Fall 2025 Levy Lid Lift
Overview
Documents
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 Proposition One passes, the Hospital District would expand healthcare services and support for healthcare workers by doing the following:
- Expand access for senior care that serves more island residents in need. Village at Home provides healthcare and companionship services to Island residents who wish to age in place. A lid lift would fund a financial assistance program for individuals who do not have the means to cover the cost of home care.
- Help secure careers on San Juan Island for healthcare workers. There is a clear need in our community for more housing and supportive services for essential healthcare workers. This would help ensure our workforce can continue to live in the community they serve.
- Expand Emergency Services so that they are there when you need them most. San Juan Island EMS’s Community Paramedicine Program helps Island residents avoid needing to use emergency medical services for preventable health care services.
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.”
Lid Lift Documents
Explanatory Statement- 2025 Single Year Lid Lift
Lid Lift Resolution No. 25-616
FAQs
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 COST | LEVY RATE CHANGE IMPACT |
| Expansion of Charity Care and Home Care | $423,600 | 0.06 | |
| 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 | $532,029 | 0.08 | |
| 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 | $72,330 | 0.01 | |
| 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) | $236,000 | 0.03 | |
| Leadership/project mgmt (annually) | $220,000 | ||
| Admin office/conference space remodel (one-time expense) | $200,000 | $16,000 | |
| EMS infrastructure and Equipment ** | $77,370 | 0.01 | |
| 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 | $1,341,329 | 0.20 |
*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
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Regular Board Meeting & Budget Hearing November 19th, 2025, at 4:00PM
The next Regular Board Meeting & Budget Hearing of SJCPHD No. 1 will be held this month on Wednesday, November 19, 2025, at 4:00 PM. The meeting will be held in person at the Hospital District administrative offices, 535 Market Street, Suite E. There will also be an online and remote component using the Teams platform. To join…
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Fall 2025 Newsletter
San Juan Island faces unique challenges in meeting the healthcare needs of its residents. Our home care program, Village at Home, and San Juan Island EMS’ Community Paramedicine program, are working together to build a new model of care that bridges gaps and strengthens support for our neighbors through supportive home services. Community Paramedicine began…
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Regular Board Meeting October 22nd, 2025, at 4:00PM
The next Regular Board Meeting of SJCPHD No. 1 will be held this month on Wednesday, October 22, 2025, at 4:00 PM. The meeting will be held in person at the Hospital District administrative offices, 535 Market Street, Suite E. There will also be an online and remote component using the Teams platform. To join the meeting online…
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Now Hiring a Medication Technician, Village at the Harbor
Full-time or part-time available , starting at $22.00 per hour Position Requirements: Home Care Aid (HCA) or Certified Nursing Assistant (CNA) License The Med Tech’s role is to maintain current, “on hold” and backup medications for each resident, to maintain medication records and other documentation and to provide medications to residents for self-administration, always fostering…
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Regular Board Meeting September 24th, 2025, at 4:00PM
The next Regular Board Meeting of SJCPHD No. 1 will be held this month on Wednesday, September 24 , 2025, at 4:00 PM. The meeting will be held in person at the Hospital District administrative offices, 535 Market Street, Suite E. There will also be an online and remote component using the Teams platform. To join the meeting…
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Regular Board Meeting August 27th, 2025, at 4:00PM
The next Regular Board Meeting of SJCPHD No. 1 will be held this month on Wednesday, August 27, 2025, at 4:00 PM. The meeting will be held in person at the Hospital District administrative offices, 535 Market Street, Suite E. There will also be an online and remote component using the Teams platform. To join the meeting online…


















