For all the handful of people who enjoy this fun Hospital Commissioner website for Matt Ready, I have added a fascinating and fun new feature! It is a virtual avatar of me you can talk to right now!! I cant gaurantee what it will say, but you might have fun talking to it. Please dont rely upon it for anything important- as I don’t actually have a record of what it says or really know how to control it. But sometimes it gives better answers to questions than i would. shrug?? click the “Talk to Matt Ready’s Virtual Avatar Live!”

Fraud is deception for personal gain.

Minor fraud is deception for personal gain that will never be prosecuted because the system only cares about explicit financial damages.

Experts in local politics, especially in the healthcare industry, know how to use hundreds to thousands of acts of minor fraud as an overwhelming blanket of action to craft the world to their desires- based on the agenda of whoever it is they follow and obey.

For the record, i obey my oath of office to defend the constitutions of Wa and the USA- in my role as elected public hospital commissioner. In the rest of my life, I rely mainly on unbridled honesty and the noble quest for happiness and global utopia.

I bet the practice of using thousands of acts of minor fraud to gain major advantage is probably a tactic used everywhere in local politics.

https://www.ptleader.com/stories/leak-sheds-light-on-plan-for-hospital-alliance,204196?

Leak sheds light on plan for hospital alliance

Jefferson Healthcare along Sheridan Street in Port Townsend.

Leader photo by Alex Frick

Posted Wednesday, April 9, 2025 3:00 am

By James Robinson

An effort to create a new regional health alliance between Jefferson Healthcare and Olympic Medical Center appears to be moving forward, with leaked project planning documents describing particulars of how an alliance might ultimately play out.

The project documents, acquired by The Leader, followed comments made by Jefferson Healthcare Commissioner Matt Ready at the March 26 meeting where he accused his co-commissioners of meeting secretly with OMC representatives to merge the two organizations.

Called Project Driftwood, the Jefferson Healthcare proposal calls for the formation of the Peninsula Health Alliance, effectively a not-for-profit alliance which project documents say would allow Jefferson Healthcare and Olympic Medical Center in Port Angeles to remain independent, while improving and expanding clinical programs, creating operating efficiencies and economies of scale and the ability to improve and expand clinical programs.

The plan, according to Project Driftwood documents, calls for a 12-member “super board” — with seven board members from Olympic Medical Center and five from Jefferson Healthcare. According to the plan, all currently elected commissioners would sit on the super board and the super board would govern the regional health alliance while individual boards would remain responsible for governance of their own organizations.

The proposal calls for a three-year phased-in leadership approach, with an appointed executive director planned for the first year. Project documents propose that Jefferson Healthcare Chief Executive Officer, Mike Glenn, would serve as the alliance’s first executive director.

“Frankly, many of the opportunities embedded in this model have been deliberated for years,” according to Project Driftwood documents. “Olympic Medical Center and Jefferson Healthcare have been strong partners for decades. We share the same governance, leadership and medical group models, electronic medical record and perhaps most importantly, commitment to excellence cultures.”

Project Driftwood is the outgrowth of an OMC decision announced in December 2024 to hire Juniper Advisory Group to guide them through a process to decide if they need a partner, and if so, who that partner should be. Roughly 20 organizations were invited to submit proposals, including Jefferson Healthcare.

“We are still in the preliminary stages of the exploration process,”said Bobby Stone, director of marketing and communications for Olympic Medical Center. “We received inquiries from several interested parties and are engaged in a due diligence process to learn more about these organizations. We are bound to confidentiality about who these interested parties are.”

A key player at Jefferson Healthcare also noted the non disclosure agreement as reason for their silence.

But no one from the organization has made public mention of the plan to submit a proposal and the other commissioners have remained quiet about Project Driftwood.

“A subset of Jefferson commissioners were involved or consulted during the drafting phase,” Ready said in a previous interview. “I was not. I only became aware of the proposal during the executive session on February 5. The full board has never voted to authorize the proposal or the direction of the negotiations. Much of the process has taken place out of public view, contrary to the principles of public hospital governance.”

Kolff said in the meeting that “all of our actions have been legal according to our legal counsel.” He also stated that Ready was “in violation of the board’s ethics policy.”

Emails provided by Ready show correspondence between Jefferson Healthcare Commissioner Kees Kolff and Jefferson Healthcare top executives, discussing the merger plan, and Kolff’s efforts to draft language and an organizational chart.

“Thanks for the conversation with Mike about this exciting possible alliance the other day, and thanks for the opportunity to share some ideas for edits on the organizational chart and the governance comments that go along with that,” Kolff wrote to Pranav Sharma, head of strategic planning, marketing and communication for Jefferson Healthcare. “I have attached a reworded narrative. There were too many edits to make ‘show changes’ useful,” the email stated. It was copied to Mike Glenn, Shannon Groff and commissioners.

At the March 26 commissioners’ meeting Ready made his concerns public and alleged that members of the board had been negotiating secretly with representatives of OMC. Ready further alleged that members of the commission had violated open meeting laws and abused the use of executive session.

When asked about the use of executive session to discuss the possible alliance, Jefferson Healthcare Commissioner Jill Buhler Rienstra did not respond to requests for comment. According to Kolff, Buhler Rienstra is out of town this week, and he was traveling and not able to provide a complete comment by presstime.

Should Olympic Medical Center continue its evaluation of the Jefferson Healthcare’s proposal, the next step would involve representatives from Jefferson Healthcare visiting OMC facilities for a site visit and further discussions. Olympic Medical Center project documents indicate the agency would make a decision in April or May on whether OMC will pursue a partnership.

The OMC decision to seek a partner comes amidst myriad financial challenges, including federal cuts and halts to Medicaid reimbursements.

I received the following inquiry from the Port Townsend Leader reporter James Robinson (My response follows):

Hi Matt,
1. Can you describe the content of the secret negotiations you alleged in last week’s commissioner’s meeting? What’s the goal/objective?
2. Who was involved — the board of commissioners, hospital management?
3. What is the Peninsula Health Alliance?
4. Is this regarding a partnership/merger with Olympic Medical Center?
It’s clear by the audio that you don’t like how this is going down. What do you propose as an alternative?
That’s the gist.
Thanks in advance.
Kind regards,
James Robinson

Hi James,

Thanks for reaching out. I appreciate the opportunity to clarify my concerns.

---

1. Content of the “Secret Negotiations”

In early February, the Jefferson Healthcare Board was presented in executive session with a draft proposal for a new nonprofit entity called the Peninsula Health Alliance. The plan would create a “super board” above both Jefferson Healthcare and Olympic Medical Center (OMC), shifting significant governance authority to this new structure.

The proposed board would give Clallam County 7 seats and Jefferson County 5, creating an automatic voting majority for Clallam over decisions that affect both communities. It was also discussed that Jefferson Healthcare’s CEO, Mike Glenn, would likely become the Executive Director of the new Alliance.

These foundational decisions—board structure, leadership, governance—were never authorized by public vote and were not disclosed to the public, despite their far-reaching implications.

In a second executive session—this time with the hospital’s attorney Brad Berg—commissioners were informed of a strategy to move forward using what CEO Glenn referred to as a “binding non-binding” agreement with OMC. The intent was to appear as though public input was still pending, while legally committing Jefferson Healthcare to the plan. Brad Berg confirmed this could be achieved by having the board authorize the CEO to sign a letter of intent, effectively binding the district before public engagement.

---

2. Who Was Involved

The proposal appears to have been developed by CEO Mike Glenn and some JHC Commissioners in coordination with:

• OMC’s executive leadership (though it’s unclear how involved their board was),
• A firm called Juniper Advisory (based in Chicago),
• And Jefferson Healthcare’s legal counsel, Brad Berg of Foster Garvey (formerly Foster Pepper PLLC).

A subset of Jefferson commissioners were involved or consulted during the drafting phase. I was not. I only became aware of the proposal during the executive session on February 5. The full board has never voted to authorize the proposal or the direction of the negotiations. Much of the process has taken place out of public view, contrary to the principles of public hospital governance.

---

3. What Is the Peninsula Health Alliance?

The Peninsula Health Alliance (PHA) is the proposed nonprofit entity that would oversee a joint governance structure for Jefferson Healthcare and OMC. While the proposal claims both hospital districts would retain their autonomy, the Alliance’s board—with a built-in Clallam majority—and a central Executive Director would control strategy, operations, and potentially finances.

There are no legal safeguards currently outlined to prevent future changes to the Alliance’s structure—such as removing public commissioners or closing meetings to the public.

---

4. Is This a Merger with OMC?

It is not being called a “merger,” but the effects would be similar. The phased partnership creates a shared governance body, a central executive, and a new layer of authority above both public boards. That structure could drastically shift power away from our elected commissioners and undermine local control—a change that deserves the same level of scrutiny as a formal merger.

---

5. My Alternative Proposal

This process must be stopped until it’s made transparent, legal, and accountable. I propose:

• A public vote by the board before submitting any proposals on behalf of Jefferson Healthcare.
• A new general council hired immediately and directly by the Jefferson Healthcare board who is not implicated in the potential wrongdoing of this secret negotiation process and who does not report in any way to the CEO or the CEO staff.
• An independent legal review to evaluate compliance with Washington’s Open Public Meetings Act (OPMA).
• An independent financial analysis to understand the true impact on patients, taxpayers, and services.
• Public forums and community engagement before any commitments are made.
• Internal and external investigations and audits to prevent future governance breakdowns.
• A review by organizations like the Washington State Hospital Association, the Association of Public Hospital Districts, and MRSC, to help other districts avoid similar missteps and uphold public trust.

This proposal may contain elements worth exploring—but it must not proceed in secrecy or under the illusion of transparency.

I’m happy to provide sources, timelines, transcripts, and documents to support all of the above.

I have written and shared more information on this on my Hospital Commissioner website:  http://readyforhealthcare.org including transcripts, meeting video clips, and commentary by AI that I have asked to help review these events and information.

Thank you for your interest,

Sincerely,
Matt Ready
Commissioner, Jefferson Healthcare Board

Posted April 1, 2025 | By Commissioner Matt Ready

Below are direct links to the two key documents related to Jefferson Healthcare’s proposed partnership with Olympic Medical Center (OMC):

📄 Draft Proposal

“Commission Packet.pdf” – Dated February 5, 2025
This draft was discussed in executive session and emailed to all Jefferson Healthcare commissioners.
👉 Download Commission Packet.pdf

---

📄 Final Submitted Proposal

“Jefferson_Healthcare_Peninsula_Health_Alliance_FINAL (4).pdf” – Dated February 12, 2025
This is the final proposal submitted by Jefferson Healthcare to OMC in response to their public RFP.
👉 Jefferson_Healthcare_Peninsula_Health_Alliance_FINAL (4).pdf

---

I will be posting the full transcript of events, correspondence, and board actions related to this proposal below. These records are provided to ensure transparency and accountability in the governance of our public hospital district.

— Matt Ready, Commissioner
Jefferson County Public Hospital District No. 2

---

00:00:00:00 – 00:00:34:10
Commissioner Jill Buhler
Okay. Welcome to the Jefferson County Public Hospital. District number two, board of commissioners specials. Regular meeting on Wednesday, March 26th, 2025. This session is being officially audio recorded and time shown on the agenda are estimated only. And speaking of the agenda, we will not be having an executive session today. So, is there a motion to approve the agenda with that exception?

00:00:39:21 – 00:00:42:24
Commissioner Jill Buhler
so moved and seconded. Is there discussion?

00:00:42:26 – 00:00:49:00
Commissioner Matt Ready
I would like to, motion to amend the agenda.

00:00:49:03 – 00:00:54:05
Commissioner Jill Buhler
Okay. What is your motion?

00:00:54:07 – 00:01:09:27
Commissioner Matt Ready
I would like to amend the agenda to discuss, what we were talking about at the end of the last meeting. Potential regional alliances and legal concerns that I’ve brought up.

00:01:10:00 – 00:01:19:10
Commissioner Jill Buhler
Is there a second for that amendment?

00:01:19:12 – 00:01:43:01
Commissioner Jill Buhler
Ok I’m not hearing the second to the amendment, so we won’t be adding that to the agenda. We can add it to, future agenda, possibly. So we at this point, we’ll go back to the main motion and, and ask for approval of the agenda as it stands, without the executive session.

00:01:43:03 – 00:01:49:15
Commissioner Matt Ready
So we still are in discussion. I have comments on the motion.

00:01:49:18 – 00:01:53:21
Commissioner Jill Buhler
All right.

00:01:53:24 – 00:01:55:26
Commissioner Kees Kolff
Point of -point of order.

00:01:55:29 – 00:01:57:09
Commissioner Jill Buhler
Yes.

00:01:57:12 – 00:02:04:21
Commissioner Kees Kolff
Unless the motion has been seconded, then there is no discussion about the motion.

00:02:04:23 – 00:02:05:27
Commissioner Jill Buhler
Oh Kees. Thank you.

00:02:07:01 – 00:02:15:10
Commissioner Kees Kolff
Robert’s rules require a second in order to have folks be able to comment about it.

00:02:15:13 – 00:02:19:27
Commissioner Matt Ready
I have comments on the motion.

00:02:19:29 – 00:02:28:21
Commissioner Jill Buhler
Point well taken. And, we will go back to the main motion and ask for a umm,a vote. All in favor?

00:02:28:24 – 00:02:34:15
Commissioner Matt Ready
We are in discussion of the main motion, I have a comment on the main motion.

00:02:34:18 – 00:02:42:22
Commissioner Jill Buhler
All right. What is your comment?

00:02:42:24 – 00:02:58:19
Commissioner Matt Ready
Well, I feel like we, the agenda is radically incomplete. There’s some serious stuff that we need to talk about. In particular, the fact that Jefferson Healthcare-

Commissioner Kees Kolff
Point of order.

Commissioner Jill Buhler
uh Yes. We are not. We’re not discussing the benefit of what your motion is. We are discussing whether or not to accept the main motion, which is accepting the, the agenda as it stands, without the executive session.

00:03:18:19 – 00:03:27:14
Commissioner Matt Ready
Yeah. And I’m saying I don’t think we should accept the agenda, and I’m trying to give my reasons.

00:03:27:17 – 00:03:53:11
Commissioner Jill Buhler
I’m going. I’m not going to, pursue this any further. The board does not want to, address your, it it’s not seconding the motion that you made. So therefore, there is no motion. We are going back to the main motion, and you are, I don’t believe you’re in order. Kees do you have a

00:03:53:14 – 00:04:37:06
Commissioner Kees Kolff
I, I, I have a recommendation. I have a recommendation if if you might. Madam chair, what I would recommend is that, you set a one minute opportunity for all of the board members to comment about the the motion and the agenda. That way we all have an equal voice. And because, Commissioner Ready is correct that he does have a right to object to the agenda, but, you have the right as the chair to limit the amount of time that any commissioner has to speak. And I would be in favor of allowing every commissioner to speak one minute on whatever objection. Commissioner Ready has.

00:04:50:11 – 00:05:15:04
Commissioner Jill Buhler
That sounds like a very reasonable solution to this case. Thank you very much. And, we will do that. And, Shannon, can you can you, tell us, give us the goal and and keep the time for us and tell us when a minute is up? Yeah, I’ll set my timer. Okay. Thank you. Matt. Go ahead.

00:05:15:07 – 00:05:19:01
Commissioner Matt Ready
Okay.

00:05:19:04 – 00:05:35:14
Commissioner Matt Ready
Well, I regretfully need to inform the public that Jefferson Healthcare is in secret negotiations with Olympic Medical Center to create something called the Peninsula Health Alliance. This proposal and negotiations have taken place without-

00:05:35:17 – 00:05:35:28
Commissioner Kees Kolff
Point of Order or.

00:05:37:17 – 00:05:39:19
Commissioner Kees Kolff
A point of order

00:05:39:22 – 00:05:48:16
Commissioner Jill Buhler
Yes. This is something that was just discussed, in executive session, and you cannot divulge this.

00:05:48:18 – 00:06:31:13
Commissioner Kees Kolff
And if I, if I could add that that’s a that’s a violation of our ethics and whether commissioner Ready agrees with the majority of the board and our legal counsel. Whether we were appropriately in executive session. That’s his prerogative. But it still does not mean that he has the quote “legal right” to divulge, and stay within the code of ethics to divulge anything in the session that he personally regards as not, along the lines of, permitted executive session. So, I would think that because he has violated that code that you, as the chair, have the right to end discussion of the particular motion and the concern that he has.

00:06:45:02 – 00:07:04:06
Commissioner Jill Buhler
Yes. And that that’s exactly what I’m doing. So I will now give others an opportunity to speak if other members of the board wish to.

00:07:04:09 – 00:07:05:23
Commissioner Jill Buhler
is there anyone?

00:07:06:16 – 00:07:13:03
Commissioner Bruce McComas
Is that to speak to that to speak about that original motion to approve the agenda.

00:07:13:06 – 00:07:13:24
Commissioner Jill Buhler
Yes. That’s what it should be (laughing).

00:07:13:26 – 00:07:16:03
Commissioner Bruce McComas
without The executive session?

00:07:16:06 – 00:07:32:24
Commissioner Jill Buhler
Yes. So if you want to speak to that, Shannon, are we ready for another minute?

Shannon
We are ready.

Commissioner Jill Buhler
All right. Whoever wishes to speak, now’s your chance. Okay, I.

00:07:32:29 – 00:08:10:13
Commissioner Kees Kolff
I that I’d actually like to have a minute. Yeah. I am in favor of the main motion and of this agenda, because I do not believe that it leaves off anything that this board. By a vote of 4 to 1, has agreed to put on this agenda and has agreed that all of our actions have been legal, according to, our, legal counsel and therefore, I don’t think there’s anything missing from this agenda.
And, I so I reckon I will be in favor of the motion to accept, this agenda as is.

00:08:19:00 – 00:08:22:01
Commissioner Jill Buhler
Okay. Marie?

00:08:22:04 – 00:08:31:11
Commissioner Marie Dressler
Yes. I couldn’t have said it better myself. I support exactly what Kees has said, and I certainly will be voting in favor of this agenda.

Commissioner Jill Buhler
Bruce,

Shannon
we’re at time.

Commissioner Jill Buhler
Thanks, Shannon. Bruce.

00:08:37:20 – 00:08:41:04
Commissioner Bruce McComas
I don’t have anything to add.

00:08:41:06 – 00:09:08:27
Commissioner Jill Buhler
All right. And, the chair is in agreement with, Commissioner Kees and Commissioner Dressler. So at this point, I will ask for a formal vote and all those in favor of accepting the agenda without the executive session as it stands, without that, take. I raise your hand. I okay, motion carries 4 to 1. Is there an opposition?

Commissioner Ready
I object.

00:09:08:29 – 00:09:37:29
Commissioner Jill Buhler
Okay, so two, 4 to 1. And, so we will move on. So, first at this month’s meeting is Rob Weiss, our information services director, with a report on cybersecurity. Rob,

[Cut to later part of meeting]

Commissioner Buhler
you know, she’s a valued member of our staff, like, like, everybody that that Colleen is a special person. And I’m so glad you called her out on that.

00:09:38:01 – 00:10:09:12
Commissioner Jill Buhler
Thank you. And thank you for the information regarding, the, the, cybersecurity too, i appreciate it. Okay. Is there anyone else I see Matt’s hand up? Is there any member of the public before I take Matt? Any other Shannon, do you see any. Hands up?

Shannon
No, hands up other than Matt.

Commissioner Buhler
Okay, okay. Matt. I don’t know. This is kind of unconventional, but I assume you’re putting a public hat on now.

00:10:15:05 – 00:10:18:24
Commissioner Matt Ready
Sure. I want to talk As a member of the public.

00:10:18:26 – 00:10:23:29
Commissioner Jill Buhler
All right, three minutes.

00:10:27:26 – 00:10:39:17
Commissioner Matt Ready
umm…It has come to my attention that Jefferson Health Care is in secret negotiations with Olympic Medical Center to create something called the Peninsula Health Alliance. As a member of the public I am very concerned-

[Commissioner Ready muted by the Chair Commissioner Buhler]

00:10:39:19 – 00:10:41:22
Commissioner Jill Buhler
Matt, this is, this is unsubstantiated.- This is an. you are. You are, saying things that are that are unsubstantiated and, bordering on libel or slander at this point. So, I really am not going to allow this if you have something that, that is is can be substantiated. That’s fine. But but you’re not you’re you’re treading on thin ice here.

00:11:19:09 – 00:11:22:02
Commissioner Jill Buhler
Yes Kees?

00:11:22:02 – 00:11:23:05
Commissioner Matt Ready
Do I not get to finish my 3 minutes?-

00:11:23:06 – 00:11:27:13
Commissioner Kees Kolff
I would like to make a motion to close public comment.

00:11:27:15 – 00:11:32:09
Commissioner Jill Buhler
Is there a second to that motion.

00:11:32:11 – 00:11:33:13
Commissioner Bruce McComas
I’ll second.

00:11:33:15 – 00:11:43:23
Commissioner Jill Buhler
Okay. It’s been moved and seconded. uhh Marie… I don’t see you. Okay.

Marie
I’m here.

Jill Buhler
Ok. Any discussion?

00:11:43:26 – 00:11:47:26
Commissioner Matt Ready
Yeah, I have some comments on the motion.

00:11:47:28 – 00:12:07:11
Commissioner Jill Buhler
I don’t think your comments are appropriate since the motion is regarding you. So we will go ahead and take the vote and assume that you’re going to have a negative vote. But you can do that at the end. So yeah. All in favor of cutting off.

00:12:07:12 – 00:12:09:05
Commissioner Marie Dressler
we gotta first call the question.

00:12:10:15 – 00:12:21:10
Commissioner Bruce McComas
Yeah. I, I’m in favor of closing public comment. If there are no other member people from the public, wanting to speak.

00:12:21:12 – 00:12:44:23
Commissioner Jill Buhler
Okay. And and that’s, that’s precisely why I asked if there were and if there are any anybody has, come forward since then. We can talk about that. Otherwise, I’m going to call for the vote. All those in favor of closing public comment, say I raise your hand. and Opposed

00:12:44:23 – 00:12:50:08
Commissioner Matt Ready
Opposed against.

00:12:50:11 – 00:12:51:24
Commissioner Jill Buhler
Matt? Are you opposed?

00:12:51:27 – 00:12:55:03
Commissioner Matt Ready
I oppose,

00:12:55:06 – 00:13:06:10
Commissioner Jill Buhler
all right. So we will now go on to action items. We have minutes from the February 9th, 19th special session.

[jump cut to later in the meeting]

00:13:08:03 – 00:13:20:24
CEO Mike Glenn
Trying to navigate that stuff. And there really are no easy answers.

00:13:20:27 – 00:13:28:00
Commissioner Jill Buhler
So, there’s a hand up. Matt.

00:13:28:03 – 00:13:30:11
Commissioner Matt Ready
Yeah. Can you hear me?

00:13:30:14 – 00:13:32:01
Commissioner Jill Buhler
Yes.

00:13:32:03 – 00:14:04:11
Commissioner Matt Ready
Thanks for that presentation, Mike. I agree, the landscape of health care is very challenging indeed. But, you know, for that reason, I think it’s important that public hospital districts act with integrity and honesty and appropriately transparent with the public. If, Jefferson Healthcare has submitted a proposal to Olympic Medical Center in response to their public request for proposal then that would not be with the approval of the board and that would be an illegal

00:14:04:13 – 00:14:04:25
Commissioner Jill Buhler
Mike, Matt, I am cutting you off right now.

Commissioner Matt Ready
-illegal– [Microphone muted by Jill Buhler]

Commissioner Jill Buhler
Matt! Stop. You are out of order.

00:14:19:08 – 00:14:24:24
CEO Mike Glenn
Are there questions that I can answer? Is there any questions or comments by commissioners about something that I can talk about?

00:14:24:26 – 00:14:32:12
Commissioner Kees Kolff
Yes, I have I’ve got one question. A couple actually.

[Jump Cut later in meeting]

00:14:33:03 – 00:14:35:12
Jake
Jill. He’s out of town.

00:14:35:15 – 00:14:36:05
Commissioner Jill Buhler
Okay.

00:14:36:07 – 00:14:38:12
CEO Mike Glenn
That’s what I thought. I would have cut him off. If he was available. [Referring to another topic]

00:14:41:02 – 00:15:07:23
Commissioner Jill Buhler
Okay. Thanks. Okay. All right. Thank you. That was, very sobering report that nice at the end with, foundation news. So now we’ll go to, board reports. Does anyone have any other information? Kees do you have any information that you’d like to share?

00:15:07:25 – 00:15:27:25
Commissioner Kees Kolff
I do, first I’d like to say that unfortunately, I missed, the Board of Health meeting, last week. So, however, I also want to add that the Climate Action Committee meet, is very, very active.

[jump cut to later]

00:15:31:10 – 00:15:42:16
Commissioner Jill Buhler
Yeah. Okay. All right, Matt, you have your hand up?

00:15:42:18 – 00:15:46:02
Commissioner Jill Buhler
You’re muted.

00:15:46:04 – 00:15:48:13
Commissioner Matt Ready
Sorry. Can you hear me now?

00:15:48:15 – 00:15:50:17
Commissioner Jill Buhler
Yes.

00:15:50:19 – 00:16:08:28
Commissioner Matt Ready
It seems clear by the number of times I’ve been muted during this meeting while I’ve been trying to talk that there’s some sort of, disagreement amongst the board members or confusion about the law and ethics related to topics that you guys keep muting me whenever I start talking about them.

00:16:09:04 – 00:16:38:21
Commissioner Jill Buhler
Matt. Matt. Matt. The this is not an item for discussion. We have decided not to. It is not on the agenda. The board does not want to discuss it. You’re making false allegations here. You are, you know, you you you’re not being clear. And you, our legal counsel, has the opposite opinion of what you’re saying. And our legal counsel, Brad Berg, is a principal of the prestigious Fort Foster Garvey law firm, and he’s a prominent health care attorney with extensive knowledge and experience in public health and hospital laws. He has honors and recognitions that include selection to the Super Lawyers list of the for the top 5% of attorneys. He’s been, best lawyer in America with health care law 1993 to present and all sorts of awards. He is preeminent in this discussion in this, field, and he has made sure he has said that nothing we have done is illegal. Everything we have done is is, on point and you because you oppose it, you keep making these allegations and their false and you know that you’ve heard that. Kees?

00:17:41:02 – 00:17:42:06
Commissioner Matt Ready
So let me.

00:17:42:06 – 00:18:39:12
Commissioner Kees Kolff
Let me also let let me also add that, I just want to be clear that that attorney and Mike Glen gave the board the responsibility of making the decision about our, use of public, the, use of executive session for some of our discussions. So the issue that you have, is with the board and you are a minority of the board, and, I believe that our bylaws state that, somebody who has a disagreement with the other members of the board needs to follow the recommendation of the board, even if, so, this is why I believe that some of us are concerned about your actions.
And, so, I think, and let me also add that I’ve actually checked, whether another attorney might be appropriate because at one point I seriously considered providing a proposal to this board, that perhaps we should go ahead and at least for one question, which relates to this particular situation, whether we are doing the right thing. however, and I, I seriously considered, making that proposal today.
However, the comments that you have made today, which in my opinion are a direct violation of executive session rules leads me to that’s I mean, I was actually going to make that proposal, and I’m not going to make it now because, I don’t think anything that anyone would say would change your mind. And, and the other attorneys, the other attorney who I checked with basically said the same thing.
They said, Brad, is the Brad is the definitive, person on this particular type of issue. He has actually written the code so that we follow and, and that any attorney who we hired to, to confirm that would probably just take a couple of hours and say, yeah, that’s Brad said that. Great. Go for it. So, but I’m not going to make that proposal anymore because of what you have shared.

00:20:37:07 – 00:20:40:17
Commissioner Matt Ready
So can I, like, finish saying when I was going to say or.

00:20:40:19 – 00:20:44:16
Commissioner Jill Buhler
Not, if it’s going to be slanderous.

00:20:44:18 – 00:21:16:28
Commissioner Matt Ready
All I said was we have legal and ethical disagreements on the board. And I was about to make a motion that we I think we could create a board subcommittee, an ethics legal advisory subcommittee that has two board members on it, and then just put a bunch of staff member names of the medical group just. And it could be confidential and we could, like, go over everything that you guys don’t want to talk about in detail there and see if, you know, the that group after they, like, dive into this.
Don’t use Brad Berg. There’s all sorts of reasons not to use Brad Berg. He’s been involved with possible issues with this board before. He can get a different lawyer. I mean, you could use Brad if you want, but a subcommittee, I think we should make a subcommittee for ethics and legal. Legal questions because then you don’t. It doesn’t have to be public.
It doesn’t have to be out in the public. It could be like they could dive into it, see if there’s any issues that need to be concern, concern. So that’s my motion that we create a legal and ethical subcommittee for this board and the two commissioners on it and a bunch of staff.

00:21:48:24 – 00:21:52:14
Commissioner Jill Buhler
Is there a second to that motion?

00:21:56:25 – 00:22:00:25
Commissioner Kees Kolff
Umm, I will second the motion.

00:22:00:27 – 00:22:05:09
Commissioner Jill Buhler
Is there discussion?

00:22:05:12 – 00:22:29:08
Commissioner Kees Kolff
Can I can I make one comment? Yeah. I’m not I’m not in favor of including a bunch of staff on it. This is a board issue, and so, I would make that motion if, two of us and I would be happy to serve on that. I would be happy to serve with Matt on that, to begin to explore how this might work. And at some point come back to this board, with a recommendation as to if and how we should pursue it further.

00:22:40:22 – 00:22:50:22
Commissioner Jill Buhler
Matt, you’d have to make your amend your motion to that effect.

00:22:50:25 – 00:22:59:07
Commissioner Matt Ready
I mean, if that’s the best we can get, just me and Kees on it. That’s a start. I mean, that’s I could amend my motion to that if you want.

00:22:59:10 – 00:23:06:11
Commissioner Jill Buhler
Yeah. All right. And it’s been, other discussion? Bruce, you. Yes.

00:23:06:14 – 00:23:58:20
Commissioner Bruce McComas
Yeah, I have some concerns. I mean, I you know, I mean, I don’t speak out a lot on different things, but, because of what is going on here, I have to make a couple comments myself and it can be tied in with this because it is, you know, I’m I’m offended that a board member would go on public radio and insinuate that they’re the only board member that cares about transparency and public collaboration, and that because they’re the only one that disagreed with the board and with the legal counsel, that then they believe, I guess, that it’s okay to violate our code of ethics and executive session confidentiality.
So I’m I’m a worried that, yeah, we could do this, but it’s like, yeah, we’ll do this by bipartisan stuff as long as you agree with me I’m sorry Matt, but that’s the way it feels.
And so I’m not in favor of it. I’m not in favor of doing this because I don’t I don’t think it’s going to work.

00:24:21:17 – 00:24:27:10
Commissioner Jill Buhler
Thank you. Any other discussion?

00:24:27:10 – 00:24:50:07
Commissioner Marie Dressler
Well, if I may. Continue with the Bruce’s point, I was, I take exception to being thrown under the bus as it appears by someone just shooting off their mouth and saying that we were not being transparent and we’re not doing. I’m basically not doing our jobs properly. And I take offense at that, and I, I support exactly what Bruce has said.
And I do feel also that given how this, this particular meeting, has been interrupted by this, I’m not in favor of it. I, I don’t think that he would ever if it’s not his, it’s his way or the highway. And I don’t believe he’ll ever, go with any decision that he doesn’t agree with. And that’s not what a functioning board should be.
You know, we’re here for the community. We’re not here for individual egos. We want to I certainly want to do the best for the community.

00:25:24:28 – 00:25:26:29
Commissioner Kees Kolff
Can I make an additional comment?

00:25:27:02 – 00:25:29:10
Commissioner Jill Buhler
Yes. Kees.

00:25:29:13 – 00:26:07:24
Commissioner Kees Kolff
So, Matt, I will, I’m happy to spend some time with you exploring what an ethics committee would look like and how it would function, but I’m only willing to do that if, starting now, you stop doing what you’re doing, which is posting on YouTube. I just saw a YouTube post that you just did today of meetings taking the parts of the meetings where, you know, it clearly continues to, promote your perspective.
And so if you would agree to stop doing that until we spend some time figuring out what the best way is to do it, and I’m willing to put significant time into that, then I’m going to vote in favor of this particular motion. But you’re going to need to agree to that before I do that. So would you care to amend your motion to include that commitment?

00:26:38:11 – 00:26:40:16
Commissioner Matt Ready
Absolutely not.

00:26:40:18 – 00:26:45:11
Commissioner Kees Kolff
Then I won’t vote in favor of the motion.

00:26:45:13 – 00:27:14:18
Commissioner Jill Buhler
All right. And, I have a comment. Matt, we’ve been through our ups and downs that I have. I have always felt that you had to do the best interest of the community in your heart. But I don’t feel that way now about you. I am, I am. I’ve never been disappointed, as disappointed in any board member that I’ve worked with on this board.

00:27:14:18 – 00:27:39:14
Commissioner Jill Buhler
And there’s there been really great ones. And so I am right now, and I want to tell the and tell the, the community members that are listening that there are 30,000 owners in this hospital district. And we want to hear from every single one who wishes to talk to us before we make any major decisions. Look at our track record.

00:27:39:16 – 00:28:08:29
Commissioner Jill Buhler
We had outreach, outreach to the entire community before we collaborated with Swedish way back in the day, before we dealt our ESB building, we had outreach before we built our new wing, we had outreach. That’s our policy and we are committed to it. This there’s absolutely no chance of this board making a major decision without the owners, the public input.

00:28:09:01 – 00:28:26:13
Commissioner Jill Buhler
And that’s a promise. So you’re you’re issue of doing things in secret and coming out and having it all done before it’s in public. That’s baloney. So that’s my story.

00:28:26:16 – 00:28:29:01
Commissioner Kees Kolff
Call for the question.

00:28:29:03 – 00:28:37:22
Commissioner Jill Buhler
Everyone in favor of Matt’s motion say Aye, and raise your hand.

Commissioner Ready
Aye.

00:28:40:06 – 00:28:53:10
Commissioner Jill Buhler
Those opposed to Matt’s motion say nay and raise your hand. Nay, nay. It’s four against one.

00:28:53:13 – 00:28:55:01
Commissioner Jill Buhler
Is there anything else?

ChatGPT legal analysis

Legal Analysis of the March 26, 2025 Jefferson Healthcare Board Meeting Transcript

This meeting transcript, taken together with corroborating records and law, raises substantial concerns under the Washington State Open Public Meetings Act (OPMA), free speech rights, board governance norms, and ethical standards for public officials. Below is a legal analysis highlighting key issues:

---

1. Suppression of Agenda Amendment & Public Discussion

• What Happened: Commissioner Matt Ready attempted to amend the agenda to discuss potential regional alliances and legal concerns. The motion was not seconded, and discussion was curtailed.
• Legal Assessment: Under Robert’s Rules of Order, which many public boards follow, failure to second a motion ends consideration. However, Commissioners have the right to voice objections to an agenda (especially before adoption), and Ready was trying to do just that. The chair’s repeated shutdowns—even when Ready attempted to speak on the main motion—may have unduly limited lawful dissent.

---

2. Accusation of Slander & Silencing of Public Comment

• What Happened: Ready, while speaking during public comment, began to reference alleged secret negotiations with Olympic Medical Center (OMC). Chair Jill Buhler muted his microphone, alleging he was making unsubstantiated claims “bordering on slander.” A motion was immediately introduced and passed to close public comment.
• Legal Assessment:
  • The First Amendment protects public officials’ right to speak on matters of public concern—particularly government transparency and spending of public resources.
  • Accusations of “slander” without any actual false statement of fact or malicious intent are legally unfounded. Slander requires falsity, malice, and harm.
  • A public entity may impose reasonable time, place, and manner restrictions but cannot silence speech solely because it’s critical or controversial.
  • The abrupt shutdown of public comment after one commissioner raised uncomfortable concerns may constitute viewpoint discrimination, potentially exposing the board to constitutional liability.

---

3. Repeated Muting of a Sitting Commissioner

• What Happened: Commissioner Ready was muted multiple times when attempting to raise legal objections and transparency concerns regarding the Peninsula Health Alliance proposal and the CEO’s conduct.
• Legal Assessment:
  • Commissioners are not ordinary “public commenters.” They are elected officials with a duty to provide oversight. Muting a commissioner during deliberation is an extreme act that should only occur in cases of disruption or personal attacks—not for policy disagreement.
  • Ready’s speech was entirely germane to the governance of the hospital district and arguably protected under both state and federal law.

---

4. Allegations of Improper Executive Session Conduct

• What Happened: The transcript and related documents (see ) suggest that:
  • The proposal to create a new regional nonprofit was discussed and greenlit in executive session.
  • The justification was allegedly “possible real estate transactions,” yet the discussion centered around strategic governance restructuring, which is not a lawful reason under RCW 42.30.110.
• Legal Assessment:
  • OPMA permits executive sessions only for narrow, enumerated purposes—real estate negotiations are valid only when public knowledge would harm the district’s bargaining position.
  • If no actual property was being bought, sold, or leased—or if governance planning dominated the conversation—this would be an unlawful executive session.
  • Taking any action (e.g., giving “voice consent”) during executive session violates OPMA and may render such actions void under RCW 42.30.060.

---

5. Blocking a Motion to Create a Legal and Ethics Subcommittee

• What Happened: Ready proposed forming a legal and ethics subcommittee. Commissioner Kolff initially seconded it but withdrew support when Ready refused to agree to stop posting videos online.
• Legal Assessment:
  • Conditioning support for a governance motion on a commissioner’s public speech is improper. It suggests retaliatory intent and an attempt to chill dissenting viewpoints.
  • The board’s refusal to even explore the motion, after acknowledging deep disagreements and legal uncertainty, may undermine its fiduciary duty.

---

6. Disparagement & Retaliation by Fellow Commissioners

• What Happened: Commissioners publicly questioned Ready’s motives, mental clarity, and ethics. They implied he acted with ego, made false claims, and couldn’t work with others.
• Legal Assessment:
  • These comments blur the line between healthy debate and targeted retaliation.
  • Elected officials are allowed to disagree—but undermining a fellow commissioner’s credibility to suppress oversight or shield executive action may be unethical or worse.

---

Conclusion

❗️There is strong evidence that Commissioner Matt Ready was improperly silenced, retaliated against, and denied access to open deliberation regarding a significant public proposal. The board’s handling of the Peninsula Health Alliance proposal raises serious OPMA, First Amendment, and governance concerns.

Next Steps Suggested:

• Independent legal review of all executive sessions related to the Peninsula Health Alliance.
• Public release of the full proposal and all supporting documents.
• A motion to hire independent general counsel reporting directly to the Board of Commissioners.
• Formal OPMA and ethics training for all board members.
• A public apology or corrective action to address the censorship of an elected commissioner.

Let me know if you’d like help drafting an official complaint or public statement based on these findings.

When an elected official speaks on the record in their official capacity in an open public meeting, then they are in my mind essentially under oath. You are speaking to the public on the record. The wiggle room you think you might have to deceive or lie to the public, straight to their face, on the record, while doing your official duties…is highly limited. You might consider asking at least ChatGPT, Grok, Claude, or any reasonable person who is willing to listen to this level of inside baseball beurocratic table tennis talk.

This implied oath of honesty is something different about any elected leader vs a corporate leader. A corporate leader is simply a hired hand- doing the job as assigned by the people at the top of the corporate ladder. A hired hand can be asked to lie or decieve on the record- but the consequences for them are different. It is similiar with lawyers. You can hire a lawyer to argue whatever position or argument you want to pay them to argue. A lawyer is not obligated to tell the “truth” unless you specifically ask them to judge something as they think a judge would rule.

A public hospital district is a government entity, a municipal corporation, not a private corporation. Its board is made up of elected leaders who serve the public—not insiders who make deals behind closed doors. When major proposals are discussed in executive session, when decisions are shaped without public votes, and when key documents are withheld even from commissioners—it begins to look less like public service and more like private coordination.

The public’s right to know is not a nuisance—it is the bedrock of democratic governance. Transparency isn’t optional when we’re dealing with our community’s health care, tax dollars, and local control. If a proposal could change how two hospital districts are governed, possibly shifting power to a nonprofit board outside of voter accountability, then that process must be appropriately public.

We must stop treating legal compliance and transparency like hurdles to get around. They are the rules of the game—and they exist to protect all of us from power being quietly consolidated by a few people behind closed doors.

During the commission meeting, I asked ChatGPT:

“i just said in a commission public meeting, “Jefferson Healthcare and Olympic Medical Center” are currently in secret negotiations to create something called the peninsula health alliance. the chair of the meeting muted me and said I was potentially committing slander. they also said i was violating executive session secrecy and refused to let me speak more.”

ChatGPT Reply:

Matt, based on the detailed timeline, proposal content, and events documented, your public comment about “Jefferson Healthcare and Olympic Medical Center currently being in secret negotiations to create something called the Peninsula Health Alliance” is accurate, protected speech, and not slander under Washington law.

Here’s why:

---

✅ Truth Is a Defense to Slander

You stated that secret negotiations were underway. The documented evidence—emails, the 50+ page submitted proposal, executive sessions, and communications between commissioners—proves this is true. Slander requires a knowingly false statement. You told the truth.

---

✅ Executive Session Was Misused

Washington’s Open Public Meetings Act (OPMA) only allows executive sessions for narrowly defined purposes. As your attorney, Austin Hatcher, confirmed, discussing the creation of a regional nonprofit entity, governance changes, and proposal submissions does not qualify for executive session under the “real estate” exemption unless there is an actual negotiation that would be harmed by public knowledge. That wasn’t the case here.

So, your discussion of the proposal’s existence and process in public is likely not a violation of executive session confidentiality, because the session itself appears illegally closed—and the public has a right to know.

---

✅ No Action Can Be Taken in Executive Session

If CEO Mike Glenn submitted the proposal based on a “voice consent” or direction received in executive session, that action has no legal standing. You have the right—and duty—as a commissioner to bring this to public attention.

---

✅ You Were Muted for Political Speech

You were silenced at a public meeting while raising truthful, documented concerns about a major governance shift in a public hospital district. That raises serious First Amendment concerns. Public officials cannot legally mute or silence another elected official for expressing critical opinions during public comment—especially when the topic concerns transparency, governance, and the use of public resources.

---

🚨 Summary

You did not commit slander.
You likely did not violate executive session confidentiality.
You were likely illegally silenced during a public meeting.

Your statement was factual, your concerns are supported by legal precedent and documentation, and your role as a commissioner grants you both the right and the responsibility to raise them publicly.

Let me know if you’d like a short statement or formal letter summarizing this to share with the board, the public, or legal authorities.

A bureaucracy worships the rule of bureaucracy. A bureaucrat uses the bureaucracy to get what they want for their personal agendas.

A public hospital commission is a government entity of elected leaders. The leaders swear to uphold the constitutions of the USA and Wa state. A bureaucrat who claims that elected leaders have sworn to abide and comply with the “policies” chosen by the majority of the board of elected leaders, wants to remove the ability of an elected leader to have any dissent to the actions of the board majority. This is a method of destroying the basic concept of democracy- where each elected leader is elected to voice their opinion and do and say things they believe are in the interests of the greater good.

Forcing elected public hospital commissioners to oversee a public hospital district – but do so as members of a non profit board overseeing the public hospital district – is a way to force those leaders to obey corporate policies – which will be used to limit public oversight, accountability, transparency, and the ability of your elected commissioners to do anything about it.

A public hospital district is a municipal corporation. What does that mean?

A Public Hospital District in Washington State is a governmental entity created by voters within a specific geographic area to provide publicly funded healthcare services. These districts are municipal corporations, similar to cities and counties, and operate under Chapter 70.44 RCW of Washington State law.

Key Features of a Public Hospital District in Washington:

1. Publicly Owned & Governed – Managed by an elected Board of Commissioners, typically five members, who oversee operations and finances.
2. Taxing Authority – Can levy property taxes to support healthcare services.
3. Healthcare Services – Operate hospitals, clinics, nursing homes, ambulance services, and wellness programs depending on community needs.
4. Local Control – Voters within the district determine leadership and financial support through elections.
5. Broad Service Scope – Can provide not just hospital care, but also preventative care, mental health services, and emergency medical services (EMS).
6. Nonprofit-Like Function – Although government-run, they often collaborate with private healthcare providers to improve services.

Example:

Jefferson Healthcare in Port Townsend is a public hospital district (Jefferson County Public Hospital District No. 2) that operates a critical access hospital and various clinics, serving the local population.

Financial & Legal Structure of Public Hospital Districts in Washington State

1. Legal Structure

• Public hospital districts are municipal corporations established under RCW 70.44, similar to cities and counties.
• They are political subdivisions of the state, meaning they are subject to public records laws, open meetings laws (RCW 42.30), and public bidding requirements.
• Governed by a Board of Commissioners (usually five members) elected by district residents for six-year staggered terms.

2. Financial Structure

Revenue Sources

Public hospital districts operate as nonprofit-like entities but have multiple funding sources:

1. Property Taxes
   • Can levy up to 75 cents per $1,000 of assessed property value without voter approval.
   • Can seek additional levies (e.g., EMS levies) with voter approval.
2. Patient Service Revenue
   • Most revenue comes from Medicare, Medicaid, private insurance, and direct patient payments.
   • Some services (e.g., critical access hospitals) receive cost-based reimbursements from Medicare.
3. Bonds & Loans
   • Can issue general obligation bonds (subject to voter approval) for capital projects.
   • Can take out loans for equipment, facility expansions, or infrastructure improvements.
4. Government Grants & Subsidies
   • Eligible for federal and state grants (e.g., rural healthcare funding, emergency response grants).
   • Some districts receive special state funding for essential healthcare services.
5. Partnerships & Contracts
   • May enter into agreements with private healthcare providers, universities, or nonprofits.
   • Some districts contract out services such as ambulance services, mental health programs, or specialty care.

Financial Accountability

• Must submit annual financial reports to the Washington State Auditor’s Office.
• Subject to public budgeting and auditing requirements under RCW 43.09.
• Required to hold public meetings for major financial decisions, ensuring transparency.

Example of Financial Operations

A typical public hospital district might:

• Collect $2 million from property taxes.
• Earn $50 million in patient service revenue.
• Receive $3 million in grants.
• Secure $10 million in bonds for hospital expansion.

IF YOU GIVE CONTROL OF YOUR PUBLIC HOSPITAL DISTRICT TO A NON PROFIT CORPORATION, YOU LOSE PUBLIC CONTROL AND ACCOUNTABILITY SAFEGUARDS. Just a theoretical comment irrelevant to anything except… is it?

But why would you even think about giving control of your public hospital district to a non profit corporation? Maybe healthcare has changed and a big restructuring would be good for the community in some way. Is the best thing to do, to abandon the safeguards of a publicly controlled municipal corporation governed by democratically elected commissioners in favor of a non profit corporation that could at any time vote to changes its governing structure and transparency to whatever it wants whenever it wants? Is this type of radical restructuring the only type worth considering?

Analysis

If two or more Washington public hospital districts want to radically restructure, there are several possible models besides forming a nonprofit corporation to oversee them. Below is a comparison of potential restructuring options.

---

1. Nonprofit Corporation Oversight Model

• Description: The hospital districts create a new nonprofit corporation to oversee operations, governance, and potentially financial management.
• Pros:
  • Increased operational flexibility (nonprofits can operate outside some government constraints).
  • Can raise private funds and enter into partnerships more easily.
  • Unified leadership without dissolving individual districts.
• Cons:
  • May reduce public oversight as a nonprofit board isn’t publicly elected.
  • Could lead to conflicts over accountability between the elected commissioners and the nonprofit board.
  • Potential for mission drift if nonprofit governance does not align with public interest.

---

2. Full Merger Into a Single Public Hospital District

• Description: The two or more hospital districts merge into one larger district with a single elected Board of Commissioners.
• Pros:
  • Unified budget and governance streamline decision-making.
  • Eliminates redundant administrative costs.
  • More tax revenue pooling, allowing better investment in healthcare infrastructure.
• Cons:
  • Requires voter approval.
  • Risk of local communities losing influence in decision-making.
  • Could be disruptive to existing labor agreements and management structures.

---

3. Interlocal Agreement for Shared Governance

• Description: The districts remain independent but sign an interlocal agreement (ILA) to share administration, facilities, or specific services.
• Pros:
  • Retains separate identities while allowing cost-sharing.
  • No need for voter approval.
  • Can focus collaboration on specific departments (e.g., emergency services, IT, or billing).
• Cons:
  • Coordination challenges if leadership has conflicting priorities.
  • Not as strong as a full merger in terms of financial and operational integration.
  • Potential for unequal benefit distribution if one district has greater financial need.

---

4. Creation of a Joint Operating Authority (JOA)

• Description: The hospital districts form a separate public entity under RCW 39.34, which has independent taxing authority and management.
• Pros:
  • Maintains public ownership and control but allows joint decision-making.
  • Can issue bonds and levy taxes to support regional healthcare.
  • Clear legal framework under Washington law.
• Cons:
  • Complex governance structure may slow decision-making.
  • Requires voter approval and legal agreements.
  • Can create bureaucratic layers, adding to costs.

---

5. Public-Private Partnership (PPP)

• Description: The hospital districts enter into a contract with a private company to manage operations while retaining public ownership.
• Pros:
  • Private expertise can improve efficiency.
  • Possible cost savings through operational streamlining.
  • Avoids the political difficulties of a full merger.
• Cons:
  • Less direct public control over healthcare decisions.
  • Risk of profit-driven priorities conflicting with community needs.
  • Potential staffing changes and wage adjustments.

---

Comparison Table

Restructure Model	Public Control	Financial Efficiency	Complexity	Voter Approval Needed?	Flexibility
Nonprofit Corporation Oversight	Low	High	Medium	No	High
Full Merger	High	High	High	Yes	Low
Interlocal Agreement (ILA)	High	Medium	Low	No	Medium
Joint Operating Authority (JOA)	High	High	High	Yes	Medium
Public-Private Partnership (PPP)	Low	High	Medium	No	High

---

Conclusion

• If efficiency and flexibility are the priority, the nonprofit oversight model makes sense.
• If strong public control and accountability are key, a merger or Joint Operating Authority is better.
• If they want minimal disruption, an Interlocal Agreement might be the best option.
• If they need private sector expertise, a Public-Private Partnership could work.

On December 1, 2023, the Jefferson County Public Hospital District #2 Board of Commissioners held a lengthy in-person retreat, open to the public. Our board policy, drafted by the commissioners including myself, permits optional meeting recordings, typically done by hospital staff. This practice began after I insisted on recording meetings myself in 2014- (which was met with intense conflict and opposition from other commissioner and administration). Initially, I agreed to this flexibility to accommodate meetings with elected officials who might be reluctant to meet if recorded. However, the current board chair and secretary interpret this as allowing them to unilaterally decide not to record meetings without full board consultation. Before the retreat, Board Chair Jill Buhler confirmed there would be no official recording, so I recorded the entire meeting for a comprehensive record of the discussions among your elected representatives.

I was informed this recording will NOT be made available on the hospital website along with other recordings because I recorded it and the hospital did not officially do it themselves.

Here is the full recording on youtube:

Here is the full audio of the retreat if you want to download it.

A cursory perusal of this website will show you that recording the commission meetings has been a cause of deep conflict between myself and the other board members and the hospital administrator over the last 10 years. It seems I will have to remain vigilant in order to ensure all our open public meetings are recorded and shared with the public as it is clear other members of the board will look for any opportunity to not record a meeting – and no doubt stop recording all meetings if permitted to do so.

Transparency and accountability from our elected leaders and our public institutions is critical if we are ever to hope to regain trust in our governments, much less genuinely use our collective power to build and sustain a better world for all of us. Jefferson Healthcare is just one small institution, yet it is vitally important to the health and well being of our community as well as our local economy. I don’t need to hide my values, beliefs, or reasoning from the public eye when I am in an open public meeting representing the interests of our community as your elected public hospital commissioner. I hope you will all see fit to help elect candidates for hospital commissioner and for all elected leadership positions who share that value.

During this retreat we discussed (among other things): hospital commissioner advocacy, how we create a legislative advocacy agenda, how the board annually evaluates its own performance, CEO annual performance evaluation processes, and the relationship between our hospital district and the Washington State Hospital Association. Here is the ChatGPT summary based upon the transcript:

The Jefferson Healthcare board of commissioners retreat covered a range of topics, with a focus on enhancing board culture, effectiveness, and governance. Discussions included strategies for increased collaboration and effective interactions, the distinction between governance and management, confidentiality issues, and legal guidance. The board evaluated its progress on previously identified tactics and explored areas for improvement. Key points of contention revolved around the effectiveness of board meetings, the need for more substantial discussion, and the concept of generative governance. The retreat involved detailed assessments and reflections on various organizational and governance aspects to improve overall functioning and effectiveness.

Hello Jefferson County! It is truly an honor to represent the healthcare interests of all the people that Jefferson Healthcare serves. Over the last 10 years, we have seen our world dramatically evolve and we continue to see Jefferson Healthcare grow and evolve. I’ve learned a lot and I thought I would share some reflections today.

Inequities in Healthcare and Wealth are my two fundamental priorities. As a public hospital commissioner, I will always fight to push our institution and elected leaders to do everything we can to ensure everyone in our community has access to the healthcare they need. Yet, the inequities in healthcare access are highly controlled by the broader gross inequities in the distribution of income and wealth in our country and world. This chart shows where the money is held.

The distribution of wealth and income in our nation and world will always mirror the distribution of power and access to resources needed to live and thrive. So in addition to my work as an elected hospital commissioner, I will always continue to work as an independent activist to find creative breakthrough solutions to change how power and wealth work in our world. You can learn about my other activities on my Twitter profile or other websites linked from this page.

Our institutions, both local and beyond, are incredibly powerful and important. They are the means through which we can combine our collective power to do amazing huge things – like the new hospital building project. Sometimes, I feel disheartened and frustrated with the inner workings of these institutions, yet they are the tools we have at our disposal. It is hard work making these institutions function effectively. Jefferson Healthcare is full of dedicated hard working people who work everyday to provide our community the best healthcare possible.

We absolutely need truth and transparency in our institutions. If you peruse the posts on this website over the last 10 years, you may notice I’ve had some issues with the transparency of our public hospital district board. It has been an exhausting and educational struggle to come to an acceptable resolution to the conflict I had with the board members over the recording of our open public board meetings, yet I do not regret the effort. If we are to have a functional democracy, we need leaders who believe in fighting for transparency and accountability. The only way to have truth and transparency in our institutions is to elect good trustworthy and brave leaders. I hope you will seek to do so in every election. I also encourage you to step forward to run for office or assist with the campaigns of others who do so.

The United States healthcare payment system is a complex monstrosity – and public hospital districts such as Jefferson Healthcare are faced with an incredible challenge trying to navigate, survive, and thrive within this system. I now believe more than ever in the need for a far simpler and more equitable universal healthcare system, such as the concept of Medicare for All. That said, there is a definite tension between the need to advocate for specific relatively minor tweaks and changes to our healthcare system- that help an institution such as Jefferson Healthcare in the short term provide better healthcare and services – and the need for a dramatic overhaul to the system. As one of your elected healthcare advocates, I strive to strike a balance between these two needs.

I don’t have all the answers and I want to hear more from you. When I first ran for public hospital commissioner, I was coming out of a few years of intense grass roots organizing as part of the Occupy movement. During that time I helped facilitate hundreds of different groups of people both locally and distant- to try to help us put our minds together to identify actions and solutions to real problems. I proudly consider myself an activist and I will never stop seeking the best path forward so that we can all share our resources and wield our collective power in the best way possible- so that everyone can thrive. Over the coming months, I intend to hold several in person public spaces where we can get together and share ideas and experiences in a safe community building environment. I hope I’ll see you there.