On October 30th the Vashon Maury Health Collaborative held the final session in a series of three community meetings to discuss the future of sustainable healthcare for the Island. A show of hands revealed that about a third of the attendees had not been present for the previous meetings. Moderator Tim Johnson summarized the previous meetings for those gathered. The first meeting covered current clinic operations and how NeighborCare was brought to the Island following the departure of CHI Franciscan. NeighborCare senior management was present to discuss areas of difficulty with clinic services and staffing position changes taken to reduce annual clinic losses to around $350,000. Islanders voiced appreciation for having a clinic provider, but also expressed frustration with specific operational problems – notably a new phone system and the length of time to get an appointment beyond the limited number of same-day appointments offered.
The second meeting focused on what Islanders want for healthcare on the Island. Many long-time Islanders fondly remembered days when there were multiple private medical practices, with each taking turns providing after-hours care at the clinic for issues that needed prompt attention. Current medical and insurance structures (as well as the closing of those private practices) ended that procedure.
Defining what “primary care” and “urgent care” cover helped Islanders choose what services they wished for the Island. A wide array of suggestions was offered – from extended hours at the clinic, longer appointment times, having an urgent care capability (which entails different levels of certification and equipment our clinic does not have), to on-Island drug testing for employment, midwifery and dialysis. The costs associated with those services quickly added significantly to the existing $350,000 annual loss. Islanders can have any service they want – as long as they are willing and able to pay for it. Senior staff from NeighborCare addressed estimated costs of extended services, and again addressed operational changes undertaken to improve telephone service and increase availability for appointments.
The Third meeting was about how the Island wants to pay for its healthcare needs. Health Collaborative members have looked into governmental grants (County, State and Federal) with discouraging results. While the Island is classified as being a health provider shortage area, its physical proximity to Seattle and Tacoma keeps it from qualifying for Rural Healthcare grants. The Island’s size also limits grant availability – most are targeted to larger populations.
Audience members asked about organizational grants. Generous donations from Granny’s Attic have contributed $100,000 in the last year.
Others inquired about forming an Island-wide foundation to support a variety of healthcare needs and reduce individual agencies’ fund-raising costs.
VMHC member John Jenkel offered examples of how other similar Washington communities have addressed their healthcare needs. Orcas Island, Lopez Island, San Juan Island and Pt. Roberts (near the Canadian border) have all formed taxing districts to provide sustainable healthcare for their populations. Cle Elum has aligned itself with the Kittitas Valley Hospital District. Many in the audience asked about formation of a healthcare district.
Healthcare districts (which are required by statute to be called “Hospital Districts” in a formal initiative process) are entities created by voter-passed levies that provide funds for operational costs – the Fire Department, Schools, Library, Parks Department all receive support in this manner. Levies are structured in a hierarchical order with a Hospital/Healthcare district somewhere in the middle. There is a levy ceiling (again, by statute) of $5.90 per thousand dollars of assessed property valuation. Currently, there is about 17 cents available for a healthcare district on Vashon Island without impacting subordinate districts in the hierarchy. This amount may not yield a sufficient total sum for the funding of a district, but would serve as a basis upon which to start negotiations with other affected districts to find joint solutions that result in an overall community benefit. A levy at the level of $.17 per thousand dollars of assessed value would cost the owner of a $500,000 home under $100 per year for a contribution to the sustainable funding of healthcare.
VMHC members stated that these meetings are intended to be an ongoing Island conversation, not a proposed route. More research will go into other funding sources and solutions. Coordination will be done with other agencies. The bottom line is creating sustainable healthcare for all Islanders.