Hospital District – With the Election Over, Now Begins the Hard Part

January 18, 2016 by islandersvoice1

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Monica Harrington was elected to the hospital district board last November with a strong mandate, having won by 20%. Now that she has been sworn into office, with her first meeting as commissioner at 5:00 pm on Wednesday, January 27, Monica spells out for the public she serves what issues she will be concentrating on in 2016 and beyond.

Update on San Juan County Hospital District #1 Business by Monica Harrington

As many of you have likely read, I am now officially a public hospital district commissioner. There was to have been an audit review meeting yesterday (which would have been my first meeting in office) but that has been delayed pending further action related to the AG’s Medicaid fraud investigation. (The auditors basically want to understand what’s happening on that front before they start closing out 2013/2014.)

As it stands, our first regularly scheduled meeting will be January 27. Given that it’s the first regular meeting of the year, I am expecting that election of officers will be on the agenda. The approved agenda will be available on the site prior to the meeting.

I have a lot of ideas for what I want to dive into, but of course also want to hear from you. Among the items on my list (not necessarily all for January):

  • strategic planning process for EMS levy proposal
  • review of legal situation, including the AG’s Medicaid fraud inquiry, but also ongoing compliance with other WA State laws
  • assessment of health services available compared to community need
  • stronger connection with San Juan County Board of Health
  • cost and service delivery transparency for all SJPHD-funded services – what services are available, how much do they cost, what can we do to serve islanders better and operate with more efficiency

As a commissioner, I intend to honor Washington State law, which essentially says that the people’s business will be conducted in the open and open to public scrutiny. I encourage you to come to public meetings, to ask questions and to email me if there are issue/questions you want me to address in my official capacity. My official email is

We have a lot of work to do in the next year. I recently sent my fellow commissioners two reports as background reading that I hope will be helpful for mapping out our decision-making process as it relates to EMS and any levy proposal to be put before voters.

The first is a strategic planning document that was developed by King County. The second is an overview/analysis of EMS services that was developed for Oak Bluffs, MA, which is a town on Martha’s Vineyard.

I am a firm believer that borrowing from other’s experience and good ideas (especially if they’re available via public documents) is one of the most cost-effective things we can do. The combo of these two documents is interesting as background/perspective/context as we move forward.

King County is the most populous county in WA state and has more resources to think strategically about how to plan for emergency services. King County also has challenges we don’t face – e.g., the diversity of cultural/language issues. They are bound by WA State law and I like the approach they took to longer-term strategic planning (2014-2019), and am mindful that many of the challenges SJC has faced (especially with respect to declining property tax revenues) were also issues in King County. Oak Bluffs is resource constrained, but has faced many of the same challenges we face with respect to being a seasonal, island community, with a small local hospital and an ongoing need to stabilize and transport patients with critical needs to mainland facilities. Anyways, I think the combo makes for interesting reading.

Here is a link to the King County document:

And here a link to a news article which contains a link to the Oak Bluffs analysis/document:

One high level issue that is of major importance are the different thresholds required for voter approval of a levy. A new state law was passed in 2012 that allows for the continuation of an existing PHD levy with a simple majority. From a practical standpoint, this means that if we continue the EMS levy at the current rate, 50%+ of voters need to approve it. If a new levy with different terms is proposed, then 60+% of voters will need to approve it. The public’s input on these types of issues will be important moving forward.

We are also slated to discuss the PeaceHealth contract in the next meeting (per Commissioner Barbara Sharp’s input at the last meeting) very specifically as it relates to what services should be made available to island residents. This type of back and forth is expressly called for in the existing contract. If you have input or ideas, I encourage you to submit them to the hospital district board. (Our emails are available at the site.)

Thanks so much for your ongoing interest in these issues and let me know if you have questions.

– Monica

Monica Harrington
San Juan County Public Hospital District #1 Commissioner
Business email:

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