Voters in the South Peninsula Hospital service area will be asked on Oct. 1 if the Kenai Peninsula Borough should borrow $38.5 million in general obligation bonds. This question will be listed as Proposition 1 and voters will respond by checking yes or no.

Derotha Ferraro, public relations director for the hospital, has been presenting a brief campaign presentation at various public events throughout the service area over the past few weeks to describe to members of the public what the $38.5 million will cover. Most recently, she presented it at a public town hall meeting, Thursday, Sept. 12, at the Christian Community Church in Homer.

In addition to Ferraro’s presentation, five panelists representing the borough and the hospital presented their views on why they support the proposition and then took written questions from attending members of the public. The panelists included: Kenai Peninsula Borough Mayor Peter Micciche; South Peninsula Hospital CEO Ryan Smith; Kenai Peninsula Borough Assembly member Kelly Cooper; South Peninsula Hospital radiologist Dr. Edson Knapp; and South Peninsula Hospital Board of Directors member Beth Wythe. The meeting was emceed by Dennis Weidler, general manager of KHCX radio.

The main features of the bond are the expansion of infusion clinic, moving the pharmacy to a new location in the hospital, adding nuclear medicine treatment, and purchasing three leased buildings.

The panel emphasized the need for these improvements to meet growing community needs and improve general health care access. The bond would be repaid over 20 years, with a potential 25% reduction in the mill rate upon passage.

In Ferraro’s presentation, she explained the governance structure of the hospital. The Kenai Peninsula Borough owns the assets, the property and the buildings. The borough contracts with a nonprofit, has a board of directors in Homer and the nonprofit employs all of the employees of the hospital to turn the assets into care. There is also a service area board.

Next, she described the service area for the hospital — from just north of Ninilchik, through Homer, to the communities out East End Road and across Kachemak Bay to Seldovia. The total population for the Southern Kenai Peninsula is approximately 15,500 people, she said, emphasizing that the senior population, or people over the age of 55, makes up 39% of the total.

The three buildings and lots that would be purchased if the proposition passes are the Specialty Clinic, the Reconstructive Surgery Clinic and the Infusion Clinic. The property acquisition would account for $13 million of the total bond, Ferraro said.

The cost of those buildings made up the majority of the questions from attendees. Mayor Micciche was asked by Ferraro what the justification is for the purchase of the buildings. “We need them. This is where we operate,” he said.

He noted that they could have been purchased for less if a negotiation had been sealed 25 years ago, but it wasn’t, so in order to act now, that’s what they cost.

“If we continued to lease these buildings for the same period of time as the bond, we’d be spending a minimum of $14.5 million without having control of the properties, which means we can’t grow our services,” he said, noting that escalation may increase over that period of time.

The next presenter was Knapp, who was asked to explain what nuclear medicine is, what it can be used for, what it benefits and if it’s safe.

“Nuclear medicine just simply takes an X-ray source, and we ingest it, either by IV or by mouth. Then the X-rays come from the inside of us out, and we take pictures of those X-rays,” Knapp said.

He said the primary use for nuclear medicine is heart disease. It can also be used for imaging the brain, the thyroid gland, kidney and lung to look for cancer conditions. Currently, that service is not available in Homer and patients who need it have to travel somewhere else to receive it.

“I’ve been asking for eight years to get it here, because it’s kind of standard care at most hospitals, and it’s a normal tool that we’ve been using for 50 years in the rest of the country that I would like to bring to Homer so that we can take better care of each other,” he said.

Ferraro asked Wythe if the approval of bonds for Proposition 1 would prevent other municipal projects from taking place, such as the community rec center? Wythe responded that municipal bonds are specific to a project and they don’t compete with each other for funding.

Smith’s question related to the cost of health care. This bond will not reduce the cost of health care but “what’s going to happen going forward is the same thing that’s happened for the last 50 years, as we’ve had this capital partnership with the community, is we’re going to continue to charge (what) we believe is a fair price for services provided,” he said.

Cooper talked about the timing and transparency of the Proposition 1 project and the importance and process of project planning to come up with a proposal that is affordable and realistic. “So we’ve had a real, consistent process and transparent through public hearings and the public has had the opportunity to participate in testimony at the borough building,” Cooper said.

Public questions at the meeting were received in writing and addressed to the panel by emcee Weidler. The questions addressed a variety of topics beyond Proposition 1, relating to topics such as how the operating board is appointed and whether or not they receive a stipend; how increasing the mill rates with a new bond might impact financial security for the hospital; how long the currently leased properties have been under contract with the hospital; the need for increased parking space at the hospital; the environmental integrity of the hillside behind the hospital and what the facility has done to ensure building security in the event of a landslide.

The topic of property purchase price and alternatives to purchasing those was addressed in several variations, typically responded to by Micicche or Smith.

“I would like to get it at better cost than this one, but it’s just not been an option. If we don’t need it, we’re going to walk away. We need this. These are very difficult three pieces of property to walk away from. We don’t have anything else adjacent that fills those needs,” Micicche reiterated at one point.

Other questions were related to specific dynamics of nuclear medicine and those were addressed to Dr. Knapp.

At the conclusion of the meeting, Smith thanked the attendees for joining the meeting and acknowledged the diversity of opinions on the bond issue.

“One thing you can do as a community member is get involved in the governance of the hospital,” she said, noting that members of the public can seek to serve on the service area board for the hospital.

Attendees were invited to remain in the lobby after the meeting to ask panelists additional questions to the panel or hospital employees.