Among the races to be decided in the Nov. 2 general election is Position 2 on the Public Hospital District No. 2, Snohomish County, Board of Commissioners, featuring candidates Carolyn Brennan and Rico Tessandore. The elected officials of Public Hospital District No. 2, Snohomish County, govern the Verdant Health Commission, which supports programming aimed at improving the health of hospital district residents, which include those living in Brier, Edmonds, Lynnwood, Mountlake Terrace, Woodway, and portions of Bothell and unincorporated Snohomish County.
Carolyn Brennan is assistant vice chancellor, research at the University of Washington Bothell and formerly worked as an implementation consultant for Kaiser Permanente Care Management Institute. She has an MS in health policy & management from Harvard T.H.Chan School of Public Health and a BA in history from the University of Notre Dame. She volunteers for the Edmonds Food Bank.
A Snohomish County attorney, Rico Tessandore is past president of the Snohomish County Bar Association and past president and current trustee of the Sno-Isle Library System Board. He also serves on the Edmonds College Paralegal Advisory Board. He received a JD from Northeastern University School of Law in 1998 and a BA from Seattle University in 1994.
To help voters make an informed decision, we sent a questionnaire asking candidates about a range of issues facing the hospital district. Here are their responses:
Describe your relationship with Swedish Edmonds and your familiarity with controls or measures in the operation of the hospital?
Carolyn Brennan: My hospital experience is with the Kaiser Permanente system, specifically the Southern California region. I have no business relationship with Swedish Edmonds and am not familiar with the daily operating controls. According to the Swedish Hospital website, the Verdant Health Commission “no longer oversees the day-to-day operations at Swedish Edmonds, but is still involved in some of the major decisions.” Verdant is responsible for overseeing the lease agreement with Swedish Edmonds. I am eager to review the lease and learn about the explicit provisions. My understanding is that Swedish made major capital investments in compliance with lease terms. It is a beautiful hospital with a Level IV Trauma center.
Rico Tessandore: Besides being a frequent visitor to its emergency room when my children break something or have a concussion on the soccer field, I do not have a relationship with Swedish Edmonds on a professional level. I am familiar with how the hospital system operates, and how a Board of Commissioners works in conjunction with the hospital. I am also familiar with the Board’s 50-year affiliation with Swedish Edmonds, formerly known as Stevens Hospital. I think the citizens need to understand that the Health District is much more than simply overseeing a hospital: the District is charged with adopting programs to educate and serve the general health and well-being of the citizens it serves. This includes working in our community on diverse topics from access to dental care to access to behavioral health services.
The Hospital District has approximately $60 million in cash and cash equivalents. Explain to voters why an ongoing tax collection is necessary when the hospital district no longer manages a hospital?
Carolyn Brennan: Our Hospital District does not manage a hospital today. However, if Swedish decides it no longer wants to operate a hospital in Edmonds, the Verdant Health Commission would be responsible for the operating cost. I have been watching regional hospital politics with interest since I moved to Edmonds in 2010. In 2012, a relationship between Swedish and Providence formed a “unique structure” they termed it, not a merger or acquisition. Then in 2016, Providence merged with California-based St. Joseph’s to become one of the biggest Catholic systems in the country operating in 7 states: AK, WA, MT, OR, NM, TX and CA. As part of this “unique structure” Swedish Health Services operates 5 hospitals: First Hill, Cherry Hill, Ballard, Issaquah, and Edmonds with a regional leadership team and comprises about 11% of the Providence St. Joseph system’s revenue. In 2020, Providence St. Joseph posted a $306 million loss after patient revenue declined in the wake of COVID-19. While revenue stayed steady, expenses were high and very visible as Providence Everett treated the first known COVID-19 patient. Swedish Edmonds is a gem – an asset to our community – and the community wants it to stay that way. However, larger market forces are at work. We must be ready and plan for all scenarios.
Rico Tessandore: The Hospital District is much more than simply a former manager of a hospital. It provides wide-ranging educational and outreach services to citizens of the district who very likely would not receive health care services but for the grants and initiatives the District carries out. The needs of our community regarding dental care, health care, preventative health care, behavioral health and the like are in greater need more than ever. The District fills the needs for those who cannot afford insurance or full payment for preventative services. The Hospital District engages in a wide variety of programs, events and outreach services that help countless citizens in all aspects of health care, from prevention to maintenance. These programs are crucial to the proper efficient functioning of health care services in our area because the community members who would not otherwise have access to preventative care statistically end up in urgent care or emergency rooms. Successful implementation of these programs by the district should have an impact on those issues citizens find most difficult when attempting to access care: such as long waits in emergency and urgent care, lack of space or resources or attention of the medical providers who are overstretched.
The Verdant Health Commission has been operating for 11 years and yet the community still doesn’t know a lot about how the commission operates and what it does. How important do you think transparency is around the work Verdant is doing, and what would you do to enhance transparency in the community?
Carolyn Brennan: Transparency is essential! I have participated in two recent board meetings as the only member of the public. As a commissioner candidate, I was motivated to find the meetings on the website although it was not easy. The dates are set well in advance and the agendas and board packets are posted. There is some great information out there! We need to make it easier for the public to engage in the important work of the Hospital District. When I spoke to Superintendent Dr. Lisa Edwards she described plans for enhancing Verdant’s web and social media presence. In my opinion, this goes beyond enhancing the visibility of the Commission and its work to proactively create the conditions that connect people who care about these issues. The two-hour special meeting on housing on Aug. 11, 2021 was recorded and posted. Small changes such as labeling the topic and providing minutes or followups would make this information more accessible. The pandemic has isolated many people. We need to get creative, conduct surveys and focus groups to find new ways to engage citizens in the work of the Verdant Health Commission. I would promote an annual meeting for all Verdant grantees as a way to build bridges and raise awareness.
Rico Tessandore: I think the Health Commission is transparent in its operation and how it carries out its duties. Like many boards and commissions, I think the issue is not one of transparency, but one of engagement with the public and educating the public on what it does and how it operates. I don’t think the Commission would ever be accused of hiding its purpose or not being stewards of the public tax dollars, but the reality is that many citizens are busy in their everyday lives and don’t have the time to be engaged with their local health district. With that being said, I think the Commission has a great opportunity to carry out a detailed strategic plan to better engage the citizens, and to provide information on how the Commission runs and what duties the Health District carries out.
Behavioral health is an ongoing challenge in our community. What should Verdant be doing to help address this issue?
Carolyn Brennan: From my perspective, Verdant has done a lot and can do even more to address the behavioral health needs of our community. Behavioral health is a wide-ranging term that includes mental health, as well as services such as counseling, diabetes care, crisis response, addiction and substance abuse treatments. These services encompass a continuum of prevention, intervention, treatment and recovery support services, promoting behaviors that help individuals manage their health and wellness. According to Verdant’s 2020 Community Impact report, behavioral/mental health grants made up the highest percentage (21% or $1.7 million) of the approximately $8.2 million distributed. Just looking at the $2.56 million awarded in June 2021, over half of it ($1.3 million) went to support programs that address the mental health needs of our community. These partners work closely together to serve our community, funded by Verdant. I have a child in the Edmonds School District, and I see these dollars at work in programs as diverse as a peer support program to suicide awareness month. Verdant has been responsive to these urgent community needs and has shifted its funding to prioritize behavioral and mental health, which can exacerbate other medical and social conditions.
Rico Tessandore: Verdant has a great opportunity to engage the public. The public would benefit from more outreach and direct information from the district about what services are available. Verdant should continue to financially assist those providing services through grant approval and financial support. It is amazing to think that in a society that is so dependent on technology that we sometimes do such a poor job in getting information out to those in need. In summary, I think Verdant should continue to support community organizations that provide behavioral health services to those in need, but I think that the District should continue to seek to do a better job in engaging the public.
Verdant has held past roundtables on the need for affordable housing and making the connection between housing and health. What do you think Verdant’s role should be in providing affordable housing?
Carolyn Brennan: Housing is a public health issue. I was happy to see Verdant host a roundtable in August on this complex, systemic issue. Public hospital district funds must be connected to health and well-being initiatives. Verdant can be a convener, partnering with municipalities, government agencies and other grantors in the community to design a comprehensive plan to ameliorate the housing crisis.
Rico Tessandore: In terms of affordable housing, this is an issue that can’t be handled primarily by a health district alone, but I think Verdant should work with other stakeholders to seek solutions to the overwhelming issues of homelessness and a lack of affordable housing. The reality is that these issues are confronting community leaders in most Puget Sound communities. I wish I had the solution or a plan to end homelessness or lack of affordable housing, but I don’t think there is one solution that fits all. Verdant’s role must be to assist those families facing housing instability with reasonable access to preventative and maintenance health care, thereby making sure the hospital district isn’t overwhelmed by patients seeking emergency or urgent care for medical conditions which could have been diagnosed and treated in the regular course, but which these families did not know how to get care for during their financial crisis.