Jan Ko Fisher, one of the founding volunteers for International Community Health Services (ICHS), passed away on December 7, 2018. She was the longest serving board member in ICHS’s history, filling that role since 1975.
She graduated from the University of Washington in 1971 with a medical technologist degree. Ko Fisher had worked as clinical laboratory scientist at Seattle Children’s Hospital for many years, starting in 2001. She had been recruited to the cause by Dr. Allen Muramoto, another activist and founder honored by the ICHS Foundation in 2017.
One lasting legacy Ko Fisher leaves behind is her active involvement helping ICHS create a brand-new 40,000 sq. ft. medical and dental clinic in Shoreline in 2014. She served as co-chair of the fundraising steering committee.
In 2018, Ko Fisher was honored at ICHS’s 45th anniversary Bloom Gala with a Sapphire Award, recognizing her extraordinary leadership.
In 2011, she received the Ethel Bond Memorial Consumer Award from the National Association of Community Health Centers.
Ko Fisher was interviewed in 2008 for a 35th anniversary documentary project for ICHS. She recalled the early years when the clinic was an all-volunteer operation on North Beacon Hill, serving patients out of a donated medical office. Ko Fisher was responsible for opening the clinic in the evening. She got the keys from her parents, who lived across the street “It wasn’t like swarms of patients coming to our doors,” she recalled, “but we offered rides from the International District. We offered free transportation. It was targeted toward the elderly in the hotels.”
“She was such a sensitive, sweet, happy person,” said Jon Nakagawara, ICHS co-founder and ICHS’s first director. “I’ll always treasure that memory of her personality.”
“She was one of the first people I met when I got involved with ICHS in the early days. She was one of the originals,” said Bruce Miyahara former ICHS co-founder and former director. “She was an inspiration because she stuck with it for so many years. That’s true dedication. Very quiet, but so committed.”
In a later interview, Ko Fisher said she was inspired by the ICHS mission of service to the community and providing quality affordable care to underserved populations. “I can’t believe how much ICHS has grown from that small free weekly clinic on Beacon Hill. It’s given me great satisfaction to be part of this.
“With much pride, I’ve watched this health clinic grow from a small storefront space into a multi-clinic agency. I’ve been here like a proud parent through all the growing pains and triumphs.”
Teresita Batayola, ICHS CEO, reacted to the news of Ko Fisher’s passing with sadness: “She was our direct connection to ICHS’s past. She represented our soul. She was always quietly supportive, always there and deeply proud of ICHS.”
Hiroshi Nakano, a long-time ICHS board member, added. “Jan was a low-key, consistent, committed board member who was devoted to the cause of serving our patients. She will be missed by all of us.”
After completing her nurse practitioner program, Megan Wilbert wanted additional training that would help her more confidently care for patients. Wilbert’s feelings are not uncommon – and driving interest in residencies as the future of nurse practitioner training.
“Your learning is a lot more accelerated than an MD and you have no residency with the exception of clinicals, which can vary,” said Wilbert, ARNP at International Community Health Services (ICHS) clinic in Shoreline. “I’m so grateful I did it. It’s a huge transition to suddenly be responsible for patients.”
Wilbert doesn’t just work at ICHS, she was also part of the first cohort of participants in the community health clinic’s ARNP residency program, now in its fifth year and the first to be accredited in the U.S. It prepares newly licensed and certified nurse practitioners for careers as primary care providers in a community health setting. It was pioneered by ICHS provider DoQuyen Huynh, ARNP, DNP, who was named 2016 Washington state American Association of Nurse Practitioner of the Year for her work.
“ICHS’s unique population of immigrants and refugees made it the perfect place to develop and evolve this program,” says Huynh, who serves as the program’s director. “Each year, we’ve made changes to the curriculum to meet individual resident needs. We are viewed as a leader and many programs in the region mirror ICHS’s curriculum.”
Kelli Hiraoka, ARNP, immediately felt a connection. “I recall visiting ICHS on my interview and feeling inspired by the staff and workplace,” she said. “Each day is unpredictable, exciting and stimulating. You might be inserting a nexplanon procedure for contraception, managing an insulin-dependent diabetic, investigating why that six-month old kiddo has a persistent fever, or telling your female patient she’s finally pregnant after six months of trying. Or you could be helping a patient with heart failure who does not take his meds due to financial constraints, or an adolescent struggling with self harm and suicidal ideation.”
Participants credit Huynh’s leadership and the program’s high quality as selling points. Ongoing structure and support are built into the curriculum, which offers a ramp up schedule, continual education with weekly didactics and exposure to different clinical specialties. Each cohort is responsible for developing a population-focused solution to a current health challenge. Past projects led to the creation of ICHS’s Young Adult Center, the first teen health center in Shoreline, and a video storytelling initiative.
“I absolutely loved the residency and feel like it has prepared me well for the transition into independent practice. The ability to have dedicated preceptors, with decades of primary care experience was critical in my development as a clinician and has given me a strong footing for working in the challenging world of community health,” said Dan Gundry, ARNP, fourth cohort participant. “The entire team at the ICHS Holly Park Clinic is incredibly warm and welcoming, so I felt at home right away. I’m very thankful for the opportunity and would highly recommend it.”
ICHS also provides tools for building a sustainable career. Participants are taught how to manage the behind-the-scenes work of a provider. Wilbert recalls ICHS providers coaching her cohort on efficiency and clinic flow, and how to develop better charting, diagnostics and lab management skills.
“I see other colleagues who didn’t get a residency and there tends to be a high level of burnout,’ said Maura Carroll, ARNP, DNP, a participant in ICHS’s second cohort. “It gave me a solid skill set and supported my professional goals in community health.”
ICHS’s ARNP program residents are scheduled to work together. “I loved the cohort I worked with,” Wilbert said. “It was awesome to have two other people to bounce ideas off of and support you. Going through the experience side-by-side is extremely helpful.”
Many of ICHS’s ARNP residency program participants have opted to stay on at ICHS after graduation.
“ICHS used to have a difficult time recruiting providers, including nurse practitioners. Since the residency, we’ve been able to fill all vacancies,” said Huynh. “We have the added confidence of knowing residents are well prepared to provide holistic care to our diverse and complex patient population.”
As ICHS continues to invest a future pipeline of qualified health professionals, Huynh would like to expand the program to include physician assistants, and to offer consultation and support for regional programs from other organization.
Applications for ICHS’s 2019-2020 ARNP residency program are currently being accepted until March 25, 2019. Click here to apply and for more information.
International Community Health Services (ICHS) today announced Eric ‘Ric’ Troyer, MD has been hired as medical director of its proposed Programs of All-Inclusive Care for the Elderly (PACE), an innovative Medicare and Medicaid program that provides comprehensive health care and services to meet the needs of frail adults 55 and older. PACE centers aim to keep people in their homes and communities and out of a nursing home. ICHS plans to open a PACE center at Legacy House located in the International District in spring 2019. Previously, Dr. Troyer served as executive medical director of Swedish Medical Group’s continuum of care.
Dr. Troyer brings 20 years of leadership in geriatric medicine to his role at ICHS, where he will be responsible for developing ICHS capacity and programs serving the elderly, with particular emphasis on the PACE model of care. He will direct the delivery of care at the proposed ICHS PACE at Legacy House, which will open in spring 2019, assembling and leading an interdisciplinary care team, and developing and growing related community partnerships.
Studies show that PACE enrollees have better health outcomes – with fewer hospital admissions, hospital days, emergency room visits and preventable emergency room visits – at the same time Medicare and Medicaid realize significant cost savings.
“I’m pleased to welcome Ric to the ICHS team. His expertise will be invaluable as we respond to an aging baby boomer population and evidence pointing to the advantages of programs that facilitate ‘aging in place.’ Not only are there individual and systemic cost savings, but there are also emotional, social and health benefits to consider when people stay in their homes and within their communities,” said Dr. Rayburn Lewis, ICHS chief medical officer. “Ric will bring tremendous insight as we expand delivery of highly coordinated and personalized care for older, frail adults and help them live more safely, comfortably and independently.”
Dr. Troyer led a number of departments and areas of specialty during his tenure with Swedish Medical Group, including starting a transitional care program for recently hospitalized patients in 2011, and serving as the chief of family medicine at Swedish Medical Center, First Hill Campus from 2005 to 2007. He has been on staff as an active physician at Swedish Medical Center since 1998. From 2006 to 2011, Dr. Troyer served as the medical director for Evercare in Washington and Oregon, directing clinical care models for several special needs populations including those with chronic disease, those living in nursing homes, and those with Medicare and Medicaid. Over the span of his career, Dr. Troyer has contributed his leadership to a number of medical directorships and the delivery of geriatric care, alternative health care, chronic disease management and primary care to underserved populations for hospital systems and nursing facilities throughout the Puget Sound area. He was the president of the Washington State Medical Directors Association from 2009 to 2018 and currently serves as an assistant clinical professor with the University of Washington School of Medicine. Dr. Troyer obtained his MD from the Medical College of Virginia and completed his residency at Swedish Family Medicine followed by geriatric and faculty-development fellowships at Swedish and the University of Washington.
ICHS PACE programs address a growing need
The U.S. Census estimates nearly 25% of King County’s total population will be 65 years or older by 2040 — up from about 18%. ICHS plans to further meet the area’s needs for affordable senior health services by establishing PACE programs. These include Aging in PACE (AiPACE) Washington, a new non-profit organization that partners Kin On and ICHS to open a $20 million PACE center in North Beacon Hill, slated to open in 2021.
International Community Health Services (ICHS) patients are less likely to suffer a heart attack or stroke thanks to the health center’s success rate in controlling hypertension.
ICHS’s efforts were recently recognized by the American Heart Association (AHA) and the American Medical Association (AMA) through its “Target: BP” program, which aims to improve blood pressure control and build a healthier nation. ICHS earned gold status as one of just 340 physician practices and health systems to achieve blood pressure control rates of 70 percent or greater for adult patients in 2018. Of the 103 million Americans with high blood pressure, less than half have it under control.
“Thank you to all ICHS providers for working so hard to keep our patients healthy,” said Dr. Rayburn Lewis, ICHS chief medical officer. “No single risk factor has more impact on whether or not cardiovascular disease ends up being a killer than high blood pressure. Fortunately, high blood pressure can be managed under the care of a professional staff of physicians and advanced practice clinicians. We connect our patients to dieticians, health educators and clinical pharmacists to make sure they are eating right, seeing their doctor regularly and taking their medication properly. Additionally, we make sure our training reflects best practices for taking blood pressure readings and that hypertension data is recorded accurately.”
Launched in 2015, Target: BP is a national initiative of the AHA and AMA aimed at addressing the growing issue of high blood pressure. More than 1,600 physician practices and health systems nationwide have joined Target: BP.
What is public charge?
The Department of Homeland Security has proposed changes to the definition of “public charge” that would expand the criteria that apply when a person is applying for admission to the United States or seeking a green card or legal permanent residency.
Historically, those applying for permanent status must demonstrate that they will not be dependent on government programs (cash benefits like Temporary Assistance to Needy families/TANF, SSI and long-term care). The proposed regulation would expand the list of federal benefits that the government may consider as part of its process, to include:
- Medicare Part D (low income subsidy for prescriptions)
- Federal Housing (Section 8 housing vouchers and any Section 8 housing)
- Supplemental Nutrition Assistance Program (formerly known as Food Stamps)
ICHS believes this proposal undermines public health and humanitarian values as it continues to attack immigrants seeking legal residence in the U.S.
Our communities must make public comments by December 10 to stop or delay the adoption of this proposal. All comments have to be reviewed by the government prior to adoption. ICHS urges patients, families and communities to stay calm and take action to:
- STOP FINAL ADOPTION OF THE NEW REGULATION. ICHS is working with Protecting Immigrant Families, Association of Asian Pacific Community Health Organizations and the National Association of Community Health Centers to try and stop the proposal’s final adoption by generating as many public comments as possible by the Dec. 10 deadline. You can submit as many comments as you want, but each comment must be unique.
- GET THE SUPPORT AND BENEFITS YOU NEED NOW. The proposed rule is not in effect and will take months to be adopted because of the public comment, review and response period that the federal government has to legally observe. Anyone currently legally qualified to participate in Medicaid, Medicare Part D, public housing and SNAP is still qualified to use them.
- NOT ALL IMMIGRANTS ARE SUBJECT TO THE “PUBLIC CHARGE” TEST. Exempt are U.S. citizens; green card holders; refugees; asylees (applying for or granted asylum); people applying for green cards under the Violence Against Women Act; survivors of trafficking, domestic violence, or other serious crimes (those who have or are applying for “U” or “T” visas); and children seeking Special Immigrant Juvenile Status.
FOR MORE INFORMATION
The City of Seattle has created an overview with Frequently Asked Questions and resources.
On Oct. 18, Karen Wong, president of the Robert Chinn Foundation, presented a $5,000 grant to International Community Health Services Foundation that will help connect the arts with health through a vibrant community arts space at the Shoreline Clinic.
The grant will help extend the clinic’s capacity for community-curated arts exhibitions that focus on community, social issues and topics related to health care and wellness. This year, the clinic opened a historical exhibit telling ICHS’s 45-year story and highlighting its milestones. ICHS plans to extend the exhibit area to additional space.
“We’re appreciative of this generous gift from the Robert Chinn Foundation and what it allows us to create,” said Ron Chew, ICHS foundation director. “So often public spaces are sterile and even unwelcoming. Our community gallery elevates our lobby space to encourage reflection, connection and beauty.”
The Robert Chinn Foundation Grant Program was established to promote and support programs of nonprofit organizations devoted to art, culture, health and youth development.
The open enrollment period to enroll, renew or change health plans through the Washington Health Benefit Exchange starts on Nov. 1 and ends on Dec. 15 for coverage to take effect on Jan. 1, 2020. Unless you qualify for Apple Health or a special enrollment period due to a qualifying event you must be enrolled to ensure there is no interruption in your health benefits and to avoid a year-long wait until the next open enrollment period in the fall of 2020.
FREE help from ICHS
ICHS provides free help for patients and for anyone seeking to enroll or renew health insurance. Plan ahead and schedule an appointment with one of our multilingual outreach and enrollment navigators, who can explain your options and assist with sign up. ICHS staff speak languages including: Amharic, Chinese (Mandarin, Cantonese, Toishanese), Eritrean, Hindi, Korean, Russian , Spanish, Punjabi, Tagalog and Vietnamese,
ICHS will offer walk-in appointments on a first-come, first-served basis on Saturdays at the ICHS International District Clinic (2nd floor) from 9 am to 3 pm. Come see us for help from a qualified navigator on the below dates:
To make an open enrollment appointment or for more information
Call ICHS at: 206-788-3700 or find enrollment information online at: https://www.wahealthplanfinder.org. You can also call or walk into any of our four full service clinics in Seattle, Shoreline and Bellevue.