk-in clinic, if they can’t help you they will tell you you need to go to the emergency room,” said Jensen. “Once we get to a point where it will just take walk-ins, you can see by the stats, my ED visits have almost stabilized because of that walk-in clinic. If the volume is here you’ll see it as a walk-in. I hate to use the word ‘Urgent Care’ because it’s billed differently, there’s different expectations, there’s different federal expectations, so we use the word Prompt Care and we talk about primary care. You might not see very many differences between that and say a more acute care service.”

Jensen added that the number and types of services the clinic will offer over time will depend on patient volume.

Another resident asked about the status of the physical clinic construction project and if there were any foreseeable delays or issues.

“We have been working with architects in the city of Ocean Shores to make sure that the drawings and the construction are what are required by the Department of Health to be able to provide healthcare services in this community at that location,” said Tschimperle. “We are in the stages of that. The Department of Health requires what’s called a ‘construction review’ process so they have to take all of the drawings and everything we tell them that we are going to provide in these services and put them together and say ‘yes, you can do this here with those plans.’ Then being able to do all of the construction and hire staff and get all the equipment here and train them and open the doors.”

The next question regarding the Ocean Shores health clinic involved the treatment of accidental injuries.

“I think a number of us are still confused exactly what’s coming here, a lot of us thought it would be if I was on the beach and I stepped on a beer bottle and I cut my foot I could go into your clinic and get my foot sutured, now that’s not what I’m thinking I’m hearing anymore, is that incorrect or correct?” said Rick Beveridge.

“We will be providing primary care services, there may be some level of walk-in, but at first it will be by appointment only,” said Tschimperle. “Those kinds of services you’re talking about would be more along the lines of an urgent care service and we do not have at this time the means to provide that level of service at this location.”

Dr. Wong tried to further clarify the services the HRH Family Medicine Clinic in Ocean Shores plans to offer.

“However, as we’re seeing in Westport, as any new clinic starts, the schedule is not completely full, sometimes there are patients that will show up in Westport without an appointment, and if the clinician who is there has the ability they will say ‘go ahead and put them in,’” said Dr. Wong. “Is that a walk-in service, it is kind of a walk-in service. It is primary care, primary care encompasses anything that is considered family medicine, internal medicine is primary care, pediatrics is primary care, obstetrics and gynecology is primary care. The primary care focus we’re going to have here will be family medicine, we consider birth-to-death type of services for routine things. Many times your old-fashioned family medicine doctor would see you for you stepped on a bottle and your foot is bleeding and can they do something for you there.”

Many more residents took to the microphone to express their confusion and dismay using phrases like “bait and switch” and “this is not what we were expecting.” The HRH representatives were asked what it would take for this new facility to grow into the walk-in clinic the residents of Ocean Shores envision.

“Urgent care services are different services, they are attuned to an emergency room, we don’t have all of the things we need in order to provide those services, we don’t have all of the equipment and we don’t all of the personnel and we don’t have that classification,” said Tschimperle. “Walk-in services are something, yes, we can get to, but that also depends upon the level of walk-in services we can provide and staffing. I have heard from others that the want is that we are open seven days a week for much more than a regular workday. I can tell you right now I do not have the personnel to provide that level of services either at the moment. So we have to take small steps to get to that point and we have to see that we have the community demand to be open that period of time and to be able to staff to that level of service.”

Ocean Shores City Administrator Scott Andersen suggested a compromise.

“Is there any possibility of sort of a hybrid system, where obviously we could have appointment based scheduling but people could walk in off the street?” Andersen asked. “What would you be able to afford to people who walk in off the street?”

“There can be some level of simple suturing, things like that, there can be all respiratory related illnesses, ear infections, things like that,” said Tschimperle. “That’s what we do now at our Prompt Care location and we provide those services also within primary care. It’s not out of the realm of possibility. I think there is some maybe miscommunication about what urgent care is and what walk-in services are and what primary care services are. Because we are providing primary care services doesn’t mean we won’t provide walk-in services, in the sense that we have available appointments so if somebody comes in and we can see them then we would see them. We have to build our practice, we have to be open for services and have people come. It’s not like we would say we’re only scheduling appointments and you can’t get in any other way. I don’t want to commit fully to something not knowing what the utilization will be in the community.”

Dr. Wong added, “Because we call it primary care it doesn’t preclude people from walking in, it can still happen, I think that we want to start small. Part of it is recruiting clinicians is very difficult.”

Andersen was asked how the disconnect happened regarding expectations and communication about the services HRH plans to offer at the new clinic.

“I just found out about the appointment system just now, I just learned that myself,” Andersen said. “We just have to really look at that, that’s what the community needs, we’re going to have to talk about how that works. You can see what our community wants.”

No hours or days of operation have been established for the HRH Family Medicine Clinic in Ocean Shores as of yet.

A broader question regarding the disconnect in communication and expectations was put to the HRH representatives.

“We have been talking to people with the city and we’ve been very clear what we are planning to do, and what we’re talking about tonight is what we were planning and have been planning, so where the disconnect came from is really hard to say. We don’t know,” Majors said. “This is the conversation we’ve been having with everybody from the city from the beginning.”

Andersen said, “We knew that it would not be an urgent care. … I did not, honestly, until tonight did not know that people could not walk into this. We’re going to have to talk about this somehow, this may not be the place but we’re going to have to talk about it.”

By the end of the town hall Tschimperle and Andersen resolved to discuss compromises and negotiate solutions to the issues raised during the meeting.

On Thursday, Ocean Shores Mayor Frank Elduen and City Administrator Scott Andersen issued the following statement:

“After the presentation by Harbor Regional Health there was an open microphone question and answer session. During that session questions arose about the hours, schedule, and services that would be made available to walk-in patients at the Ocean Shores clinic. Both the audience and the City were taken aback by comments that the clinic would not be offering walk-in services.

“During conversations between the City of Ocean Shores and Harbor Regional Health the City was informed that the clinic would be classified as “Rural Health Clinic” as defined by the United States Department of Health and Human Services https://www.ruralhealthinfo.org/topics/rural-health-clinics. The Ocean Shores clinic would therefore afford scheduled primary care services, but it was clearly understood by both parties that the clinic would also offer walk-in clinic services to the public. In correspondence from both the Mayor and the Project Manager the clinic is referred to as a “walk-in clinic”.

“In correspondence drafted by City Administrator Andersen and sent by Mayor Elduen to CEO Tom Jensen on Dec. 18, 2024, the opening includes the following: ‘Hello Tom, I truly appreciate everything you are doing at Harbor Regional Health to facilitate the introduction of a walk-in clinic in Ocean Shores. Our community has longed for this development for many years, and I anticipate this service will prove to be exceedingly popular.’

“After the meeting, City Administrator Andersen and Finance Director Logan debriefed Mayor Elduen on what had been said and what transpired during the meeting. The Mayor immediately put in a call to Harbor Regional Health CEO Tom Jensen. CEO Jensen returned the Mayor’s call this morning. On that call Mr. Jensen promised Mayor Elduen that walk-in services would be available at the Ocean Shores clinic. Mr. Jensen noted that the level of services would be determined by the volume of visitors and that hours and times walk-in services would be afforded to the public would ultimately need be decided based on usage, a position the City finds acceptable, but when asked directly if he could openly be quoted as stating for the record that the Ocean Shores clinic would categorically make walk-in services available he said ‘yes, you can quote me on that, we will get this done,’ and that he ‘regrets any confusion that was caused last night.’

“The City of Ocean Shores respectfully looks forward to next steps with Harbor Regional Health on staffing, hours, and the types of walk-in services that will be made available to our community and guests.”

On Friday, Jensen and Harbor Regional Health Public Hospital District Chairman Michael Bruce sent a letter addressed to Mayor Elduen, Scott Andersen, and the citizens of Ocean Shores that reads, in part, “Initially, our plans included providing primary care through scheduled appointments, along with acute same-day services, as required by federal guidelines for Rural Health Clinics. However, after hearing the clear feedback from the City, we are committed to partnering closely with city officials to develop a plan that accommodates broader walk-in access.

“As the clinic launches and patient volumes grow organically, we anticipate expanding our service offerings and operational hours to reflect increased demand. Our aim is to ensure that your clinic not only meets regulatory standards but, most importantly, fulfills the healthcare needs of the Ocean Shores community.”

Executive Director Harbor Medical Group Elizabeth Tschimperle

Ocean Shores City Administrator Scott Andersen