Funding district could help Kitsap health care woes

Problems getting health care in Kitsap County are well-documented, and the Kitsap Public Health District is looking into ways to help that situation.

A recent report recommended the possibility of a Public Hospital District so the KPHD is studying that as a possible solution.

At the KPHD meeting June 4, Susan Young of the Alliance for Equitable Health spoke to the board about it. That nonprofit formed in December of 2021 with the intent of improving health care and has studied the possibility of a hospital district.

Young said there are 56 such districts in the state and a quarter of them don’t even have hospitals. So the title is a misnomer as funds raised can be used for anything dealing with health care. She said a district on one island in the state uses the funds for housing to draw health care workers there. Because they are so local, officials can “tailor services to meet the needs of the community. It’s really a funding mechanism,” she said, adding that it’s not a “cure-all for every health issue we face.”

Such a district can be placed on the ballot and only needs a simple majority to be approved. Just like a fire or port district, commissioners would be elected to oversee the district. Property taxes are the main way to raise funds. Young said amounts range from 25 cents to 75 cents per $1,000 valuation, but at the average of 35 cents $22 million could be raised each year in Kitsap. On a $500,000 home that would be $175 a year.

Young said such a district should be countywide to keep costs down for every taxpayer, but director Becky Erickson suggested it might be better for the district to be in Central and North Kitsap because South Kitsap often doesn’t pass funding measures. Young said that wouldn’t be fair because those taxpayers would be paying for something those in South Kitsap still would be able to use.

“I’m OK with that,” said Erickson, who is also the mayor of Poulsbo.

Young suggested that the public just needs to be educated about the topic. Director and Bremerton Mayor Greg Wheeler agreed that the county would support it if it is shown that such a district could help fill gaps in health care countywide.

Director Christine Rolfes, who is also a county commissioner, said a poll needs to be done to find out what people would be willing to pay. “I don’t know that we can move forward until we answer those questions.”

KPHD board chair Dr. Tara Sell said more health care providers need to be providing services, and that the responsibility should not just move on to taxpayers.

“This doesn’t let anybody off the hook,” Young said of forming a district.

She said a decision needs to be made soon because it’s a long process getting a district on the ballot. “People’s lives depend on what we decide to do with the health care situation in this county,” Young said.

Her presentation included summaries of reports describing healthcare needs in the county. She said none is surprising. “They’re things we’ve talked about for a very long time.” Shortcomings include: mental and behavioral health; housing and homelessness; reproductive health; health equity; primary health care; and workforce issues.

Young said there are many organizations working on health care, and they need to work together to address the gaps. “Stop chasing the dollars all the time and work together more efficiently,” she said.

Health officials provided more information on shortages regarding reproductive justice in another presentation to the KPHD board.

Dr. Gib Morrow, the district’s health officer, said that term refers to all women having the right to have children, or not, along with having the right to have proper care for those children.

He introduced Maite Garcia, KPHD’s first Centers for Disease Control and Prevention legal fellow, who studied the issue in Kitsap. She said pregnant women in Kitsap have 40% less access to care than the rest of the state. She said each state sets its own Medicaid rates, and that impacts access to care.

One trend that could help right away is the increase in doulas, someone with obstetric training who guides and supports pregnant women. Garcia said the state recently allowed reimbursement of such health professionals to $3,500, the highest in the nation. Midwives and community health workers also provide a “great return on investment,” Garcia said.

Morrow added, “Getting funding streams in order is the name of the game.”

Morrow said problems during pregnancy are 80% preventable. Often they deal with substance use or mental health problems. “We need to help them every inch of the way.” He said states like Idaho, Texas and Oklahoma that are pulling the plug on reproductive rights are struggling with inequities in health outcomes because professionals don’t want to practice there.

In his report, Morrow quickly talked about concerns regarding bird flu, whooping cough, measles and tuberculosis. He also expects a hotter, drier, smokier fire season due to a “skimpy snowpack.” Masks are needed to lower the harm of smoke. And he talked about the KPHD working with the Navy regarding the nuclear weapons stored in Kitsap.