Endorsement: Ballot Issue 2Q is a much needed sales tax for Denver Health

The Front Range’s largest safety net hospital is struggling to subsist and Ballot Issue 2Q would infuse Denver Health with $70 million a year.

The cost of shoring up this critical health system would be a .34% sales tax which translates to a little more than $.03 on every $10 someone spends on non-grocery food items in the City and County of Denver. It’s an investment this city’s voters can make for the future of health care.

Denver Health has long been one of the best trauma hospitals in the state — the place you want an ambulance to go when tragedy strikes — but it serves the state in other ways. The mom and baby unit delivers one in three children born in Denver. The quasi-governmental entity also operates primary care and mental health clinics in our schools, neighborhoods, and jails. It runs ambulances and hires our EMTs. It has dental clinics and provides vaccines.

The hospital has operated at a net loss over the last three years, although for the past two years, the new CEO, Donna Lynne, has managed to tighten the belt and solicit enough emergency funds to stay in the black — just barely. In 2022 the hospital reported a $58 million loss and in 2023 the hospital came out ahead by $11 million.

The driving factors of this fiscal crisis have been increased costs associated with rising wages and inflation, and increased uncompensated care from homeless individuals, South American migrants, and the thousands of Coloradans who were kicked off of Medicaid this year. The hospital receives state, federal and city of Denver payments for patients who cannot pay, but those payments have remained fairly stagnant for many years.

Denver Health needs a dedicated revenue stream so it can remain a thriving force for public health in our community.

For the past five years, The Denver Post editorial board has taken a conservative stance on sales tax increases, urging voters to not create new programs using the city’s limited ability to increase sales taxes.

But Denver can still afford one more sales tax increase, and this proposal is not for a new, untested, and ungovernable venture. Denver Health is one of the state’s oldest institutions. At one point it was a city agency before it became independent and it historically made its budget work by tightening its belt in lean times and expanding only when prudent.

Donna Lynne has a proven track record of leadership. She ran Kaiser Permanente in Colorado before becoming the state’s lieutenant governor under John Hickenlooper. She has pledged that the hospital will disclose exactly how the new sales tax revenue is spent during its annual “Report to the City.” The ballot language limits how the money is spent to five main categories of care: emergency, primary, mental health, pediatric, and substance abuse recovery. Additionally, when Denver City Council members voted 12-1 to refer this measure to voters, they included language stipulating that the city’s annual $30 million contribution to Denver Health would not be reduced in response to the new tax, although other economic factors could cause a reduction.

Denver Health’s financial security benefits the entire region. The hospital serves people from across the state, not just the metro area, so it is fitting that a sales tax that is paid by not only Denver residents but also visitors be the funding source for operations.

Some of the money will allow for the expansion of the hospital’s mobile clinics into parts of the city that are underserved, but most of the new dedicated revenue stream will help prevent layoffs, improve retention of staff, and prevent potential reductions in services.

However, Colorado’s elected officials cannot rest on their laurels even if Ballot Issue 2Q passes. Two other major reforms are needed.

Colorado collects a fee from patients for every night spent in a hospital and uses that fee to get federal matching dollars for Medicaid payments. Those matching dollars are then sent to hospitals through an opaque equation that must be revised based on hospitals’ needs. If the Colorado Healthcare Affordability and Sustainability Enterprise Board won’t adjust the formula, state lawmakers must force their hand.

Second, Colorado lawmakers can tighten requirements for “nonprofit” hospitals to spend more of their required “community benefits” helping other hospitals and medical providers with their uncompensated care. Nonprofit hospitals should be helping to backfill their regions’ uncompensated care before they spend the money on other purposes. Kaiser Permanente set the precedent for this in 2023 when it donated $10 million to Denver Health and started a fundraising effort this year for the Denver Health Foundation.

Health care in America is broken. Everything is too expensive while our healthcare workers are often overworked and underpaid. Even the best medical providers can struggle financially and there are deep flaws with Medicaid, Medicare, and all private insurers.

But one thing we can fix, this November, is ensuring that Denver Health has the resources it needs to serve the Front Range for years to come.

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Endorsement: Will Proposition 129 help or hurt Colorado pets and their vets?

If you’ve taken an animal to a veterinarian in Colorado recently, you know that medical care for pets isn’t cheap. Even a routine checkup for vaccines, heartworm prevention, and diet recommendations can cost a couple of hundred dollars, and any medical procedure starts at $1,000 and can reach $10,000 quickly.

A ballot measure could help or at least help prevent care from getting more expensive. Proposition 129 would create a master’s degree program to train a new level of care provider between technicians and doctors – a veterinary professional associate or VPA – who could perform surgeries, provide care, and perform other important tasks.

Most veterinarians work hard to keep their prices affordable, but the Denver Dumb Friends League – one of the most trusted animal shelters in the state — and Colorado State University  – our agricultural higher education hub – have teamed up to find ways to keep prices down.

The Dumb Friends League knows first-hand how many animals get surrendered or euthanized every year because a life-saving procedure is too expensive or an animal’s quality of life has deteriorated too far and the surgery would cost thousands of dollars to repair ligaments or remove bone spurs.

Colorado State University runs the state’s largest veterinarian college and is fighting to keep the state supplied with enough doctorates of veterinarian medicine to meet demand.

But Colorado is a pet-loving state, and there is a shortage of vets.

So the Dumb Friends League brought us Proposition 129. It changes state law and directs the State Board of Veterinary Medicine to create a licensing process for a two-year master’s program for veterinary professional associates. And CSU has drafted up a proposal to implement the master’s program.

These VPAs once licensed by the state will be able to perform almost all of the same duties as a doctor of veterinary medicine under the doctor’s supervision.

The language of the ballot measure limits the VPA’s work to what they were trained in school to do and what the licensed veterinarian assigns them to perform. The state board will create credentialing requirements for schools, and we urge them not to allow programs to be primarily conducted online. Physician assistants for human care — a master’s degree program — spend long hours in clinical care seeing patients and getting hands-on experience diagnosing and developing treatment plans. VPAs must get the same hands-on training with animals.

There will be a licensing test and required ongoing professional development.

We understand the concern from veterinarians across the state that this change could lead to substandard care. No one wants hurriedly trained employees working with animals. Large vet chains, including some who have donated money to help put this on the ballot, may abuse these new employees setting up teams of VPAs working under the supervision of a single veterinarian who doesn’t have time to ensure quality of care. There is no guarantee that any savings realized by hiring fewer doctorates in veterinary care would be passed along to pet owners.

The issue is being framed by the American Veterinary Medical Association — which opposes the measure — as a choice between substandard care and the status quo.

But for many Coloradans today the status quo is prohibitively expensive and the choice often is not seeking any medical care for their animals. The risk of poorly trained VPAs or large chain veterinary hospitals abusing the intent of the law is worth the potential outcome of more Colorado pets receiving medical care when needed because it is readily available and more affordable.

Just as humans seek care from PAs who received master’s degrees, so too pets should be able to get care from VPAs with master’s degrees.

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Endorsement: On Ballot Measure 2R, Denver voters should say not this tax, not this time

Mayor Mike Johnston has a plan to infuse our tax dollars into the housing crisis to help build affordable housing in a city that has become all but unobtainable for middle-class Coloradans.

But we have to agree with Denver city council members who expressed grave concerns about the plan to raise Denver’s sales tax to fund a new venture into affordable housing for the city.

“I will support it going to the voters but we have to be honest; good intentions exist but the clarity and specificity doesn’t,” Councilwoman Jamie Torres said this month while casting her vote to help place it on the ballot in November.

Denver voters should not approve this dedicated sales-tax increase, at least not without a more thoroughly vetted plan. Johnston does have a vision that he spent an hour sharing with The Post editorial board, but the Affordable Denver Fund needs more scrutiny than it has received in the weeks since Johnston first unveiled the proposal.

If voters approve the $100 million-a-year increase in sales tax, it will be up to Denver City Council to approve spending plans. In other words, this is a tax-first, get-the-details-later approach that has resulted in mixed success for city voters in the past.

For example, Denver’s preschool program was a smashing success that has helped thousands of kids access quality early childhood education since 2006. The Educate Denver sales tax is getting scholarship money into the hands of seniors graduating from Denver high schools but has amassed a $30 million fund. The fund has not moved to reduce its sales tax rate of 0.08%.

Denver needs more affordable housing – particularly housing for Denverites who are making less than $60,000 a year. These middle-class and low-income Coloradans are falling through the cracks. They can’t qualify for subsidized housing through Section 8 (Housing Choice Vouchers) or Denver’s many public housing units but also struggle to afford market-rate rents.

But the city needs a concrete plan to make a dent in the housing crisis, especially given that this 0.5% sales tax would be in place for the next 40 years. Johnston should go back to the drawing board and come up with a proposal that provides voters with more details for how $100 million a year will create affordable housing in Denver. As it’s written now, the ballot language says the money will be used to: increase “production, preservation, financing, acquisition, conversion, (and) subsidies” for housing deemed affordable for those making less than 80% of the area median income. It also could be used for a homebuyer assistance program for those making less than 120% of the area median income. Those income targets feel right, but the “First Year Plan” for how to actually spend the money will be created by the manager of finance and the Department of Housing Stability sometime between the November election and Jan. 30, 2025. Voters need that plan now to judge whether this is a good idea.

We do like many of Johnston’s ideas, especially his plan to emphasize the acquisition of existing affordable housing in Denver, either through direct purchase or the purchase of an easement, to protect it forever from becoming new luxury housing. Johnston understands the housing market and wants to leverage the tax to dollars with other state and federal funding to build new units, preserve existing units, help first-time homebuyers escape the rental market, and help renters on the verge of eviction.

In the meantime, Johnston should select one key initiative in his proposal, find existing funding, and run a pilot program to demonstrate how his Affordable Denver Fund will work on a $100 million-a-year budget. Then build a “First Year Plan” around that success. Rome wasn’t built in a day, and Denver didn’t become unaffordable overnight. It’s OK if the mayor doesn’t solve this problem in his four-year term in office.

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