||| FROM BOB THOMAS |||
I’m Bob Thomas. We first came to the San Juans when we chartered a sailboat about 26 years ago then again about 16 years ago. We moved here in 2012 after visiting on land the prior 3 years.
I became involved in the clinic at the second public meeting of the Coalition for Orcas Health Care. After the election I continued attending meetings for the next four years or so occasionally commenting and raising questions particularly about the use of our tax dollars. This may have had something to do with a call I received a couple of weeks ago suggesting I present the Argument Against the levy. I look at as this as more of an opportunity to watch how information is presented and fill in the gaps. So:
ARGUMENT AGAINST
In late 2017 the Coalition for Orcas Health Care was formed by residents of Orcas with the result being a measure placed on the 2018 ballot to form a public health care district for access to high quality primary, urgent and after hours care in a financially sustainable and cost effective manner.
The commissioners established an efficiently running clinic; upgraded facilities and staff; partnered with Island Health; set up processes that included appropriate administration with transparency all with public input and within budget.
The current commission now is proposing a new 10 year Temporary Levy Lift (LL) increasing the millage rate from .415 to .700 or 69%. The LL contains this statement: “Longer term, the district intends to serve as a catalyst to bring all health care stakeholders together to support a community approach to care that addresses all health care needs on the island”. This statement is a significant expansion of the original mission.
The proposed LL includes many high cost programs for modernization, staff housing and additional services.
I strongly encourage voters to learn exactly how the substantial increase will be spent in order to decide if you are willing to pay for those things with your tax dollars.
The above Argument against will appear in the San Juan County Voter Pamphlet
A FEW TOPICS:
MILLAGE RATE
The millage rate will increase from .415 to .700 an increase of 69%:
- For a $500,000 house the Levy will increase from $207 to $350.
- For a $1,000,000 house the Levy will increase from $415 to $700.
- For a $2,000,000 house the Levy will increase from $830 to $1400.
MISSION CREEP
Original definition by COHC: Primary, Urgent and After hours care in a financially sustainable and cost effective manner. Through out the election and on into the OIHCD this mantra was continually repeated.
From the original commissioner candidate bios:
“Apply my extensive leadership and strong fiscal discipline to make educated, balanced, commonsense decisions on how to most efficiently utilize precious tax dollars to support our health care system.”
“….exercising fiduciary responsibility in setting the level of taxation necessary to ensure delivery of high quality services….”
“I will spend taxpayers dollars in as responsible and efficient a manner as possible. I will do everything I can to keep the levy rate as low as possible and achieve the goal.”
“Fiscal responsibility to assure our tax dollars are spent carefully by keeping as much locally as possible.”
Somewhere along the line the original goal of quality primary, urgent and after hours care was modified and replaced by the following statement on the OIHCD website:
“Longer term, the district intends to serve as a catalyst to bring all health care stakeholders together to support a community approach to care that addresses all health care needs on the island.” Note that ALL has been used twice in this statement and this is a significant expansion of the original mission of primary care.
There are now two “clinics” on the island under the OIHCD umbrella:
Island Primary Care-Orcas
Orcas Community Dental Clinic
There are continual updates on what is considered primary care.
It appears with this Levy Lift and the election information available we are beginning the transition from primary care to ALL or full care.
PROPOSED CONTRACT WITH ISLAND HOSPITAL
Tentative agreement, lawyers reviewing. About 4-6 weeks before ready for signatures. Basic rate goes from the current $1 million to $1.2 million with a yearly 5% increase or COLA whichever is larger. There is a clause that allows further negotiation/increases for“extraordinary circumstances”. All proposed “additional services” may not be included in this agreement.
MODERNIZATION
The clinic had an extensive upgrade under the first commission.
As new proposed “services” are taken on by the clinics additions, upgrades and specialist
specific equipment may be required. Support staff may have to be added. At what point
might a new facility be proposed?
STAFF HOUSING ON VACANT LOT
Topics include temporary housing for providers, housing for visiting medical specialists or
other related activities. Permanent housing for providers? All of the above?
Note: Currently there is up to a $50k signing stipend for new hire caregivers for moving
and temporary housing during permanent house search. I understand this can be “clawed
back” if the employee leaves in less than 3 years. It may be cheaper to continue this
program rather than a multimillion dollar capital project of residences/apartments with
ongoing maintenance and housekeeping.
SPECIALISTS VISITS
Could include specialists from Anacortes or other medical related activities and consultants.
EXISTING LOAN
Does OIHCD still have an outstanding loan? What is the status? How does it fit into theproposed plan?
The above is just a start. Hopefully there will be more details available in various forums and meetings. I encourage you to attend meetings (by zoom?) and make use of the OIHCD website. I applaud the District in their very thorough website. Be sure to look at “Documents” then “Meeting Documents” to get a feel for what the Commission is doing, how the funds are being spent and plans for the future.
THEN VOTE
TENTATIVE MEETING TIMELINE
- Meeting, Levy Lift Argument for Group 3/13
- First OIHCD Town Hall Meeting 3/21
- Regular OIHCD Board Meeting 3/26
- Meeting, Levy Lift Argument for Group 3/28
- Second OIHCD Town Hall Meeting 4/4
- Meeting, Levy Lift Argument for Group 4/11
- Final OIHCD Town Hall Meeting 4/18
Confirm the dates, place and hour of meetings with listed groups.
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Thank you for presenting a clear and realistic picture of what’s happening at the medical center. I will be voting NO on the 70% levy increase.
“The Commissioners established an efficiently running clinic”.
This sentence evaluating the original Commission achievements fails to mention that we lost three beloved and respected full time physicians as a result and had to scrap the EPIC patient portal system in which we had a recent investment of over $500,000 because Island Hospital did not use it.
We were told UW did not want to stay on our island. The truth being they did not want to write a NEW contract at that moment. UW still maintains a clinic on Lopez and we should have, and could have, kept that affiliation.
No surprise “the only game in town” wants more patients seen daily and more revolving door providers and services.
My $700 will go to three Air Ambulance services , Fire Dept. levy and ferry fare e;lsewhere..
Unrealistic 70% increase, this is a rural clinic,
Let’s managed the growth !
Thank you for your thoughtfully researched presentation of OIHCD history, record so far, and cost analysis. I appreciate your respectful approach toward the argument against the levy, by encouraging voters to study the Website and attend the meetings for ourselves, before making our own decision on how to vote. You have made it easy for us by outlining the picture very clearly, and providing us with the information to follow-up ourselves.
Getting the vote of approval for having our tax supported OIHCD was a hard fought achievement in the first place. We certainly very much need it, and your argument remains supportive of OIHCD itself. However, it is indeed our responsibility as voters to pay attention to how our tax contributions are spent, and you are being very helpful in this regard. That’s the benefit of the Argument process, so again, thank you.
I as many others are tired of island politics of “bait and switch ‘, first promised a 24/7 clinic, the nope, not possible. So many tried to warn that this ‘district ‘ would be mostly to keep the medical center going. The medical center is not a 24/7 as promised. But that’s OK as they switched their plan after receiving a yes vote and the money.
Sound familiar?
So no thank you
We were told multiple places would be subsidized,
Nope just the medical center and now dental.
The money wanted is to hold up the medical center not as promised.
Such is the life on Orcas as of late.
But it will pass as that’s what they want.
Melissa,
I was an initial commissioner on the Hospital District and I can say with certainty that no commissioner ever promised to provide a 24/7 clinic. In fact, when the District was formed, UW was already operating the clinic and refused to provide after-hours urgent care at an affordable price. Fortunately, the clinic physicians came in voluntarily on occasion.
Secondly, when the district was formed we did subsidize Dr. Shinstrom’s practice, Orcas Family Health Center, as well as the clinic until it became clear that that model was not sustainable. After an extensive review and with Dr. Shinstrom’s full support, we determined that Island Hospital (renamed Island Health) was a good match for the medical needs of our community, and they agreed to provide after-hours care. That was an important additional service to our community and prevented many unnecessary transports off-island.
Since its inception Orcas Island Health Care District has been financially responsible and never collected the $0.75/thousand millage rate allowed by law. The original mission of the District was: “To Ensure quality, island-appropriate primary and urgent and urgent/acute medical care, including after-hours urgent cat care, is available to all the members of our community in a financially sustainable and cost-effective manner”
The current commissioners are proposing a levy lid-lift for a number of uses that voters need to decide if they are willing to pay for with taxpayer dollars. I agree with Bob that it is important for voters to become fully knowledgeable about the specifics of what the levy increase will be spent on.
Thank you, Art, for that clarification. I remember, when UW’s contract was up and they chose not to resubmit and the Board awarded the contract to Island, how much consternation there was in the community–Resistance to any change. That change has been, IMO, a very good one.
I also agree with both you and Jean that Bob’s counter-argument provides information and raises questions to be answered, debated and considered; and, as he points out, there will be opportunities to do that. I would urge other commenters not to jump to judgement.