In response to a few questions raised in the press and at public forums concerning Proposition 3, I would like to share what I have learned during my four years on the Board of the Canyonlands Health Care Special Service District. I am now vice chair of the board and served as chair in 2014 and 2015.
First, I learned that, notwithstanding concerted and ongoing efforts to maximize revenue and minimize expenses, extended care services can not be provided at the Canyonlands Care Center without a subsidy. Revenues are substantially limited by amounts Medicaid reimburses and expenses are in large part dictated by staffing levels required by regulation. So, while center staff works hard to run the center as an efficient business, the impact of management efficiencies is quite limited.
Second, I learned not to expect a “white knight” solution. During a legislative hearing on the bill that allows the center to benefit from the proposed sales tax, Sen. Brian Shiozawa, R-Salt Lake City, a physician and leader on health care issues, encouraged his fellow senators to support our bill since we were, in his words, a “provider of last resort.” He recognized that extended care services would not be available in Grand County without a public subsidy and that no other entity (profit or nonprofit) could provide those services since a profitable business model simply doesn’t exist. A business model which is apparently profitable in urban areas blends extended care services with more intensive rehabilitation services that are reimbursed by Medicare (rather than Medicaid). For a number of reasons, including limited local demand for Medicare reimbursed services, that business model isn’t viable in Grand County.
I encourage county voters to conclude that the high-quality services provided at the center are worthy of public support and to vote “yes” on Proposition 3. In any event, please don’t rationalize a “no” vote by assuming there is a management or privatization solution without giving the board an opportunity to explain why that assumption is incorrect. The board’s next meeting is on Thursday, October 27, at 5:30 p.m. in Education Room 3 at the hospital (across the hall from the cafeteria).