KEN GRAHAM: FROM THE PUBLISHER

Snowballs roll downhill, and that's where the entire healthcare system in the Touchet Valley will head if upgrades aren't made soon to Dayton General Hospital. That's the message supporters of a bond levy measure in front of voters this fall are sending us.

The levy will, if passed, allow the Columbia County Health System to modernize and reconfigure the Dayton General Hospital building. These changes will put nursing and dietary employees much closer to the patients and residents they serve, and they will increase the level of associated services the health system can provide, including physical therapy and lab services. (See the article that begins on Page 1.)

The ultimate goal of these improvements, however, is to allow CCHS to maintain its full range of services, including keeping Booker Rest Home open. The majority of Booker's 40-plus residents are Medicaid patients, and the state's Medicaid program only covers about three-fourths of their costs. Taxpayers in the Columbia County Hospital District (which includes Columbia County and the Waitsburg School District) make up the difference.

Out of a total $15 million-plus annual budget, the district receives about $800,000 in property tax revenues. Booker currently runs a deficit of about $400,000 per year, which uses up half of that support. That gap will only get bigger over time.

Rather than improving employee efficiency and increasing revenues from other services, like physical therapy and lab services, which is the goal of the levy in question, another option would be to close Booker. After all, why continue a service that has to be so heavily subsidized by taxpayers?

That's where the snowball starts rolling. On the surface, the loss of a rest home in the Touchet Valley would be a big hardship for those local families who have loved ones that need that level of care. Almost without exception, Booker residents are either local residents themselves, or are close family members of local residents.

But that's just the start. Booker has 40 direct employees, whose jobs would be eliminated. Most of the17 jobs in dietary services would also be eliminated. Those jobs provide a payroll of nearly $130,000 per month, and represent more than a third of CCHS employees.

On top of that, the 44 (plus or mi nus) residents at Booker would have to move out of the area, and they would no longer use CCHS services. They wouldn't be seen by local doctors, and they wouldn't use local lab and physical therapy services.

All of a sudden, services provided by the CCHS clinics in Dayton and Waitsburg would be under-utilized, resulting in staff cuts there. Other cuts in services, like labs and PT, would have to be made as well. Revenues would drop, and either taxpayers would have to provide even more support or we'd lose most of our local healthcare services.

As CCHS board chair Ted Paterson put it, local healthcare works as a "system." If you take away one part of it, the rest of it is greatly weakened. In the first ten years after I moved to Dayton (I was 41 and healthy then), I saw a doctor once - for a sprained ankle. (I was told that, when you reach your 40s, such injuries take longer to heal and I needed to be patient.)

I'm now still pretty healthy, but I'm even older, and I see the doc fairly regularly. The thought of living in a community without a broad range of health care services, including a staff of doctors and an emergency room, is pretty scary to me.

Since you are all getting older too (whether or not you want to believe it) you are facing increased use of healthcare services, just as I am.

Think about that when you fill out your ballot in the next few weeks. That snowball could roll over the top of you, too.