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Filling the PHD board vacancies 2.0

EDITORIAL: One can hope that out of  respect for the voters and taxpayers in the San Juan County #1 Hospital District, the actions taken February 8, 2018 by two of the statutorily five-member board would be voided. And a fresh, open discussion and unanimous action by the three board members - Dr. J. Michael Edwards, Dr. Mark Schwinge and Anna Lisa Lindstrum - would take place to appoint two people to fill the vacant positions on the board. 

There are questions about whether two votes were enough to appoint Rebecca Smith to fill one of the positions. The district's bylaws require a majority of the five-member board to pass resolutions. The bylaws are silent on the number of votes required to pass motions. When asked the state Attorney General's Office said it would take an Attorney General Opinion to answer questions about whether  a 2-1 vote was enough to appoint a board member and if the Open Public Meetings Act was violated by Edwards and Schwinge conferring privately ahead of the meeting. 

The board plans to reappoint Dr. Warren Appleton at their February 28 meeting. His appointment at the February 8, 2018 meeting was invalid because he was not a registered voter in the district. He and his wife live part-time in King County and were registered to vote there.

Barring an AG's opinion, the board would be wise to take a step back. Instead of rubber-stamping their previous decision, rewind and start again. Have an open public discussion among the three board members - Edwards, Schwinge, and Lindstrum - about how the candidates' qualifications mesh with the district's needs. Reach a 3-0 vote, a clear unquestionable majority of the statutorily five-member board. 

The citizens of the hospital district will be best served, if the board makes deliberate, transparent choices. Let us hear why you favor one candidate over another. Drop the hidden agendas and do what is best for the entire populace. It's way past time for the Hospital Commission to operate in the light. 

The list of the district's needs include: 

The community's need for a long-term healthcare center. Determining what if any role the district will play in filling that need will require significant attention and discussion by the board.

Deciding if San Juan Island Emergency Medical Services should merge with San Juan Island Fire and Rescue District is another important topic. What are the options regarding annexing, contracting, etc. What happens to the levy? What happens to the EMS staff? Are they moved as a whole with a merger, or does the fire district pick and choose and essentially create its own new EMS?

How sustainable is the SJ EMS budget? In 2017 expenses exceeded revenue by $76,322. (Revenue was $2,163,808 and expenditures were $2,240,130.) There are no funds set aside for capital expenditures.

How will the district handle the results of the state Attorney General's Office Civil Investigative Demand against SJI EMS regarding possible medicaid, medicare fraud.

Those are the major issues facing the district in 2018. 

So let's look at the candidates in the order their applications were submitted. 

1. Rebecca Smith - has lived on San Juan Island for more than 30 years. She was a volunteer firefighter and EMT on San Juan Island for 22 years. She was a San Juan Island Fire District Commissioner for six years. She wrote that those experiences plus her involvement in getting the EMS levy passed and her years in corporate management "have given me the operational and financial skills to perform well in all aspects of this job. I would like to use my expertise to assist in the discussions about a merger between fire and EMS, and to continue to develop the EMS agency in the context of the current pre-hospital care environment."

She has been a state certified Real Estate appraiser and associate broker. She has 14 years in corporate management with Honeywell and Thorn. She was a radio newscaster and newspaper reporter. She co-founded San Juan Central, a company that specialized in long-term residential, vacation and commercial rentals on San Juan Island. She has a B.A. in Journalism/Communications from California State University. She is married to Francis Smith who is a senior EMT.

2. Barbara Sharp - retired attorney, has lived full-time on the island since 2002. She served on the Hospital Board from 2015-2017, she received 68 percent of the vote.  She was a Judicial Clerk for Judge Gregory Orme, Utah Court of Appeals, staff attorney for Workers Compensation Fund Salt Lake City Utah, Assistant Attorney General, Washington AG's Bellingham Regional Office. 

Sharp chose not to run for re-election because  "I was unwilling to go through the campaign process. My experience in the 2015 campaign was difficult for me due to its toxic environment and I did not want to experience that again." While on the board she served as secretary and monthly reviewed the warrants and provided consistent expense oversight. She served on the  EMS budget preparation and review committees. She believes her previous board experience will be an asset to the board as it tackles the challenges of a potential merger and a  solution to the need for a long-term care facility. 

At the December 20, 2017 meeting Bill Williams said, "Her legal background has been an asset in our discussions with legal council. And in her  writing the new employment agreements and  job descriptions for the board Superintendent and EMS Chief position." 

Edwards said, "The EMS appreciates her participation on the community paramedicine committee, she has been attending those meetings for many many months."

Schwinge said, "I would like to add my  thanks for your many long hours, often unsung, of service for the district residents." 

3. John Manning, retired San Juan County Health and Community Services  Director,  ran against Lindstrum and received 38 percent of the vote. He has lived on San Juan Island for 24 years. He was the San Juan County Director of Health and Community Services from 1994 to 2014. From 1986-1993 he was the Health and Social Services Planner II for the State of Alaska Department of Health and Social Services in Juneau. He was that department's Health Facility Surveyor in Anchorage from 1984-1986, and its Health Planning Coordinator/Director in Ketchikan from 1980-1983. From 1977 to 1980 he was the Tribal Health Planning Consultant for Alaska and Washington. He was a nationally registered EMT in Anchorage in 1978. He served in the Peace Corps from 1973 to 1975.   He has a Masters of Public Health from University of North Carolina and a B.A. from Boston College.

4. C. Mitchell Shlosser, a former U.S. Navy SEAL and Seattle Firefighter and Senior Medic,  has lived on the island for a year. He wrote: My service-oriented history of SEAL turned Life Saver, as a Seattle Fire Dept. FF/Senior Paramedic, has granted me the satisfaction of the Hypocratic Oath, "doing no harm". Working a lifelong career, close to medicine, the impact upon community, provides me with a valuable insight towards serving the public. As we approach the melding of Fire and EMS under one umbrella, my experience of having worked in such a model as Seattle Medic One should prove to be an added strength to the hospital board's synergy. He was on U.S. Navy SEAL teams #1 and 2 from 1972-1975 and was with Seattle Fire Dept from 1978 to 2017. He had his paramedic training at University of Washington School of Medicine in 1982.

5. Warren Appleton - lives eight months of the year on San Juan Island and the rest of the year in King County. Appleton worked at PIMC Emergency Department for four years, retiring in May 2017. In his letter to the board he wrote: "My focus, if selected to the board,  would be listening to the public, team-building (both at the board level and community-wide), addressing the island mental health and addiction/drug issues, collaboration with providers from throughout the county to use evidence-based and logical approaches to address the uniqueness of providing medical care in San Juan County." He does not expect to seek re-election when the two-year position expires.

He has a M.D. from Wayne State University Medical School and a J.D. from Seattle University School of Law. His extensive experience includes stints at Emergency Departments in New Zealand, Seattle, Detroit Michigan,  and Redmond. He was Director of Evergreen Hospital Medical Center Emergency Department from 2003 to 2007. He co-founded Jeffries Health Care Clinic in Detroit, has been an advocate in Olympia for legislation on Domestic Violence and was an advocate for the first seatbelt law in Washington State. He was Chairperson and director of the Evergreen Hospice Campaign that successfully passed a bond to create a hospice. 

6. Kerry Talbott - withdrew her application

7. Dr. David Balmer, who has lived on the island for six years, has 25 years of primary care experience and 13 years with Health Plan management and program development. In addition to his medical degree from Ohio State University, he has a masters in Public Health and an M.D. from University of Washington. He also has a M.D. from the Royal College of Surgeons in Ireland. He practiced primary care medicine at Emergency Medicine and Family Practice in British Columbia, Canada from 1972-1975. From 1999-2012 he was Medical Director of Mid-Valley IPA. His experience also includes being Associate Medical Director Human Inter-mountain Region and Seasonal Medical Director, Humana Part D Medicare Review.

8. David Meiland - has been a full-time resident on San Juan Island for 15 years. He was a volunteer firefighter in Friday Harbor from 2004 to 2008. He has a B.A. in political science from the University of Michigan. He's worked as a general contractor and construction manager for 30 years. He wrote: "Professionally I have long full responsibility for large and complex budgets, and consider myself to be highly skilled in this regard. I have worked successfully for and with hundreds of diverse people in our community, in a role that requires high levels of flexibility, collaboration and problem-solving. I am concerned that the hospital district comply with state laws regarding reproductive freedom and end-of-life care. And, I am concerned that EMS organization continue to operate in a manner that best serves the residents who depend on it."


The Hospital District Board of Commissioners will meet twice this week. 

February 26: Special Meeting from 12:30 to 2 p.m. at the Frank Wilson EMS building on Spring Street.  Topics being Discussed include the Open Public Meetings Act, public records, the role of a commissioner, strategies for a well-functioning board, and management versus governance.

February 28: Regular Monthly Meeting beginning at 5 p.m. in the Legislative Hearing Room at 55 Second Street in Friday Harbor. 


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