Forming the West End Health Service District

Question 6A reads in full: "Shall West End Health Service District be organized?" A yes vote forms a health service district covering most of the West End of Montrose County, from west of the divide road to the Utah border. It takes in the towns of Naturita and Nucla and the unincorporated area, including Redvale, Bedrock and Paradox. The service plan estimates the area's 2023 population at 2,259.

Basin Clinic, Inc., a Colorado nonprofit corporation in Naturita, prepared and submitted the service plan. The plan gives the district's purpose as "to assist in funding essential health services in the western region of Montrose County." It says the West End has been without 24/7 care since August 2013, and that the Public Safety Sales Tax and yearly grants keep the clinic open: "If not for these revenue sources, BCI would be operating at a $500,000 deficit each year."

The Montrose County commissioners approved the service plan in Resolution No. 18-2026 on June 10, 2026, finding among other things that the existing service in the area "is inadequate for present and projected needs."

State law lets a health service district establish, maintain or operate public hospitals, nursing care facilities, emergency facilities, community clinics and other health facilities, as the plan notes. In 2027, its first year, the board "is expected to direct its initial efforts on deciding the location for a future CAH," a critical access hospital. The plan puts a preliminary cost estimate of approximately $82.2 million on facilities of approximately 65,000 square feet that the district may consider, and calls both figures "illustrative planning estimates only."

The plan states that "no indebtedness will be authorized at the organizational election," and it proposes no new facilities for the next two or three years. It anticipates that the board may, over time, seek voter approval for debt for identified capital projects. Its 2027 projection lists $418,358 in net patient revenue and $949,951 in district property tax against $1,302,235 in expenses.

A five-member board would govern the district. Voters elect the first board at the organizational election on November 3, 2026, and the ballot prints those director contests with this question.

Question 6A sets no tax. Ballot Issue 6B, on the same ballot, asks for $949,950 in annual taxes beginning in collection year 2027, and amounts generated thereafter, to pay district operating and capital expenses through a property tax of up to 20 mills. That rate may be adjusted to offset revenue losses from refunds, abatements, and changes in the law or the method of calculating assessed value. The question also authorizes the district to collect, retain and spend that revenue and all other district revenue outside TABOR's limits and those of any other law. The plan states that the district has power to levy property tax upon approval by its eligible electors. Question 6A decides whether the district exists; 6B decides whether it may levy that tax.