Hospital District 1 releases “A Year in Review”

From staffing, facility upgrades, staff training and working to access Medicaid beds at Village at the Harbor, 2023 was a busy year for the San Juan County Public Hospital District #1. A full report of the Year in Review was presented to the Commissioners, who expressed pride and amazement at the Year in Review at the meeting, noting its professional quality and sheer quantity of achievements.

“This year, I am most proud of our leadership teams’ growth,” Nathan Butler, SJCHD1 Superintendent and EMS Chief Administrator told the Journal after the meeting. “The successful execution of our projects was made possible by the support and hard work of our dedicated executive team.”

As part of a significant leadership transition, Tina Smith assumed the role of Executive Director at Village at the Harbor, according to Butler, and Evan Perrollaz took on the dual responsibilities of Deputy Superintendent and Executive Director of Home Care Services. Meanwhile, T. J. Bishop, as Assistant Chief of Training and Operations at San Juan Island EMS, worked to overhaul our training program, bringing it up to date and enhancing its effectiveness. Butler noted that the establishment of the finance department played a pivotal role in enabling staff to effectively manage the substantial growth the district experienced in a responsible manner.

“The collective expertise and knowledge of our team was instrumental in completing all of our projects in 2023,” Butler said.

Among the training, Butler himself received a certificate of completion from the Ambulance Service Manager course. “The course was very informative,” Butler stated, adding that he learned a variety of management skills from leadership experts in emergency services. Some of the valuable topics covered during the course included:

· EMS economics, finance, and budgeting

· Communications techniques and key considerations for effective writing

· Project management and change leadership

· Government relations and regulation

· EMS system design and deployment

“I found the training really affirming – we do a really good job at San Juan Island EMS, and it was neat to interact with leadership from across the nation. Most notably, we have had extremely low attrition over the last few years compared to our peers,” said Butler.

Other training included Tactical Emergency Casual Care that included multi-agency involvement, advanced medical life support, advanced stroke support, pediatric education for prehospital professional providers, wilderness first aid credentials, wilderness first responder recertifications, and marine calls with the Sheriff’s Office, just to name a few.

The “Mass Casualty Plan” was updated, and while that sounds terrifying, Butler said “As scary as the phrase ‘mass casualty plan’ may sound, the fact we have a plan is very good for the community.”

One of the cornerstones of emergency services, he continued, is having a plan for the unexpected. The casualty plan primarily centers around determining what resources are available, how to deploy them and how to provide the most efficient level of care to the most people possible. “We also held a large-scale scenario to try out this plan. This plan is overseen by the state-designated medical program director for all EMS services in the county, Joshua Corsa, MD, who is also a trauma surgeon and active duty member in the military,” Butler explained.

To combat increasing fentanyl use in the community, San Juan Island EMS distributed about a dozen doses of Narcan through an outreach program. A smaller amount was left by the ambulance crew when appropriate. “The total number of doses was approximately two dozen. The majority of Narcan distribution to the general public is managed through the San Juan County Sherriff’s Department,” Butler noted. “We are grateful to be able to work with the Sheriff’s Office on this initiative.”

One of the critical achievements the hospital district had been working toward at the Village, was ensuring some beds available through Medicaid. Last year, that goal was obtained, and they are working toward more. According to Butler, there are currently five rooms assigned to Medicaid at Village at the Harbor, all of which are occupied.

The report states, “We were able to accept five Medicaid clients before the end of 2023 – people who had no other option and desperately needed the help.”

When asked what goals are for this year, Butler responded that the main goal is to begin accepting clients to their home care program, Village at Home. “Currently, we are waiting to receive licensing through the Department of Health for Village at Home,” Butler said. They currently rely on the County for a large portion of their financial processing, and by mid-year will be taking those responsibilities in-house. “We hope to make progress on our plan for expanding Village at Harbor and providing housing for healthcare workers.”

Islanders also should be aware that San Juan Island EMS had a banner year, with amazing response times both for first-out calls and concurrent calls (when more than one aid call is going at once). “Our staff and volunteers have readily handed everything thrown our way and have taken great care of the public,” Butler boasted. “We are very grateful for the community’s support. The accomplishments of the Hospital District would not be possible without funding from taxpayers,” Butler said.

The Hospital District Commissioners meet the fourth Wednesday of the month at 4 p.m. For more information visit