Among the races to be decided in the Nov. 2 general election is Position 5 on the Public Hospital District No. 2, Snohomish County, Board of Commissioners, featuring incumbent Dr. Jim Distelhorst and challenger Anita Shad. 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.

Shad serves on the boards of the Snohomish County Children’s Commissioner and the Pakistan Association of Greater Seattle. Her professional experience includes serving as accounts manager for Hospice MD, as a medical assistant, phlebotomist and EKG technician. She received an MS in biology from Forman Christian College and an MSW from John Vianney Institute for Management and Development.

To help voters make an informed decision, we sent a questionnaire asking candidates about a range of issues facing the hospital district. Here are Distelhorst’s responses. Shad did not reply by our deadline

Describe your relationship with Swedish Edmonds and your familiarity with controls or measures in the operation of the hospital?

I am a retired family physician, but I have never served on the medical staff at Swedish Edmonds. My only personal relationship with Swedish Edmonds is as a patient and family member, neighbor, and friend of others who have been patients.

As a current commissioner, with the other four commissioners one of my responsibilities is to oversee the management of the Hospital District contract with Swedish Edmonds. I am familiar with the contract with Swedish and the contract’s requirements.

I served as the administrator for medical and quality services at another area Public District Hospital for over 10 years. In that role I administered medical staff, quality and safety issues throughout the hospital, and attended over 200 Board of Commissioners meetings. I am very familiar with controls and measures in the operation of hospitals including Swedish Edmonds.

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?

This question requires a detailed answer.

A Public Hospital District is by state law a taxing district. Public hospital districts receive a limited percentage of property tax revenue from their legally defined geographic Districts to own and operate hospitals and other health care facilities and to promote health and wellness for the residents of their district. Our hospital district is legally defined within South Snohomish County. (Here is the District map: Our Community | Verdant (verdanthealth.org).) For 2021 our hospital district, which does business as Verdant Health Commission, will receive less than $3 million in property tax revenue. Our district expects to invest more than $11.8 million in grants to support the health and wellness of hospital district residents for 2021. Over $1.6 million of these funds are emergency grants for Covid-19 services primarily to support behavioral health, food security needs, and COVID-19 testing and vaccinations.

One way of looking at these data (as a district property taxpayer and non-financial person) is that in 2021 for every $1 of tax revenue our district receives it will pay out approximately $3.93 in health and wellness services to residents in South Snohomish County. This substantial community return on its tax investment is possible because our District receives most of its revenue from a non-tax source, the Swedish hospital lease.

In my work for hospital districts, I found that a critical feature of a hospital district is its community focus. The legal and tax structure center the work and funding of a district into its legally defined geographic boundary. Hospital Districts are designed to focus specifically on the health and well-being of the residents within their districts.

Regarding our hospital district’s cash reserves, the Swedish Edmonds management contract is a 30-year contract signed in 2010. If the contract were breached, the district would need financial reserves to keep the hospital open by making payroll, paying power bills and the like until the revenue stream pivots back from Swedish to the hospital district. This revenue change can take at least 60 days. The cash reserves are on hand to keep the hospital open until that revenue shift occurs. The cash reserves are like a self-funded insurance policy to keep the hospital open and functioning in the unlikely event that the hospital management contract is not fulfilled.

To return to your question: given these finances, why is ongoing tax collection necessary?

A public hospital district is by state law a taxing district. If a hospital district is no longer a taxing district and does not receive tax revenue, is it still legally a hospital district? An attorney with expertise in public hospital district law would need to answer that question. One concern is that a previous public hospital district that is no longer a public taxing entity may lose public election of its board and, in our case, its exclusive focus on South Snohomish County and the health and wellness of its residents.

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?

I hope these accompanying answers themselves help inform the district residents about how the Verdant Health Commission operates and what it does.

Transparency and accurate information are very important to all of us at Verdant—five commissioners, eight full-time staff, and two interns. The Verdant Board of Commissioners and the Verdant staff want South Snohomish County Public Hospital District residents to know more about how the district works and what it does. The Verdant website, which is being redesigned with a new website launch date of December 13, has helpful information about the programs Verdant funds (Programs by Organization | Verdant (verdanthealth.org), and we encourage public attendance of our public meetings. The board of commissioners monthly meetings are open to the public, currently by Zoom, and we often have members of the public join us. Other public meetings have included the Verdant Housing Study meeting in August. The public meeting schedule is also available online (Public Meetings | Verdant (verdanthealth.org)).

I continue to be impressed by the Verdant staff and interns. Their ongoing efforts to increase information-sharing through local media and other sources, through meeting with community partners and stakeholders, and through updating the Verdant website, all inform our South Snohomish County residents about Verdant’s operation including the grants available to support health and wellness programs in the community.

One of my goals as commissioner is to continue to support the work of the Verdant team. I’ve joined them for athletic field dedications, program openings, community networking with our partners, educational programs, and meetings with community stakeholders. I will continue to support community outreach and education programs.

Behavioral health is an ongoing challenge in our community. What should Verdant be doing to help address this issue?

Behavioral health continues to be a priority for Verdant and the nboard of commissioners. For example, a major focus of Verdant’s emergency response to COVI-19 is the support of behavioral health including behavioral health outreach. Verdant also supports programs that address substance abuse issues including opioids.

Verdant continues to work with Swedish Edmonds, the Snohomish Health District, and our other community partners to identify district behavioral health needs and to support programs that address those needs.

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?

Affordable and safe housing is crucial for health and wellness. Verdant has supported community affordable housing programs and will continue to do so.

Verdant’s primary role in affordable housing is to fund wrap-around programs that support the health and wellness of the residents of such district properties. Verdant also works with our community partners to identify those properties. In 2019 Verdant worked with the City of Lynnwood, the Edmonds School District, and other partners to try to provide housing for some of the estimated 500 families of students in the School District who are living in motels, vehicles, or doubling-up, couch-surfing, with family or friends. After due diligence, the specific property was found to be inappropriate for rehab and new construction was too expensive.

Verdant will continue to work with and actively seek out potential partners to identify safe and affordable housing opportunities in South Snohomish County and to fund programs that support the health and wellness of those residents.