Nearly three years ago we faced the closure of the Vashon Island medical clinic, when CHI Franciscan left Vashon. We faced the scary prospect of limited medical service to treat the broken arm, the flu or the many other day-to-day medical needs of our island population.
We might have had severely reduced medical care available for those on Medicare or Medicaid, for the uninsured or for those with certain third-party insurance policies. Fortunately, this potential crisis was avoided, and the closure of the clinic was limited to a period of weeks due to the efforts of many people working on the islands’ behalf. The tremendous outpouring of community support allowed Neighborcare Health to reopen the clinic and begin providing services on an accelerated schedule.
It is clear nearly three years later that Neighborcare Health cannot sustain the financial load of providing clinic services on the island even in a lean and basic service model. As is the case in most communities in Washington, supplementary funds are required to support basic medical service levels. This is particularly true in rural areas such as ours. Significant and sustainable funding is needed to supply adequately robust services of the kind that our community wants and needs. As other communities have learned, even significant foundational support and fundraising activities are not sustainable enough to attract and keep the services that are needed.
I believe the solution to obtaining sufficient, sustainable funding, and to do it in the most equitable way, is to create a public taxing district. A district is the only means by which we will be able to continue to have a medical clinic providing sustainable primary care services accessible by all the members of our island community. A district also allows island residents to take control of the medical services offered on the island and to become empowered to change or enhance services in the ways that best suit the needs of the island now and in the future. For this reason, I am asking Vashon and Maury Island residents to consider supporting the formation of a public hospital district – and it will require a vote island wide.
No one is suggesting that we build a hospital on the island. We do not have the population or patient load to support such a facility. The words “hospital district” are words that are required under State of Washington law for organizations of the type we are discussing. We would actually be forming a public health district run by commissioners responsive and responsible to the island who would have the authority to negotiate for, support and manage certain medical services on the island. This would be a dramatic change from the recent past (and current) practice of placing the decisions about how to provide care for islanders in the hands of external health organizations.
To be sure, there are challenges posed by the establishment of a district supported by property tax revenues. Current local property taxes have been near the maximum amount assessable by law, and while rising property values have created a little bit of financial room to work with, there isn’t enough available tax revenue to support the maximum amount every taxing district could legally take. It will be important for public hospital district commissioners to work together with other districts to prioritize needs and to determine how funds are allocated. It is important for the community to engage in those discussions as well. The fact that islanders are weary of increasing property taxes should not be overlooked, but the price of saying no to a district will once again place the clinic in jeopardy.
Let’s be clear. This is not about any specific provider, although we are grateful for those like Neighborcare Health, who came to us in our time of need. Whether you are happy with current service levels or you desire improvements, we are currently on a financial path to neither.
Neighborcare Health cannot and should not continue to sustain financial losses that they must subsidize from grants and programs received for use in other communities, and there aren’t any other organizations waiting behind them to take on those losses. As someone with 18 years of experience in King County and Olympia, I can assure you that we cannot expect the county or the state to begin to adequately meet our financial or health needs. There is no one coming to save us if we do not act to help ourselves, and the way to do that is a public hospital district.
Please consider adding your name to the petitions you will soon see circulating. Ask questions and engage in a conversation with your friends and neighbors about our islands’ future.
— Sharon Nelson, who lives in Gold Beach, is the island’s former state senator.