City of Seward, Health

Community Health Center transition concerns addressed


CHC Interim Director Sharon Montagnino speaks at City Council meeting. Heidi Zemach photo.
CHC Interim Director Sharon Montagnino speaks at City Council meeting. Heidi Zemach photo.

PSMC Administrator Joe Fong, and Seward Community Health Center Interim Director Sharon Montagnino, addressed some public misconceptions and concerns that some residents seem to have about the transition at Monday night’s City Council meeting.

The Seward CHC opens February 26, 2014 in the hospital building where it the clinic now exists at Providence, replacing the hospital’s own out-patient clinic. The old clinic it runs will close its doors on February 14, 2014 to enable the new CHC to renovate the space, and begin seeing patients. Both Providence, and the CHC folks have been working hard to accomplish the transition, and there remains much to be done, Fong said.

But inevitably with change, there are concerns.

The greatest misconception people have is that Providence is leaving Seward, Fong said. It is not. Its emergency room, hospital beds, labs, physical therapy, and Seward Mountain Haven long-term care facility—everything but the clinic will remain. The clinic portion will be replaced by the new Community Health Center seven working days later.

Providence Seward waiting room. Heidi Zemach photo.
Providence Seward waiting room. Heidi Zemach photo.

Despite the transition, both personal and professional, Providence’s staff have been speaking on behalf of their patients who are concerned about what the transition gap will mean, so Providence and the CHC are evaluating that issue, and looking into possibly providing some alternatives, Fong said.

Another concern frequently expressed is the safety of medical records, and confusion as to what happens with them in the transition.  Providence and CHC have been letting clients know that they have to specifically ask that copies of their medical records be transferred to the clinic. The CHC is its own entity, and not a part of Providence Seward, so federal regulations require that patients specifically request the transfer, Fong said. They don’t allow Providence to do so, unless they make that request.

Everyone’s health records will stay with Providence, however, for as long as clients may need them to be there.


Montagnino suggested that people have no need to rush to have the hospital release their health records at this stage. Rather, a client could wait for their first appointment, and depending on what they are seen for, they can then ask their provider which records would be best to transfer to the clinic, based on their circumstances. The clinic’s new staff have not been hired yet, and clients could be seeing some of the same providers as they had before, or perhaps new ones, she said.


Despite the pricey new Electronic Records System software recently obtained for the hospital, patient’s records will still have to be transferred to hard-copy, (paper) at least initially, as the CHC won’t get its own ERS system for several months, and the new system purchased by the clinic, one that meets federal CHC reporting requirements, may not be compatible with the one that Providence is now using.

Councilwoman Marianna Keil asked Fong to help clarify concerns about a statement at the bottom of the records disclosure form that appears to suggest that the confidentiality of health records are not guaranteed. Fong allayed those concerns, explaining that was a catch-all phrase in legalese designed to address certain situations, such as the confidentiality of medical records that are released directly to individuals, rather than to other medical facilities, and which are therefore beyond the facility’s control. Direct health facility transfers must follow strict federal confidentiality guidelines, he said.

“I know this is a difficult time, but I do know and firmly believe that this is in the best interest of the community,” Fong concluded.

Some are questioning the kind of health services that the new clinic would offer, and whether it may lack some of the services now available, said Keil.

“That depends on what those services are. CHC centers are primary care services and HRSA, which provides the money, tells us what those basic services are that we have to provide, and then you can provide other services,” Montagnino said. If the clinic wanted to add physical therapy, which is not one of those basic services required for all CHCs, the board could apply for a “change in scope” to address that desire.

“So, we start out with those basic primary care, family care/ practitioner types of services, and then typically the health center will add services as the patient population dictates that those services need to be added. So it always comes back to what does the patient population really need?”

Meanwhile, Seward Providence Medical & Care Center has paid off all of its outstanding loan balances with the City of Seward, including $300,000 that it loaned to PSMC to implement its new electronic records system, plus more than $2 million toward the amount of money delayed due to its rate reimbursement dispute with the State of Alaska, said City Manager Jim Hunt.

This would enable the city to repay its water enterprise fund money that it had borrowed for the hospital’s needs, said one council member.


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