Fall 2025 Levy Lid Lift

Overview
FAQs
Finances
About the District/Learn More

Overview

In the Special Board Meeting that took place on July 10th, 2025, San Juan County Public Hospital District No. 1’s Board of Commissioners voted to present a ballot measure for a levy lid lift. This lid lift will appear on the Fall 2025 ballot.

The decision to lid lift, or ask the public for further funding, was made due to the growing needs of our Island community. With recent federal changes leading to a potential reduction in healthcare coverage—particularly in Medicare— the District is taking proactive steps to bridge the increasing gap between our community’s healthcare needs and their access to essential services. Commissioner Trish Lehman noted in the special board meeting that, “On this island we need to be prepared to take care of each other. I’m concerned about vulnerable populations.”

If the lid lift is approved, the District plans to add Medicaid for home care, work on converting short term rentals into long term housing for healthcare workers, and expand the scope of San Juan Island EMS’s community paramedicine program.

Financial Assistance Program: In 2024, the District launched Village at Home, which provides healthcare and companionship services to Island residents who wish to age in the comfort of their home. If the levy lid lift is approved, the District intends to launch a financial assistance program to ensure that Island residents without adequate insurance or financial resources can still receive essential healthcare services in the comfort of their home.

Housing for Healthcare Workers: There is a clear need in our community for more housing, especially for essential workers. The District currently employes over 70 employees, all of whom are crucial to providing emergency care and support. If voters approve the lid lift, the District intends to purchase short-term rentals and convert them into long term housing for healthcare workers. This would help ensure our workforce can continue to live in the community they serve.

Community Paramedicine: San Juan Island EMS’s Community Paramedicine Program helps Island residents avoid using 911 and the Emergency Room (ER) for preventable health care services. While the District is already taking steps to expand this vital service, approval of a lid lift would allow for a broader reach and greater impact—bringing more care directly to those who need it most.

The choice to expand services is a decision the community can make through voting in the upcoming local election. Superintendent Nathan Butler noted that, “We always approach asking the public for funding with caution. Ultimately the public decides what matters to them.”

FAQs

    • This Hospital District is a local government taxing district that relies on property taxes to own and operate the following services:

    • Village at the Harbor: The only assisted living community in the county for people who are 65 years or older. It is located in the heart of Friday Harbor.
    • San Juan Island EMS: Provides emergency medical services and transport for people in need on San Juan Island and nearby islands like Brown, Henry, Pearl, Speiden, Johns and Stuart.
    • Village at Home: Established in 2024, this branch extends our mission by offering compassionate, in-home care to island residents, supporting their independence and well-being.

    A levy lid lift is a voter-approved measure that allows a local taxing district—like our hospital district, a school district, or a library district—to increase its property tax levy beyond the state-imposed annual limit of 1%.

    In light of state and federal spending cuts, local labor housing shortages, and unmet healthcare needs, this lid lift will enable the district to expand healthcare on San Juan Island.

    This lid lift is a permanent one-time increase.

    For a $500,000 home, this lid lift would increase taxes by about $100 annually. For a $1,000,000 home, this lid lift would increase taxes by about $200 annually.

    The district’s current rate is $0.5067 per $1,000 in assessed value. The lid lift would increase this rate to $0.71 for 2025 (for collection in 2026).

    If the lid lift passes, the Hospital District will expand healthcare services and support healthcare workers who provide those services. Some of these services include:

    Village at Home: In 2024, the district launched Village at Home, which provides healthcare and companionship services to Island residents who wish to age in the comfort of their home. If the levy lid lift passes, Village at Home intends to expand Medicaid services (low-income health insurance) and start a financial assistance program for individuals who do not have the means or insurance to cover the cost of home care.

    Housing for Healthcare Workers: There is a clear need in our community for more housing, especially for essential workers. The district currently has over 90 employees and volunteers, all of whom are vital to providing healthcare. If voters approve the lid lift, the district intends to purchase short-term rentals and convert them into long term housing for healthcare workers. This would help ensure our workforce can continue to live in the community they serve.

    Community Paramedicine: San Juan Island EMS’s Community Paramedicine Program helps Island residents avoid needing to use emergency medical services for preventable health care services. While the district is already taking steps to expand this vital service, approval of a lid lift would allow for broader reach and greater impact—bringing more care directly to those who need it most.

    If the lid lift does not pass, the District will continue to offer its current services, but will not expand services.

    PeaceHealth is a separate entity from the district. PeaceHealth has many locations across the region. Their Friday Harbor location, Peace Island Medical Center (PIMC), receives a subsidy from the district to support its operations. However, it operates independently of the district and is not a part of the district.  

    This measure will be on the Fall 2025 ballot. Election day is November 4, 2025.  

    A simple majority, or 50% plus one voter.

    The District is happy to answer any questions you may have. Please contact 360-378-2857, or check our website, www.sjcphd.org for more information. Other groups may provide information for or against this project.

    Finances

    Core Services

    The Board determined that the following considerations should be the primary focus of our future focus:

    • Select EMS infrastructure and equipment needs
    • A simplified Housing for Healthcare project
    • Select Village at the Harbor infrastructure projects and ensuring that there are reserve funds for future capital expenditures
    • Village at Home overhead costs
    • Expansion of charity care and community paramedicine
    • Administrative support for expanding services
    • Staffing to support infrastructure

    Please see below for a breakdown of the specific projects and their cost breakdown.

    Proposed Projects and Cost Breakdown

    PROPOSED PROJECT BOND YIELD REQUIREMENT (COST) ANNUAL COSTLEVY RATE
    CHANGE IMPACT
    Expansion of Charity Care and Home Care  $423,6000.06
    Additional home care worker dedicated to low income (annually) NA $110,000 
    Nurse for Community Paramedicine Program (annually) NA  $150,000 
    Additional administrative costs and overhead (annually) NA $150,000 
    Vehicle – van or truck (5 yr loan) $60,000 $13,600 
        
    Housing for Healthcare – Simplified Plan   $532,0290.08
    Purchase of property (one-time expense) $4,000,000 $329,600 
    Renovation, $1 million total (one-time expense) $1,000,000 $82,429 
    Additional staffing needs (annually) NA $120,000 
        
    Village at the Harbor Infrastructure Investments  $72,3300.01
    Roof replacement (one-time expense) $250,000 $21,165 
    Install electronic locking systems (one-time expense) $250,000 $21,165 
    Increase capital reserves (annually) NA $30,000 
        
    Growth Package (Admin Support)  $236,0000.03
    Leadership/project mgmt (annually) $220,000 
    Admin office/conference space remodel (one-time expense) $200,000 $16,000 
        
    EMS infrastructure and Equipment **  $77,3700.01
     Air conditioning and heat pumps (one-time expense; financed through Opalco Switch It Up Program or similar — 3% / 10 yrs. $250,000 $29,370 
    Life Pak monitors (One-time expense; financed through Washington State LOCAL Program or similar — 3.38% / 10 yrs. $400,000 $48,000 
    TOTAL ASK  $1,341,3290.20

    *Based in part on 20 year general obligation bond or similar instrument
    ** Covered for first three years under general levy then transferred to renewed EMS levy

    About the District

  • Rick Frazer (left), Commissioner and Nathan Butler (right), Superintendent
    • Learn more about the hospital district
    board meetings