Health Care District: Listening and learning from islanders

Comfronting the broad set of healthcare issues on Vashon is complicated, but our commissioners have accepted the task.

This spring, after making an agreement with Sea Mar Community Health Centers to operate independently but collaboratively, Vashon Health Care District launched a listening tour regarding its ongoing purpose, given that its tax subsidy is currently no longer required for primary care — the previously central though not sole district mission.

We met islanders at coffee shops, grocery stores, and the food bank, and engaged a variety of targeted voices, from civic groups to parents’ organizations to health care providers to the social service network. We sought out underserved, underheard populations, directly where possible (a special thanks to those who helped with introduction and translation and advocacy).

We held public meetings, showed up at those of others, joined collaborative groups, attended activities, fielded emails, stopped to chat on the street, and sought the counsel and perspective of our valued island elders.

We also needed to sharpen our internal focus and processes for identifying and setting appropriate priorities for the stewardship of public resources that align with both original and current obligations.

We hired strategic expertise to facilitate reviewing our strategic vision going forward, and commissioned an advisory committee of island experts in the areas of health care, community engagement, and organizational development, to whom we are extremely grateful for the continuing gift of time and wisdom.

We’ve been privileged to receive a wealth of information about needs, wants, and responsibilities — about being careful balancing our priorities and your resources, not trying to be all things to all people, but also not allowing failure through inaction because the decisions are hard and complex and not unanimous.

Right now, our commissioners continue to listen and learn, and are leading study groups looking into areas of need raised by our listening efforts. We are exploring problems, solutions, alternatives, and yes, costs. We have paid back the money we borrowed to operate our first year with no taxes, and are debt-free for the first time. We are addressing proper and prudent reserve levels.

It’s no surprise that the number one response to the question of unmet needs across the breadth of our conversations is after-hours/acute/unanticipated care, often referred to under the general term urgent care.

But we’ve also heard about the shortage of behavioral health resources in a time when we are all collectively as stressed as ever, about seniors struggling to stay on the island not just from tax burdens, but the lack of access to home-care resources.

We’ve heard about the need for health education and prevention programs and about fears of what might happen if our current primary care providers should leave as so many have before them.

We’ve heard about the financial struggles of the working poor, homeless, undocumented, and elders on fixed incomes, the difficulty of finding, gaining access to, and affording care, and the financial and time burdens of merely getting off the island for care, including for minor issues on short notice. We’ve heard about the shortage of dental care.

Understanding, much less prioritizing such a broad set of issues is complicated, but we’ve found many allies and resources to help us move forward, and our commissioners have accepted the task.

We know that we will not solve or improve these problems merely by cutting our tax rate or going away, nor by simply throwing more of your tax dollars at them. We are being diligent, careful, and importantly, widely collaborative as we move through the prioritization process.

We endeavor to avoid mission creep, hasty decisions, and poor planning. We are committed to striking a proper balance between opportunity and responsibility, deliberation and action, and to finding the most sustainable, highest and best use of the proper quantity and type of resources under our stewardship to meet the health needs of the island.

If you’re curious to know more or how you can participate, we meet every first and third Wednesday of the month at the Presbyterian Church at 7 p.m., and you can attend in person or via Zoom by visiting our website at You can also reach me personally at

Please continue to bring us questions, complaints, advice, ideas, information, and support. We need and value them all as we prepare to act on what we learn. Lean in and stay tuned.

Tim Johnson is the superintendent of the Vashon Health Care District.