When Neighborcare gave us their pitch of how good they would be for our community, the rosy picture was, “We can be the clinic that Vashon has been looking for. Raise money now so we can get our infrastructure in order. We will buy an X-ray machine for the community. We turn no one away for lack of payment. We are your answer.”

Two years later, the rosy picture seems tarnished. Neighborcare seems surprised that Vashon’s population make up does not match the low income neighborhoods of Seattle. They are saying our population mix is not working financially for them. Anyone who can read a census report knows that only 13 percent of us are living 200 percent below the federal poverty level. This is their bread and butter since Medicaid pays Neighborcare 106 percent of what they bill. This is their cash cow. Their second highest insurance reimbursement is Medicare. The census says about 20 percent of us are 65 and over and on Medicare. Just under half of the people who use the clinic are on private insurance, which they receive about 57 percent of what they bill. The private insurance reimbursement is most probably what any other medical provider receives.

Now Neighborcare is telling Vashon that none of their Seattle clinics are self-sufficient and that is with the majority of those clients on Medicaid. They are telling us that each clinic must break even financially.

They now are telling us that they get government grants from the City of Seattle, the state and the federal government. But that none of those grants can be used for the Vashon clinic. Why did this not get mentioned earlier?

Neighborcare says, “We turn no one away for lack of ability to pay.” What they do not say is that a bill will follow you out the door. That unpaid bills may end up in collections. People who have no insurance or very high deductibles are being billed at full cost of services. Why are they expected to pay more than the private insurance companies pay? Why should the poor pay more?

Neighborcare has caused some of their own problems.

In June, two physicians were dismissed for cost-cutting reasons. Gary Koch had been the clinic’s doctor forever. Not to let him retire in December, as he had planned, hit this community hard. Beloved Katie Konrad left shortly afterward. Probably many of her patients will follow her to Vashon Natural Medicine, where she is now working. Some of Gary Koch’s and Scott Chaffin’s patients may find other medical providers as well.

This summer — with a new off-island phone system that did not seem to work well — people were on hold for long periods of time. Once they got through, appointments could be as far as six weeks out because the Vashon clinic only had two medical providers working each shift. Again some had to find other doctors to see.

Referrals have fallen through the cracks. Some were not being made in a timely manner, or lab results and X-rays were not being sent over to the specialist.

In Seattle, Neighborcare pays to have translators on site to help patients understand their exams. Here people can use a phone during exams, which is not very welcoming. How can people get good care if they are not understood by the doctor why they are there, if they do not understand what is being done and what follow-up care they may need?

Neighborcare is not being forthcoming. They say they are not leaving. They say they cannot ask the community for money. Yet at the last meeting, while John Jenkel was proposing a hospital district to funnel money directly to Neighborcare, he failed to mention that he is on the board of Neighborcare.

How can anyone ask for money and refuse to supply profit and loss statements? Yet, Chief Development Officer Joseph Sparacio and CEO Michael Erikson said no to making public these financials for the Vashon clinic and the Vashon school-based clinic. They refuse to include the income from the school-based clinic with the regular clinic even though we are all the same community. The school clinic receives money from Best Starts for Kids and insurance reimbursements billed.

We have already raised $650,000 to get Neighborcare here. They have received money from Granny’s each funding cycle. This year alone they have received $100,000 from Granny’s. Neighborcare’s 2017 tax return shows they made a profit of $2.5 million, and they have $13 million in the bank. Do they really need more money?

Neighborcare needs to earn our trust and show they are the right fit for Vashon. They need to show the community that the clinic here can run efficiently, well staffed with medical providers, timely appointments, available translators and a smooth referral system. This all needs to happen before any conversation about financial support is even talked about.

— Hilary Emmer is a community activist.