Eight of the nine candidates for the proposed hospital district’s board of commissioners took the stage at Vashon United Methodist Church on Thursday, Oct. 10, in a highly-anticipated forum before a standing-room-only crowd of residents who asked them questions about the future of the island’s health care needs.
The healthcare focus group of Invisible Vashon and United for Democracy sponsored the two-hour forum, which included John Steczek and Donald Wolczko (position 1); Eric Pryne (position 2); Bill West and LeeAnn Brown (position 3); Dan Erin and Wendy Noble (position 4) and Tom Langland (position 5).
One of the candidates, Bonny Olney (position 5), could not attend due to a previously scheduled commitment and Bill Swartz (position 2) did not join the candidates on stage because he said he had withdrawn from the race. His name, however, will still appear on the ballot. Speaking briefly at the top of the meeting, Swartz apologized for the confusion around his candidacy and said he wholeheartedly supported the ballot initiative.
The forum was moderated by former Voice of Vashon station manager Susan McCabe, who provided the candidates with written questions from islanders. Forum attendees also got a chance to ask candidates questions directly near the end of the event.
The forum’s organizers told The Beachcomber the event was held for people to learn about the candidates themselves, not to debate the merits of having a public hospital district, which will be included as a separate measure on voters’ ballots.
EXPLANATION OF HOSPITAL DISTRICT
But prior to the questioning of candidates at the forum, Rep. Joe Fitzgibbon, the island’s elected representative to the state Legislature, gave attendees an overview of state statute, which provides for public hospital districts.
“This is a really significant choice that is before you on the November ballot,” he said.
Public hospital district statute went on the books in 1945 as “an option for communities that felt the need to supplement their local health care assets,” Fitzgibbon said. There are currently 58 districts, including ones that include San Juan, Lopez and Orcas Islands.
If approved by voters on Nov. 5, Public Hospital District No. 5 would bring with it a 5-member board of commissioners, responsible for overseeing the island’s health care services.
“One thing I think it’s really important to be clear about: A hospital district does not have to operate a hospital,” Fitzgibbon said, noting 44 districts operate such facilities. “The remaining 14 provide other health care services, that could include nursing care services, urgent care, that could include ambulances.”
According to state statute, RCW 70.44, a public hospital district board of commissioners, including ones on Vashon, could contract with health services on or outside of the island for health care services. The board could, for instance, decide to have the Seattle-based Neighborcare Health as a provider, though no promises have been made by candidates and Neighborcare’s spokeswoman has said there has been no discussion or made plans about what would happen to its Vashon clinic after the election.
According to the statute, the commissioners would be able to raise revenue by levying property taxes to collect .75 per $1,000 of an assessed home’s value.
“Hospital districts are not required to collect the full 75 cents; it is up to 75 cents,” Fitzgibbon said. “If the voters in the hospital district choose to vote for more than that, they are allowed to.”
Olney, a family practice physician and physician advisor for Level Of Care, provided an opening statement, read by McCabe, saying she could not attend because she was attending a health care conference.
“‘I’m not a natural politician, but I am pleased that this initiative is on the ballot and Vashon truly needs a hospital district in order to better secure long-term access to health care,’” McCabe read from Olney’s statement.
Steczek, a former National Security Agency linguist with a varied resume, talked about how the commissioners would approach decision making as a new body.
“It’s important for us to make certain we ask the right questions of the community and the community gives us the correct and honest answers about what it needs and what it wants,” he said. “Then, as a commission, we work together … to determine how it can prioritize those wishes and needs and come back to the community and say, ‘We propose doing it like this.’”
Pryne, a retired journalist for The Seattle Times, said the commissioners would need to “manage expectations” with islanders about what the board can achieve.
“We have a limited tax base, we have a limited ability for people to pay,” he said. “Our top priority needs to be maintaining a clinic, increasing same-day appointments and walk-in care, expanding clinic hours … those are the priorities.”
Erin, a software engineer, responded to a written question about how the commissioners would work together to prevent “mission creep,” a term used to describe executive overreach into niches of health care issues beyond the scope of the district’s primary mission. He said it could be prevented if the commissioners “keep one eye on the prize” — proving health care services.
“And not get distracted by other things,” Erin said. “That’s going to be my message over and over.”
The candidates were asked if they would accept the salary provided to them by statute. Everyone on stage said they would not, but Noble, a nurse practitioner, pointed out that such a salary should not be ruled out for future commissioners, as it could encourage inclusivity in participation by lower-income members of the community.
Wolczko, a veterinarian who owned Fair Isle Animal Clinic for many years, responded to a written question about whether money brought in from the levy would go to Sunrise Clinic or another provider.
“The first phase, once the hospital district would be formed, would be to get a broad canvassing of what the total needs are,” he said. “Then the next phase is to negotiate with care providers — that can be care providers that are already on the island and it can be groups that are off-island, and probably using a hybridization of both groups will be the best solution … We would not disclude care providers … but they would have to enter into a contract.”
Brown, an independent insurance broker, responded to a questioner who said the island was better off without Neighborcare Health. She said she disagreed, saying that after other providers fell through, Neighborcare “came in our time of need.”
Brown added that if the commissioners are elected, it will be up to them to chart a new course for health care.
“What we have to do as commissioners is we need to really have our own brand of Vashon health care here,” she said. “We need to create a true rural community center here … this will be the first time we’ve really ever done that. It’s going to be really fantastic.”
Noble responded to a written question referring to islanders who are both weary of paying more taxes and not sure if a hospital district is a good idea.
“One of our biggest responsibilities is fiscal accountability to the community,” Noble said. “I certainly appreciate the concern about taxes. We’ve become well aware there are options, particularly with seniors who are struggling with taxes to delay the taxes … so I think there are a number of ways we can be sensitive to that issue. But my other concern is, there’s going to be a lot of expenses that people incur if they have to keep going off-island for every medical need, and those expenses can easily add up to more than what we’re paying in terms of taxes.”
West, a consultant and school bus driver, responded to a written question about whether he has given consideration to what impact the formation of a proposed hospital district levy could have on the Vashon Park District. Should commissioners of an island hospital district choose a levy that exceeds a certain threshold, it could curtail the tax revenue of the park district. The park district relies on levy dollars for about 80% of its annual income.
“I believe that it is our task to be responsible to our community,” West said. “My own personal feeling is that a healthy community needs not just a clinic, but it needs places for people to recreate, and that would be in my mind if I am elected.”
Langland, the longtime former owner of Vashon Pharmacy, responded to a written question about eminent domain and where it could build a new medical facility.
“That’s almost in the same conversation of building a new hospital — that’s not what we are setting upon initially, and who knows if ever,” he said. “There’s so many other ires to stamp out before we build a state-of-the-art physical plant or clinic. It certainly deserves to be in the conversation at some point.”