Sea Mar Community Health Centers could continue to operate at Vashon’s Sunrise Ridge health care clinic until at least June 30, 2023, and perhaps longer, according to Vashon Health Care District commissions.

In recent weeks, Vashon Health Care District (VHCD) and Sea Mar have returned to negotiations, following an initial impasse after Sea Mar’s surprise announcements, in late August and early September, that it would sever its contract with VHCD as of Dec. 31, but wished to continue to occupy the Sunrise Ridge clinic as it builds its own health care facility on Vashon.

According to commissioners, VHCD and Sea Mar are now close to an agreement in which VHCD would sublease the clinic to Sea Mar, effective Dec. 31 to June 30, if Sea Mar executives agree to retroactively honor a proposal they made to VHCD in April — to reduce VHCD’s tax subsidy of Sea Mar’s operations at the clinic from $1.5 million per year to $1.1 million per year.

Under this agreement, VHCD would, retroactive to April, lower its monthly subsidy payments to Sea Mar accordingly through Dec. 31, when the subsidy will cease altogether.

However, according to documents included in the board packet of VHCD’s Oct. 19 board meeting, another proposal is also now on the table — one that would give Sea Mar a longer timeline to exit Sunrise Ridge.

Under this proposal, VHCD would agree to an extension of the sub-lease beyond June 30, 2023, potentially giving Sea Mar a base on Vashon as it builds a new primary care clinic on the site of the Spinnaker Building — property Sea Mar also announced, in September, that it has tentatively agreed to purchase.

The document, “Proposed Acceptance Criteria,” dated and sent to Sea Mar on Oct. 12, outlines a broad set of criteria under which VHCD would agree to extend the sublease on a longer time frame.

These criteria, said commissioners, were developed in collaboration with VHCD’s strategic planning task force — a group comprised of commissioners and longtime island health care advocates.

Under the terms stated in the document, VHCD would require Sea Mar to agree to fully fund the operations of a Vashon primary care clinic for 10 years, and provide a proforma to VHCD showing how it intends to fund net clinic operating losses.

The document requests other financial assurances as well, including a description of the sources of capital funds for Sea Mar’s building project.

The criteria ask Sea Mar to specifically describe how it will engage with the community on a broad range of issues — ranging from the design process of its new clinic, to coordinating with local organizations, including Vashon Youth & Family Services and other island-based social service providers, to what type of direct communications with the public Sea Mar will regularly undertake to inform islanders about its operations.

Among other requirements, the document asks Sea Mar to describe how it will provide same-day/extended-hour access to all patients, and also explain what acute/urgent care services its clinic would not to able to provide.

Addressing the possibility that Sea Mar could decide to exit the island earlier than 10 years, the document asks for assurance of a 12-month notice in that case, as well as a right of first refusal to sell its assets to VHCD.

VHCD has asked Sea Mar to respond to the criteria set forth in the document, with a written plan, no later than Nov. 15.

At that time, commissioners said, the district’s planning task force will conduct a private review, engaging Sea Mar as needed, for the purpose of determining whether or not its plan meets the acceptance criteria, and then decide whether to recommend acceptance of Sea Mar’s terms to the commissioners.

Sea Mar’s response to the document is important, commissioners said.

“Given the island’s history of being abandoned by off-island service providers and the questions being asked to the District by its constituents, the District believes it should, and has, developed criteria to evaluate the credibility of Sea Mar’s plan for serving the island,” the document states.

Commissioners mull budget, levy considerations

At the Oct. 19 meeting, commissioners also reviewed a draft budget, prepared by its superintendent Eric Jensen, that proposed different scenarios possible in the coming year, depending on whether VHCD would need to engage a new provider for the clinic at Sunrise Ridge and other financial impacts.

The budget draft now calculates income to the district of almost $2 million, assuming the same levy rate for VHCD in 2023 as in 2022, with an additional $93,000 in income from payments made by Sea Mar as a sub-lessor of the Sunrise Ridge clinic.

Commissioners, in a round table discussion, discussed whether or not VCHD could perhaps lower its tax levy in the coming year — a possibility that Eric Pryne urged other board members to consider, given that its subsidy payments to Sea Mar would be eliminated as of Dec. 31.

Other commissioners, most notably Don Wolczko, favored a more conservative approach, citing the uncertainties facing the district, including the possibility of having to secure a new provider for the Sunrise Ridge clinic.

Wolczko also referenced VHCD’s budget goal to support at least one new non-primary care service goal in the coming year, and in particular, signaled his support for VHCD to consider supporting the work of organizations such as Vashon Care Network.

VHCD’s timeline calls for its proposed new budget to be published on its website by Nov. 1. A budget hearing will take place on Nov. 14, with board approval scheduled for Nov. 16.