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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Thank you again, Susan, for this detailed report.
I’m so grateful that Diane Boteler has volunteered to continue on for another term of office. Thank you Diane!
I feel our current Commissioners work with extreme diligence, individually and as a group, to do thorough research for backing the tough decisions they make in their efforts to bring us the best health care they can.
Is the consulting teleconference open to the public? I have grave concerns about the District actually becoming a provider of services, rather than simply supplying subsidies for the extraordinary costs of care in island settings. (For example, a new physician group taking over the practice.) There is a huge difference when the District becomes the legal entity, most principally extensive exposure for overpayments and potential fraud and abuse penalties, most of which come to light only years after the actions in question.
There is a perverse form of advocacy that specializes in denying services through authoritative obfuscation that perversely weighs institutional risk as always greater than the organizational mission creating such risk.
There is never case law cited or solutions proposed..
juuust this threatening cloud, legal talk of ill defined risk.
As if nonsensically there were simultaneously a multitude of well known examples of high-dollar settlements financially crippling ignorant but well intentioned do-gooders and a corresponding dearth of legal solutions to some utterly novel high-risk liability for helping. Anyone. Ever.
..Legal lifeboat ethics. Make the smelly, the unpopular, and the warty walk the plank to appease an ocean of legal uncertainty, while the rest of us sail on, self-righteously if ineffectually, into a future where WE ourselves become smelly, incontinent, and unpopular…
oops
This form of advocacy wants as well, $100,000 ..a nice round number, to create a strategy for aging. Something that while universally occuring to us all, has gifted a few with the authority to pay themselves to think about it.. and then presumably ask for $$M? to implement it.
I say, show me the plan and I’ll tell you if it’s worth $100,000! and b.t.w, there is a government agency tasked with providing qualified expertise in doing just this kind of statistical assessment: The San Juan County Health Department.
just sayin’
A report on the SJI Hospital District’s current issues.
https://sanjuanislander.com/news-articles/30118/re
thank you.
Q.E.D.