Statement from Richard Fralick
This is an exciting and critical time for our community. The creation of a Public Hospital District (PHD) gives us a new tool to design, build and in some instances, streamline the delivery of health care to fit the unique needs of our community.
The election of the Hospital Board of Commissioners is important. As the first governing body of this public funded hospital district, the Board will be charged with defining the structure of our PHD; determining the level of assistance provided existing practices; establishing performance metrics; exercising fiduciary responsibility in setting the level of taxation necessary to ensure efficient delivery of high quality services to as many members of the Orcas community as possible. The decisions made by this Board will influence the quality of health care services available to our community for years to come.
In my opinion the most important issue facing our health care system today is sustainability. In the past our community’s medical practices have been sustained by philanthropy, either through direct donations of money or through the donation of services. Unfortunately, those days are past!
The only way to maintain current levels of health care delivery is to replace past philanthropy with a stable source of funding and the establishment of a public hospital district appears to be the only way to achieve this. Other suggestions such as increasing sales tax are not authorized by state law.
Specifically, the establishment of a PHD must address the sustainability of primary, urgent and after-hours care. The long-term sustainability of the PHD itself must also be addressed.
With regards to primary care we have studied the problem and find that the PHD will have the revenue capacity to assist both practices at their current levels. Additional work needs to be done to minimize duplication of services and to quantify the costs of improving after-hours and urgent care. The PHD will need to contract with existing practices for desired levels of service and include in the contract specific metrics to determine that the services contracted for are being delivered. Also, it will be necessary to determine if the acceptance of public funds might cause current services to be modified.
Critical to the sustainability of the PHD will be securing suitable financing for the period-of-time between when the PHD is established and when tax revenues are collected in April 2019. Also, from my public-sector experience, I believe that for long term sustainability a rainy-day reserve fund must be built into the financial structure of the PHD.
The elected commissioners will need to prioritize these sustainability issues and after public discussion make the hard decisions as to how best to implement them.
I believe I have both the vision and skills needed to participate positively in this vital process.
As a 37-year Orcas Island resident, I know the history of our health management challenges and appreciate the importance of health care delivery to maintaining our economically diverse population. As a small business owner and a former County Council member, I understand budgeting and am willing to ask hard questions to pursue solutions using limited financial resources. I am a consensus builder and will seek out and listen to diverse viewpoints, work collaboratively to find balanced solutions and act decisively to address issues of concern.
See www.richardfralick.com for more information.
