Park County voters will have the final say on a proposed $14.2-million capital facilities tax for upgrades to West Park Hospital in Cody.On a split 3-2 vote Tuesday, Park County commissioners approved putting the question on the Aug. 17 primary ballot.If supported by a majority of voters, the $14.2 million would be paid through an additional 1-cent sales tax, which would take a little over two-and-a-half years to collect, West Park officials have estimated.The capital facilities tax funding would account for a little more than half of a total $26.2-million project that would upgrade or add more than 110,000 square feet of space at West Park. The remaining funding would come from $12 million of reserves that the hospital will commit to the project.{mosloadpositionuser201}

The project would relocate the 1972 hospital's laboratory and imaging departments, demolish the existing vacant Coe Medical Office building and create separate entrances and areas for visitors and staff and patients, among other improvements.

Dr. Kirk Bollinger, West Park's chief of staff and emergency room director, said West Park's facilities were outdated when he started with the hospital 12 years ago. Crowding in the emergency department is a frequent problem.

“We can't keep doing what we're doing as far as patient confidentiality and privacy,” Bollinger said.

The county's three municipalities — Powell, Cody and Meeteetse — had already voted to put the measure on the primary ballot by Tuesday, leaving the county's OK as the final hurdle.

While not questioning the need for the project, Commissioners Tim French and Dave Burke voted against the proposal.

“It's a district issue, to me,” said French. He noted that Powell residents do not vote on West Park's publicly-elected seven-member board of trustees, which put together the modernization plan. French said it amounted to “taxation without representation.”

“I don't think it should be on the ballot,” he said.

West Park Attorney Chris Edwards countered that all county residents would be represented when they voted on the proposal in August.

After saying he struggled with the isssue for weeks, Commissioner Burke said it was important for the commission to play the role of gatekeeper.

“Just passing it on to the voters is probably not the way it should be done, pro or con,” he said.

Burke also expressed concerns about competition between the Powell and Cody hospitals, and said West Park already has a funding mechanism for capital projects.

0“The hospital (West Park) does have a taxing district. The Powell hospital has a taxing district. These were set up, appropriately so, for taxing within those districts,” he said.

“I think West Park has a dire need here, but I don't think this is the tool to address that now,” Burke added.

With commissioners Jill Shockley Siggins and Bucky Hall having already indicated they would support the measure, that left Commissioner Bill Brewer as the potential swing vote.

“I don't believe that I should sit here and say yes or no for this proposal — whether I'm for it or against it,” said Brewer. Health problems had forced him to miss the commission's meetings from January through March.

“I believe that this should come before the voters. Let them decide,” Brewer said, joining Siggins and Hall in supporting the resolution.

After the vote, Siggins said she wanted voters to decide the fate of the proposal.

“It's an excellent, needed project,” said Hall, after the vote. If it was the Powell hospital before the commission with a capital facilities tax proposal, “my feelings would be the same.”

Hall said he understands the argument about having hospitals tax within their districts, “but the problem is, then it's just the property owners getting taxed. At least this (a sales tax) kind of gets at everybody,” he said.

Edwards noted that tourists will pay a share of the cost under a capital facilities tax, with visitors estimated to pay between 25 and 30 percent of sales tax collections.

She also rejected the suggestion that the two districts were competitors.

“Both hospitals should be strong, and we definitely don't see them as competing,” said Edwards.

“It's amazing what happens every day ... in support our facility provides to Powell, and vice versa,” said West Park CEO Doug McMillan.

He noted that some people in Cody choose to get their medical services in Powell while some people in Powell get their care in Cody.

On a given night at the emergency room, Bollinger said four or five patients — a quarter of the total — may be from Powell.

Overall, including all types of visits, West Park has said that around 9 percent of patients come from Powell, among 31 percent of patients who come from out of the hospital's district.

Bollinger said that if a medical need can't be handled in Powell, patients are sent to Cody when possible.

“The hospital (West Park) kind of is the medical center for Park County,” Bollinger said.

“I really believe that it is necessary for us to support both hospitals,” said Melissa Fraser, a West Park trustee. She said that without support for both, Park County residents will end up having to send all health care to Billings facilities.

Fraser re-emphasized that if Powell ever sought to address its needs through a capital facilities tax, “We're going to be there to support them (Powell),” she said.

Powell Valley Hospital had looked at beginning a similar series of upgrades that would be funded through a general bond issue in its tax district, but put the plans on hold when their finances and the national economy tumbled last year.

If West Park sought a general bond issue for the improvements — which would have to be approved by the hospital district's voters — it would take nine-and-half years to pay off, and, largely because of increased financing fees, cost $18.2 million, officials have said. A bond issue would be paid for by property taxes, and West Park officials have said they do not believe it is a viable option to ask for more property taxes now.

Fraser cited the benefits of the faster payback with a capital facilities tax.

“Our children are not paying for this for 25 years,” said Fraser. “We pay for it right now, as we go.”