In 2019, Vashon faced yet another primary care clinic shutdown.

The campaign for a Hospital District envisioned financially stabilizing that clinic, seeking weekend and evening care, and assessing other needs not currently met. 71% of Vashon’s voters agreed with this vision.

Two months later, patients began to show up at hospitals with a mysterious illness that we now know as COVID 19. The world had changed.

The new commissioners, borrowing from King County, moved forward with subsidizing the clinic, and when NeighborCare was unable to continue services to Vashon, contracted with Sea Mar to replace them.

Late 2022 brought the news of an independent, unsubsidized Sea Mar clinic, and a time of re-assessment for the District.

The commissioners evaluated the pledges and priorities expressed to the community, the status of health care needs, and what that meant for the future. After extensive study and consultation with experts and constituents, the commissioners recognized that their original mission was not fulfilled.

They needed a plan to address current and future needs, including, as they had so recently learned, the unexpected needs.

The result of that process has been the development of a strategic plan based around four key values: equity, access, collaboration, and stewardship of community resources.

Utilizing those values to assess community needs, the district has established four strategic priorities: preserving primary care access (chiefly through reserves), establishing and sustaining urgent care services, addressing gaps in behavioral health services, and prioritizing services for vulnerable populations. It made significant progress in all categories — most notably the arrival of 7-day-per-week urgent care services in 2024. It retired its debt early and built prudent reserves for expected and unexpected future needs, without raising its levy.

Then the world changed again.

In late 2024, the district recognized that the impact of federal election results on policy, funding, and service access was likely to be immense. It began an “emergency planning” overlay to the strategic plan, working to recognize the changes before and as they happened, and preparing for multiple future scenarios, including large-scale funding and service losses.

Key in that process was the proactive development of local, resilient infrastructure to adapt to a wide range of possibilities. In collaboration with multiple partners, the district is preparing an updated plan that will aggressively combat existing and potential loss of funds and services, while continuing to address its core priorities.

It has agreed to fund the majority of the cost of the existing and expanded services of the VIFR Mobile Integrated Health program over the next three years, including the addition of a physician assistant, and has allocated funds for future expansion as needed. Utilizing existing resources, while allowing VIFR to use its funds for its fire, rescue, and disaster preparedness mission, strengthens local, proactive, sustainable capability to address a wide range of needs.

It continues its contract with DispatchHealth to provide urgent care services.

It broadens partnerships providing critical social work, navigation, and mental health care services, and will look to expand those services significantly, serving youth, seniors, and a broad range of residents in between, paying particular attention to the needs of the vulnerable among us.

It is expanding its support of vouchers and other social and health services to those who need them, including an anticipated increase in uninsured or under-insured residents.

It supports smaller projects like immunization and health screening, and community planning.

It maintains significant additional reserves for sustaining primary care and other key services as necessary.

Twelve to fourteen full time equivalent core frontline workers serving the health needs of the Island will be directly funded by the district under this plan, without a levy increase, and at significantly less than its maximum taxing authority.

The district provides a collaborative voice for its community, one capable of sustaining a broad range of vital services by connecting community resources to community partners serving community needs.

More changes are coming, and the Vashon Health Care District, along with the many other organizations serving this island, is prepared to meet them with agility, practicality, and collaboration.

Learn more at vashonhealthcare.org, sign up for our newsletter, and make sure to share your thoughts with us, because this is your health, your island, and your district.

Tim Johnson is the superintendent of Vashon Health Care District.