TONASKET – Candidates and incumbents for North Valley Hospital Board of Commissioner positions open for election in the upcoming Nov. 7 election gathered in the Tonasket High School Commons last Wednesday, Oct. 11, for a question and answer forum open to the public.

The forum, organized by Tonasket Chamber of President Marylou Kriner and emceed by former Oroville School District Superintendent Ernie Bartelson, asked questions of all the candidates, and allowed the audience to direct questions to candidates as well.

What skills do you think you can bring to the position of the hospital commissioner?

Helen Casey: This would be my fifth term, and I have 46 years in banking; in a leadership role in that for 40 years. I am an active member of the community, and have been involved with the Chamber of Commerce in both Oroville and Tonasket. I keep track of money at rodeos and parades. I am an active member of church in both in a leadership role and doing what needs done. I have the ability to listen, think it through and act in a professional manner giving it the very best of my abilities. I have a passion for what I do in the hospital district. It takes time, energy and ability to think, listen and trust people.

Jean Pfeifer: I have a very strong healthcare background with 37 years in nursing at Seattle Children’s hospital, and more than 10 years with the State Nursing Association. For many years I was involved in collective bargaining at Children’s. I know hospital based care, with a background with the Washington State Nurses Association. I know about healthcare throughout the state, and have been involved in lots of discussions on rural health. I’ve been in Tonasket seven or eight years, we retired here, I love it and immediately immersed myself into what is going on here with involvement in the CCC. I am on the board there and enjoy doing all the things. I am trustworthy, and can be trusted to make a good meal there. I have two children, a son in Walla Walla who works with the Forest Service and a daughter in Seattle in graphic design. I live just outside of Tonasket and love it here. I can bring to the board a passion for good healthcare and the ability to work with all stakeholders in healthcare and be a good listener. A commissioner needs to be accountable and have trust with all people.

Adam Tibbs: From life experiences, work experience, honesty, ability to listen, and being open to suggestions. Things I’ve done in life is where I draw my experience. Being from here and the people I’ve met have instilled the skills in me to be here to listen, and if there is a concern I will bring it to the board and the CEO and address it with respect.

Matt Alexander: I worked at the hospital for five years, and have seen the inside. There was a problem there the maintenance department had to address and it created some frustration, and when I quit I had talked about running for the board. Unlike Helen Casey, I am a blue collar worker and wear tools. I worked as a maintenance operator and there was a multi million dollar geothermal project the board had approved. I talked to them individually and the project still went through, even though when having the conversation, they said they didn’t understand what I was talking about or the contract they had signed. I want to get on the board because you aren’t going to sell me a three million dollar system we don’t need.

Clarice Nelson: One thing about running for re-election, it gives you time to think what skills do I bring, why am I doing this again, and I came up with several reasons. I made a commitment 14 years ago to do this to the best of my ability and I still have a passion for this in the healthcare field and I have flexibility in my schedule to travel to conferences and read information, and I am well informed, so my skill is that I have the time to do it.

Jerry Bradley: I consider myself to be a leader in several ways, and I have a history of successful problem solving in my work career. I like taking on new ideas and seeing whether they are worth doing. A character trait I have is good integrity, and I have businesses I own and run. I am involved in church, and with several volunteer organizations around here.

What process would you use to offer advice and counsel to the hospital administrator that might improve the operation of the hospital and help him be more effective in his job?

Nelson: I think I would approach him on a one-on-one basis. With 14 yrs experience as commissioner, I have seen a few CEOs come and go. I understand they each bring their own qualities and experience to the position, but they do work for the board. I have not been in that position, but I guess I would sit down and visit with him and be open to his concerns and hear what he has to say and expect the same from him; for him to listen to me as well.

Bradley: the process would be dependent on the situation, if it called for problem solving, I would seek to identify the facts involved. I would provide facts and have him seek out facts, and I would have a good system of follow-up. If he has a plan, I would set up some metrics to see if he has follow-up and to see if he does what he said he is going to do.

Casey: Since I had the privilege of serving on the board, the opportunity to work with the CEO is an important one, as the board’s role is oversight; to be able to sit down with that person is paramount to do the job right. You have to be open and aboveboard. The administrator is the person that knows all the answers, we hope, but as a board doing oversight we have to sit down with them and see their goals, and work together with trust and respect for making things happen.

Pfeifer: I would approach not just the CEO with an idea or to get his, but have other stakeholders in the group at the meeting. At the initial meeting, include the COO and the person in charge of finances, to have more than one person hearing the dialogue that is going on. Not just me, but perhaps have a community person there to ask questions and give ideas to the CEO about what rare ways the problems that can be fixed and dealt with at the time, and futuristic issues. You need the opportunity to establish strong trust, in a viable institution in this county, so we won’t need to have more than one meeting, after establishing trust and open communication at this initial meeting.

Tibbs: I would say get out in the community, be out there once a week if not more, go and speak to leaders in the community, go the different outer areas, meet the businesses get to know the people, find out what people really want. Hear it from them, not just the five board members, but members of the community because that is who you serve. So that is the best advice, get out there and hear what they have to say.

Alexander: as a board member, one-on-one would be my preference. Anyone could be listening, but I would need to meet with him face-to-face.

Please share an example of a time when you helped coach or mentor someone and what improvements did you see in that person?

Tibbs: We have a family business, apple orchards, and I have a great employee I go check on every day; I mentor him every day. I have coached basketball here at the school, and have mentored people through previous jobs with the company I worked for; watching someone grow with the process you put before them and it is a great honor to be able to do that. I recommend everyone do it.

Alexander: I also have been a coach of athletics. It’s been a few years, as I started when I was really young. I have mentored people through work; I am a manager of my own company and if you want good employees, to do what you want them to do, mentoring is a part of that.

Nelson: I don’t think I’ve been in that position in the past to coach or mentor someone. I have not had to do that. I’m sure it would be good to know you have helped someone, but I don’t think I have been in that position.

Bradley: I have coached baseball, soccer, and assisted with other teams. In my work with Kenworth trucking, we had college interns and I would help coach and instruct them. I would spend three months mentoring them, and then seeing what they are accomplishing at the end of that. Those would be my best examples.

Casey: It is a pleasure, a few years ago I had the opportunity to raise some youngsters who always came to the school to work. One person, Jerry Mills, said “because you coached and mentored someone, I knew I was always going to get a good employee.” To do that is a pleasure. I’d do that with my staff; you know what the ground rules are and you can see them grow. We coached little league baseball for years; I didn’t know how to coach but I kept stats. Coaching is the key to success and we all need that to be able to grow.

Pfeifer: I mentored many young nurses. To see them fresh out of school and they start and are scared to death to do anything, then you let go and they start shining, making critical decisions on their own and they become confident in their own work. I also got to work with families. I worked in the neonatal ICU, and had to work to get them to be strong advocates for their child, and to be able to show them the way how to do that was very rewarding. You saw them begin to relax and ask good questions, and how to give love and hands-on care when the situation was very vulnerable. It was extremely rewarding for me.

What policy changes or investments do you believe are necessary to be implemented over the next five years?

Casey: Policies in the healthcare industry are pretty set, mandated by state and RCWs. Can you go forward and do something to ask to have them change? Federal government is not too fond of that. We need to continue to invest in our healthcare and the people, and to look to the future whether that would be the addition of a surgery suite, and we need to invest our energies in keeping up with all the changes. I work in the financial industry. Healthcare has a lot of unfunded mandates, and you have to think outside the box to make those changes. An example is our cat scan future. John James had the vision we should have a cat scan, and what a gift to see the future but you have to think outside the box. We have a 1952 hospital, with a new addition, and we have to sit down as a community and do what is right and move forward.

Pfeifer: Policy, also within the hospital to make it run, not just RCWs and WACs, but those policies established by the hospital have to be looked at periodically by the CEO and COO to be sure they are up to date and addressing all the issues. We should not just count on the staff at the hospital. Each of the policies should have a procedure to carry out that policy, and the staff has to have a clear idea what the procedures are and the expectation of them to do their job well. They have to be very clear to all the staff, and if not, it needs to be dealt with by staff and commissioners

Tibbs: For investments, the surgery center is important. We want this community to always have a place to have surgery. We have talked about geothermal and helicopter pads, but making sure the hospital stays here and the Emergency Room stays open, those are the most important investments that I would be interested in, and we take a lead from the community. If the hospital closes, we are traveling that much further to Omak or Wenatchee. Policies, you make up each day. Things change so fast in any business. No one knows where healthcare is gonna be tomorrow, it changes so fast. You need to be involved, like Jean said, and be there to affect the policies and make changes as they come at you

Alexander: I would like to form a steering committee again, including members from the community. When we got into a pickle remodeling the second floor, we did some things illegally and we learned our lesson. We got in and formed a steering committee, I was on that and we had great success. I like what we did. Working at the hospital and understanding all the different guidelines to do things legally, I don’t work there anymore but the steering committee’s responsibility is to the community is to see what they want. We have to put that surgery in the basement, although I’m not sure how it will be done. The way to do that is to get the public involved; your opinion is going to affect what we do.

Nelson: Concerning investments, our priority is our employees, to be a prefered employer. If we do assessment needs, we need to invest in our community, our healthcare partners, we need to collaborate with them and work together. In policies, a lot of them are mandated, so there’s not much we can do there, but I agree they need to be reviewed more often and signed off on. We have employee updates where a lot of policies are brought forward in individual booths, for employees, and we could stand to have more of a review process implemented.

Bradley: I haven’t been on the board, but I can say the process would include being interested in investing in relationships. There needs to be healing between the board and employees and the board and the community. So if anything, invest in healing relationships.

In your experience, what is the key to developing an effective team?

Nelson: The key is respect for one another, if you don’t value each other and what part they play on the team, I don’t see how they can move forward.

Bradley: The key is leadership, mutual respect and good goals; and having a leader that sees the goal and can bring it to the team. That’s what makes a successful team.

Casey: Teams don’t just happen, they come with hard work, trust and respect and the fact you utilize the strengths of each person at the table. It can be two or 200, but it takes a leadership role to mentor, listen and to guide. But teamwork is key; if working against each other nothing will succeed. We need to work for one common goal and decide what that goal is going to be. We spent several years in warrants, it took a team effort by all employed at the hospital and the community to make that team, with a common goal to keep the hospital alive. The team can be two or 200 but we have to keep the team alive.

Pfeifer: I agree with Helen. My many years of nursing were built on teamwork, essential in any type of organization. Trust yourself and one another, lay down commonalities you have. And if members of the team disagree, if you trust what they are saying, and it’s consensus-wise, it’s a win-win for the team. Besides trust, they need to know they can count on someone to go to, to work for the commonality of the organization. Helen said it well and can’t add too much to that.

Tibbs: Something I enjoy to do, a very exciting thing is to bring a group of people together and bring their abilities out and watch them grow together and bring different pieces together. You don’t want everyone to be alike, bring different personalities for a strong team; people that want to go places, people who don’t want to settle but have ambitions and goals and things they want to do. That makes a strong team and those are the people I want on my team. It can be a blast and a lot of fun, whether rowing down a river or putting a management team together.

Alexander: Honesty and integrity. You have to trust each other, and leaving your ego at the door is very important, key. Talent and diversification is there, and to get to that is to get the egos out of the the way. And when you have trust you can get the information.

Describe what you feel is the primary responsibility of a commissioner and why you should serve in that position.

Casey: I care, I trust and I respect the people who come and go and work in the institution. I care about the community, and care closest to home is such an important thing, to know it is there when we are going to need it and it is important to be there as a board member, you have several things to think about. We are the boss of the CEO and he is your only employee. You can’t go in and try to micro-manage. It’s a big responsibility, the board needs to look for efficacy, and to look to the future to make it continue to be what we want it to be. The economic value is a big thing. We need to listen, have respect and trust each other.

Pfeifer: A primary, or important part is to have a person who is passionate and a community leader, and passionate about healthcare. I feel I am qualified because I know hospital-based settings and what they are like, and what they need to be doing. I am really impressed with having a hospital in this community, but we need to be a well-run hospital. There needs to be more transparency between the board and the staff and the community; decisions then can be made with more input and with all stakeholders being considered. I can bring a lot of those traits to the table as a commissioner.

Nelson: The primary responsibility is the community, we are elected by them and we do what we do with their best interest at heart. Sometimes we do things that the community doesn’t understand so I agree with Jean, and we need to be transparent.

Bradley: In your one-fifth part of the board, your responsibility is to manage the CEO and to represent the community that elected you. Why me? I have a vested interest in the community, and the hospital played a major role in saving my own son’s life. With having a business in town, this is an opportunity to serve and give back. I have volunteered in different modes, this one would be more intense but I would take it on as a challenge.

Tibbs: All the same things Jerry said, and I would add I would do what you want me to do. I represent all of you. I am open to suggestions, I listen and respect all your opinions. I was born at that hospital, I graduated from school here and am here to do what you expect.

Alexander: I would try to add a level of transparency. The community would like to know a lot more about what is going on at the hospital. Live streaming the board meetings would help considerably, so people in outlying communities wouldn’t have to come to meetings.

Candidates were asked to talk about themselves as a person.

Bradley: I grew up in western Washington, in a coal mining town, and we raised kids in Enumclaw. It grew from a dairy farm town to a mini metropolis, and it took going through 36 stoplights to get to work. So when our son was getting out of high school, and we were 40 years old, we quit our jobs, and landed in Tonasket.

Nelson: I moved here from Wenatchee in 1994 when I married; my husband was already here. We have two Vizsla, a type of hunting dog, and we love to go camping to keep them exercised. I have gone to the Tonasket Bible Church the last six years.

Pfeifer: A friend did not want me to say I came from the west side, well all of you know I am a coastie, since I said I worked at Children’s Hospital. I spent my whole life there until nine years ago, and I was so glad to get out of there. I love it here, we moved up to the Aeneas, my husband and I; he is no longer with us. I live off Highway Seven on two acres, most of it grass, and I have a dog I absolutely love; he is my dear friend and companion. I don’t get to see my kids much but love it when I do. I talk to them all the time, they are wonderful kids. I have lots of brothers and sisters here in Washington. I like gardening, and have lots of flowers and I’m good at lawn mowing.

Casey: I was born in Omak a long time ago and moved to the Methow, where I graduated from Winthrop High School. It is a beautiful valley and as life would have it, I got married and we moved 17 times, he was offered a job in Tonasket, and our kids all went to THS. I enjoyed all those things, the fellow in my life is a special friend and we’ve been married 50 years. A child passed away, but we have two grandsons and great grandsons. I am active in the community in a lot of ways, and that’s important to me. I attended several churches and decided Tonasket Community Church, that’s the one I wanted to be in. We also keep track of our island on the river and enjoy our time gardening and a doing a little bit of traveling. And I love this community and all our friends and family.

Tibbs: I was born here in 1975, I graduated from THS, and am proud to be from this community. I was an Ellisforde kid; my dad is from Oroville, and my mom is from Tonasket. I grew up on our apple orchard riding dirt bikes and driving tractors, it’s a great place to grow up and live. We have two great children, I met my wife here. After graduating, I moved away to Seattle and went to college, did lots of jobs, including software support, I built hot tub covers, delivered uniforms, then left and went to Ephrata, Moses Lake, the Tri-Cities, and decided to come home and run the family business and get back involved with the community that helped raised me. I attended Tonasket Community Church my entire life, but we got married in the Elliforde church because the Tonasket church wasn’t big enough for all our friends and family to attend. I always called this home no matter where I lived. I always enjoyed football. AndI was a Mr. T here. I also enjoy golfing, vacationing with my family and sitting around with them in the evening.

Alexander: My wife Kari was here at the forum earlier, but she had to leave because our daughter in high school is playing powderpuff football tonight, and our other daughter is playing volleyball tonight in Omak. I moved here from LA, my family emigrated there from Great Britain. I have been a builder most of my life, a union carpenter, a journeyman and trained in the arts of carpentry. I have built dozens of custom homes, and ended up working a second year at Veranda Beach, where I hired local kids. I am not working as a contractor now. I worked at the hospital five years, but am not employed now, as I am taking care of my mom in California with my brothers. LA changed really quickly, so when Kari and I got together and started to raise a family, we bought her grandma’s house and have been happy here ever since.

Questions from the audience:

Question directed to Bradley: You were asked to answer on the policies and investments needed and you talked about healing the community. What does that look like to you?

Bradley: As a spectator at board meetings the last few months, and in conversations I’ve had with employees, I think there are a lot of relational issues between the board and the community and the board and employees. I think if they could feel free and open to talk and ask questions, even if response is down the road, to be confident they would get a response and have a channel where they could get questions answered and know they are going to get a response.

Comment from audience: Over the years my concern has been the board has to make decisions that people don’t like, but I think you can always do it if you explain why. The last few years, why haven’t we explained to people, then even if they don’t agree at least they understand. Why don’t we tell people? We gotta be willing to talk.

Alexander: I agree with his comment.

Nelson: This is not necessarily an answer, but we’ve seen as board members we don’t have a regular attendance from the community members. A lot of meetings there’s nobody there unless there’s an issue there. A lot of times we have discussed these issues and the paper hasn’t picked it up or it’s not reported on, so if you don’t attend on a regular basis, you miss all that history. So if you don’t attend, you miss all those facts.

Question directed to Bradley: what is your view on transparency and having the board be open?

Bradley: It’s important to have transparency in any type of position like this in the community. I know that there is confidentiality stuff that has to be watched over, and I don’t want to sit on this side of the fence and throw rocks when I’ve never sat on that side, but I feel there should be more transparency. I won’t know until I am sitting there, but yes, I believe it should be transparent.

Mikaela Marion: The hospital is trying to move in a way of whole person care, with behavioral and mental health included. Clarice is on board with potentially being an ACH (Accountable Communities of Health), and I wonder if you all have the time to invest in this area, and would you be interested in that or able to pick up the slack if Clarice is not in that position?

Tibbs: Yes. It’s a huge commitment of time, a very important time,and you don’t realize until you get involved. I was appointed, I replaced Teresa Hughes, she said, “you have a lot of opinions, why don’t you become a board member?’ Come to find out, you can spend 40, 80, 200 hours real quickly. Clarice spends a lot of time reading in the evenings, and not sleeping; I’ve lost a lot of sleep over some of the decisions that have been made. Clarice attends all the new employee hires, once a month. Also finance meetings, medical staff meetings; it’s a big commitment of time, you have to be willing to not be at work that much and to be available at any time. You get called at all hours at any time. When we had the fires here recently, you need to be there to support the employees and the community. If anyone wants to get involved on any board I recommend having lots of freedom.

Question to Tibbs: What do you feel as a newer board member, are a few of your biggest challenges?

Tibbs: The biggest is I did not want to see the Assisted Living closed, but the board had to make a tough decision. I thought hiring Sarah and now Mikaela in that role is the most important decision I had to make, to develop that position and have that person out in the community. And Sarah and Mikaela have done a great job, so that they are available to you and they can come back to the board and let us know what the community wants. I want all of you on the hospital’s side. We have to have the hospital there, it is really important.

Marcus Alden: Thank you Marylou for putting this together, and I appreciate all the candidates showing up, that is what democracy is about. Some things I learned from the military are accountability and personal responsibility. My vote has value, your vote has value; my tax dollars have value, your tax dollars have value. I could ask everyone here many questions, but you solve problems by addressing leadership. So my question to Helen Casey is, explain to me why my vote is of value to you. Under your leadership, I am concerned about these board members who should have been trained once they were in the position they were elected in. The hospital has almost failed, and there are lots of lawsuits against it right now. When you worked at Wells Fargo the hospital banked there, now you work at Umpqua and the hospital banks there. Why is my vote of value if it is in conflict with what you stated?

 Casey: We all bring a voice to what is right. I am a banker and the hospital has been able to do banking at whatever bank they want to. I am on the finance committee, so I am aware of what comes and goes out of the accounts. Why we almost failed, an act of 1996 started not being reimbursed for what we do. Unfunded mandates. At the time we did not have the strong controllers, until we were able to gain that type of person knowledgeable. In response to why we did not hire the right people, it does take time and not everyone wanted to come to Tonasket. When you look at what we did and what we had, they are not easy decisions. When we sold the clinic in Oroville, Medicare said you will wait on 12 or 15 people and they were only waiting on five or six. We went from almost four million dollars in registered warrants, to now no longer in warrants. We did a lot of great things. I do need your vote because it’s the right thing to do because I care and you care.

Comment to Nelson by Loretta Beaughan: I was offended you said no one has attended the meetings. I and a friend have been going to the meetings without fail, for seven or eight years.

Nelson: I apologize, her and Linda Noon have been very faithful in attending our board meetings.

Question from audience: I want to ask about your fiscal integrity. In 2015 I had a routine colonoscopy. The clinic in Oroville sent me to Omak, I talked to scheduling, asked how much, and they said between $1500 and $18000. My copay was $15. Seven months later my husband went to NVH, and had it done. He had no prior issues. The procedure was done in July 2015, and a month later our insurance contested the bill for the same procedure I had and they paid. I know there is difference between maintaining a hospital facility and a clinic, but it was the same procedure. Our insurance said they refused to pay a bill of $7,200. After four months of our insurance company working on it, the fee came down to $5,400. Our insurance paid their share. We were left with $1500 out of pocket. My question is, how are we supposed to support the hospital when this is the kind of thing that happens. Are you in a position as a commissioner, in terms of setting fees for procedures?

Casey: I am very sorry that took place, there is a fee schedule, and we also have a charge master who sets prices for procedures. I’m not sure, but I would like to have had you see our CQI person who may have assisted you in that. I don’t know the prices, I have not gone shopping, but we do need to be aware of that sort of thing.

Aaron Kester, question to all six: What three issues are you going to strive to make changes to, if elected?

Alexander: Finishing the surgery downstairs, so it’s not only there for us if we get hurt, but vital to the OB. Dr Wilson at the clinic cannot see patients that are pregnant and follow them through if he cannot perform c-sections. Second would be the geothermal project, we need to come up with a plan consistent with the previous and third, have a steering committee.

Tibbs: The relationship with the community, the surgery center and third, to get the employees to know how much we know we support them. Without them, none of us get taken care of. We can never not pat them the back enough.

Bradley: First, to educate myself to know and understand everything in order to make good decisions and to prioritize things. Second, the relationship with the community and the employees has to be addressed. Third, a high priority for the board is to support the administrator; to support him and keep him and make his job effective.

Nelson: Our employees, and the surgery center, we need to get that settled. I agree with Matt, we have to be able to have the c-section available for prospective moms. A collaboration with the other healthcare entities in the area. With the whole person care initiative, we are going to be integrating behavioral and mental health care.

Pfeifer: The employee issue is a big one, not sure of appreciation by staff or board, and employees are afraid to talk for fear of retaliation. I’ve seen too much of that, no matter how much the board says otherwise. We need more transparent board meetings and more discussion. I’m not used to a board meeting where there’s an agenda item and you vote up or down with no discussion about that. How can a community know what’s going on if there is no discussion? Since these are open public meetings, they need to be doing a better job. Having solid professional staff, nurses and doctors, is extremely important and I know how hard it is to recruit to this area in Tonasket, so we need to do a better job and make sure they stay. The surgery center is very important and needs to get done, we need to be diligent with work done on that proposal.

Casey: It’s all about you, the community. We have done some exciting things for our staff, we’ve just gone through union negotiations, and the opportunity to share what transpired there could help in mending fences. Some of those folks go above and beyond. We have had lots of change and change is tough. I don’t know if the change is done, but we have to have the employees’ trust. The last couple of board meetings when people from our facility were sought out about what they did or didn’t do, that’s not the way to make things happen. We have a surgery center in great need, we did some planning along the way with the steering committee and we are committed to do the basement. We will do good but have a lot of things on our plate, the geothermal and the generator we need. There’s a lot of issues we need to come to the plate, but we need to have professional healthcare quality close to home.

NVH employee Wes Torzeski: You mentioned mentoring and how important it is. In what ways do you feel you mentored effectively the last CEOs that you had? And how were you effective in mentoring the last one?

Tibbs: Ron’s (O’Halloran) been around a long time, I think he mentored me more than I could ever mentor him. I gave my opinion to him, and made suggestions, but CEOs have a tough job. They hear lots of voices from lots of people in the community, their employees, their boss, I would not want to be a CEO. I do mentoring financially, watching taxpayer dollars. I ask lots of questions, that’s where I mentored Ron; I told him to watch every penny, spend it wisely, be conscientious of taxpayer dollars, talk to the community, talk to employee. You say those things and ask them to do these things and you hope they do but that does not always mean they do what you ask.

Nelson: I’m not in a mentoring position with the CEOs, I mainly learn from them. Healthcare is changing so quickly and CEOs have been very knowledgeable in that area, so I learned more from them than them from me.

Kristen Super: I have a couple comments, I got a bill that was messed up. I recently had an ultrasound, and I received a bill for $3,000 for emergency room services and IV therapy, and I was not even in the emergency room. Is this happening to others? And second, to board members, Ferry County and Mid-Valley Hospitals do not have a COO. Why does NVH feel it’s necessary to have a COO when other hospitals the same size do not, and when that money could have been spent to better meet the needs amongst the staff, which would raise morality. Why does NVH need this?

Casey: When we had the opportunity when Mike Zwicker was gone, we had Ron come and spend time with us and review where we were at and where we were going and major issues, such as the geothermal project, the surgery suite, a lot of big projects. Basically we decided that was the right thing for us to do. A person after the interviews had a great wealth of knowledge and we felt would be able to do those things and so we changed some of the senior leadership.

Question from a local business owner: The hospital receives money from local taxes, state and federal. Most of it is from federal insurance, medicare and medicaid. The effort to repeal and replace lost by one vote. How do you foresee it if that happens; can this hospital survive and function without that?

Casey: Taxes do make a difference. We have a 24 million dollar budget. County taxpayers pay about five percent of that. The feds want to deliver block grants to replace some of the Medicaid done by the state. What’s going to happen to Tonasket and Okanogan County I don’t know, but I can see that block grant going to Seattle or Tacoma but not rural communities. They want to give the medicaid back to the states in a block grant, a much smaller amount.

At the close of the meeting, Bartleson suggested anyone who did not have the opportunity to ask a question write down their question with their name and address, as candidates agreed ahead of time to call and discuss any questions voters might have. To contact your candidates, visit the Okanogan County Auditors page and choose ‘Candidates Who Have Filed’ under ‘Elections.’