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 loan balance, the LIHD could be in financial difficulties by 2025 without a Levy Lift
The LIHD commissioners have shown good money management capability. That is why the LIHD startup loan has been reduced steadily since 2018 and the $600,000 Reserve fund is available. If the Reserve fund did not exist, LIHD would be in financial difficulties today.
There is no consensus among Lopezians that the Clinic should take on additional services. The LCHC have expressed their thoughts, but a wider discussion needs to be had among all Islanders. A series of Community meetings held in 2024 could help form a Lopez Healthcare consensus.
Additional services may be constrained by funding. The levy amount can never exceed $0.75 per $1000.
If there is surplus funding, LIHC commissioners can return it to property owners by reducing the levy rate in future years. The Orcas Island Hospital District did that this year and the LIHD commissioners have expressed a willingness to do likewise.
Proposition #1 does contain the possibility of a 6% per annum increased levy amount to keep Income more in line with Costs. This multiyear request brings financial stability to provide appropriate health care to Lopezians. However, it represents a possibility, not a guarantee, The LIHD commissioners may choose to not take the full amount. Also, if an individual property value grows at 3% per annum, the individual LIHD levy amount can only grow at 3%, again being limited by the $.75 per $1000.
If the Levy Lift fails in 2023, a new Levy Lift would probably be on the ballot in 2024 with the additional election expense paid by the LIHD to the County’s Election Office.
No matter the final vote on Proposition #1, 2024 should see a thorough Healthcare discussion on Lopez Island. I’d like to hear your resourceful, “outside the box†solutions.
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 loan balance, the LIHD could be in financial difficulties by 2025 without a Levy Lift
The LIHD commissioners have shown good money management capability. That is why the LIHD startup loan has been reduced steadily since 2018 and the $600,000 Reserve fund is available. If the Reserve fund did not exist, LIHD would be in financial difficulties today.
There is no consensus among Lopezians that the Clinic should take on additional services. The LCHC have expressed their thoughts, but a wider discussion needs to be had among all Islanders. A series of Community meetings held in 2024 could help form a Lopez Healthcare consensus.
Additional services may be constrained by funding. The levy amount can never exceed $0.75 per $1000.
If there is surplus funding, LIHC commissioners can return it to property owners by reducing the levy rate in future years. The Orcas Island Hospital District did that this year and the LIHD commissioners have expressed a willingness to do likewise.
Proposition #1 does contain the possibility of a 6% per annum increased levy amount to keep Income more in line with Costs. This multiyear request brings financial stability to provide appropriate health care to Lopezians. However, it represents a possibility, not a guarantee, The LIHD commissioners may choose to not take the full amount. Also, if an individual property value grows at 3% per annum, the individual LIHD levy amount can only grow at 3%, again being limited by the $.75 per $1000.
If the Levy Lift fails in 2023, a new Levy Lift would probably be on the ballot in 2024 with the additional election expense paid by the LIHD to the County’s Election Office.
No matter the final vote on Proposition #1, 2024 should see a thorough Healthcare discussion on Lopez Island. I’d like to hear your resourceful, “outside the box†solutions.
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 ... Read All