Hospital District: “The same care my Golder Retriever gets.”

Hospital District:

“The same care my Golder Retriever gets.”

Medical care on Vashon-Maury Islands is not what it used to be.

We used to have a few doctors here, plus the clinic up on the hill at Paradise Ridge. If your kid, or you, fell and broke a bone, you could have it x-rayed and put in a cast here on the island.

No more.

I recently sat down with Annie Miksch, who is one of the members of the Vashon-Maury Health Collaborative. This is a group of people that has been working for five years trying to answer the question, “How do we get and keep a stable health care presence on Vashon/Maury Islands?”

They have been having public meetings about health care on the island, at one of which a gentleman got up and said that he’d like to get “The same care my Golder Retriever gets.”

The point being, animals on this island have easier access to health care than people do at present.

In the past, Miksch said, “All we had to offer was, ‘come out here and lose money,’” when the island tried to lure providers to the island. “The providers wanted $1 million up front, plus $500,000 against their losses their first year. We could not offer that.”

“If a Hospital District passes, we’ll have money that can talk,” Miksch told me. “With a Hospital District the island could raise enough money to subsidize on-island health care. Whatever comes, it has to serve all of us, from the homeless on the island to the wealthiest.”

So what is a Hospital District? It does not mean we’ll have a hospital.

It is a taxing district, same as a Fire Department taxing district, or Parks taxing district, or School taxing district.

It is run by a board of commissioners elected by us. The commissioners are people who represent us, and have business, medical, and community knowledge. They would have public meetings, and answer to the public.

The commissioners would set the tax rates, and yes, our property taxes would go up. Can we afford that?

Can we afford having no urgent medical care for human beings on the island?

Why do we need a Hospital District? Glib answer: so we can have care as good as our animals have.

If you’ve been paying attention, you know that the clinic on the hill has been a revolving door as various providers have passed through.

Primary care clinics and urgent care clinics do not make enough money to pay their own way. They need a population of 25,000 to 35,000 to draw on, and Vashon/Maury has fewer than 11,000 people on a good day. Beyond that, clinics make money from their affiliations with specialists, surgeons, and hospitals, Miksch told me.

“We’re too small, we’re too rich*, and we’re too close to major health care,” Miksch said.

Swedish Hospital, for example, is only twelve miles away. That’s only a short drive, right?

The original clinic lost money, and Granny’s Attic was established to make up for the shortfall. It wasn’t enough. Highline came in.

Highline lost money, and Franciscan took over Highline.

Franciscan failed to calculate that most islanders went to hospitals and specialists in Seattle, not Tacoma, where most of their hospital and specialist connections were, so they lost money. Bye, bye, Franciscan.

For a time, the clinic was closed, and no provider would come to the island. If you needed a doctor, you had to go to the mainland, or call 911.

Neighborcare was willing to come to the island when no one else would. Yay, Neighborcare!

However, Neighborcare has limitations.

They cannot do urgent care. We can go to a hospital ER, or, those of us who go to Seattle know there is now a Franciscan urgent care clinic on Fauntleroy in West Seattle. These options require a trip off the island. Not everyone is able to drive themselves off the island or afford the ferry fare to get back. Not everyone is able to drive.

The Neighborcare clinic tends to be overwhelmed and understaffed. It can take a long time – weeks – to schedule an appointment at the clinic. You might be able to get a walk-in appointment, or you might be told they’re not doing walk-ins that day.

Neighborcare has established a school medical clinic here funded through Best Starts for Kids, and that clinic is a success, but at the main clinic they are losing money and they can’t keep that up forever.

When Miksch says, “losing money,” she is talking about $350,000 to $400,000 a year.

One of the major contributing factors to this loss is that both private medical insurers and Medicare do not reimburse medical costs with as large a percentage of the fee as they did in years past. Ironically, if most patients were on Medicaid, Neighborcare would receive higher reimbursements for their charges, but many islanders have private insurance. (*That’s the “We’re too rich,” part)

A Hospital District levy is not on the ballot yet. To get it on the ballot this November, many people will have to sign petitions asking to put it on the ballot. You will soon see petitions around the island – it is up to you to decide if you are going to sign a petition.

Once it is on the ballot, assuming enough signatures are obtained, at least 40% of the people who voted in the last election must vote on the issue to validate the election, and of those, 50% +1 must vote to pass it.

For some reason the island had a big turnout for the 2018 election, so if you are in favor of a Hospital District, you need to get out and vote for it.

The ballot would ask: Shall we have a public Hospital District? And: Who shall be the commissioners? Meaning, the commissioners would be elected at the same time the Hospital District is formed.

A Hospital District would mean that a health care provider at the clinic would to some extent answer to us, instead of the other way around, because we would be able to keep them afloat financially.

Meanwhile, we can drive to Seattle or Tacoma or call 911 if we must.

Vashon is not alone in the dwindling of medical care in rural communities. Forming a Hospital District will give us some traction to get stable medical care here.

When a Hospital District was put to the vote twelve years ago, it sank like a stone, because it did not benefit enough people. People did not want to have their property taxes raised for something that would not benefit them.

That has changed. Now a Hospital District has the potential to benefit most, if not all, of us on the island.

Keep Your Eye on Easter

Lent was never mentioned in the Baptist Sunday school I attended as a child, so when I came to the Episcopal Church as an adult, I had to learn about Lent.

I grew up in a town with a large Roman Catholic population, and I had this idea that Lent was about giving something up. It seemed like chocolate was a popular choice for my Catholic friends.

You can give up whatever you think is appropriate in Lent. It is a season of prayer and fasting. I’ve heard it said that it doesn’t count if it’s too easy. For example, if I said I was giving up pickles, that would not count. I hate pickles. So not much self-denial there, is there?

You need to give up something you’ll miss.

Chocolate, cigarettes, video games, Facebook – the possibilities for self-denial are endless. If you’re going on a weight loss diet for six weeks and calling it your Lenten fast, some would say that’s not exactly the spirit of Lent, but I would not judge. Discipline is discipline.

The other part of Lent is self-examination.

How hard is it to look at yourself honestly? How hard is it to see yourself clearly, without doing a bash job on yourself, or repeating all the lies you were told about yourself, or denying your gifts and strong points? Or thinking you are such a good person that nothing about you needs any work?

Answer: Hard. Really, really hard.

In my youth, I was one of those, “I’m a good person. It’s everyone else who’s screwed up,” types.

This is a terrible way to go through life.

I look back at that young woman now and think, oh, the force was weak with that one. My life was based on being a goody-two shoes victim. I had been wronged, therefore I could do no wrong.

I had to learn that I wasn’t as bad as I had been told, nor as great as I liked to fantasize, that I was not the only person who’d had some hard knocks, and that everything wasn’t all about me.

What a relief.

 I will not tell you how many years and sorrows it took me to arrive at the knowledge distilled in that one paragraph. You might get discouraged.

Suffice it to say I did not achieve enlightenment in the six weeks of the first Lent I observed in the Episcopal Church.

To be honest, I found 12-step programs much more efficient than the church in introducing me to myself. They say, “Here are the tools.” It’s up to you to do the work, and they’ll support you all the way, but the only heavens and hells involved are the ones you make of your own life.

But I digress, as usual.

So, here we are in the season of Lent. When it comes to self-examination at my age I look at myself and say this is probably as good as it gets. It’s not that I think I’m done and don’t need improvement, I always need to keep walking that way, but I’m old and I’m tired, and I’m not shooting for perfection here.

I try to behave, I do. Kindness is my rule, and it’s a good rule, because by nature I am easily annoyed and can go from zero to unhinged in under a second. Because of that reactivity, I try to maintain a calm demeanor, even when I or anyone else would be saying, “Are you bleeping kidding me?” I try to keep that sort of language where it belongs, in the home.

It never hurts to check in with yourself and some trusted friends or guides and see how you’re doing. One of the attractions of church for me is having people around me who can help me keep on track. I love solitude, but I need reference points and perspectives that I don’t have here on Planet Mary.

A dear friend has announced that she is giving up malice for Lent. Malice, resentment, and grudges. That sounded great to me, and an example of true self-denial. What is more enjoyable than going over the sins others have committed against us, and feeling that self-righteous affirmation of our own innocence and goodness? Giving that up – man, that takes some grit.

Lent is the season when last summer’s stores have run low. Keep your eye on Easter. Life shall rise again. It always does. Bulbs are already blooming.

A blessed Spring to everyone. Except my friends in Australia, where it’s Autumn.

Congratulations to Clare, Xavier, and Cora on the arrival of Rowan Samuel Blakemore Mayes. It’s a big name, but I think he can handle it.

Snowmageddon in Retrospect

A STANDING OVATION to the men and women who were out in the snow and ice repairing power lines, cutting up and moving trees and branches, clearing roads, finding and fixing broken water lines, and running generators. Everyone who was out in the worst of conditions taking care of the rest of us, THANK YOU, for risking your lives and your sanity by doing your jobs.

THANK YOU to the Food Bank for delivering bags of food because people couldn’t get to the Food Bank.

THANK YOU to the people who made sure other people got to medical appointments.

THANK YOU to the people who checked up on the elderly, the disabled, and the snowbound, and asked what was needed.

However you stood by your island neighbor, THANK YOU, and I apologize to anyone I have not mentioned specifically.

Now.

There’s been talk about whether this was the biggest snowstorm ever.

It was not a snowstorm; it was three snowstorms. The first one was a sweet little storm, and then everything froze for a few days. Then at exactly noon on Friday the 8th the first few flakes of the second snowstorm began to trickle down.

I was going into the pharmacy to pick up a prescription at the time. I saw those flakes and thought, “Uh-oh.”

From there I went to the store for last minute supplies and drove home a little before one, by which time there was maybe a half-inch of snow on the ground. Once I was home, I hunkered down for the duration.

The power went out at midnight on Friday, which was not unexpected. On Saturday morning, nine inches of snow stood around my house, and we were all snowed in together.

The electricity came back on here just before five on Saturday afternoon, and to my amazement, so did the cable and internet. Now I had snowbound bliss.

On Monday the third snowstorm began in the late morning, and by the time that snow was done we had achieved the one-foot status here at Casa Tuel.

The first day of enforced confinement I had a touch of cabin fever. The second day, not so much. I put on my Wellingtons (rubber boots), grabbed the ski poles, and took a walk up to the mailbox. No mail, of course, but it was a good walk.

The third day I decided that leaving the house is highly overrated.

It only got better as the week went on. No need to set alarms to wake myself in the morning, no obligations, no guilt.

People in the Midwest and Northeast who always have snow and ice in the winter mocked us to scorn – wimpy Washington people, freaking out over a little snow.

Tuesday evening I happened to tune into the CBS News, not something I usually do. Their lead story was how winter weather was making it difficult for people in the Midwest and Northeast. Snow! Ice! Cold! Cars going out of control! The horror!

I looked at the TV and said out loud, “Aw, are you having a little trouble with SNOW?”

It was mean-spirited of me and I will pray for forgiveness. Soon.

Did I get bored? Did I miss being with people?

I was texting, emailing, or on the phone a lot of the time, so definitely not lonely.

As for boredom, I had books, magazines, and those good old rabbit holes, TV and the internet. I wrote. I slept.

Wow, did I sleep. I stayed up late reading, and I slept until I woke up, also late, but I had that unfamiliar feeling of having enough sleep. I felt rested, which has not happened often in my adult life, know what I mean?

For those of you who had to get out and deal with the snow for whatever reason, my deepest condolences.

There were times in my earlier years when I had to go out in snow and ice, going to, coming from, or doing my work. Usually I came out of it unscathed, but once, on the way to work, I hit black ice, flipped, rolled, and ended up with a broken back.

My husband had to go out in bad weather because he was a water system maintenance guy. He was dedicated to keeping the water flowing.

We are most fortunate and blessed that the people who keep us going during the hard times are dedicated to their work. It is no pleasure to go out into the roaring elements and stay there night and day until the storm is over and the job is done.

Thank a utility worker this week, or anyone who went above and beyond during the recent unpleasantness. We owe them.

Coffee and Prayer

My friend Sonya came to visit for a few days the other week.

Her daughter and son-in-law gave her a Kindle for Christmas, and while she was here she got onto my computer and logged into one of her library accounts to download a book.

When she was done, she got up and walked away from my computer, leaving her library card on the computer desk. Some time later I came in and saw it there and thought, oh, I’ll give that to Sonya.

So I picked it up and took it into her bedroom and left it on the table next to her bed.

Or so I thought.

The next day Sonya asked me if I had seen her library card. Of course I had – and went to the table next to the bed, where the card was conspicuously absent.

There followed a search – on the bed table, on the computer desk, on the kitchen table, in the living room, on the floors of all the rooms through which I had walked. Everywhere I could think it might be. Nada.

Finally I took a deep breath and said, “Okay, I’m going to leave it to coffee and prayer.”

I made my morning cup of coffee, carried my mug to the kitchen table and sat down. I took a calming breath and prayed, God, help me find that library card, then said, “Come, holy spirit,” and sat there quietly.

In a couple of minutes it came to me: the washing machine.

Got up and went there, and sure enough, there was Sonya’s library card. It was on the dryer, actually.

I had stopped to move a load of laundry from the washer to the dryer, and set the card down, and by the time I cleaned the lint screen and got the dryer going, I had forgotten all about the card.

This sort of forgetfulness is sometimes attributed to aging but I’ve been losing and forgetting things all my life. Some of us don’t even need to move. We have something in our hands, set it down, and it is gone.

I’m finally learning that what frenzied searching won’t do, calm reflection and prayer sometimes will. The coffee is something to enjoy regardless. And maybe a cookie.

Now, for you constant readers, I said in my last column that I was praying for a dear one who was going through a rough patch. To catch you up a little, things are better now. When I posted that essay on my blog, I added this:

“Post Script: the rough patch has passed, and my dear one is doing better. Not that I'll stop praying. Don't believe in praying? Just think of it as deeply and faithfully and constantly wishing all the best for someone you love, with all your heart and mind and soul. I believe this sort of thing tips the balance of the universe.”

Yeah. I do believe that. Looking at that paragraph now, I think perhaps I should have mentioned that even though you pray and think and wish and hope, you cannot control any outcomes. So don’t expect that.

I know. It’s a bitch. On the other hand, it works in our favor when someone is praying that God would smite us.

Coffee, prayer, and calm breathing are getting me through a lot of rough patches these days, both in my personal life and in my feelings about what is going on in the world. So much has stopped making sense.

I am still watching or listening to the news on Canadian television and radio frequently. It’s good to hear the news of the United States from the point of view of another country. You also realize that the USA is not the only country with problems.

Recently a group of Canadian politicians in their Parliament broke into singing, “Barrett’s Privateers,” a rousing Stan Rogers song/sea chanty, and it made the CBC news. They sang it badly, but still. When have you ever heard any of our legislators spontaneously break into a sea chanty?

Canadian politics became dear to me years ago. I was listening to CBC news, and they had a story about a bill that parliament had fought over. When it came time to vote, one side was certain the other side did not have enough members present to win and they were congratulating each other on what they were sure would be a victory.

Then, at the last minute, a gaggle of opposition voters jumped out from behind the drapes and voted and won.

American politicians never do anything fun like that.

Maybe I’ll pray for singing in our Congress when I have my coffee tomorrow morning. Singing, and prayer, and calm breathing.

Coffee is a personal choice.