Orcas Healthcare Advocates

10/19/2026

ORCAS HEALTHCARE ADVOCATES’ RESPONSE TO THE OCTOBER 8 OIHCD PUBLIC STATEMENT

In letters dated September 22, 2026, the Orcas Healthcare Advocates (OHA), on behalf of the Orcas Community, sent two letters to the Orcas Island Health Care District (OIHCD), Orcas Clinic Manager Aaimee Johnson, and Island Health (IH), requesting a meeting, in the spirit of sincere dialogue, to discuss the following petitions:

1. petition to reinstate Dr. Jennifer Simpson-Manske (Dr. JSM), citing several legal and moral reasons why Dr. JSM’s reinstatement is the just and necessary remedy that both OIHCD and IH must provide to the Community; and

2. petition for disciplinary action against an Orcas Clinic Physician Assistant (PA) who, for several months, had displayed a pattern of behavior that evinced an utter lack of professional and medical ethics towards her patients, citing the lack of responsiveness by both the OIHCD and IH to various specific complaints already filed against such a PA.

On October 8, 2026, OIHCD responded with a general public statement:

—regarding Dr. JSM, stating that OIHCD “does not intend to pursue any further action”—without specifically addressing the cited legal and moral reasons why it should act favorably on the Community’s Petition; and

—regarding the complaints about the unprofessional and unethical PA, providing a link wherein complaints can be filed—without addressing the cited fact that several complaints had already been filed against such a PA and that the OIHCD-IH complaint process does not only fail but also refuses to provide any reasonable response or update to any such filed complaints.

IN EFFECT, THE OIHCD’s RESPONSE TO THE COMMUNITY’S ABOVE-CITED PETITIONS AMOUNTED TO AN UTTER LACK OF RESPONSIVENESS.

In particular, the OIHCD's citation of statistics on certain healthcare targets that neither OHA nor the Community questioned demonstrates a lack of responsiveness to the specific issues raised by the OHA and the Community. The specific issues raised by the OHA and the Community (regarding Dr. JSM and the PA) called for the OIHCD to address certain qualitative, not quantitative, problems that are deeply felt in the Community and go to the core of the Community’s dissatisfaction with its healthcare officers.

This is very unfortunate for the Community, for the subtext of OHA’s request for a dialogue meeting between OIHCD and the Community was the OIHCD’s breaking of the Community’s trust in the first place, and OHA’s request for a dialogue meeting was precisely aimed at helping to repair the Community’s lack of trust in its health district officers. Hence, OIHCD’s decision not to specifically address such problems proves, yet again, OIHCD’s failure to inspire trust and confidence.

The OIHCD broke the Community’s trust when the OIHCD Commissioners and the Superintendent attempted on several occasions, including the June 24 OIHCD Board meeting (when the Petition to Reinstate Dr. JSM was discussed before the Board), to mislead the Community with statements that falsely claimed that OIHCD had no legal or moral power whatsoever to advocate for the Community’s petition as regards Dr. JSM’s reinstatement with IH. Specifically, OIHCD claimed it was “merely a landlord” to IH and that IH allegedly had the absolute power to dismiss Dr. JSM without cause, without due process, and without due notice to anyone, including the Community.

In our letter dated September 22, we debunked both of these statements, citing several well-grounded legal and moral reasons. OIHCD, in its October 8 response, sadly chose not to respond specifically to such legal and moral reasons.

As regards the many complaints cited against the unprofessional and unethical PA, OIHCD simply posted the link to file such complaints—wherein several complaints had already been filed against such a PA. Answering such complaints by merely reiterating the link through which one can file the same complaint all over again is begging the question. Worse, it is an utterly inconsiderate act of throwing the Community into a hopeless bureaucratic loop that makes no reasonable attempt to redress this specific grievance—hence, rendering the Community helpless and feeling disregarded again.

Because of OIHCD’s refusal and failure to repair the Community’s broken trust, OHA recommends that the Community continue to closely monitor OIHCD meetings, plans, and actions—especially regarding the clinic expansion project, which involves millions of dollars of the Community’s money. We specifically invite attention to examining areas where the OIHCD is vulnerable to potentially overstepping its authority under the 2025 tax levy.

10/01/2026

Due process is a basic human right—yes, even for our doctors.

09/29/2026

REVIVING OUR PETITION TO REINSTATE Dr. JENNIFER SIMPSON-MANSKE! During the Orcas Island Health Care District (OIHCD) board meeting on September 23, we handed our Health Superintendent and OIHCD Commissioners two sets of letters requesting, among others, a dialogue meeting respectfully reiterating our Petition to Reinstate Dr. Jennifer Simpson-Manske (signed earlier this year by no fewer than 430 Orcas community members).

Yesterday, we mailed the same letters to the incoming executive leadership of Island Health (IH). We have some hope that the incoming executive leadership of IH would be more sympathetic to our petition about Dr. Simpson-Manske because of reports suggesting that the ongoing changes in the executive leadership of IH may have been partly fueled by protests against the unjust dismissal of several doctors, including Dr. Simpson-Manske.

In our letters, we cited, among others, the following just, moral, and practical reasons to reinstate Dr. Simpson-Manske::

1. Dr. Simpson-Manske’s dismissal was not fair to the Community.

While it is true that the Primary Care Services Agreement (the “Contract”) between OIHCD and IH grants the exclusive power to dismiss a physician employed at the Island Primary Care Clinic-Orcas (the “Clinic”) to IH, we submit that such power cannot, and should not, be exercised in so absolute a manner as to likewise result in violating IH’s legal, contractual, and moral obligations to the Community.

Under the Contract, including IH’s mission statement and other voluntary declarations of its commitments to the communities it serves, including the Community, IH promised:

—To provide high-quality, accessible healthcare to the Community
—To achieve patient satisfaction at the Orcas clinic
—To collaborate with the Community regarding their healthcare needs and interests
—To advocate for the Community’s high-quality, accessible healthcare interests on Orcas Island

It is one thing for IH to claim it has the right to do something (such as its alleged absolute right, as an at-will employer, to dismiss Dr. Simpson-Manske), but quite another for IH to exercise such a right with seemingly careless disregard for the negative effects and consequences such an action could reasonably have been foreseen to cause, as it did cause, Dr. Simpson-Manske’s patients and the Community.

2. IH failed to provide proper transitional healthcare for Dr. Simpson-Manske’s patients and the Community when it suddenly, unilaterally, and summarily dismissed Dr. Simpson-Manske.

Providing “proper transitional healthcare” means, among others, having a plan in place before any doctor’s dismissal to ensure that patients affected by any such firing would be promptly and amply protected by adequate care from a substitute doctor (who should possess the same, if not better, professional qualifications and experience as the doctor to be dismissed). It bears noting that such an action requires providing a physician, not just a physician’s assistant (PA), for the latter is not truly equivalent to a doctor.

Proper transitional healthcare also means ensuring adequate coordination and communication with the patients and the Community, including due notice to the patients to help them prepare for losing their doctor and thereby help them avoid any lapse in their medical care and ensure their timely access to prescriptions.

IH’s dismissal of Dr. Simpson-Manske was, from the perspective of her patients and the Community, so unforeseen, sudden, and shocking because IH accomplished this with absolutely no due notice to, nor proper guidance for, the patients and the Community about where, or to whom, they could get proper substitute medical care.

Many of Dr. Simpson-Manske’s patients did not even know their doctor was dismissed until the day of their appointment when they showed up at the Clinic where, to their dismay, receptionists casually told them that their appointments were cancelled because their doctor “was gone.”

The Clinic receptionists then instructed the patients to simply secure appointments with other healthcare providers. For many of those patients, this practically meant just contenting themselves with the lone PA then available at the Clinic (since there was only one remaining doctor who could no longer accept new patients, and two of the three PAs were on indefinite leave). Such PA also happened to be the one whom many patients soon complained of for traumatizing them with her unprofessional, rude, and arrogant remarks and conduct.

This dire situation continued for several months until only recently, when a new doctor (fresh out of residency) joined the other doctor (who could not accept new patients), and the two PAs who were on leave finally returned to work.

Consequently, countless patients and Orcas residents were, and are still being, forced to go off-island to seek proper healthcare—contrary to the promise of both IH and OIHCD to provide high-quality, accessible healthcare on Orcas Island. This is not acceptable. This is not providing high-quality, accessible healthcare on Orcas.

The least that IH can do now for the Community is to reinstate Dr. Simpson-Manske to compensate the patients and the Community for the incalculable suffering caused to them by IH’s careless dismissal of their favorite doctor. This is the moral imperative.

3. Reinstating Dr. Simpson-Manske would address the lack of doctors at the Clinic.

The ideal doctor-to-patient ratio is said to be one (1) doctor per 1,000 residents. Orcas has about 6,000 residents, which balloons to more than twice that during the seven-month tourist season. Based on the ideal ratio, Orcas should have at least six (6) doctors, plus—one could even argue—an additional six (6) doctors during the peak season. Yet, OHA does not insist on this. We are amenable to accepting a reasonable compromise of four (4) doctors at our Clinic year-round.

At present, only two (2) doctors serve at the Clinic—one of whom cannot accept new patients and the other, while promising, is fresh out of residency and, therefore, cannot be truly considered Dr. Simpson-Manske’s equivalent.

Some have suggested counting the private doctors on Orcas along with the current two (2) Clinic doctors in computing Orcas’s doctor-to-patient ratio to posit that Orcas is already enjoying the ideal doctor-to-patient ratio. This is not only misleading but untrue.

Many of the private doctors on the island—including, now, Dr. Simpson-Manske—do not accept patients on Medicare/Medicaid and other health insurance, let alone patients who don’t have insurance. The Clinic, on the other hand, is required by the law to accept all patients, insured or not. Therefore, private doctors who cannot accept insured and uninsured patients cannot be reasonably considered the same as Clinic doctors who can, and must, accept all patients in computing the proper doctor-to-patient ratio.

Regarding Dr. Simpson-Manske, in particular, wouldn’t it be facetious to exploit her continued residence on the island and her involuntary conversion into a “private” doctor (due to her dismissal), to propose that, as now such private practitioner, she should be counted as satisfying the recommended doctor-patient ratio on Orcas?

Many of the healthcare problems and issues can be readily addressed by simply reinstating Dr. Simpson-Manske.

We requested replies to our letter-petitions within 15 days from receipt of such letters. Let us hope that our healthcare officers listen to, and heed the plea of our community. And let us all continue to persist in fighting for what we all deserve not just by legal right but moral justice.

09/23/2026

Join us at the Orcas Health Care District board meeting TODAY, Sept. 23, 2026, 5-6:30 pm, Orcas Public Library!

As we said during our successful town hall meeting on “Select Orcas Healthcare Problems & Possible Solutions” last Sunday, Sept. 20, nothing less than consistent, active attendance and participation at our healthcare district’s meetings is necessary to uphold our right to high-quality, accessible healthcare on our island--based on, and as supported by, the commitments that the OIHCD and Island Health have made to the Orcas Community under their Primary Care Services Agreement, mission statements, and other declarations.

See you there!

09/21/2026

BIG SUCCESS! BIG THANKS to everyone who attended our town hall meeting yesterday on “Select Orcas Healthcare Problems & Possible Solutions,” who filled all the tables at the Orcas Fire & Rescue Public Meeting Room and then some (additional chairs)—despite the fact there was a Seahawks game and another significant community event happening at the same time!

The Orcas Community’s energetic participation validated our citizens’ desire to pursue our advocacy to promote high-quality, accessible healthcare on our island by, among others, making the Orcas Island Health Care District (OIHCD) and Island Health accountable to our community for their actions and/or lack of action.

We reiterate the critical importance of our community’s attendance and active participation at all OIHCD Board meetings to remind our commissioners and superintendent that they serve at the pleasure of our Community and must hold themselves accountable to us.

The next OIHCD Board meeting is this Wednesday, September 23, 5-7 pm at the Orcas Public Library.

(Unfortunately, for privacy reasons, we can’t post our presentation video online, but will try to find a way to share our presentation in another way.)

09/19/2026

HAPPENING TOMORROW! If you want to make a positive difference, please join us tomorrow:

—DATE: September 20, 2026 (Sunday)
—TIME: 2-4 pm
—WHERE: Orcas Fire & Rescue Public Meeting Room (45 Lavender Lane, Eastsound)

to discuss “Select Orcas Healthcare Problems & Possible Solutions.”

Quality, accessible healthcare is a human right—yes, even on an island!

Democracy is a constant work-in-progress. Be an agent of positive change.

09/16/2026

I. THE NEED FOR BALANCE. The Orcas Healthcare Advocates (OHA) appreciates the good that the Orcas Island Health Care District (OIHCD) and our healthcare facility operator, Island Health (IH), do for the Orcas community.

Contrary to baseless rumors, OHA does not aim to destroy the current Orcas healthcare system; rather, it aims to help the system be better by helping the OIHCD and IH remain true to their shared mission “to provide high-quality, accessible healthcare on Orcas.” Among others, OHA tries to do this by asking questions to which our healthcare authorities must be held accountable for answering.

In particular, OHA seeks to help in the mission to promote high-quality, accessible healthcare to the Orcas community by helping the OIHCD and IH focus their attention on achieving a much-needed balance between addressing the present and future healthcare needs of the Orcas Community.

For instance, the Orcas community presently needs an adequate number of qualified, experienced, and, most importantly, caring licensed physicians—not just PAs. Based on the ideal doctor-patient ratio, the Orcas population, which numbers between 5,500 and 6,000 and balloons to more than twice these numbers during the summer season, needs at least six (6) doctors.

OHA is willing to compromise by considering accepting at least four (4) qualified and experienced doctors to serve the immediate, present healthcare needs of the current Orcas population at the Orcas clinic—wherein Medicare and Medicaid patients, along with patients who have no coverage and patients covered by other health insurance, are required by law to be served by our Clinic healthcare providers.

The legal obligation of our Clinic to provide compassionate care, albeit possibly uncompensated or uninsured, is one big reason why the suggestion that there are other private doctors on the island whose number should be counted as satisfying the doctor-patient ratio on Orcas Island is questionable.

Both the OIHCD and IH should be focused on meeting the community's present need for an adequate number of licensed physicians at the Clinic—now, and within the current footprint of the Orcas clinic, not only after several years when the Orcas clinic has been expanded and renovated.

II. CARROT-ON-A-STiCK. Right now, the Orcas Island Health Care District (OIHCD) is doing an eloquent job describing its plans for the future healthcare structure of Orcas. But—let’s get real.

The beautiful-sounding press releases of the OIHCD about its clinic expansion and other healthcare-related projects are, at present, little more than a carrot-on-a-stick that the OIHCD is waving at us as though to justify its plan to spend several millions of dollars of the community’s tax levy funds. Why carrot-on-a-stick? Because such plans pertain mostly to the future; they fail to specifically respond to the immediate, present healthcare needs and problems of the Orcas community.

III. POTENTIAL FOR OVERSTEPPING OIHCD AUTHORITY. During the July 23, 2026 OIHCD Board meeting, a financial adviser hired by the Board suggested the potential need of OIHCD to take a loan to bridge the projected gap between the funds sourced from the 2025-authorized tax levy and the expected total cost of the Orcas clinic expansion. This is concerning because undertaking additional public debt through a loan to answer for any shortfall in funds sourced from the tax levy may potentially result, in practice, in an indirect taxation of the Orcas community that would impose additional financial burdens on the community beyond what was authorized by the 2025 levy vote.

In this connection, it must be recalled that Mr. Bob Thomas, in the “cons” he cited to substantiate his “anti” position on the 2025 levy proposition, expressed similar concerns regarding the budget, spending, and other authority of the OIHCD in the levy’s context. Unfortunately, the Orcas residents who voted for the tax levy failed to either grasp or heed Mr. Thomas’s well-founded concerns and warnings, which now appear to be rearing their ghostly heads to haunt us all. (For reference, please see Mr. Thomas's article that appears in The Orcasonian archives, which comprehensively explains his concerns about the 2025 tax levy.)

IV. IMMEDIATE, REAL, & PRESENT ORCAS HEALTHCARE NEEDS & PROBLEMS. Today, countless Orcas residents either don’t get proper healthcare on Orcas or are forced to seek proper healthcare off-island because the healthcare services provided at the Orcas clinic by IH are not only inadequate but also below the standard of quality promised by the OIHCD and IH under their Primary Care Services Agreement and their charter or mission statements.

Furthermore, juxtapose this against the unilateral, summary dismissal by IH of a doctor beloved by the community because she had listened to her patients, and IH’s retention, instead, of a PA who has traumatized patients by, among other unprofessional behaviors, suggesting that we Orcas residents have to accept the reality of low-quality healthcare (which, apparently, she’s good at providing) on an island and that we have no one else to blame but ourselves for suffering low-quality healthcare since we choose to remain on Orcas.

Hardly any reasonable person can deny that there is something very wrong with a healthcare system that, on the one hand, dismisses—without due process and with seeming careless disregard for the community’s sense of justice and its other legal obligations to the community’s present healthcare needs—a highly-competent, experienced doctor beloved by the community, and, on the other hand, retains, instead, a PA who now has a record of a pattern of behavior that evinces not only a gross lack of professionalism but, worse, a seeming careless disregard for the dignity and wellbeing (psychological and physical) of patients.

V. APPARENT WILLFUL INDIFFERENCE OF ORCAS HEALTHCARE AUTHORITIES. Health Superintendent Chris Chord, the OIHCD Board, and the IH management have been informed about the unprofessional, rude, and careless behaviors of the PA above-mentioned. Our health authorities’ response? Silence. And no concrete remedy offered.

Our concerns and grievances unfortunately seem to be unheard by our healthcare authorities. Such ignoring of our concerns is to an extent that suggests that our healthcare authorities have decided to be willfully indifferent to our community’s expressed present healthcare needs, problems, and concerns. And such willful indifference by our healthcare authorities, by itself, has become the biggest of our healthcare problems.

For instance, Health Superintendent Chord was unequivocal when, after the OIHCD Board meeting on July 23, 2026, and in response to our request for a dialogue with the Board to discuss and consider our problems, concerns, and issues in the wake of Dr. Jennifer Simpson-Manske’s dismissal, he declared that he had “arrived at a ‘reasonably argued’ position not to act.”

We don’t know for sure what “reasonable arguments” Chord relied upon; however, it’s also reasonable to assume that while they may be arguments, such arguments may not necessarily be reasonable or true—for such are likely related to the statements that both Chord and OIHCD Board President Mark Salierno, during the June 24 OIHCD Board meeting, repeatedly stated in response to the Petition to Reinstate Dr. Jennifer Simpson-Manske signed by 430 members of the Orcas Community—to wit:

1. that the OIHCD is, allegedly, “only a landlord” to IH (This is a defeatist statement that is also not true. We will explain why during our town hall meeting.)

2. that IH has unquestionable power to dismiss its employed physicians “at-will” (While it is true that the contract between OIHCD and IH grants the exclusive power to dismiss employed physicians to IH, we will explain during our town hall why the exercise of such a power cannot be arbitrary nor absolute as to result in violating IH’s legal, contractual, and moral obligations to the Orcas Community.)

VI. TOWN HALL MEETING GOALS. The OHA will hold a town hall meeting on Sunday, September 20, 2-4 pm, at the Orcas Fire & Rescue Public Meeting Room to:

1. identify certain current healthcare needs and problems of the Orcas community that need to be addressed now;

2. debunk the defeatist and misleading statements of the OIHCD and describe how both the OIHCD and IH are failing to address certain current Orcas healthcare needs and problems; and

3. envision and develop collaborative solutions to certain current Orcas healthcare needs and problems.

Your attendance at this town hall meeting and constructive participation in helping to address our current healthcare needs and problems are vital to ensuring the democratic governance of our healthcare system on Orcas and our healthcare system’s responsiveness to our community’s present healthcare needs and problems.

We look forward to collaborating with you!

09/11/2026

Islands’ Sounder article about the Orcas Healthcare Advocates’ Town Hall Meeting regarding prevailing healthcare problems and issues on Orcas Island to be held on September 20, 2-4 pm at the Orcas Fire & Rescue Public Meeting Room.

If you have concerns about the state of our healthcare system on Orcas, please join us. Your perspective is valuable, and our combined strength game-changing!

Submitted by The Orcas Healthcare Advocates.

08/31/2026

The Orcas Island Health Care District Board meeting is happening today at the Orcas Library, 5-7 pm.

The Orcas Healthcare Advocates will be there to invite our healthcare officers to join the Community at our town hall to discuss Orcas residents’ healthcare problems and issues on September 20, 2-4 pm at the Orcas Fire & Rescue Public Meeting Room.

Please join us not only at today’s Board meeting to signal your continuing concern about our unresolved healthcare problems but also in future Board meetings, including, especially, our town hall meeting on September 20. Thank you!