Needs remain after defeat of $45-million renovation bond
Although a majority of voters in both Okanogan and Douglas counties approved the “hybrid renovation” plan for Three Rivers Hospital, that wasn’t enough to meet the 60% threshold to pass the $45-million bond issue.
Okanogan-Douglas Public Hospital District No. 1, which operates Three Rivers, proposed a 30-year bond to make what the hospital board and administration said were crucial upgrades to bring the facility – some of it 76 years old – to modern standards.
Okanogan County voters approved the bond by a vote of 52% to 48%, and Douglas County voters by 50.5% to 49.5%. There were 4,342 total votes as of Nov. 10, with just a few hundred left to count, easily surpassing the validation minimum of 2,678.
The plan proposed by Three Rivers called for renovating all patient areas, enlarging surgical facilities, and upgrading radiology equipment and lab areas. It would have also replaced the aging HVAC system and the roof and created a dedicated ambulance entrance. Design and construction were expected to take about three years.
The bond would have collected 78 cents per $1,000 of valuation through property tax over 30 years. That translates into $234 per year for the average home in the district, valued at $300,000, and $546 for a home worth $700,000, according to Three Rivers.
Strongest support for the bond was in precincts in Winthrop, Brewster and Alta Lake. Overall, voters in the lower valley, including in Carlton and Methow, opposed the bond, as did a different Brewster precinct.
Next steps
The hospital board and administration will regroup and talk about next steps, Three Rivers Business Development Coordinator Jennifer Best said this week. That could include looking at another bond or other options for repairs, she said. Three Rivers proposed a complete rebuild of the hospital for $72 million in 2023, but that proposal failed to get a majority of votes.
Three Rivers recently applied for a grant to replace the hospital roof, which requires annual maintenance to avoid leaks, particularly in the winter, Best said. The hospital also has a new $14,000 water heater to replace one that failed (they have been relying on a back-up). Because the hospital has many needs, grants have always been part of renovation plans, she said.
Three Rivers provides 24-hour emergency care and has 25 patient beds. It’s a critical-access hospital, a designation for small hospitals in rural communities to ensure people can get emergency care without traveling long distances, according to Best.
The designation addresses care for trauma patients, who are stabilized and transferred to larger hospitals. It provides better reimbursement from Medicaid and Medicare. (The other two hospitals in the county, Mid-Valley in Omak and North Valley in Tonasket, are also critical-access hospitals. All three were built with federal funds in the 1940s.)
Hospital consolidation?
A group calling itself the Okanogan Health Care Planning Group proposed an alternative to the Three Rivers renovation. The group of retired health care professionals and health care consultants, all based in the Methow Valley, favors a centralized medical center in Okanogan County to replace what it calls “a string of four small, mostly struggling hospitals each half an hour apart from the next one” (they included Lake Chelan Community Hospital).
The planning group argued that it didn’t make sense to commit to a 30-year bond without researching alternatives. The group proposes combining hospital districts to create a bigger, single hospital, most likely in the Omak area, with outlying emergency rooms and/or enhanced urgent-care centers that have extended hours.
The planning group is meeting this week to look at next steps, said Peter Bauer, a retired family physician and member of the group. They hope one of their first moves will be to talk with Mid-Valley CEO Andy Bertapelle.
North Valley Hospital in Tonasket follows a different model, in part because it operates a long-term care facility, and has not expressed interest in consolidation, Bauer said.
The planning group aims to do something constructive and is not celebrating the defeat of the bond, Bauer said. Their current task is to see if they can move forward with a better plan.
Three Rivers is working with facilitators to study options for collaboration between the county’s hospitals, Best said. That process, facilitated by Thriving Together NCW, a state-designated group that works on regional health care issues, is still in the early stages, she said.
As a public hospital district, Three Rivers is publicly owned, with 1 1/2 to 2% of the budget coming from property taxes. Currently, an average of $1 million annually goes to maintenance, according to the hospital’s chief medical officer.
Dissolving or combining public hospital districts involves actions by commissioners of each hospital, petitions to the Superior Court, and an election, according to a legal manual published by the Association of Washington Public Hospital Districts.
District voters approved a one-year renewal levy for Three Rivers’ emergency operations in September with almost 72% of the vote. The levy rate is 33 cents per $1,000 of assessed property value.
