Estes Park Health Election on May 2, 2023: Ballot Issue 8A and Colorado's Fair Campaign Practices Act

The upcoming Estes Park Health election on May 2, 2023 includes ballot issue 8A and features six candidates vying for three positions. The campaign involves permissible and non-permissible actions under Colorado's Fair Campaign Practices Act, outlining what Estes Park Health employees can and cannot do in relation to the election.

• Estes Park Health
• Election
• Ballot Issue 8A
• Colorado Fair Campaign
• May 2

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1. Estes Park Health Election on May 2, 2023 Ballot Issue 8A Authorizing Estes Park Health to Enter Into Multi-Fiscal Year Obligations Estes Park Health Employees April 19, 2023 1

2. Estes Park Health May 2, 2023 Election Six (6) candidates running for three (3) positions 5 of 6 candidates support Ballot Initiative 8A Todd Nardi Brigitte Inge Foust William C Pinkham John David Meissner Stephen Alper Cory Dale Workman 2

3. Estes Park Health May 2, 2023 Election Mail Ballot Election Ballots Mailed April 10 to April 17, 2023 If not received by Mon April 24, get alternative ballot Candidate Photos/Narratives: eph.org Your Vote. Your Voice. League of Women Voters Candidate Forum https://youtu.be/HMxQAiqgcvU Estes Park Trail Gazette https://www.eptrail.com/ Ballot Issue 8A: League of Women Voters Zoom Coffee April 15, 2023 https://www.lwv-estespark.org/ 3

4. Colorado's Fair Campaign Practices Act What actions are permitted and not permitted for Estes Park Health employees within Colorado's Fair Campaign Practices Act C.R.S. 1-45-117: State and Political Subdivisions like EPH? 4

5. Colorado's Fair Campaign Practices Act What actions are PERMITTED: The Estes Park Health Board can: Pass a resolution or take a position of advocacy on an election issue, Report its passage, Distribute the resolution through established, customary means EPH can dispense a factual summary of a campaign issue including arguments for and against as long as the summary does not contain a conclusion or opinion in favor of or against the issue EPH can respond to questions about the election issue if we do not solicit the questions. 5

6. Colorado's Fair Campaign Practices Act What actions are NOT PERMITTED acting as an employee: Spending any public moneys in the form of letters, telephone calls, or other activities incidental to expressing his or her opinion on any Election Issue. Making any contribution in campaigns involving the nomination, retention, or election of any person to any public office, Making any donation to any other person for the purpose of making an independent expenditure, or Expending any moneys from any source, or making any contributions, to urge electors to vote in favor of or against any of Election Issue 6

7. Colorado's Fair Campaign Practices Act What actions are PERMITTED acting as a private citizen: Expressing their personal opinion on any Election Issue. My personal opinion as a private citizen .. Making personal contributions and using personal time to urge electors to vote in favor of or against any Election Issues. 7

8. Executive Summary Estes Park Health Overall Goal: Ensure excellent healthcare services for many years to come for our community and visitors 8

9. Challenges to Accomplishing the Goal Challenges to accomplishing the overall healthcare services goals: 1. Significant and increasing capital investments are required to keep current with evolving medical technology 2. Healthcare services reimbursement is becoming increasingly dependent upon membership in a payor network 3. Many independent rural hospitals are experiencing significant financial challenges 9

10. Challenges to Accomplishing the Goal Challenges to accomplishing the overall healthcare services goals: 1. Significant and increasing capital investments are required to keep current with evolving medical technology Example: Epic electronic medical record 78% of patients in US Mayo Clinic, Cleveland Clinic, etc Majority of top ranked hospitals and Med Schools Not possible without UCHealth prior investment Affiliation Advantage: Access to capital, direct and indirect 10

11. Challenges to Accomplishing the Goal Challenges to accomplishing the overall healthcare services goals: 2. Healthcare services reimbursement is becoming increasingly dependent upon membership in a payor network Example: Pay less in-network, pay more out-of-network Paid less out-of-network, paid more in-network Intermountain Health & UCHealth CIN Affiliation Advantage: Membership in large payor network 11

12. Challenges to Accomplishing the Goal Challenges to accomplishing the overall healthcare services goals: 3. Many independent rural hospitals are experiencing significant financial challenges Example: 30 % of rural hospitals at risk CHQPR Jan 2023 Leadville and others Post Pandemic Not EPH: 2023 $1.2M Net Assets, $5M EBITDA Advantages: Supplies, Labor, Contracts, Admin Affiliation Advantage: Savings from larger scale operations 12

13. Executive Summary The overall goal is to ensure excellent healthcare services for many years to come for our Estes Valley community and visitors The EPH Board believes that an affiliation with a larger, nonprofit integrated healthcare services organization is necessary to accomplish this overall goal Establishing an affiliation with a nonprofit integrated healthcare services organization will require entering into one or more multi-fiscal year agreements 13

14. Executive Summary 4. Subsection 4(b) of Article X, Section 20 of the Colorado Constitution ( Taxpayer s Bill of Rights [TABOR]) states that districts like EPH must have voter approval in advance to be able to enter any multi-fiscal year agreements 5. Ballot Issue 8A asks voters to authorize EPH to enter into one or more multi-fiscal year agreements 14

15. EPH Ballot Issue 8A Without imposing any new tax or increasing any tax rate, shall Park Hospital District, doing business as Estes Park Health, be authorized to enter into one or more agreements, constituting a multiple fiscal year financial obligation, with one or more nonprofit health care providers concerning the ownership, operation, and maintenance of all or any portion of the District s hospital and other healthcare and related facilities and assets, including the lease or other conveyance from the District of real and personal property, and to pledge all or any portion of the District s revenues pursuant to such agreements 15

16. EPH Ballot Issue 8A Without imposing any new tax or increasing any tax rate, shall Park Hospital District, doing business as Estes Park Health, be authorized to enter into one or more agreements, constituting a multiple fiscal year financial obligation, with one or more nonprofit health care providers concerning the ownership, operation, and maintenance of all or any portion of the District s hospital and other healthcare and related facilities and assets, including the lease or other conveyance from the District of real and personal property, and to pledge all or any portion of the District s revenues pursuant to such agreements 16

17. EPH Ballot Issue 8A Without imposing any new tax or increasing any tax rate, shall Park Hospital District, doing business as Estes Park Health, be authorized to enter into one or more agreements, constituting a multiple fiscal year financial obligation, with one or more nonprofit health care providers concerning the ownership, operation, and maintenance of all or any portion of the District s hospital and other healthcare and related facilities and assets, including the lease or other conveyance from the District of real and personal property, and to pledge all or any portion of the District s revenues pursuant to such agreements 17

18. EPH Ballot Issue 8A Without imposing any new tax or increasing any tax rate, shall Park Hospital District, doing business as Estes Park Health, be authorized to enter into one or more agreements, constituting a multiple fiscal year financial obligation, with one or more nonprofit health care providers concerning the ownership, operation, and maintenance of all or any portion of the District s hospital and other healthcare and related facilities and assets, including the lease or other conveyance from the District of real and personal property, and to pledge all or any portion of the District s revenues pursuant to such agreements 18

19. Arguments For EPH Ballot Issue 8A 1. Affiliation will provide direct and indirect access to required capital, both financial and intellectual, supporting investments and development to keep current with evolving medical technology 2. Affiliation will provide membership in a large payor network with better reimbursement for services 3. Affiliation with a significantly larger integrated healthcare services organization will provide significant opportunities for cost savings in procurement, contracts, administration, etc. that will ease financial pressures 19

20. Arguments Against EPH Ballot Issue 8A 1. Affiliation with a significantly larger integrated healthcare services organization will reduce local decision-making autonomy 2. Affiliation with a significantly larger integrated healthcare services organization may result in increased healthcare costs for those without insurance 3. Arguments against EPH Ballot Issue 8A expressing concern about possible job loss and possible adverse impact on local healthcare providers (Audiology, Physical Therapy, Optometry, etc.) considered unlikely 20

21. The Decision for the Voters Do affiliation advantages outweigh the disadvantages? Then voters should select YES on Ballot Issue 8A authorizing EPH to enter into multi-year financial agreements with a larger nonprofit integrated healthcare services organization. Do affiliation disadvantages outweigh the advantages? Then voters should select NO on Ballot Issue 8A and NOT authorize EPH to enter into multi-year financial agreements. 21

22. Questions, Comments, Discussion 22