||| FROM TREY HOLLAND |||
As we approach the April 22 deadline for voting on Proposition 1 — San Juan County Public Hospital District #3 10-year temporary levy lid lift ballot measure — it might be worthwhile to briefly summarize the rationale for the ten-year temporary levy lid lift request and to clarify a few points that have been raised by interested islanders during public commentary.
Orcas Island Health Care District’s (OIHCD) current contractual agreement with Island Health (IH) to operate Orcas Primary Care (the clinic) expires in November, 2025. That contract, which was signed in 2018, contained no provisions for cost escalation, which has been wonderful for OIHCD and island residents. But, since the pandemic, healthcare costs have increased 30%, and they are predicted to continue increasing. IH cannot continue to fund this deficit.
Consequently, the proposed contract to continue OIHCD’s partnership with IH calls for an annual increase of either 5% or the regional consumer price index, whichever is greater, over each of the next ten years. The current levy rate and OIHCD’s cash reserves are not sufficient to cover this cost escalation, which is the reason for the proposed 10-year temporary levy lid lift from $0.415 to $0.70 per $1,000 assessed value.
How will the revenue from this temporary levy lid lift of $0.285 be spent? Aside from covering the general operating expenses of the clinic, the Commissioners envision expanded primary care services to reduce off-island travel for healthcare, and the recruitment of more healthcare providers in an effort to increase the clinic’s operating hours.
Additionally, the clinic building, which is over 30 years old and is stretched to its maximum capacity to provide current services, will need to be renovated in the future to ensure that the building is capable of handling the projected long-term growth of our aging population and the future industry-wide advancements in primary care.
Without an increase in the levy, OIHCD has sufficient cash reserves to operate under the proposed contract for between three (3) and eight (8) years. It is critical to note, however, that, to survive for eight years, necessitates not saving for needed building renovations, no new innovations in healthcare programming, and the extremely unlikely scenario of no reductions in Medicare and Medicaid reimbursement rates, both of which are currently under review at the state and federal levels. This proposed temporary levy lid lift is a proactive effort on the part of OIHCD to address an inevitable funding gap, which, if unmet, will necessitate a reduction in clinical services available on Orcas Island.
Two (2) points have been posted during public commentary that require clarification from OIHCD’s perspective. The first point relates to a post stating that, during creation of OIHCD in 2018, residents were promised “24/7 care.” In terms of having a physician and support staffsitting in the clinic awaiting the arrival of anyone who wants to be seen, no matter what the time of day or night, there was no such promise. However, after hours care has been and remains available on an on-call basis outside of the clinic’s normal operating hours. If an individual calls the clinic after hours, the answering service will contact the on-call provider. Depending on the situation, such as a laceration that requires stitches, arrangements can be made to see the patient at the clinic, regardless of the day or time. This service is available to all island residents and visitors, even if their primary care is provided elsewhere.
The second point pertains to a post that stated, “The Orcas clinic commissioners correctly state [they] have not used all of their possible levy money saving taxpayer dollars, but the banked levy amount is only $24,265 overthe six years of tax collections … accurate talking point but pretty much financial white noise.”
This statement is partially correct; the Commissioners have been fiscally responsible in that they have drawn down the maximum number of dollars available through the existing levy only once in the last six (6) years — 2022. But, as a result of thoughtful budgetary policies related to cash expenditures, the banked levy amount over that six-year period is actually $849,000 ($61,400 in 2019, $70,200 in 2020, $73,000 in 2021, $300,400 in 2023, and $344,000 in 2024), not $24,265.
Vote “Yes” to maintain our current healthcare services, to invest in modern facilities for the next 30 years, to add new primary care services that improve health, reduce off-island care and strengthen our island economy, and to “protect and improve the health of islanders now and over the long term.”
More detailed information about this proposed temporary levy lid lift can be found on theOrcasonian by searching using the term “levy.” Additional helpful links include:
- https://www.orcashealth.org/sustainable-community-based-care
- https://www.orcashealth.org/files/97e14d7fd/OIHCD+-+Levy+Lift+Informational+Town+Hall+-
+Presentation+Slides+-+03282025.pdf - https://lopezislandhd.org/lihd-board-shows-support-for-orcas-island-health-care-districts-levy-lid-lift-measure/
- https://www.islandssounder.com/life/hospital-district-seeking-levy-increase-on-april-ballot/
Do you still have questions? Please join OIHCD’s Commissioners and administrative staff on April 9 at 5:30 p.m. for a Town Hall Meeting at the Eastsound Fire Hall for answers to your questions.
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1. ‘The Commissioners envision expanded primary care services to reduce off-island travel for healthcare, and the recruitment of more healthcare providers in an effort to increase the clinic’s operating hours.´
TO WHAT, as this current issue continues to be non-existent for many.
The hours for “clinic after hours and days are not posted, and no one seems to know what the schedule is, except those who work there.” And the current flyer and website state that after-hours care is provided. SO there is that…
2. Yes, I asked at a meeting before the first vote if “after-hours care” meant 24/7. I was replied to, “Yes, 27/7 care is going to be offered.”
OIHCD’s Purpose https://www.orcashealth.org/about-us
‘As a Public Hospital District, the OIHCD exists to protect and improve the health of our community. In the immediate term the District does this by ensuring that island-appropriate, quality primary and acute/urgent medical care, INCLUDING AFTER HOURS CARE is available to all members of our community in a financially sustainable and cost-effective manner. 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.”
So, let’s post the current after-hours care information. An Islander can receive care after hours, Monday through Friday, 8 am to 4 pm, which are the current hours.
Does after-hours care mean only till 5 pm Monday through Friday?
HOW about posting the hours the clinic is available after 5 pm weekdays and on weekends…..
Please send a message VOTE NO, and make the hospital district, which is really an Orcas Medical clinic tax, come up with a better plan.
Thank you for this informative letter. You state that the “Commissioners envision expanded primary care services to reduce off-island travel for healthcare, and the recruitment of more healthcare providers in an effort to increase the clinic’s operating hours.” I am sure I can find this information, but wanted to ask here also… If the levy passes what exactly will be the increases in services and which positions will be hired. Thank you again for taking the time to inform us regarding the levy.
Hopefully, this comment will clarify the question that you have raised, Melissa. After-hours care is available by calling the clinic ANYTIME the clinic is not open. This includes nights, weekends and holidays. Calling (360) 376-2561 will connect the caller to the answering service, which will then be able to contact the on-call provider to assess the situation and properly triage the call. This service is available to all islanders and visitors, even if their primary care is provided elsewhere.
Thank you for your questions, Kevin.
The Commissioners believe that the temporary increase in the levy will allow for an expansion of primary healthcare services with the hiring of two additional healthcare providers – a physician and a physician’s assistant.
Currently, there are several healthcare services that are available through the clinic, helping to mitigate off-island travel for healthcare needs. These services include cardiology tele-health visits and pain management consultations and follow-up visits. Additional services that have been discussed by the Commissioners and that would help decrease the need for off-island travel even further include early-term prenatal care, mental and behavioral health services, rotating chronic care clinics (diabetes management, pacemaker follow-up, etc.), extended clinic hours (evening or weekend) and home visits for frail elders. It should be noted that the offering of these additional services would be a collaborative effort between Island Health and Orcas Island Health Care District that is deemed by both entities to be both impactful and financially sustainable.
Trey Holland is probably correct in stating OIHCD has substantial banked financial capacity in the complicated” authorized but not used” tax system in Washington State . It may seem trivia to most the public, but banked capacity is taxpayer money that was legally available to the health district, but they asked for less than what they were authorized when they finalized their annual budgets. The confusion comes from the the SJC Assessor stating the following in the 2025 Levy Highlights:
Districts that used Banked Capacity:
Orcas Hospital used funds not previously levied but authorized to increase their levy by $360,910 or 22.02% over last year’s levy. The district used less
than the maximum allowed, leaving $24,265.86 in unused capacity.
The confusion arises when it’s not made clear whether that is total banked capacity or only the 2025 unused capacity. The Assessor has responded to an email that his office will calculate the total authorized banked capacity.
It seems a bit counter intuitive to be asking for a large levy lid lift when for five out of the six years they have not asked for their authorized tax amount. They claim they were being responsible for asking for only what they needed and being mindful of keeping the taxes revenues as low as possible. That’s a commendable take, but the financial position of the district is currently quite healthy with about $1M in reserves and last of their bond debt payments soon expiring. If the levy passes, it’s my understanding the banked capacity will continue to exist.
All this financial “in the weeds” discussion is to say that the district is financially healthy today, but the new contract with Island Health increasing 5% or more a year is a major cost increase over the next 10 years, and OIHCD wants to expand some services and make capital improvements. Complicating the proposed levy increase is the state legislature proposing (and likely approving) annual property tax increases that would include adding additional revenue to special districts, including the OIHCD which the commissioners were not aware of when the proposed levy lift was approved to go to voters, not to mention the current tariff war that has just started.