Around a dozen Skagway residents attended the first town hall to ask questions about Proposition 1, which would transition Dahl Memorial Clinic into a non-profit.

 

Concerned citizens met at an Aug. 21 meeting to discuss changing the operating structure of Skagway’s Dahl Memorial Clinic. Owned by the municipality, Skagway’s clinic is the only one in Alaska that answers to an assembly. Recently, the clinic ran afoul of federal funding requirements. 

Albert Wall is the clinic director. He explained that it wasn’t the level of care that was the issue, but the oversight model.

“It’s not a problem with the municipality doing the wrong thing,” he says. “It’s the fact that the system of health care has evolved over the years and has diverged, if you will. And the federal government wants all of these little clinics to have their own standalone, self-supporting, self-sustained, authoritative, autonomous board of directors.” 

Wall says a revised co-applicant agreement between the municipality and the clinic, and bylaws approved by the assembly this month, helped address that issue. But he, and everyone on the panel, made arguments for voters to approve Proposition 1, which would give the clinic 501(c)(3) status.

Wall says if the proposition fails, services at the clinic will remain as they are. It’s a question of how to pay for those services. He would like to have access to non-profit grants, which are unavailable under the current structure.

“I can’t do a number of things like stop the subsidy that we’re currently providing to tourists for their health care out of our pockets,” he says. “I can’t stop the drain on the city coffers. We’ve put together a plan to basically back off our budget requests from the municipality by a third every year for the next three years. I can only do that as a nonprofit, because then I can avail myself of the other grant money that’s out there.”

Assembly member Alex Weddell is the clinic liaison. She stressed that if the clinic becomes a non-profit, it still remains a co-applicant with the municipality. The transition is not a sale, just a change in structure. The non-profit, if approved, would lease the clinic building from the municipality. Weddell hopes to eventually spend the money the borough now budgets for the clinic on other projects.

“When we’re not paying the clinic a million dollars a year, we’re now going to have more money to do other things, which I don’t know – pool, rec center expansion, daycare program…”

According to the new rules, Lea Mauldin cannot be re-elected to the clinic board because she works for the municipality. She will serve out the remainder of her term as board president. When asked if the board supports the transition to non-profit status, Mauldin answered in the affirmative. 

Clinic Director Wall says that making the medical center a non-profit also allows for direct community community governance. Meaning, complaints migrate from assembly meetings to the clinic board, which would have the authority to affect change.

He also said retirement benefits already in place would not change.

He emphasized that the clinic board cannot sell the clinic, as there is nothing to sell. While the municipality owns the building, it does not own the clinic business or much of the equipment.

“Everything else that’s there is given by a grant and a license by the federal government, which is not for sale,” Wall says. “It is not a sellable item.”

Mayor Sam Bass was the event’s moderator. He offered some statistics.

“In fiscal year 15, the city gave the clinic about half a million,” Bass says. In 2023, we gave about a million, and this year, we’re giving $2.2 million. So, it’s growing exponentially as we go forward, and we’re hoping that this 501(c) transition, along with some other innovative ideas brought by Director Wall, we’ll be able to meet that 33% reduction that he mentioned earlier.”

Bass encouraged voters to cast a yes vote for Proposition 1.

“I believe that the 501(c)(3) will give us more flexibility to provide those services, to have more funds,” he says. So I also hope it passes. But as usual, I know that the citizens are the smartest entity here, and when they choose something through the electoral process, they usually get it right.”

The next town hall will be held Sept.12 at AB Hall.