Clinic subsidy boost proposed; levy increase may go to voters next year

The Point Roberts Hospital District is planning to substantially increase its subsidy to the community clinic and ask voters to approve a levy lid lift next year, but residents questioned whether the district has enough current information to justify paying for the higher level of care.
Hospital district commissioner Vic Riley outlined the proposal Aug. 13 at the regular monthly meeting of the Point Roberts Taxpayers Association.
The district up until this month paid the provider, SuperTrack, $16,000 a month, or $192,000 annually, to operate the clinic. Riley said the subsidy had remained unchanged since 2019 despite inflation and increased services. The district increased payment to $36,000 a month this month for the rest of this year to cover SuperTrack's projected loss, before settling at a proposed $27,000 a month next year, or $324,000 annually, a 68.75% increase over the current amount.
The clinic costs approximately $500,000 annually to operate. Patient revenues contribute slightly more than $200,000, while the district provides $192,000 and SuperTrack has been covering the remaining shortfall. SuperTrack reported a $75,000 loss from the Point Roberts clinic last year and projects a $102,000 loss this year. The company has been covering those losses with revenue from its other operations and by paying its Point Roberts providers below-market salaries, Riley said.
“It's not appropriate that the provider subsidizes,” Riley said. “The provider should be making a small profit, at least a reasonable profit. That's why they're here. That's why they're in business. They shouldn't be paying us for the privilege of treating us.”
The district's current contract with SuperTrack requires a doctor at the clinic one day a week, a nurse practitioner or physician assistant two days a week and telemedicine two days a week.
Riley said SuperTrack has voluntarily provided doctors three days a week since 2020. The district wants to make that level of service a contractual requirement and extend the contract through 2028.
The proposed contract, which begins at the end of next year, would also allow the subsidy to be adjusted based on factors including inflation, patient revenues, patient needs and district reserves.
The district has more than $500,000 in reserves, but Riley said those reserves would decline as the higher subsidy is implemented, remaining above approximately $150,000 if voters approve the levy lid lift.
“Arguably, most of that money should have been going to support the clinic all along instead of going into the district bank accounts,” Riley said.
The hospital district currently collects about $300,000 annually in property taxes. Its levy rate is approximately 28 cents per $1,000 of assessed property value. The district's legal levy limit is 75 cents per $1,000. The district has never asked voters to increase its levy rate. The goal of the levy lid lift proposal for next year’s ballot would be to establish sustainable funding beginning in 2029 and would allow the district to set rates flexibly for the next six years. But it’s worth noting that such an approval is only good for six years.
“If we want doctors here, we're going to have to pay market rates,” Riley said. “We haven't been paying market rates so far, and anyone we get who's going to have the qualifications that our current doctors have is going to cost that much or more.”
If voters do not approve the levy increase, Riley said the district could reduce clinic services or seek another provider.
Riley referred to a 2018 community survey during his presentation, including survey responses in which residents cited access to a doctor as a reason they did not use the clinic.
Residents questioned whether an eight-year-old survey and the district's current data are enough to determine what level of medical care the community needs today.
One resident asked whether SuperTrack or the hospital district tracks what level of practitioner is actually needed for individual visits.
Riley said the district does not track that information and does not get involved in individual medical services.
“As a community member, I'd like to see an evaluation from a SuperTrack's point of view of not that they provided doctors because in a survey we said we want to see doctors, but we actually need doctors,” the resident said, “There are nurse practitioners these days that are having an amazing experience and education, and we could be utilizing them better too.”
Another resident specifically questioned relying on the 2018 survey.
“I understand that you're going from a 2018 survey about what kind of a provider would people prefer, but I think it would be worthwhile to do a survey that's current because it's 2026, that's eight years later, and the way healthcare is provided is changing with others other than doctors a part of the picture… A high-quality nurse practitioner or a high-quality physician's assistant could be a very good fit here, potentially,” the resident said.
Residents also raised concerns about insurance coverage, particularly for younger residents whose insurance is not accepted by SuperTrack. One asked whether part of the district's subsidy could be used to encourage SuperTrack to accept additional plans.
“If we're seeing 50% of the population utilize, and those are all people who are on Medicare,” the resident said, “they will eventually age out, and we're going to have people who are younger moving in, whose insurance is not necessarily covered by or accepted by SuperTrack, who won't go.”
Riley said insurance changes and patient needs could be considered when determining future subsidy levels.
Residents also questioned the district's current survey, available through the clinic's website, and whether responses could be submitted anonymously so patients would feel safe criticizing the clinic.
“I know some people have had criticisms, and they were fearful of incriminations or loss of services if they complained,” one resident said.
Riley said identifying information is required for specific complaints so the district and SuperTrack can investigate individual patient experiences. He also noted that information submitted to the public hospital district that does not contain protected medical information may be subject to public disclosure.
Riley said the district plans to continue gathering public input as it considers the future of the clinic and next year's levy proposal.
“My seat is up for election next year, along with the levy lid lift,” Riley said. “So next year will be a big year for the district and our decision as a community about the path forward for the clinic.”