Rival clinics set up next door to each other
By KATHERYN HOUGHTON
Daily Inter Lake
For roughly a decade, people living in and around Polson facing kidney failure have been separated from treatment by long highway drives.
This year, however, two separate dialysis centers are expected to open in Polson — next door to each other.
Health officials have estimated roughly 25 people in the area currently need dialysis, a blood cleansing procedure that substitutes for the function of the kidney.
Together, the new facilities would be capable of treating nearly 200 dialysis patients a week.
However, as one center works to complete its building that’s already partially staffed, the other new clinic sits empty as administrators search for qualified staffers.
Kevin Howlett, the director of the Confederated Salish and Kootenai Tribal Health Department, said the delay has forced dialysis patients to continue to go to Missoula or Kalispell to access care. He said it has been more than 10 years since the area had a dialysis provider.
“Dialysis is three days a week, four hours a day,” Howlett said. For people around the southern tip of the Flathead Lake, that has meant spending at least six hours a week just driving to dialysis.
This month, Fresenius Medical Care — a German-based for-profit company — finished construction on its new dialysis center. But it still needs to fill two more positions before it can open its doors to patients, according to the Fresenius area manager of operations. She estimated the center would open sometime in June.
The Polson location puts Fresenius near the top of the list for the most dialysis centers in the state, right behind Dialysis Clinic Inc. — or DCI — a Tennessee-based nonprofit that announced its intention to set up shop in Polson roughly two years ago.
Howlett said he approached DCI in 2014 about opening a clinic in Polson. He said at the time, he hadn’t heard of any providers considering the location.
The department established and funded a transportation program for tribal members who needed to get to appointments more than 10 years ago, he said. Currently, the program has three full-time drivers who are collectively on the road 14 to 16 hours a day driving 11 patients to their appointments.
“It’s a monumental effort — more so for the patients. And it’s not cheap,” Howlett said.
Howlett said the tribe signed a 10-year contract to steer tribal members toward DCI care before they knew a second clinic was opening. He said the department decided to connect with DCI because Fresenius’ Missoula location was more expensive for patients and, at the time, didn’t accept Medicaid or Medicare patients.
“We haven’t heard from Fresenius, but — and I’m sure they’ve done their research — it’s hard to imagine how they see there’s a need for two dialysis providers in Polson,” he said.
Officials from each company estimated there were 20 to 25 people in the Polson area who need dialysis. Each center has the ability to treat 96 patients a week.
Kevin Donahue, the DCI West Montana dialysis clinic administrator, said if he had known Fresenius had any intention of expanding to Polson, DCI probably wouldn’t have committed to building there.
“Yeah, Fresenius will be the only dialysis provider in Polson — at least for a few a months until we’re right next door,” Donahue said. “It’s just not a good use of health resources.”
The nonprofit will be located at 303 Ridgewater Dr. while Fresenius is located at 305 Ridgewater Dr.
Donahue said while DCI bought the land first, Fresenius built its clinic first. He said the lengthy city permit and contract negotiation with the tribe took longer than he would have liked.
“We’re like any nonprofit, everyone wears a few hats and each new effort takes some time,” he said. “We don’t have that kind of money to do things the way [Fresenius] did. They answer to shareholders. Our mission is to go to underserved populations. Patients are who we answer to.”
Donahue estimated the DCI clinic would be completed sometime this fall. DCI has branches in Kalispell, Browning, Libby and two in Billings.
Fresenius has clinics in Missoula, Butte, Bozeman and another opening in Great Falls later this summer.
Kristin Flo, the Fresenius area manager of operations, said the company had its eye on Polson for three to four years. She said she has heard from Polson patients visiting Missoula who have wanted care closer to home for years.
Flo said she called Donahue to hear if it was true that DCI was also building in the area and he said yes. Both companies bought land in Polson in summer 2015.
“They started construction about a month ago and at the moment they’re just a foundation,” Flo said about DCI. “It’s not uncommon in a lot of other places for clinics to be across the street from each other. I think both companies had been looking at it for some time because it was so needed for the community.”
Donahue and Flo both said the close proximity wouldn’t create a price war, since each estimated that 85 to 90 percent of their clients receive treatment through Medicaid or Medicare.
Howlett said the Tribal Health Department would keep its commitment to DCI, even if Fresenius opens for patients first.
“DCI is certainly what our preference will be and there will be an effort made on our part to convey that to patients,” he said.
At the same time, Howlett said he had expected the DCI clinic to be completed last fall.
“Whatever reason for the delay, it’s going to cause some confusion for some patients, and we’re still going to struggle until it opens,” he said.