St. Michael changing SANE program, closing pediatric clinic

Published 1:30 am Tuesday, March 17, 2026

Changes are coming to St. Michael Medical Center in Silverdale, including the alteration of a program and the closure of a clinic, which could have staffing impacts.

Starting March 27, SMCC plans to transition from a hospital-managed SANE (Sexual Assault Nurse Examiner) program to a partnership with RSI, an Oregon-based forensic nursing services organization that provides SANE services at all other VMFH locations.

“SANE services are not being eliminated, and patients presenting to SMMC will continue to receive timely, trauma-informed care here locally. We remain grateful to our dedicated team members and are providing transition support, including the possibility of applying for available positions at RSI, so they may continue this important work,” SMMC president Chad Melton said.

Additionally, Melton said SMMC also decided to close the Pediatric Outpatient Rehabilitation Clinic April 24, following a “thoughtful discernment process.” VMFH ultimately determined it necessary to close the clinic, he said, adding that VMFH is working with impacted patients to ensure a smooth transfer of care, and the clinic will continue all scheduled appointments until the clinic closes.

The hospital president declined to specify how many patients and staff will be directly impacted by the clinic closure, adding, “We remain grateful to our dedicated team members and are providing transition support, including the possibility of applying for available positions at VMFH. We are also working closely with each patient on an individual transition plan.”

Melton estimates roughly 60% of VMFH patients are enrolled in either Medicare or Medicaid systemwide and about 70% at SMMC, which pays roughly 20-50% below the cost of providing care.

“Virginia Mason Franciscan Health, similar to other hospital systems across the state, is facing significant financial pressures, including rising labor and supply costs, increasing claim denials, and chronic underpayment from government programs like Medicare and Medicaid. These challenges have only intensified for hospital systems like ours with the recently passed H.R.1 (One Big Beautiful Bill Act) and enacted Washington state taxes and reduced reimbursements. These compounding fiscal pressures are impacting vital, safety-net programs and services across our communities,” he said.

UFCW3000, the union representing roughly 931 nurses at St. Michael, confirmed they have been notified about both changes to the outsourcing of the SANE program and the Pediatric Outpatient Rehabilitation clinic closure and layoffs. Five impacted workers are expected at the pediatric clinic: one occupational therapist, two speech-language pathologists, and two physical therapists. For the SANE program, one nurse will also be impacted. Union officials haven’t yet confirmed the reasoning for the possible outsourcing or clinic layoffs, as of March 13.