Tensions on rise over changes at Sunshine clinic

March 30, 2007

By John R. Moses

For the Frontiersman

WILLOW - People don't usually carpool to get to the Sunshine Community Health Center's board meetings. In fact, the public seldom - if ever - attends.

Tuesday night's 52-person turnout at a local church marked the first public signs of a controversy that has roiled beneath the surface during the region's quiet winter months.

A petition of &#8220no confidence” in the clinic's board of directors is circulating through areas served by the regional nonprofit clinic, the only source of health care for 40 or more miles around in growing upper Susitna Valley communities like Talkeetna, Willow, Sunshine and Trapper Creek.

Staff resignations, for various reasons, are changing the face of a clinic in a close-knit area where doctors, nurse practitioners and patients have lives that often overlap on many personal levels. Adding to community tension are administrative changes. There is a board vacancy, and a new and controversial clinic director on the job for just 10 months resigned Tuesday night.

An abysmal employee satisfaction survey recently led the board to hire an outside facilitator to work on improving morale and communication between employees and clinic administrators.

The director resigned by letter while on a family vacation, and executive control was given Tuesday to board chair Doralynn Issel.

Then, for more than two hours, the audience offered often bruisingly emotional testimony. Many criticized the clinic's board and ex-administrator for allegedly pulling away from the public, moving away from the clinic's founding goals and alienating dedicated employees who built the clinic and made it work for the community.

Talkeetna resident Diane Ziegner testified about her personal ties to the clinic and the effects its services and veteran healer Jessica Stevens had on her life.

&#8220She has helped me through difficult times, both as my health provider and as my friend, and I will defend her integrity,” Ziegner said of Stevens, who resigned as physician's assistant after feeling she was being blamed for deficiencies in the clinic, personally attacked as having some kind of personal agenda and simply ignored by the board of directors. &#8220We are a small town with lots of interconnections.”

What became clear was how many supporters Stevens had among those testifying, as sometimes tearful and often angry speakers lashed out at directors for not pursuing Stevens and two other employees who are leaving and trying to get them back.

Clinic staffers testified that as many as 30 percent of the clinic's employees are seeking other work. Many clinic employees and patrons see Stevens' departure, and the administration's apparent lack of interest in getting her and the others back, as a sign something is seriously wrong in that community organization.

Founding board member Pam Robinson, who was there when bank accounts were more than low and the clinic was just beginning, told the current board, &#8220The best thing we ever did was hire Jessica.”

A history of the clinic written in 2002 by Stevens states she was hired in 1993, and her first job was to help a patient suffering from a chain saw wound using expired anesthetic and a variety of on-hand cleaning solutions while wearing a black garbage bag and plastic sacks on her feet.

In 2002, Stevens won the Phil Nice Memorial Award at the Alaska Rural Health Conference, where she was credited with rescuing and building up the Sunshine Clinic &#8220to the model it is today” and for years of commitment to improving health conditions in rural Alaska.

Stevens, who said she tried to raise red flags about the clinic's direction and have some input into the ex-director's probationary review in October, felt dismissed and betrayed by the board.

&#8220I have worked diligently for many years, often putting the needs of the clinic before the needs of my family,” she said. &#8220I realize that was my choice.”

What she didn't expect, she said, was to find a board that &#8220has built themselves a concrete bunker” and now looks out at angry comments &#8220from the gunnels.”

A key accusation was that the clinic was moving toward more of a business model than that of a nonprofit community health clinic.

The board may have been in the line of fire, but under rules announced by the chair, its members would not respond to questions or comments made during three-minute testimony slots.

Larry Dearman of Talkeetna accused the current board of hiding from the public, compared with past boards, which even took part in town festivals.

&#8220All of a sudden this board has decided go underground. I'm from the CIA, I know underground,” the former government employee said during lively testimony.

Many in attendance called for an open dialogue and urged the board to take the turnout seriously. Several also tossed some olive branches, thanking the volunteer board for their time and attention to the testimony.

Others wanted more say. Talkeetna resident Jim Graupmann said he misses the clinic's previous outreach efforts. He said bylaws demand the clinic reach out into the community and ask what services are needed.

I haven't heard from you in two years,” he said.

There were also calls for the board's mass resignation.

Some seemed to hope everything could be worked out if the formalities were dropped.

&#8220It's apparent to me as a community member that there is a problem, said Mike Lindgren. &#8220These people wouldn't be here if there weren't. Acknowledging the problem is the first step. It's like going to an A.A. meeting.”

The petition, and the tense board meeting, came during a week former clinic Executive Director Bruce Wiegman was away to attend a family event.

Wiegman, interviewed in early March well before the &#8220no confidence” petition went public, seemed aware of staff dissatisfaction and community concerns. The director declined to comment on personnel issues and specifics of the latest employee satisfaction survey.

&#8220We decided on this survey to bring in a facilitator and try to research issues that were here before me,” Wiegman said.

He said such surveys are standard practice at the clinic.

Wiegman said if he could say one thing to the clinic's patients, &#8220I would say they don't have to be worried about the future of the clinic.”

Changes are in the works, he said, including investigation of a new &#8220practice management system” for running the office and its billing processes more efficiently. During the February meeting, Wiegman announced that a contract previously missing had been located, and the clinic could now bill for services already rendered to members of a health organization.

While one staff resignation came months before, the loss of longtime nurse-practitioner Stevens was the event that sent ripples through the community. The clinic still has signs on the community's many message boards seeking her replacement. Wiegman had said the clinic is actively recruiting and noted that it's not easy to recruit people to rural Alaska without perks such as housing.

In ending Tuesday's session, the board voted unanimously to work with the community to find a solution to the problems facing the clinic. Chair Issel told an audience that largely accused the board of secrecy that Tuesday marked the first time in her term members of the public came to participate in a board meeting.