In response to Trish Lehman’s reply to our earlier letter concerning the PHD’s purchase of the Village, Ms. Lehman criticizes our statement that Assisted Living facilities are a model of financial failure (as are SNF’s). Indeed both are ‘financial failures’ once Medicaid clients are accepted as is the case with the Village acquisition plans. As the PHD’s FAQs state: “Assisted Living and Skilled Nursing homes are struggling across the country, and many have closed.” In other words, financial viability of the Village will forever be dependent on tax monies or other external sources.

Additional concerns we have, include:

• The PHD’s FAQs further state that “As this is a taxpayer-supported program, our San Juan Island and District residents will have preferential enrollment.” Medicaid patients CAN NOT be discriminated against in terms of domicile or otherwise. In reference to the FAQ question “How will this affect underserved islanders like Medicaid clients?” potentially any or all of the initial 4-6, Medicaid clients may well NOT be District residents or islanders at all. Additionally, private pay clients from Orcas or Lopez et al will now be discriminated against as non-District residents.

• Will simply raising staffing salaries 10% (ie $2.00 over a base salary of $20.00/hour) and adding benefits magically make available a critical lack of credentialed staff? Certainly, this assumption is problematic given the global dearth of like kind workers nationwide.

If this first attempt of a PHD levy lid lift fails we strongly encourage the PHD to revisit alternative proposals to reestablish long-term services with a much more robust, comprehensive and transparent vetting process with town hall meetings, proper financial proforma etc. as such a major outlay of tax monies demand.

J. Michael Edwards

Rebecca K. Smith

San Juan Island