Kootenai Health outlines Post Falls Prairie Medical Campus, describes CityLink transit partnership; commissioners raise questions about county grant support

Kootenai Health CEO Jamie Smith and senior staff presented to the Kootenai County Board of Commissioners on May 27 about the hospital system’s organizational structure, community benefits, a planned Post Falls Prairie Medical Campus and an existing transportation partnership with CityLink.

Jamie Smith, CEO of Kootenai Health, described the system’s recent conversion from a hospital district to a private 501(c)(3), citing state law and House Bill 603 as enabling the transition. "Our mission is to provide health care to the citizens of our community. We don't exist for any other reason," Smith said as she explained the organization’s decision and the governance structure under an 11‑member board based in Coeur d'Alene.

Why it matters: Kootenai Health serves a multi-county region and is planning capital investment in Post Falls that county leaders said could affect county residents’ access to care and local infrastructure. Commissioners probed the hospital’s philanthropic, operational and grant relationships with the county, particularly regarding public transit.

Key points on the Prairie Medical Campus: Kootenai Health said it has acquired a roughly 30‑acre parcel at the corner of Highway 41 and Prairie Avenue in Post Falls and plans a phased campus focused on outpatient services, imaging and a freestanding emergency center. The campus will be developed as a joint venture with the Washington-based MultiCare system and a local developer, Parkwood Properties. Kootenai Health said it will be the managing partner and that the Phase 1 micro-hospital and medical office development is intended to open in roughly 36 months, contingent on permitting and construction. Estimated project cost cited in the meeting was about $120 million, with Kootenai Health bearing roughly half of that amount.

Community benefits and uncompensated care: Michelle Bowie, Kootenai Health senior staff, presented high‑level community-benefit figures. She said the system provided approximately $41,000,000 in uncompensated or discounted care in 2024 and that donations and in‑kind services were substantial; a figure for donations cited during the discussion referenced prior-year totals but financial close-out for 2024 was still in process.

Transit partnership and CityLink: Kootenai Health staff explained a long-standing partnership with CityLink (a regional transit provider) that dates to 2010. Staff said the hospital provides in‑kind operational support and pays operational expenses for some services; CityLink was able to secure about $5,500,000 in grants between 2017 and 2024 with the partnership, and the hospital has received seven buses over time as part of the arrangement. Kootenai Health staff said their transportation program provides about 2,000 rides per month (roughly 24,000 annually) and cited just-under-900 rides to Heritage Health in 2024.

Questions from commissioners and public comment: Commissioners asked for clarity about whether the hospital-operated buses are part of the paratransit system required to accompany fixed-route transit, and whether the county is an appropriate sponsor for grant applications that primarily support one provider’s network. Staff said they would provide more detail about service maps and vendor relationships. A public commenter, Ron Hartman, urged the county to stop sponsoring public transit grants for private or quasi-private providers and to prepare a shutdown timeline and cost estimate if the county were to cease support. "The end game for the county is to get out of running a public transportation system," Hartman said during public comment.

What remains open: Staff agreed to clarify the relationship among CityLink, Kootenai Health buses and paratransit requirements, to provide service-area maps and to return with further documentation about grants and matches. Commissioners did not take formal action at the meeting; concerns remain around county sponsorship of grants and whether funding and services cover the entire county population.

Speakers identified in the record included: Jamie Smith (Kootenai Health CEO), Katie Bobbitt (Kootenai Health representative), Michelle Bowie (Kootenai Health senior staff), and county commissioners who asked questions. Public comment opposing county backing of transit grants was delivered by Ron Hartman.