This November, West End voters will vote on ballot issues 6A and 6B, the passing of which would result in the formation of a hospital district and the construction of a mini-hospital, respectively. The Forum gathered arguments from an opponent and a proponent of the 6A and 6B.
George Lewis resides in the proposed hospital district and helped draft arguments against the proposal. The Basin Clinic’s Executive Director Christina Pierce shared her reasons for supporting the proposal. Both parties responded to the same questions.
How would a health district be helpful, or not, in the West End?
Lewis: No one doubts the need for better healthcare availability in the West End. The question is how to make it happen in the most cost effective and sustainable way without overburdening taxpayers and by using resources that are already available.
Pierce: A health district would address several critical healthcare gaps in the West End by providing services that are currently unavailable locally, including 24-hour emergency care, acute care, rehabilitation services, and long-term care. Today, many residents must travel outside the area for these services, which can be difficult during emergencies and burdensome for families.
What’s your current stance on the approval of a health district?
Lewis: We oppose it and want a chance to consider less costly options before this is passed. Many of the arguments made to support the health services district are misleading and do not reflect reality.
Pierce: I strongly support the approval of a health service district because it keeps healthcare decisions and governance within our community. Local residents would have a direct voice in how healthcare services are provided, allowing the district to focus on the unique needs of the West End.
Why or why not could a mini-hospital be sustained?
Lewis: According to Becker’s Hospital Review, a leading medical industry trade publication, more than 25 hospitals have closed nationwide in 2025, eliminating thousands of jobs. Critical Access Hospitals — small, rural facilities that rely heavily on federal and state subsidies — are particularly exposed. The cuts in Medicaid imposed by HR-1, the “Big Beautiful Bill,” will make the situation even more troublesome as our communities head into 2027.
Pierce: A mini-hospital could be sustained through the reimbursement model available to Critical Access Hospitals, which is specifically designed to support healthcare facilities in rural communities. These programs recognize the unique challenges of serving smaller populations and help ensure that essential healthcare services remain available to local residents.
What are the ways collaboration from communities could be supportive at this time?
Lewis: Proponents point to the West End Vision Plan as proof of widespread support for the Health Services District. That is not true. The vision plan called for collaboration among all healthcare resources in the two counties included in the plan. It did not endorse this particular strategy or this particular entity as the best and only way to fulfill the goals of the plan.
Pierce: Community collaboration is essential to building a healthcare system that truly meets the needs of West End residents. Collaboration creates opportunities to share resources, coordinate services, and reduce duplication of efforts.
What are you hearing from voters?
Lewis: They want to know more about other, less costly options and why these haven't been pursued in addition to this proposal. They want choices.
Pierce: Many voters appear supportive of a health district because they recognize the challenges associated with limited local healthcare services. At the same time, some voters have expressed concerns about the proposed mill levy and the financial impact it may have on taxpayers. Ultimately, each voter must evaluate those costs against the benefits of having healthcare services available locally 24-hours a day, seven days a week, throughout the year.
What else would you like to share?
Lewis: The population statistics used to try to substantiate the viability of this Health Services District include everyone living in the west ends of both Montrose and San Miguel counties, not just Montrose County, although the proposed district is in Montrose County only.
Pierce: A local health district has the potential to provide critical services close to home while creating jobs and keeping healthcare dollars within the community. It could also help ensure that seniors, families, and individuals receive timely care without traveling long distances.
