||| FROM MIKE MILLER |||
The upcoming April election contains a vital measure to continue funding our health clinic. I propose we should all vote Yes. Why? First some back story.
For those of you that want a challenging and often thankless job – the role of Health District Commissioner may be for you! The OIHCD was created in 2018 with the mission of protecting and improving the health of all islanders – something that simply hadn’t existed before. To a large extent it’s been a major success. The District has to forecast the rise of health care costs over a 10 year period, negotiate with the only party willing to provide health care to our island (Island Health), and then raise capital to secure the service provider, and maintain/enhance the clinic building. No health group can operate our clinic at scale for profit. We use a mix of philanthropy, grant dollars, and tax dollars to subsidize Island Health to staff our clinic 9-5, 5 days a week. We all understand the cost of healthcare is going up quicker than inflation. We also understand that will continue. Our contract with Island Health is up for negotiation. They are the only game in town. They give us the best reimbursement rates on the market. Our commissioners have even negotiated a significant discount on the upcoming decade contract (in the order of 20%). This contract is still under negotiation, but it is clear we will need to raise the tax levy to be able to cope with the increase in costs – over 30% in the last few years. The timing of this levy lift is constrained on both ends by the contract negotiation. Too soon and a levy lift would be uninformed. Too late and we will lose leverage with Island Health and the deal may fall through. We need to do this now.
What will happen if we don’t raise the levy? We will not be able to continue operating the clinic as it currently works. The exact timing of crossing from the black to red depends on factors we can’t fully predict, but it will likely be 2-4 years from now. That said, we need to raise the levy now or we will not be operating in good faith with Island Health, who know the public details of our finances. At first the clinic won’t entirely close, but the scale back will ultimately lead to provider loss and reduced to no health care for a large portion of our populace.
How much should we raise the levy? This is the realm of health care economic experts. Our commissioners have a long range financial plan that keeps the clinic in the black without scope creep or lavish spending. To be frank, the commission hasn’t even drawn down all of the tax capital it could have over the past years (5 of the last 6 years to be exact). We have no reason to believe the commission will operate differently if we vote yes on this levy.
Where will the capital go? This is a complex question that depends on how healthcare expenses change and if the new federal administration or the State (with a projected 15B budget gap) make material changes to government reimbursement. It is the burden of the commission and the proponents of this levy to explain that to the islanders over a series of town halls, online materials and door-to-door campaign. But at a high level, the dollars primarily go to: (1) cementing a 10 year deal with Island Health to staff the clinic at current operating rate (2) maintaining the physical building and (3) scaling the clinic size, housing options, and primary care related clinical services with the needs of a changing island population.
Health care is a fundamental need on this island. Being able to see a pediatrician on a weekday and only missing 60 minutes of school instead of a day of work and a day of school should not be considered a luxury. Providing solid health care for all islanders is fundamentally good for our local economy. The job of the OIHCD is, at the most fundamental level, to keep us alive. They are here to protect us and this is the time when we must make the ever challenging decision to temporarily modestly raise taxes to provide another decade of health care to all islanders.
Watch for fliers and online announcements of a barrage of upcoming meetings to introduce and debate this issue in the detail it deserves. All voices will be heard, but the opinion of the commission is clear: they are unable to maintain health care without this levy. It is our time to listen and act. Six weeks is plenty of time. Come ask myself, Trey Holland or Rick Hughes if you are interested in helping with this campaign.
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Thank you, Mike Miller, for the well-explained background. At a time with so many uncertainties which will affect us financially but which are beyond our immediate reach at the federal level, this is one situation we can directly affect. Our Island Health Care District has gone from a startup, ironing out some initial wrinkles, to a functional new contract with Island Health that helped us through the pandemic and is steadily improving its service beyond. I have full confidence in its volunteer commission and will look forward to more information in order to support our Health District’s needs.
This is a clear and reasonable overview, Mike. So much of this happens behind the scenes and it’s helpful to know the realities. Thanks for sharing your thoughts!
The premise of the Island Health care was not to just fund the medical clinic, but others too.
The offer was for 24/7 care, for all
I question this and was told to just go with the flow.
So while I recognize the need for care I am struggling with funding a facility that can’t meet the full numbers here on Orcas, is not open as promised 24/7.
While many realized these promises were unattainable, I now wonder why we are asking everyone to pay for a clinic that can’t and doesn’t serve the entire community.
But hey I may be told to shut up again, what do I know.
The commission is proposing a new 10 year Temporary Levy Lift (LL) increasing the millage rate 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.
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.
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.
Tentative Meeting Timeline:
Meeting, Levy Lift Argument for Group 3/14
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.
We will be continuing to add information on levy details on the Hospital District Website – https://www.orcashealth.org/serving-our-community-sustainably – We’re a small team, but happy to answer any questions.
I was initially skeptical when this was first proposed, but the founding commissioners did an outstanding job establishing the district and the relationship with Island Hospital. I now believe this is the best option for continuity of medical care on the island and worthy of our full support.
Unfortunately iInflation has driven up costs across the board, from fire service to electrical rates and, yes, to the cost of medical care that includes recruitment and housing for staff. From my perspective this is well worth the cost.
In a small community 24/7 care is a practical impossibility, but our EMT’s working in conjunction with clinic staff can and do provide excellent service for a rural area such as ours. I would like to understand how the clinic ” can’t and doesn’t serve the entire community”. I recognize that individuals have the option of seeking service from other providers but that’s discretionary. Is anyone being turned away, and if so understanding the reason(s) may give direction to potential solutions.
Last and long overdue, my thanks to our founding commissioners, particularly Art Lange, and to all who have served since for providing quality care on the island with excellent referrals to specialists and services at Island Hospital.
Phil
Our experience mirrors yours. We can thank our five founding members for developing and providing a functional program that they turned over to the next “generation” of commissioners.
As far as 24/7, I don’t believe it was promised to have the clinic open 24/7 but that an emergency would be handled by EMT’s with the help of phone triage and available clinic providers. Last resort the patient would be flown off island. I believe the providers would be paid $250 for going to the clinic after hours.
Maybe someone more up to date could speak to this.
I am not sure why every taxpayer is being asked to subsidize a medical clinic that not every taxpayer uses. The illness industry operates at many levels and milking remote/isolated communities with the promise of clinic services and coverage that never actually materialize seems to be one of those scams. Please explain EXACTLY what the Orcas clinic provides that a simple doctor’s office doesn’t. If people want to pay for a clinic, that’s their choice. I don’t use the clinic and don’t see the value for my tax dollars. I will be voting against this SEVENTY percent tax increase and I hope everyone else will look at it closely and ask themselves if the community has received services commensurate with all the money we have poured into the medical center over the last 25 years?
The reality is that for anything medically serious you will be flying off island. Anything less-serious can wait until the next ferry or take a water taxi. For routine medical care a doctor’s office is obviously entirely adequate. So what EXACTLY does the medical center provide in that in-between zone of “too serious for a doctor’s office but not serious enough for a helicopter” ?
I, and many others, see the medical center as a taxpayer funded doctor’s office that we don’t even use. If we are going to pay be forced to pay for socialized medicine, then I would like to get something useful for all that money. A 24 hour emergency clinic was something I was willing to help fund, but that’s NOT what we got, is it?