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On August 6, 2019, our community will vote on Proposition 1, supporting a $345 million issuance of general obligation bonds to fund the second phase of our master facilities plan, EverHealthy.

EverHealthy has three main areas of focus, including:

  • seismic upgrades for major disaster readiness
  • a new critical care unit
  • a new outpatient medical building for programs like mental health
  • an upgraded family maternity center
  • provide life-saving medical equipment, technology and facility upgrades to support these projects, and poise our organization for ever-evolving technology and the next generation of care.

Since 1972, our community has embraced EvergreenHealth as the Eastside’s public hospital district, supporting our organization’s evolution every step of the way, as we strive to meet the growing needs of our patients and enrich the health and well-being of every life we touch.

Lifelong residents and new Eastside families alike continue to recognize the value of the services we offer close to home, earning community preference and recognition from industry peers.

We're proud to have been named one of the nation’s top 100 hospitals for the second year in a row, and also be the recipient of accolades from Healthgrades, Leapfrog, CMS and other notable national accolades.

We thank the residents of our district for their forward-looking vision over the past 47 years and continued partnership in helping us meet the ever evolving needs of our growing community through EverHealthy.

A public hospital district is created and owned by a community and its residents, and authorized by the state to provide health care services to the community it serves. It is similar to a school district or fire district.

King County Public Hospital District No. 2, known as EvergreenHealth, was formed by Eastside residents in 1972 and is one of almost 60 public hospital districts in Washington State.


How is EvergreenHealth governed? How is the board of commissioners different from private hospitals?

As a public hospital district, EvergreenHealth is governed by a publicly-elected board of commissioners. This is different from private hospitals, which are often led by internally-appointed boards of directors. EvergreenHealth’s publically-elected board has ultimate responsibility and accountability for the hospital district and the quality of its medical care and financial stewardship on behalf of the district's residents. The board approves all major financial decisions along with many other responsibilities as provided by law.

Each member of the board represents a different community within the public hospital district—acting as an advocate for the unique health care needs of their sub region, and supporting the greater district as a whole. In 2016, EvergreenHealth sought to expand our number of board members from five to seven. The Eastside community voted to approve the expansion, to support additional representation of the growing population within our district.


How does the community benefit from a public hospital district model, rather than a for-profit hospital model?
Because public district hospitals are created by the community, for the community, the public hospital district model is vital to ensuring citizens have access to the health care services they need, empowering communities to respond to health care access insufficiencies, as they present.

The public hospital district model also empowers public hospital districts to respond to their population’s changing and growing health care needs over time, as the sole mission of a public hospital district is to serve its community, and respond to the community’s own unique demands and challenges to ensure the best possible care for patients and families. 


How are public hospital districts funded?
Public district hospitals are funded in various ways. However, the majority of financial support comes from public (Medicare and Medicaid) and private (commercial) insurance—like most hospitals. Typically, only two to three percent of total funding comes from property tax revenue, paid by district homeowners. In concept, the community has greater ownership because of their tax contributions. 

From the 2018 EvergreenHealth annual report, the graphic below demonstrates the financial composition of EvergreenHealth, noting that .2 percent of revenue is from taxpayer support.

GRAPHIC-2017-Gross-Revenue-Sources.jpg

Does a public hospital district have legal obligations to its community and other legal parameters, like a nonprofit?
A public hospital district is held accountable in numerous ways, as defined by law and also by the nature of its mission. For example, one of the most prominent parameters is regarding the formation of the organization’s board, transparency and public information.

All board members of a public hospital district are publically-elected and provide the statutory oversight to help EvergreenHealth strive to assure access by the community to high quality medical care and related services. The Commissioners approve major financial decisions for the District—such as approval of the annual budget, and have many other responsibilities as provided by law. The Board's meetings are open to the public and the agenda is publically posted prior to the meeting. There is an opportunity for public comment at the beginning of the Regular Board Meeting on the third Tuesday of the month.

Public Hospital Districts are also typically required to report transparent financial information to the public by releasing an annual report.

Why is EvergreenHealth seeking to pass Proposition 1?

For the past 47 years, EvergreenHealth has delivered vital health care services to our Eastside community and beyond—serving to enrich the health and well-being of every life we touch through thoughtful expansion alongside our ever-growing community.

On occasion, we’ve come to the community to ask for your support to help with that growth. Thanks to that support, we were able to open a hospice center and hospice homecare program in 1991 as well as an expanded emergency department and eight-story inpatient tower in 2007.

With Proposition 1, also known as EverHealthy, we are seeking your help to support new projects vital to the ongoing health of the community.


What is EverHealthy?

EverHealthy is the second phase of EvergreenHealth’s 10-year facility improvement plan, created in 2015.

The successful first phase—made possible in part by community support—was completed in 2017 on time and on budget, creating:

  • A new 31-bed Progressive Care Unit on 5-Silver
  • A new 31-bed Medical Surgical Unit on 4-Silver
  • The Neuroscience, Spine & Orthopedic Institute in the DeYoung Pavilion
  • A new primary and urgent care facility in Kenmore
  • A new primary and urgent care facility in Mill Creek

This second phase will transform EvergreenHealth’s Kirkland campus even more to help us continue to deliver the exceptional care and service our patients know and trust, and meet the health care needs of our community for decades and generations to come.


How was the EverHealthy plan created?

EverHealthy was developed in 2015 by EvergreenHealth and the EvergreenHealth Board of Commissioners utilizing strategic insight to population trends, community health assessment and third-party projection data to help us understand and anticipate the growing health care needs of our community.

The impetus for this plan includes:

  • Population Growth - As we know, our community has grown significantly in recent years, and to no surprise, the population will continue to increase – estimated at 71,000 new residents by 2022. Populations are also living longer than previous generations.
  • Community Preference - In addition, more and more people are choosing EvergreenHealth as their first choice for health care, increasing our patient population by both volume and preference.
  • Future Readiness - Adding capacity to clinical space to accommodate growth and to address aging infrastructure in need of improvements and preparation for a critical seismic event will allow EvergreenHealth to continue to deliver the safest care and an environment ready for all circumstances for our evolving community.

What specific projects within the EverHealthy plan will Proposition 1 support, if approved?

As with everything we do, our focus is on safety and growth that meets the clinical and service needs of our patients and community.

On August 6, the community will be presented with the opportunity to support our public district hospital through the following projects in the upcoming election:

  1. The bond issue is primarily a critical safety project, with over 60% allocated to seismically retrofit our oldest buildings and replace aging 1970’s-era infrastructure in the core of the hospital. After a major disaster, this is critical for EvergreenHealth to continue to function and serve the community.
  2. Relocate and upgrade our Critical Care Unit so patient rooms will be able to accommodate vital modern equipment.
  3. Construct a medical building for programs like outpatient mental health.
  4. Upgrade and expand our outdated Family Maternity Center.
  5. Provide life-saving medical equipment, technology and facility upgrades to support these projects, and poise our organization for ever-evolving technology and the next generation of care.

Why are seismic upgrades needed?
Our current buildings on our Kirkland medical campus are safe. However, living in the Cascadia zone with ever changing seismic codes and available upgrades, we seek to create a facility that the community can rely on in the event of a historic natural disaster – a 9+ earthquake. An earthquake of that magnitude is expected to take out all major highways, and potentially limit access to clinical care due to major damage to other health care facilities in the area.

EvergreenHealth will likely be one of the few hospitals in King County still open and functioning after a Cascadia type event. Most hospitals on the West side of I-5 will suffer severe to catastrophic damage, including our regional Level I Trauma Center, Harborview and our pediatric center, Seattle Children’s.

Not only is the EvergreenHealth campus built on bedrock which is structurally resilient, it is well located in terms of fault lines and geographic shake maps, making our hospital the most viable option to care for our community and beyond in the aftermath of a Cascadia event.

Unfortunately, the most recent reminder of the threat of earthquakes along the Pacific coast came in the form of the November 30, 2018, quake that shook Anchorage, Alaska. The damage there to roads is similar to what we would expect in our region. The two Anchorage hospitals sustained cosmetic and systems damage, yet remained open to care for patients thanks to strict building codes. We seek that same level of sustainability and have focused our planning on having the ability to be a receiving hospital, committed to staying open to serve patients.

To that end, the seismic retrofit is a critical step in ensuring that we are fully operational after a significant seismic event.


Are the current buildings safe?
Yes. Our buildings meet the seismic codes that were in place at the time of construction.

These seismic improvements will help ensure we are able to care for patients in every circumstance and in all areas of the Kirkland campus.

Our goal is not just to be safe, but to be available to continue to receive patients when the region needs us most.

After a catastrophic earthquake, our goal is to meet FEMA’s Level of Immediate Occupancy so that we can remain open and ready to care immediately for patients in our community and beyond.


What areas of the Kirkland campus will be included in the seismic upgrades?
Upgrades will be made to the oldest areas of the original 1972 hospital, including our Red, Green and Purple areas, as well as to our Central Garage and Coral medical office building space.

These areas house not only our current Critical Care Unit, but significant portions of vital infrastructure including IT, heating/cooling systems, Health Information Management, Lab, Outpatient Rehab Unit, Supply Chain Management, and more that must be upgraded to preserve our functionality after a disaster.


When will the seismic upgrades be completed?
The timelines for this project will begin to be finalized after the election. We have completed a substantial amount of preliminary planning, but the specifics will be designed out once we kick off the project.

Our goal is to complete this project within the next few years, and to continue to update our community, keeping everyone informed of our progress every step of the way.

How will a new critical care unit impact patients? 
Along with the absolute best and modern technology, physical safety and exceptional clinical care, we seek to provide an environment that supports the full spectrum of care and treatment modalities—particularly for critical care patients during some of the most vulnerable and pivotal moments of their lives.

 

The current critical care unit (CCU) is located in one of the oldest remaining portions of the original hospital.

The new CCU will be moved to the third floor of the Silver tower, offering expanded space to support some of the most recent cutting-edge technology and design features creating the best environment for patients, nurses, doctors and staff.

 

The new CCU space will also promote family-inclusive care, ensuring the health and well-being of the family members supporting loved ones in the CCU are accommodated as best as possible during what is by nature of “critical” care, a very challenging time.

 

When will the new critical care unit be completed?
The timeline for this project will begin to be finalized after the election. Along with physicians and staff, we have completed a significant amount of preliminary planning, but the specifics will be designed once the project officially begins. Our goal is to complete this project within the next few years.

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Why is a new building necessary for outpatient medical care?
As our community population grows and evolves, so too does their health care needs. A new outpatient medical building will allow us to expand to meet these demonstrated needs and support our ability to offer new services, such as mental health.


What kind of mental health services will be offered?
Mental health care is an important part of our community’s overall health and well-being. A new outpatient medical building will poise our organization to provide mental health services and/or other outpatient services as we continue to learn more about the specific needs of our patients and their families, and how we can best tailor our services to support access in our growing community.


Where will the new outpatient medical building be located?
While there is space on our current Kirkland campus for this new construction, we will consider all possible locations based on population needs.

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If EvergreenHealth is already the preferred birthing center, why are upgrades needed?
Our maternity center has not been updated since before 1996, when EvergreenHealth became the first hospital in the United States to earn designation as a Baby-Friendly Hospital.

Our goal in upgrading the Family Maternity Center is to ensure in the that all families now, and well into the future experience the same warm welcome, accompanied by the latest equipment, technology and if needed, critical care during one of the most important moments in a mom, baby’s and family’s life.


What will the Family Maternity Center upgrades include?
We anticipate a completely renovated Family Maternity Center, with a new entrance that safely and warmly greets patients and families, and modernized, hospitality-focused rooms to accommodate the entire family—with parent and baby’s comfort top of mind.

Because of the reputation for quality and service that we have established, our highly regarded childbirth experience is often times close to capacity. The enhancement we have planned will allow us to increase the number of families we serve.

These upgrades will allow us to continue to welcome babies into the world in an enhanced setting that is supportive of the needs of the laboring mothers, the multi-generational family and our NICU littlest patients.


When will the unit be updated?
The timelines for this project will begin to be finalized after the election. Along with physicians and staff, we have completed a substantial amount of preliminary planning, but the specifics will be definitively determined once the project officially begins.

Our goal is to continue to update our community, keeping everyone informed of our progress every step of the way.

How will EverHealthy be funded?
Voters in the EvergreenHealth district will be asked to approve Proposition 1 through a districtwide election on August 6, allowing issuance of general obligation bonds totaling $345 million that will support funding for EverHealthy projects.


Will the property tax rate increase for district residents if Proposition 1 passes?
No. Approval of Proposition 1 will not increase the total tax rate homeowners in our district currently pay.


In April of this year, EvergreenHealth sought to pass Proposition 1 in a special mail-in election. Approval in the April election would have increased annual property taxes for homeowners in the district by $0.18 per $1,000 of assessed property value. Why now, in the August 6 election, will homeowners not see a property rate tax increase if the same proposition is approved?
The April election afforded us the opportunity to learn how we, as a community hospital and partner to those we serve, can best approach our steadfast commitment to ensuring we continue to offer the safest, highest quality care now, and well into the future. Our renewed approach includes a financial structure that does not impact the current tax rate for homeowners in our district.


How is it possible to raise $345 million without increasing the tax rate?
Issuance of the bonds as outlined in Proposition 1 extends the longevity of repayment. Current bonds are set to expire in 2023. Proposition 1 extends the payment period. However, the rate will not increase. Other financial projections also indicate that the growing economic health of our district make this approach sustainable and viable.


Why wasn’t this approach taken in the April election to negate increasing taxes on the district’s residents?
The April election provided two significant takeaways that have guided our new financial structure to support EverHealthy:

  1. While we reached the 60 percent voter turnout threshold needed to validate the election, we did not receive 60 percent of yes votes by just 900 votes out of the 59,000 votes cast—narrowly failing short of reaching the supermajority (greater than 60 percent) of yes votes needed. From this takeaway, we know that our community recognizes the importance of the projects outlined in EverHealty, and endorses our pursuit to expand and enhance our health care services as to meet the needs of families in our district.
  2. We also heard from our community that some reluctance was due to the increased taxes that would have resulted from our original bond issuance structure in the April election. We listened; and with new projections, we have determined it is feasible to increase the timeline for completion of these projects to align with the interests of our district—while remaining timely in proactively meeting the health care needs of our patients.


Why is it necessary to fund EverHealthy projects through bonds? Why can’t EvergreenHealth pay for these improvements from profits?
As a public hospital district and nonprofit, we are trusted stewards of the financial support we receive from the community and our overall resources. As such, it is our obligation to utilize funds as judiciously and strategically as possible, meaning cash generated from operations is reserved to cover routine capital needs to sustain care for our community.

Nuanced and significant financial investments are made with “checks and balances” in consideration—unlike for-profit hospital models, that have much greater flexibility in their ability to draw from operational funds to pay for new investments.

We look to our community district as owners of our organization for guidance and partners in our decision-making process on how funds are invested to meet our patients’ growing needs.


How much will phase two of EverHealthy cost?
The cost is $345 million. This investment will improve your public district community hospital and the Eastside’s most trusted health system, to meet the needs of those who have placed their trust in us now, and for the next generation.


How many votes are needed to approve the bond measure?
Sixty percent of our district’s voting population must cast a ballot for the election to be viable. Sixty percent of the voters who cast a ballot must vote yes to approve Proposition 1.


Where can I get information about property tax exemptions for senior citizens or disabled persons?
Senior citizens or disabled persons may qualify for tax exemptions.

For King County residents, contact the King County Assessor’s Office at 206.296.3920 or www.kingcounty.gov/depts/elections .

About the Big Picture

Who will benefit from EverHealthy?
All of us. We will address safety, service and quality needs and strengthen, literally and figuratively, areas that serve patients during some of the most vulnerable moments of their lives.

Additionally, improvements will be made to clinical areas of Kirkland campus including the maternity center, critical care unit, and the oldest parts of the hospital – all to the benefit of our patients and families in these areas, as well as the staff and providers who care for them now and years into the future.


What will happen if the bond to fund EverHealthy does not pass?
We will reassess the projects, collectively and individually, to prioritize or eliminate them if necessary; and seek alternate ways to fund them – though the bond initiative is viewed as imperative at this point in order to advance these complex projects.


How Can I Register to Vote?
The deadline to register is July 29, 2019.

To register, contact the Washington Secretary of State by visiting www.sos.wa.gov/elections and vote by August 6, 2019.