Klickitat Valley Health (KVH) is a critical access hospital in Goldendale, Washington, a rural agricultural city and the county seat of Klickitat County located near the Columbia River Gorge. Since its founding in 1949, KVH grown from a single hospital to a campus that includes a Family Medicine Clinic, Wellness & Outpatient Therapy Center, Home Health & Hospice services, and a range of outpatient hospital services. Klickitat County is one of the three Washington state counties in the region served by SWACH.
We spoke with CEO Leslie Hiebert to learn more about KVH’s work to improve health and wellness in Klickitat County, as well as KVH’s projects to address the opioid crisis and improve access to primary care, dental care and pharmacies.
What are some of the needs and opportunities in the areas served by Klickitat Valley Health?
Klickitat County ranks 17th of 39 Washington counties on health outcomes. And we face a variety of challenges, ranging from access and transportation, to things you might not think about in an urban setting like basic phone and internet services.
As an organization, we are very focused on wellness and prevention, both for our community and our employees. We must also ensure that we provide the services our community wants. That’s why our health needs assessments and community surveys are so important. If you listen to your medical staff and the community, you’ll know what the needs are.
Today, when we look at that community input, mental health, dental and access have been identified as the three greatest needs. Pharmacy access is another big issue.
As a critical access hospital, it might be surprising to some readers that you are so focused on the dental issue. What’s driving that and why is dental access such an important part of your transformation plan with SWACH?
We know that a significant number of ER visits are related to oral issues. We also know that many of those situations would be preventable if folks had dental access on a regular basis.
Legislation passed a few years ago allowing Rural Health Clinics (RHC’s) to bill Medicaid for dental encounters. We’ve applied for grant funding for dental equipment and we’re working with the state so that we can offer dental services, hopefully in the next year. We’re also working closely with local dental providers, public health and our board to move this forward.
We decided to include dental in our transformation plan for a few reasons. Of course, the funding helps, because it helps us get the program off the ground. However, what’s been most impactful with SWACH is the technical support and expertise. If we run into roadblocks, I’m confident we’ll have SWACH’s support.
How is KVH working to address the access issues you’ve identified?
We’re hoping to open up hospital-based outpatient pharmacy services for our Express Care, ED and hospital patients who need to have a prescription filled soon. Our local pharmacists are great partners. But running a pharmacy in a rural setting can be difficult. Sometimes patients leave here with a prescription that they can’t fill due to the retail pharmacy hours of operation, or transportation or other barriers. So, when necessary, our goal is to get medication in patients’ hands before they walk out the door.
We’re also working to increase access to primary care. While it’s difficult to recruit primacy care providers to rural communities, we recently hired a provider for our Express Care clinic and we’re looking for second provider to be able to offer extended hours and Saturday coverage. We’ve also hired a few behavioral health specialists and we’re hoping to hire more as part of our efforts to better integrate physical and behavioral health services.
Plus, there is no urgent care in the county, which is a big challenge for the community because people have to travel to get same day service. We want to provide that service through our express care program, which is another initiative we’ve been working on.
How are you partnering with local stakeholders and SWACH to respond to the opioid addiction and overdose crisis?
Much of our work on the opioid issue started with a retired physician in our community, Dr. Garnett, who is passionate about responding to the opioid crisis. He helped lead the development of an opioid taskforce, which SWACH also helped with. Our focus areas include awareness, prevention, appropriate prescribing and low barrier access to treatment.
SWACH has been very supportive. In addition to helping with the opioid taskforce, they helped us identify and secure an opportunity for an Opioid Treatment Network grant through the Washington State Health Care Authority. Now we’re collaborating with PeaceHealth, the SWACH team, local schools, the local jail and others. We have two providers waivered for Medication Assisted Therapy, and plan to have our Express Care providers waived, which helps reduce barriers to treatment.
I understand that KVH will be a participant in the SWACH Equity Collaborative. Why are equity issues important to KVH?
It’s really about learning and growing as much as we can so that we can better serve our community. In order to do that it’s important to understand the barriers that impact community members, including biases that are built into structures and systems. We plan to do an equity assessment, which will help us identify opportunities to grow and remove barriers. We’re also conducting an all-day training with our leadership.
Learn more about Klickitat Valley Health at