Monday, December 22, 2014

Falls’ dialysis access to be explored

There’s definitely a will. Now they’ll have to find out if there’s a way.
A cross-border task force will put together a business plan for a pilot program so International Falls area residents might be able to access renal dialysis treatment at the Thunder Bay Regional Health Sciences Centre’s satellite unit at La Verendrye Hospital here.

The proposed plan was the outcome of the first international “Medical NAFTA” meeting held last Thursday at La Place Rendez-Vous, which attracted about 40 community and health-care leaders from both sides of the border.
“We had the players from both sides of the border in the same room together, talking about renal dialysis,” said International Falls Coun. Cynthia Jacksa, who co-organized the meeting with Fort Frances Coun. Rick Wiedenhoeft.
“That is a first.
“We have to start with the players and they have to be talking to each other, and we got that done today,” Coun. Jacksa noted.
“So we opened the door for future work.
“We got the consensus today that this is a worthy effort to pursue, and we put forth some steps we will be taking to examine the issue and present it in a way that it will achieve maximum success for providing renal dialysis for U.S. citizens in Canada,” she explained.
The task force includes Allan Katz, CEO and president of Riverside Health Care Facilities, Inc., Chief Jim Leonard (Rainy River First Nations) Chief Wayne Smith (Naicatchewenin FN), and Dr. Paul Watson of the Ontario Renal Network.
It also is comprised of Dr. David Nikcevich of Essentia Health, Dr. Jay Knaak of the Rainy Lake Medical Center, and Julia Salomon of the North West LHIN, director and renal services manager for the dialysis unit at the Thunder Bay Regional Health Sciences Centre.
Coun. Jacksa said the task force will develop a plan and deliver it to provincial, state, and both federal governments.
She conceded there’s no doubt it’s going to require a lot of work.
Not only will the task force find out more about where cross-border partnerships have been successful elsewhere, such as Sprague/Roseau, but also look at barriers such as cost reimbursements for patients, liability insurance for hospitals and physicians, licensing, and demand issues.
For example, Coun. Jacksa said the dialysis unit here only can treat so many patients, and what happens when it reaches capacity and there’s patients from both Canada and the U.S. looking for treatment?
Do Canadian patients take precedence?
“I think we start with what we can do and as we achieve success at the smaller corners of this larger problem, then we build and build until we’ve solved a major problem as far as health care access goes,” Coun. Jacksa reasoned.
“That’s the view you take.”
As Fort Frances Coun. Ken Perry pointed out at last Thursday’s meeting, Coun. Jacksa agreed the task force will have to make a case that opening up renal dialysis access will have a reciprocal benefit to the Canadian side.
Whether that might mean more jobs or some other form of economic development, or that a health-care service now provided on the U.S. side one day will be provided to patients from Fort Frances.
“We didn’t have time today [Thursday[ to really flesh that out, but it will have to be,” Coun. Jacksa acknowledged.
Coun. Wiedenhoeft felt the meeting was successful, but admitted the focus ended up being more narrow than he first expected.
“I might have been a little naive in thinking that we were going to get to further topics, such as shared MRI, shared obstetrics, shared psychiatric services,” he remarked.
“But we, as a group, decided to focus on a business plan for renal dialysis and set that as a priority,” Coun. Wiedenhoeft said.
“We’ll come up with a pilot program for renal dialysis and pursue that at all levels, and see how that goes,” he explained.
“Once we’ve explored that, once we’ve seen how well that came out, then we can maybe attack other shared services such as MRI, such as obstetrics, such as psychiatric services.
“This is a start. This is a foundation,” Coun. Wiedenhoeft stressed. “We’ve got a game plan, we’ll get a business plan.
“We’re ready to move forward on renal dialysis and see where we go from there.”
Coun. Wiedenhoeft said he was “very impressed” with the turnout, which featured doctors, health-care administrators and executives, First Nations’ chiefs, government reps, and municipal leaders from across Northwestern Ontario and Minnesota, including as far away as Minneapolis-St. Paul.
“When Cynthia and I got this thing started, we wanted to cast our net as far and wide as we could to be all-inclusive,” Coun. Wiedenhoeft said.
“So we covered every aspect of the potential sharing of health-care services, and the cross-section we had here today certainly represented that broad spectrum of anyone involved in health-care services.”
Katz was among the delegates who felt stakeholders should address one medical service at a time.
“It’s been my strong conviction that we do one thing,” he reasoned.
“We focus our attention on this one activity. We hammer down all the consequences.
“We address them comprehensively and then we take those lessons learned and move them onto other activities,” he noted.
“But you do one thing first,” Katz reiterated.
“It’s a heck of a lot easier to juggle one ball than it is to juggle more than three.”
Jamshed Merchant, the Canadian Counsel General based in Minneapolis who also was on hand here last Thursday, said the “Medical NAFTA” meeting exemplifies the type of cross-border teamwork he likes to see.
“What I found really insightful—and I see it constantly—is the real commitment of the two communities, the Falls and the Fort, to really start working together,” he remarked.
“And I see that really building.
“The communities are unique because the nearest big centres are quite a distance away, so they can help themselves,” Merchant added.
“That’s what I found really interesting about this conversation is they are taking an area like health care, which is really a fundamental part of all our lives—good, quality health care—and figuring out how they can help each other help their citizens.”
Merchant said there’s certainly issues to address, but from what he is hearing from the parties involved “is that nothing is insurmountable.”
“And, of course, it has to be done in a way that doesn’t impact the quality of health care that Canadians get from their health-care system in Ontario, and vice-versa for the U.S. citizens and the health care they get from their health-care provider,” he added.
“So the idea is not to reduce the quality of those at all; it’s how do you work together in areas of critical need?” he stressed.
Members of Fort Frances council hope to present the case for renal dialysis access for Falls’ area residents to the minister of health when they attend the Association of Municipalities of Ontario annual conference in London, Ont. on Aug. 18.
Meanwhile, the reality of Borderland residents having to travel far to receive certain medical services was made clear at last Thursday’s meeting.
Local resident Randy Thoms, 93.1 The Border news director, said that since 2005, he, his wife and children probably have had to make 15-20 trips for various medical reasons to Winnipeg or Thunder Bay.
These trips can be any time of year, with varying weather and roads conditions, for appointments that sometimes are very early in the morning or late at night.
Such trips cost money and time.
Thoms applauded the group for looking at cross-border sharing of medical services, adding he hopes some good recommendations come from the meeting that will help him and his family for years to come.
Rep. David Dill, who has served in the Minnesota House for more than 20 years, owns a resort in Canada, and has a home on Crane Lake, said he had a constituent who lived at Kabetogama whom he’s convinced died from the stress of having to travel to get renal dialysis treatments in Duluth.
Dill, who himself was suffering renal failure but got a kidney transplant five years ago, said the current situation doesn’t make sense.
It’s “inexcusable” that a solution can’t be found and the issue must be kept on the “front burner,” he stressed.

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