Public Hospital District 4, better known as the Snoqualmie Valley Hospital District, has been through some big developments in recent years, including a short-lived exploration of a possible sale to Overlake Hospital and the construction and this spring’s opening of a state-of-the-art new hospital facility, pictured at right.

The hospital district is governed by a five-member board, with two board seats up for election in November. Position 1 has three contenders, incumbent David Speikers, Tim Noonan and Fritz Ribary.

We asked the candidates:

• What do you hope to accomplish as a hospital commissioner?

• What do you see as the challenges for the district in the next four years?

• What are the district’s opportunities? How would you capitalize on them?

Commissioner Position 1

David Speikers

David G. Speikers, 55, is an attorney. He has lived in the hospital district for 13 years.

Goals as commisioner? Challenges?

Develop a plan to make the district more profitable by expanding services without a major financial hit;

Clean up past administration financial disasters by making the district more transparent. I have done so by opening the district’s finance committee to public participation;

Continue to provide outstanding care to citizens who use the hospital although under projected smaller reimbursement costs by Medicare and Medicaid.

Opportunities and how to capitalize?

We have a new hospital complete with state of the art infrastructure and an award-winning, awesome staff. We have a chance to bring diverse care to taxpayers by expanding outpatient services and attracting quality doctors who can actually make money with our new efficient hospital lay out.

In addition, I believe that we can capitalize on affiliations with other nearby hospitals to streamline and expand services to meet the needs of the local community.

We have a higher than average suicide rate in the Valley. Viability and profitability means a better chance to serve all citizens and a chance to address this and other local health concerns.

Fritz Ribary

Fritz Ribary is retired from a career in banking, financial services, and marketing. He has lived in the area more than 60 years.

Goals as commissioner?

Plan for the future of local health care. Provide public education for patient options, patient safety information, and patient wellness opportunities. Look forward rather than backward, and actually plan for the future.

Challenges ahead?

Provide relevant, appropriate rural and recreation-oriented basic health care. Anticipate and think strategically for the future of health care delivery and health maintenance promotion. Remain financially viable in an ever-changing Affordable Care Act environment. Pursue niche medical markets that also complement other hospitals in western Washington.

Opportunities and how to capitalize?

Find other programs similar to the Swing Bed program which benefits patients, families, and other participating hospitals.

Find and/or develop patient wellness programs which address and improve both mental and physical health.

Continue to pursue partnering with community organizations like Encompass, Friends of Youth, and senior centers to address overall health concerns for all ages.

Tim Noonan

Tim Noonan, 60, is a retired Seattle City Light electrician. He’s lived in the area since 1975.

Goals?

The just-completed bond sales totaled about $80 million. The district equity has been cashed out, a huge debt service created and a trophy hospital built. I will work to build equity and lower health care costs, a place that the district had nearly reached. I hoped I would see this happen in my life time.

Challenges ahead?

The district will once again have the challenge of keeping the doors open squarely before us. Without proper leadership from the district commissioners, the cost of health care will continue to escalate and the competing hospitals 10 minutes down the road will prevail and our district will not. The hospital district we pay for is in financial peril, again.

Opportunities?

This district is not based upon making a profit, but upon providing the best health care at the lowest cost, subsidized by our tax dollars. I would capitalize on this the same way I did throughout my career: By providing the best health care at the lowest cost; increasing assets and reducing the debt service; rebuilding a hospital district that is owned by the community; listening to the people.

Commissioner Position 5

Position 5 also has three contenders, incumbent Joan Young, Bruno Kelpsas and Steve Weaver.

Joan Young

Joan Young, 69, is a retired RN. She has lived in the district for more than 35 years.

Goals as commissioner?

We govern the district, we don’t operate the district. I’m most interested in getting a continuing strategic plan and long-range planning in place. My biggest interest is helping to achieve affordable health care for all citizens of the Valley.

Challenges ahead?

Affordable health care and education for the citizens. Our hospital revenue currently is $38 million, and the tax-payers’ percentage of that is 9 percent. I want to keep citizens informed of what’s going on.

Opportunities ?

With an appropriate strategic plan, and long-range planning, that’s the best way to capitalize. Opportunities to improve and have efficient health care for more citizens in the Valley. We currently have a number of outreach programs, including lab, and providing physicians. We have a lab person who goes to several places, including the senior center in Carnation, and does lab draws for people who need them. We also provide physicians for the skilled nursing facility in North Bend. There are clinics, in addition to the ones on the Ridge, for everybody. We also have excellent outpatient hospital rehabilitation clinics.

Bruno Kelpsas

Bruno Kelpsas, 50, is an IT director in the health care industry. He’s lived in the district for more than seven years.

Goals?

I envision our new hospital as becoming a wellness hub‚ everyone within the district can receive value. To accomplish this, I would collaborate with local outreach programs to identify and triage community health needs and risks.  I foresee youth wellness as being a critical priority.

At least 51 percent of personal health is driven by lifestyle. A wellness hub vision for the hospital would contribute to a balanced lifestyle and attract employers to the Valley.

Challenges ahead?

One immediate challenge is to expand our communications network. Local outreach and public-private partnerships can contribute to this. Growth also requires a community health roadmap. We have new homes being built in Carnation, Snoqualmie, and North Bend. Aligning, and then anticipating, community health needs with the hospital’s services and cost model is necessary for success and to create a sustainable business model.

Opportunities?

Our district can become the gold-standard for well-being. Surrounding the hospital can emerge a medical park and potential medical training facility. Spokes of a wellness hub would be tele-health in schools, natural medicine and outreach programs to food banks and the senior citizen centers.

Steve Weaver

Steve Weaver, 56, is a financial advisor with Weaver Financial, LLC, in North Bend and has lived in district for 22 years.

Goals?

Strengthening the hospital’s relationship with the community. It’s imperative that we move beyond the misinformation and vitriol of the past and help the community understand that we have a valuable resource in the hospital. Through objective governance and thoughtful management oversight, commissioners can demonstrate  healthy working relationships with a path toward long-term viability. Acting with respectful guidance and due diligence, the commission will see support for the hospital increase.

Challenges ahead?

As the financial model of the health care system is shifting, the hospital must ensure we can maintain usage and funding levels. While a change from the current Critical Access Hospital status could be managed, it would significantly alter funding. Through a rigorous risk management process we can ensure viability regardless of any changes.

We must maintain positive relationships with area hospitals. Since the new hospital opened, we’ve experienced significantly increased use of the ER and a high bed utilization. The second is due in large part to referrals through the swing bed program. This will only be sustained by maintaining the reputation as a high quality extension of services delivered by larger hospitals.

Opportunities?

It’s imperative that the community perceive the hospital as a resource. The opportunity is to be a resource for proactive wellness programs, not a reactive health care source. Educating our community on healthier lifestyle choices will elevate the community-wide health profile. We need to reduce the need for physicians to prescribe meds and other invasive procedures when unnecessary and enable people to advocate for their own good health choices. Health care costs have skyrocketed and the ways hospitals and doctors are reimbursed for health care services will be incentivized by a pay-for-improvement model in the future. For the hospital to thrive and provide optimal care, we need to empower our patients.