Continues to collect information on options to increase reimbursements

— by Susan McBain, Orcas Issues reporter —

November 5 was the official day for the Orcas Island Health Care District commissioners to adopt their 2020 budget and levy. And they did, in two hearings conducted as part of their regular meeting.

District Superintendent Anne Presson first presented a levy summary showing the calculations used to establish the levy and expected levy rate, including use of banked capacity. She then walked the commissioners and those attending the meeting through highlights of the final proposed 2020 budget document. This document shows line item totals to date for this year and proposed totals for each item for 2020, including descriptive comments for most items.

Presson said that the District will fully draw down its general obligation bond in 2020. She also discussed 2020 expenses, noting that subsidies to providers are about 54% of total expenses, and buildings and equipment costs about 30%. Administrative costs, which were about 16% in 2018–2019, should drop substantially next year, since setup costs will not be repeated.

The commissioners voted 5–0 to adopt a 2020 general fund budget total of $2,542,522. They also voted 5–0 to set the 2020 tax levy at $1,755,500. The expected levy rate will be approximately $0.65 per $1000 of assessed valuation, about the same as this year’s rate, although the rate will be applied to 2019 assessed values, which increased 14% countywide. Individual property owners will have different increases in assessed value, which will lead to different tax increases.

Those formal actions out of the way, the commissioners moved on to discussing continuing issues. They felt that questions remain on Federally Qualified Health Center (FQHC) status and that they were not ready to dismiss the option of a Provider-Based Rural Health Clinic (RHC). They decided to engage one more set of experts on the various federal designations to help them make the critical decision on which to pursue. They approved $7500 for a teleconference with consultants from Wipfli CPA and Consultants, a nationwide firm with broad expertise in all the options they have considered, including FQHCs, provider-based RHCs, and stand-alone RHCs.

The commissioners also continue to gather information on maintaining the clinic building’s roof and HVAC system and on how those interact. Hargis Engineering is preparing a comprehensive plan for the HVAC system, but its full costs aren’t known yet. Commissioner Richard Fralick is still seeking detailed costs of roofing materials, methods of insulation, and installation for the clinic’s specific, and complicated, needs.

Finally, two candidates have applied to do project management work for the District as contractors. One has healthcare experience, the other experience in financial modeling. Both may be engaged for different types of work.

The Public Hospital District on San Juan Island (known as SJCPHD#1) asked the commissioners to consider being part of a network of entities in the County. The group is applying for a $100,000 planning grant to develop a strategic plan for meeting the long-term care needs of seniors. Based on the District’s current workload, the commissioners agreed that the timing isn’t right for them to participate.

The regular District meeting scheduled for Tuesday, Dec. 19, has been cancelled. The next regular meeting will be held December 3 at 5 p.m at the Eastsound Fire Hall. A special meeting for the videoconference with Wipfli is scheduled for December 10, 9 a.m. to 3 p.m. at the Fire Hall.

For more details about meetings, minutes are available on the District website. Minutes are posted soon after final approval by the commissioners, usually at their next meeting.

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