If you’ve been reading the news about recent developments regarding health care on Vashon, your head must be spinning.

You’re not alone: We’re the commissioners of the Vashon Health Care District, and we feel like we’ve been riding a roller coaster for the past few weeks.

To recap, briefly: Seattle-based Sea Mar Community Health Centers, which we engaged in 2020 to operate the clinic at Sunrise Ridge on our behalf, told us on Aug. 24 that it intended to terminate the contract and leave Vashon by Dec. 31.

They cited irreconcilable differences with us.

Then, days later, Sea Mar’s leadership pulled a 180. It informed us and the community that it intended to stay – and build a new clinic facility – and perhaps build affordable housing – and perhaps provide dental care – all of it independent of the District, without the tax subsidy from us that has provided nearly $2.9 million since 2020 to keep the clinic out of the red.

This is, as they say, a developing story. By the time you read this, the situation may have changed yet again.

But one thing won’t change: Our commitment to represent and advocate for you, our neighbors, to ensure Vashon has the health care services that meet its distinct needs and standards. That’s what you elected us to do when you voted to establish the Health Care District three years ago.

Sea Mar may have more experience running primary care clinics than we do. But we know a lot more about Vashon — its people, their needs, their values — than Sea Mar’s corporate leaders do. We’re accountable to you; they’re not.

And we, like you, are painfully aware that other off-island organizations have come to Vashon with big plans, only to abandon the island later when things didn’t go as expected. We don’t want a repeat of that.

So, as we review Sea Mar’s surprise offer of a free lunch for the island, we need lots more information. And we need ironclad commitments.

For starters: How does Sea Mar plan to operate the clinic with no subsidy from us? Without our subsidy, according to Sea Mar’s own financial statements, the clinic’s revenues between November 2020 and July 2022 would have covered less than 60 percent of the clinic’s expenses. And Sea Mar told us as recently as April that it still needed a subsidy of more than $90,000 a month.

We — and you — are entitled to see Sea Mar’s financial plan for operating the clinic without a subsidy. The island also is entitled to a binding commitment from Sea Mar that it won’t cut and run if things don’t go according to plan – a secured reserve account to cover future losses, for instance.

Saying “trust us” isn’t good enough.

We also have questions about what kind of clinic Sea Mar would operate if left entirely on its own.

Our 2020 contract with Sea Mar — the one they now plan to terminate — draws attention to Vashon’s distinctive health care circumstances. It speaks to the need for the clinic to provide same-day and walk-in care — not the norm for a primary care clinic, but important on an island with no urgent care center.

It also speaks to the importance of the clinic accepting all major health insurance plans, including Kaiser and other commercial plans that reimburse Sea Mar for only a small fraction of the cost of the care it provides. We believe the clinic should be accessible to all.

Will a Sea Mar clinic that is untethered from the Health Care District continue to offer all the same services, and accept all the same insurance plans — including yours? Sea Mar should commit to a detailed baseline level of service for the island. That commitment, too, should be binding.

Sea Mar’s corporate leaders also should commit to meaningful community involvement in the design of any new clinic building. Yes, Sea Mar has built lots of clinics around the state. But it hasn’t built one on Vashon. And we all know cookie cutters don’t fit this island well.

During our own preliminary planning for a new clinic, we heard lots of ideas from islanders about what features it might include. As your elected representatives, we’re obligated to consider and weigh your suggestions. Sea Mar has no such obligation, unless it chooses to.

These are some of the safeguards we’ll be pushing Sea Mar to accept. To do any less would be a disservice to you, our neighbors. Meanwhile, we’ll also continue to explore alternatives for sustainable health care on Vashon.

You elected us to protect your interests. If we don’t hold Sea Mar accountable, what assurances do we have that their promises will be kept?

Tom Langland, Don Wolczko, Alan Aman, Wendy Noble and Eric Pryne are elected commissioners of the Vashon Health Care District.