Started by Robert Buchholz
Oct 31, 2023
Oct 31, 2023
12
Vote YES on Proposition #1 to Support Lopez Island Healthcare
Oct 31, 2023
The comments below address issues raised by various sources, including LopezRocks postings by Mr Hendel (10/14 & 10/20), Mr Waugh (10/22), Mr Eppenbach (10/27) and Mr Heinlein (10/28).
Issue: Lopez residents are choosing to go off island for primary case as it is too difficult to get a Clinic appointment.
Since the departure of one provider this summer, the Clinic has been short-staffed during the recruitment and hiring process. This situation will be improved in December when a new, full-time Physicians Assistant joins the Clinic staff.
Even prior to the most recent provider loss, UW added a full-time nurse practitioner position to the Lopez Clinic in order to provide additional patient care and give administrative relief through telehealth and in-person visits.
Over the six months from April to September, the Clinic averaged approximately 6 to 8 same day appointments. For a recent one week review of 47 patients seeking same day care, all were accommodated to the patient's satisfaction
Finding medical providers is a challenge throughout the state and nation. It's even more difficult on Lopez due to our dependence on the ferries and housing issues.
Issue: LIHD should talk to Island Health to see if they would be a better fit for the Lopez Clinic.
The LIHD should always work to get the best use of tax payer funds. This can include discussions with Healthcare Administrators other than UW Medicine. If making a change would be a better deal, the change process would probably require 1-2 years. It is also possible that a new Administrator would offer no advantage over UW Medicine.
With or without a new Administrator, funds are needed to cover current LIHD Budget projections. The LIHD 2024 Budget shows a year end deficit of -$145,000. Passage of the 2023 Levy Lift is needed to avoid deficit operation.
Issue: Vote NO on the Levy Lift to force LIHD to talk with Island Health. Fund deficits from Reserves.
Voting NO is not necessary to force LIHD talks with Island Health. Using Reserves to fund LIHD operations is not a good idea.
Presently, LIHD has $600,000 in Reserves. If the Levy Lift is not passed, the 2024 LIHD Operating deficit is projected to be -$145,000. If the deficit is financed from Reserves, LIHD will begin 2025 with Reserves of $455,000.
At the same time, LIHD owes approximately $270,000 on the bank loan that was necessary to start operations in 2017 before initial taxes were collected in 2018.
With $455,000 in Reserves and approximately $270,000 in debts, LIHD could have an approximate net worth of $185,000 to start 2025 with the possibility of continuing losses in 2025.
Under these circumstances with a low net worth and a 2023 Levy Lift failure showing lack of citizen support, a prospective Administrator might be reluctant to take on the Lopez Clinic. Recall that UW Medicine was the only Administrator willing to take on the Lopez Clinic in 2017.
Issue: The Levy Lift raises too much money.
National Healthcare costs are rising at +6% per annum. The proposed Levy Lift can keep LIHD Income more in line with Expenses.
In addition, the LIHD is being asked to consider new services such as Urgent Care. If services are added, more Income will be required.
If the Levy Lift raises excess funds in a given year, the LIHD has the ability to reduce tax rates in subsequent years.
Issue: “Scare Tactics†are being used to promote Levy Lift passage.
If the 2023 Levy Lift does not pass, LIHD will be in financial difficulties. Acknowledgement of this fact does not represent a “Scare Tacticâ€.
A YES vote on the 2023 Levy Lift (Proposition #1) is the best option for retaining quality Lopez Island Healthcare.
Issue: Lopez residents are choosing to go off island for primary case as it is too difficult to get a Clinic appointment.
Since the departure of one provider this summer, the Clinic has been short-staffed during the recruitment and hiring process. This situation will be improved in December when a new, full-time Physicians Assistant joins the Clinic staff.
Even prior to the most recent provider loss, UW added a full-time nurse practitioner position to the Lopez Clinic in order to provide additional patient care and give administrative relief through telehealth and in-person visits.
Over the six months from April to September, the Clinic averaged approximately 6 to 8 same day appointments. For a recent one week review of 47 patients seeking same day care, all were accommodated to the patient's satisfaction
Finding medical providers is a challenge throughout the state and nation. It's even more difficult on Lopez due to our dependence on the ferries and housing issues.
Issue: LIHD should talk to Island Health to see if they would be a better fit for the Lopez Clinic.
The LIHD should always work to get the best use of tax payer funds. This can include discussions with Healthcare Administrators other than UW Medicine. If making a change would be a better deal, the change process would probably require 1-2 years. It is also possible that a new Administrator would offer no advantage over UW Medicine.
With or without a new Administrator, funds are needed to cover current LIHD Budget projections. The LIHD 2024 Budget shows a year end deficit of -$145,000. Passage of the 2023 Levy Lift is needed to avoid deficit operation.
Issue: Vote NO on the Levy Lift to force LIHD to talk with Island Health. Fund deficits from Reserves.
Voting NO is not necessary to force LIHD talks with Island Health. Using Reserves to fund LIHD operations is not a good idea.
Presently, LIHD has $600,000 in Reserves. If the Levy Lift is not passed, the 2024 LIHD Operating deficit is projected to be -$145,000. If the deficit is financed from Reserves, LIHD will begin 2025 with Reserves of $455,000.
At the same time, LIHD owes approximately $270,000 on the bank loan that was necessary to start operations in 2017 before initial taxes were collected in 2018.
With $455,000 in Reserves and approximately $270,000 in debts, LIHD could have an approximate net worth of $185,000 to start 2025 with the possibility of continuing losses in 2025.
Under these circumstances with a low net worth and a 2023 Levy Lift failure showing lack of citizen support, a prospective Administrator might be reluctant to take on the Lopez Clinic. Recall that UW Medicine was the only Administrator willing to take on the Lopez Clinic in 2017.
Issue: The Levy Lift raises too much money.
National Healthcare costs are rising at +6% per annum. The proposed Levy Lift can keep LIHD Income more in line with Expenses.
In addition, the LIHD is being asked to consider new services such as Urgent Care. If services are added, more Income will be required.
If the Levy Lift raises excess funds in a given year, the LIHD has the ability to reduce tax rates in subsequent years.
Issue: “Scare Tactics†are being used to promote Levy Lift passage.
If the 2023 Levy Lift does not pass, LIHD will be in financial difficulties. Acknowledgement of this fact does not represent a “Scare Tacticâ€.
A YES vote on the 2023 Levy Lift (Proposition #1) is the best option for retaining quality Lopez Island Healthcare.
Comment by Robert Buchholz
Nov 4, 2023
Nov 4, 2023
2
Hi Becky, here are some thoughts on your reply to my initial post.
The Lopez Island Clinic is a Primary Care facility. It is forecast to operate at a -$145,000 loss for 2024 if the Levy Lift does not pass. As you acknowledge, when the projected loss is combined with the remaining $270,000 startup lo ... Read All
The Lopez Island Clinic is a Primary Care facility. It is forecast to operate at a -$145,000 loss for 2024 if the Levy Lift does not pass. As you acknowledge, when the projected loss is combined with the remaining $270,000 startup lo ... Read All
Comment by Becky Smith
Nov 3, 2023
Nov 3, 2023
7
I am disappointed once again to see you have not addressed that this is a multi-year levy increase being requested. To me, this is one of the biggest obstacles to voting YES for proposition #1. None of your pre-election education material or communications from the commissioners themselves have been able to explain what exactly will be done with the increase in money raised each year. Why would any taxpayer vote for an increase each of the next 6 years unless a reasonable plan for when the increase is in place? Where is your long range plan? What services will be added for our increased tax dollars?
As a member of Lopez Citizens for Healthcare, it has been my experience that this board of Commissioners has not been willing to listen or acknowledge gaps in service and recognize the discord among Lopezians with their current ability to access appropriate healthcare. A month ago the Commissioners and Clinic staff realized bringing our issues out in the open might affect the passing of their levy increase so the scare tactics began and we as a group have been blamed for wanting to “close the Clinicâ€, “close Physical Therapy†and take away any money to help the Pharmacy stay open. All of these claims are false and if you look at the actual budget and books for the Hospital District you will find that there are plenty of funds to operate “as is†for 2024. Beyond that without a levy increase the financials do get questionable. So prove you can manage the money responsibly. Address the issues and come up with a plan. Be transparent with where the increased taxes will go.
So my unsolicited advice to the Commissioners of the Hospital District is to accept whatever the vote results are and then begin your real work. As this controversy has shown, you need to improve communications and begin listening to all input. We all want to have the best healthcare possible for where we live. We are not like mainland America and what works there does not necessarily work here. But we are a group of resourceful individuals who are used to thinking outside the box. Do what works best for the entire community.
As a member of Lopez Citizens for Healthcare, it has been my experience that this board of Commissioners has not been willing to listen or acknowledge gaps in service and recognize the discord among Lopezians with their current ability to access appropriate healthcare. A month ago the Commissioners and Clinic staff realized bringing our issues out in the open might affect the passing of their levy increase so the scare tactics began and we as a group have been blamed for wanting to “close the Clinicâ€, “close Physical Therapy†and take away any money to help the Pharmacy stay open. All of these claims are false and if you look at the actual budget and books for the Hospital District you will find that there are plenty of funds to operate “as is†for 2024. Beyond that without a levy increase the financials do get questionable. So prove you can manage the money responsibly. Address the issues and come up with a plan. Be transparent with where the increased taxes will go.
So my unsolicited advice to the Commissioners of the Hospital District is to accept whatever the vote results are and then begin your real work. As this controversy has shown, you need to improve communications and begin listening to all input. We all want to have the best healthcare possible for where we live. We are not like mainland America and what works there does not necessarily work here. But we are a group of resourceful individuals who are used to thinking outside the box. Do what works best for the entire community.