By Dr. Steven Nourse
As Bob Dylan said, “Everybody has to serve someone.” Regarding the Vashon Health Care District, it has to effectively serve both the healthcare clients it provides funding to and the taxpayers that pay its bills.
Several years ago, when healthcare on Vashon was in crisis, I was approached by two now-former VHCD Commissioners who were promoting the VHCD’s creation. I was told emphatically that Vashon’s healthcare was indeed in crisis, with two healthcare organizations leaving the Island and no longer providing services.
They were proposing a property tax to support creation of the VHCD to provide “primary care services.” At that time, I asked specifically, “Are only primary care services the significant and main driver behind this proposal?” I was told, “Yes.”
I have attended the last few VHCD meetings via Zoom, and as a result, have several serious concerns that our community and the VHCD need to address quickly. They are as follows:
1. Mission creep. The VHCD is expanding its mission far beyond what was originally proposed when we were in true crisis. Before we go into unintended or unasked-for service areas, the current mission should be revisited, with a quality community evaluation conducted by professionals.
Since the time of crisis, and post-COVID, community opinions about the VHCD may be very different. Based on discussions with other Islanders, my experience is that opinions have changed drastically.
2. In looking at the proposed 2024 VHCD budget, and listening to VHCD meetings, there seems to be almost a sense of urgency – to my ears, the message was, we have the money ($2 million annually), and we need to spend it, so let’s throw it out and see what sticks!
The VHCD 2024 budget calls for $1,387,000 for urgent care, behavioral health, outreach/health fair, and new programming. Without analysis, throwing money at a problem never works.
3. I am very concerned about any immediate entanglements with both the DOVE Project and Vashon Youth & Family Services. I don’t intend to deny the need for behavioral counseling. The problem is, when asked, neither of these organizations had a clear concept of “expected outcomes” or quantifiable expectations.
At the meeting, one of the VHCD commissioners kept asking about outcomes, and received only vague and nebulous responses like, a “great need” and an “oasis of service needs.”
If you can’t define it, you certainly will have no accurate accounting of value for anything done.
4. The VHCD is not a grants organization. This was not in the original plan that taxpayers were presented with and supported. The services these organizations are asking for are not sustainable without the VHCD and your taxpayer funding. Once you start paying, you might as well consider it an annual budget line item.
The surveys the VHCD ran for parents and students (no longer available online) seemed to address only the negative aspects of Vashon’s behavioral counseling services. The results showed that the choir was singing to the choir, and was neither professional nor fair to the community at large. I also question how wide the range of responses were, demographically. These aspects alone can dramatically skew results to a predetermined and hoped-for result.
I can’t see providing ongoing funding unless a professional, consistent, and quantitative system of evaluating outcomes is completed – before actual service money is provided. Otherwise, it will be only qualitative analysis, which is not good enough.
I speak from a standpoint of having a master’s degree in social work and having done exactly this type of organizational research. I predict that the VHCD, one year later, with no evaluation, will start again at square one, having made no progress towards a quality solution.
If the VHCD is honest and wishes to maintain credibility with the Island, it has absolutely no business expanding its services into behavioral health, mobile health units, and other new programming. These are all components of a quality program that first need to be explained fully and transparently to the community of Vashon.
Unfortunately, the citizens of Vashon and Maury Island have been given the classic “bait and switch.” We were promised one relatively simple goal – primary care – which has morphed into a wide range of, in my opinion, unsubstantiated, unasked for, unneeded, and already provided services. Simply said, we are not getting what was bargained for and what was agreed to.
I plan on continuing to attend VHCD meetings and I hope you will join me. They are held on the third Wednesday of the month, at the Presbyterian church in town, or you can Zoom in – you can find the address at vashonhealthcare.org.
When Dylan said, “You have got to serve somebody,” he also meant you need to roll up your sleeves, be informed, and participate in the local politics that affect you and the community in which you live!
