By Jack Reaney SENIOR EDITOR
Millions of taxpayer dollars that could fund health and wellness services in Big Sky are on the line. On May 5, ballots are due by mail or by drop-off for a local election that will ask Big Sky voters whether they’d like to create a hospital district, or a “wellness district” as it’s being called locally.
If voters on the Madison County side of Big Sky say “yes,” it wraps up the multi-year struggle that was resolved in Senate Bill 260 last year, and redirects roughly $23 million of existing taxpayer dollars into Big Sky over the next eight years—plus more moving forward.
On the Gallatin County side, voters can create a similar district that would link up and receive those dollars through an interlocal agreement to fund health and wellness services offered by providers such as the Bozeman Health Big Sky Medical Center, Wellness In Action and the Big Sky Community Food Bank.
After ballots are mailed April 17, voters will have a tremendous impact on Big Sky’s future.
The following questions were submitted by audience members during a live Q&A facilitated by Jack Reaney, senior editor of Explore Big Sky, on March 24 at The Waypoint. The full livestream is recorded and available on YouTube.
Panelists include local health and wellness leaders from the Big Sky Wellness Coalition: Katie Grice (Big Sky Resort), Kelly Halmes (Bozeman Health), Kiernan Volden (Wellness in Action) and Sarah Gaither (Big Sky Community Food Bank).
Some answers are condensed for readability and brevity.
Q: Could you each go through and give an idea of what the voter sentiment is around this ballot initiative to create the wellness district in each respective county? What do you think the voters think about this?
Katie Grice: I’ve been involved since the beginning, right, since the initial conversations of, ‘What are the possibilities out there?’ I will tell you that prior to [Senate Bill] 260, there was a sentiment of concern, of what this means for the Madison County side of Big Sky—also making sure that the community of Ennis and the Madison Valley Hospital District are not being put in a really difficult situation… Senate Bill 260—the negotiation, the compromise that came out of that was because both sides… came to the table and agreed upon a solution that was going to work, but was also going to bring those meaningful dollars back into the community.
So for me, I am less concerned about voter sentiment, I am more [concerned about] the need to provide voter education. And also getting people to vote is critical.
Kelly Halmes: I have two things—I’ve heard a lot of people think this has already been passed, and already done. And they didn’t know about the May 5 [election]. So please, please, tell your friends we’re not done yet, we still have to get [voter approval].
And then the other thing I think is really special about Big Sky, [and] is very different from what’s happening in Madison [Valley], where all of the funding went straight to the hospital. That is not how we’re gonna roll here in Big Sky. We have lots of people doing lots of amazing things in our community health partners, and so I think that’s super important to know that. That [the money] is going to be spread throughout the community.
Kiernan Volden: I also have two comments. I’d say the first is that Big Sky residents are excited about the fact that this creates local representation. So often, our community does not have people directly directing our funding that we collect in our communities. So I think it’s exciting that we have that chance now.
And the second is, on the Gallatin County side, I know it can be scary when we talk about special purpose districts, and potential new taxes. But I just want to clarify that this vote does not create any new taxes on the Gallatin County side. Any new taxes would have to be brought before the voters again, and voted on by our residents.
Sarah Gaither: I guess I would only add that, it feels like this vote is not as divisive as turf fields were last year. Which is maybe a problem, because we need people to vote.
So yeah, if it were more divisive, it might get a little more turnout. But yes, everybody please vote.
Q: What happens if we don’t get our votes, because of our post office?
Katie Grice: Yeah, so BASE is another location for ballot drop-off for Gallatin County… Pre-planning is the most important thing that we can possibly do, including just ensuring that you are registered to vote. I’ve had way too many conversations over the last few weeks where [people assumed] they were registered to vote, and they were not.
Q: Knowing how the money will be spent is, for me, very important for an educated vote. How will the money be spent?
Kiernan Volden: We unfortunately cannot answer that question. I know that is tough to hear, however, on April 21 there’s a candidate forum at the Warren Miller Performing Arts Center where you can hear from the trustees that will be on the ballot and can maybe share a little bit more then about what their priorities would be [for] how they would direct this funding throughout this community.
Again, this vote just creates the mechanism and [elects] the trustee positions that will go through a whole legal process to set up bylaws, how they will actually function… It is outlined in [Montana Code Annotated] what can be funded, and what cannot be funded.
Sarah Gaither: Just an additional thing that the community should know; While none of the coalition partners will be able to determine exactly where funding will go—of course, that’s up to the trustees—we have been working together for years, and we did just go through a strategic planning process and have outlined community needs in a pretty strategic way. And we have data behind the projects that we kind of want to tackle next. So there is that background that exists, that hopefully the trustees will be able to lean on.
Q: Kiernan, can you address the fact that there are two groups of trustees, [one each] from Madison County and Gallatin County.
Kiernan Volden: So there are sets of trustees since there are two districts, three [trustees] on each side. So the hope is… the two boards of trustees could work together through an interlocal agreement to be able to fund priorities across that boundary… [and] it isn’t separated by the counties within Big Sky.
One audience question asked whether anyone understood exactly how the interlocal agreement allows money to flow from the Madison side into facilities located in Gallatin County, to which all panelists shook their head, “no.” When asked if that money exchange can happen, legally, panelists nodded their yes, “yes.”
Q: Are there any statistics on which employees [use] these services? Who recruits the employees who use these services? Because landowners bear these costs… If it was YC or Lone Mountain Land Company, or Moonlight, then they should be providing more services to their employees.
Sarah Gaither: People who use the food bank are largely our workforce, you know? There are a wide variety of folks from every employer… and I’m seeing it’s about 25% of the seasonal workforce for every employer. So whether that’s a small business, or whether that’s one of our giant businesses.
Kiernan Volden: I would say from [Wellness in Action’s] perspective, we definitely see a range of community members but I will share that… upwards of 25% to 30% of individuals accessing counseling services through our partners are local youth aged 0 to 11. So there’s definitely a lot of long-term local families using these [resources] that aren’t just seasonal workforce.
About 25% to 30% of counseling clients are seasonal workers. Most individuals, about 75% have a 59716 Big Sky zip code, and about 10% in addition to that have a 59730 Gallatin Gateway zip code [which includes part of Big Sky]. So many of the people using and accessing, at least, Wellness in Action services are folks that identify as long-term residents.
Kelly Halmes: I would say our family med practice is mostly locals as well, and our mental health is very similar statistics as yours.
EBS: Cool, we have a couple of questions asking about how much money is actually at stake here. One of our writers has suggested that it might be $23 million at some point over the next eight years, so maybe we can confirm that number. [Also], more specificity around our estimate of how much these interlocally joined districts might generate long term.
Katie Grice: The primary question is, what kind of money are we talking about? SB 260’s established framework is the negotiation that allows us an eight-year step down with upwards of $23 to $24 million coming back into the Big Sky community, collected by Big Sky taxpayers over the next eight-year period.
So we’re talking meaningful dollars that are coming in—this is not that far away, this is soon, if we can establish this… That is just on the Madison County side. There is also opportunity if voters approve later on, for additional funds [to be collected] on the Gallatin County side…. This is only effective if both counties are establishing districts.
Q: Cost of primary care in Big Sky is about 30% to 50% higher than in Bozeman (according to audience member)… Will the cost of primary care here in Big Sky be reduced? Also, trauma patients here in Big Sky are overwhelmingly visitors, compared to residents. Maybe we can balance the way that costs can potentially offset costs for locals and residents?
Kelly Halmes: [That is] correct, we are about 22% to 25% more expensive than Bozeman, and that’s just truly because it costs more to keep the electricity on and the heat on, and all the things. So yes, we are.
We gave over $6 million of discounted patient visits in the last 10 years, so we do have a pretty robust patient financial service department. But it could always be better… There is funding that could be made bigger with wellness district funding. But that’s, again—we have to vote the whole initiative in, and that will be the trustees that decide [allocation of funds].
Trauma patients—I don’t know. That’s a really hard question… I could get that data for the next time we do this [at Ballots and Breakfast].
EBS: So just to confirm, it sounds like with a wellness district, it’s possible that some of the funds could be used to help keep the costs of primary care down, and reduce those costs for residents?
Kelly Halmes: Potentially, yeah. Potentially.
Q: We’re talking a lot about funding wellness—and we’ve seen some of the definitions of what wellness can be, between social services, food security, mental health, etc. Does that include environmental wellness? For example, pollution to the Gallatin River.
Kiernan Volden: I’d go back to that Montana Code… In general, it’s restricted to hospital and hospital-related services… I would say probably not, for this funding mechanism.
Sarah Gaither: But, if people had to pay less for the health care and wellness services, they would have more money to donate to the river.
Q: Does this move or change the county line? Or just where the taxes paid go.
Kiernan Volden: No county lines will be moved with this vote.
Q: Can funds be used toward a nursing home or elder care?
Katie Grice: [Montana Code] does point to that being permitted and allowed. That’s up to the trustees to determine.
Q: It’s not clear who can vote. Is this just property owners? Is this renters? Registered voters in Montana? Registered voters in Gallatin County? Who’s voting for these districts?
Katie Grice: Registered voters within the district. How do you know [if you’re registered]? You use that QR code (votemt.gov) and double check that you are registered to vote.
Q: To follow up: we have a lot of workforce that may live here for a year, or two years, and they’re originally from Ohio… How do you deal with those?
Katie Grice: You need to first go and understand where you sit as a registered voter. And then if you’re not registered to vote, then you go through the voter registration requirements from there.
Sarah Gaither: Just to be explicit, you can only be registered to vote in one place. You can’t be registered to vote and vote in the same election in Ohio, and here. You have to change your registration status to here.
Q: Can you talk a little bit more about the elected trustees. They can be anyone? How long [do they] serve for? Already decided for Madison but not yet for Gallatin?
Katie Grice: The trustee [candidates] will be at the April 21 candidate forum. [On Madison County side], all three trustees are ‘acclaimed’ because there were three seats that were open. Now, the important part about these seats is that they will have established terms—so one-year term, two-year term and a three-year term, and that’s for both the Madison side and the Gallatin County side… We need to start by staggering those trustees so that it makes those election processes easier in the future… The eligibility to be a trustee is to live in that area, as well.
Q: What if this were to only pass in one of the counties? What if this only passes in Gallatin County, not in Madison County. Would they forfeit the money that’s laid out in Senate Bill 260?
Katie Grice: Listen, it’s critical. It has to happen. It has to happen, right? This will be meaningful only with both sides forming. If it passes on the Gallatin side but not on the Madison side—my goodness, those three-and-a-half to four years of efforts to get to this point… those funds would not be [brought in]… in a meaningful way to the Big Sky community.
Paula Cleary (trustee candidate for Madison side): The money from Madison Couty won’t be able to come down the hill unless there’s a vehicle to receive it.
Q: How much money potentially is available this year?
Katie Grice: I believe the estimate was about $800,000 within the next 12 months that has the opportunity to come into the Big Sky community.
Q: If there end up being three representatives from Madison County, three representatives from Gallatin County, what’s to say that Madison County doesn’t approve that [funding] for the folks that are standing here? What if they want something that is closer to their homes?
Katie Grice: Well, I mean, you’re right. I think that is the beautiful part of having elected representation from within the community to make decisions for the community too. And that’s why an interlocal agreement is going to be critical for getting both pieces, and the vision is to have two boards that are working and facing the same direction—much like our [Wellness] Coalition partners as well.
Paula Cleary (trustee candidate for Madison side): My answer is, I have no interest in building a hospital right now.
Daniel Bierschwale (BSRAD staff): I think it’s safe to say the intention of the entire initiative is to ensure that the service area of Big Sky, which includes the meadow and the mountain, is congruent with how we all use it. I don’t want to speak on behalf of a future board member, but I believe… our intention is to make both counties work. And ensure that the services that our currently being provided are supported by the $23 million surplus.
… [Trustees] could do whatever they want with the money. What is being told to you today, and the intention behind both of these boards when they get set up, is to operate through an interlocal agreement. That’s why this initiative is happening on both sides of the county… What we can speak to today is intention, but to be blatantly honest—to the point that you’re making—if they wanted to build a hospital up there, they could.
Q: Will this relieve some of the pressure on Resort Tax, which is currently funding a number of health and wellness nonprofits in Big Sky, for example.
Daniel Bierschwale (BSRAD staff): Yes. Yes it does. We will be here to support all of these initiatives until this is off the ground… It will alleviate some pressure on BSRAD.
Q: Sounds like there was a survey that the [Wellness] Coalition distributed… when was the survey circulated, and how can they find the results?
Kiernen Volden: Yeah, we’ve done several surveys over the past few years. The hospital and HRDC need to do needs assessments every year. We’ve recently done one this winter that was distributed November through February through all of our partner channels, through Explore Big Sky, and many other businesses and community partners in Big Sky.
That was in partnership with the Katz Amsterdam Foundation, which does the same survey of mental and behavioral health specifically across 11 Mountain West resort town communities, including Big Sky… That one was specific to mental and behavioral health. The results are not yet available, but should be available by the beginning of May to our community… distributed out through all of the partners as well, through our website, and e-blasts, things like that.
Sarah Gaither: Katz Amsterdam has a really cool dashboard where you can find historical data for all of the mountain communities. Over the course of the last 10 years, maybe longer. They’ve been doing it for a long time, I think this was Big Sky’s first involvement.
Q: Say, if Madison said no, and Gallatin said yes—could we still have another vote of tax dollars coming through to continue funding the Gallatin side for those trustees to create a framework?
Paula Cleary (trustee candidate for Madison side): No. This is your once chance to get it right.
Katie Grice: … Yes, I think you can. The money to do so would be challenging. The voter fatigue would be challenging. This is our shot to do this… we have to right now.
