Harrisville clinic to get new provider

The Harrisville Health Center is shown in 2013 just after Lewis County General Hospital reopened the clinic after taking it over from Carthage Area Hospital. Watertown Daily Times

HARRISVILLE — Town of Diana officials have given the Lewis County Health System notice that no new lease will be offered for the Harrisville Health Center building, and they are now in negotiations with another area hospital to fill the need.

The decision was made in the town’s Nov. 9 board meeting not to renew the one-year lease that ends on Dec. 31, according to town Clerk Janet L. Taylor.

On Friday, the Health System was given seven weeks’ notice when a letter arrived from the board by certified mail.

No one saw it coming.

“It is a little bit shocking. We have had a strong team in place for approximately 2½ years and they are doing a terrific job when considering our quality health indicators, patient satisfaction scores and the number of patients being seen. We have a medical doctor who is at Harrisville, followed by an incredibly competent member of the nursing service and a strong physician office assistant. They have really stepped up to provide medicine of the highest level,” Mr. Cayer told the Health System’s Executive Committee. “So at this point it’s hard to understand where the town leaders are coming from. If there were concerns they were not communicated to me or to Jeff. We had hoped for a lease that would be longer because of the significant investments we’ve made in the structure.”

The suddenness of the situation mirrors the 2019 change in medical provider at the clinic that was part of the driving force for the town’s desire to change health partners.

That year, the health system provider switched from physician assistant and Harrisville resident Brittani L. Bickel to Dr. R. Brian Shambo who was relocating to Lake Bonaparte at the time. The personnel change was made for two reasons.

The first was because it was brought to the health system’s attention that her supervising physician on the main campus in Lowville was too far, at about 30 miles, even though it had been the case for some time, and because of unspecified personnel issues with Ms. Bickel.

Ms. Bickel was offered a position on the hospital’s main campus which she refused, opting instead to work in a different facility.

Although some patients followed Ms. Bickel to her new job through St. Lawrence Health System at the Edwards Health Center and continued on with her earlier this year when she started working at Clifton-Fine Hospital in Star Lake, a number of other Diana residents embraced the new doctor in the house.

Health System Chief Financial Officer Jeffrey W. Hellenger said during his financial report given in the hospital’s Executive Committee meeting on Tuesday evening that in October, the Harrisville Health Center recorded its third-highest number of patients ever seen.

The Diana board, however, had a plan to get Ms. Bickel back beginning with the April 2019 board meeting when her removal by the health system was discussed.

According to the minutes, “no one... spoke against” the idea that the board should, “no matter what the time frame involved... move forward to take the necessary measures to get Brittani Bickel back at the clinic” and the board unanimously empowered Supervisor David Parow “to explore any and all options regarding contract obligations with LCGH and any and all options regarding providers for the Harrisville Clinic.”

The advent of the COVID-19 pandemic may have caused a delay in the plan so that the town was not left without a clinic in the middle of a health crisis; however, earlier in the fall, the town board began making its move.

“The town actually reached out to me a little bit ago and asked Clifton-Fine if we might be interested. After doing a little work on my end, and they did a little work on their end, we responded back that we would be interested in looking into that further,” said Clifton-Fine Chief Executive Officer Dierdre D. Sorrell. “They let me know that their contract with Lewis County would be expiring at the end of the year.”

Because it is in the early stages of the negotiations, Ms. Sorrel said the topic of staffing has not yet come up, but it will be addressed soon.

“It may be a combination of folks. That’s kind of what we’re envisioning, so certainly if we can get her back there and make it right we will, but in the meantime, (Ms. Bickel) serves Star Lake and we don’t want to disturb that because she’s built quite a clientele here,” Ms. Sorrell said.

While Ms. Bickel was a factor in the decision not to continue the relationship with the county hospital, Mrs. Taylor said that there were other contributing factors to the decision, including the fact that the board felt the health system was trying to take over the building.

A building assessment earlier in the year pinpointed asbestos in the furnace area of the basement that needs to be removed and an upgrade to the HVAC system that needs to be done. However, Mrs. Taylor said two options were offered to the town — the health system could invest in the upgrades but wanted longer than a one-year lease, or the town could “give” the county hospital the building to take care of all improvements, upgrades and cleanup now and going forward.

Mr. Cayer confirmed the health system’s preference for a longer lease if they would be making a substantial investment in the building.

Prior to the 2019 personnel change, contracts between the two were for at least two years, but have been for one year each since.

In the early fall, Mr. Cayer also communicated through the health system’s facilities director, Frank Pace, that if the town gave the building to the health system, it would be included in long-term capital planning for additional improvements, following the model that has stabilized other community clinics.

In the current contract, the health system was obligated to maintain the inside of the clinic and the town the outside, Mr. Cayer said.

This year, rent for the space has been about $846 per month, to total $10,148 by the end of the year.

Mr. Cayer said he reached out to Mr. Parow on Friday afternoon “to try to understand the backdrop” of the town’s decision, however, as of Monday night, he had still not received a response.

“We’ve made an investment at the Harrisville Health Center. We have spent thousands of dollars internally, and we are providing a high level of physician coverage for a rural community. We are in fact subsidizing medical access (there). The irony is that it would help our bottom line if we didn’t provide access to primary care in Harrisville. However, we are the county health system,” Mr. Cayer said. “Ideally we should continue to provide services there, but I’m very pragmatic. The Harrisville community does not have an adequate population base for two primary care providers.”

According to the 2020 Census, the population of Diana was 1,610.

Lewis County Health took over the clinic from Carthage Area Hospital in 2013.

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