At the Vashon Brewing Community Pub on election night, the place was buzzing as supporters of the proposed hospital district gathered over food and drinks to celebrate the end of the Protect Vashon Health Care campaign, which spearheaded get-out-the-vote efforts in favor of the ballot measure.

When it was timefor election results to come in, Eric Pryne, a candidate for the district’s board of commissioners, looked at the laptop of the campaign manager and exclaimed, “Wow!”

The voters of Vashon-Maury Island had decided overwhelmingly to form a hospital district — the 59th in the state — after shooting down the same proposal 13 years earlier.

With the passage of Proposition 1 comes what’s will be known as Vashon-Maury Island Hospital District No. 5 and a 5-member board of commissioners, tasked with holding meetings and making decisions about the island’s health care services. The commissioner-elects are: Pryne, LeeAnn Brown, Donald Wolczko, Wendy Noble and Tom Langland.

“I think it’s hard on Vashon to get any kind of a mandate established, but … for all five candidates to have a mandate, I think is really a solid foundation from which to start,” Wolczko said.

One election night att the Vashon Brewing Community Pub , cheers and applause erupted once the lopsided results came in; words of disbelief were uttered; smiles and laughter filled the room. Brown, a hospital district commissioner, wiped away tears with a tissue as she marveled with Pryne and others.

“This just means so much for our community — and it’s really emotional for me,” Brown told The Beachcomber. “I feel so honored that our community members are willing to trust us.”

Protect Vashon Health Care released a prepared statement to The Beachcomber, saying voters approving a hospital district sends “a clear message they want access to health services on the island.”

Tim Johnson, a steering committee member of Health Care for Vashon and a member of the Vashon-Maury Health Collaborative, was quoted in the statement explaining what establishing a hospital district means for the island.

“A public hospital district is the best way to provide care that is accessible to the greatest number of island residents,” he said. “We can work together to build a system with medical providers that are responsive to us, we can keep tax collected here for the benefit of islanders, and we can save time and money by not having to leave the island for routine care and minor emergencies.”

Johnson continued, “This vote is about more than a clinic, though. This is a vote to preserve our physical health and economic vitality, to take care of our fellow islanders, and to keep this a great place to live and work.”

Jeff HansPetersen, a physician at Neighborcare Health, told The Beachcomber he was relieved the hospital district had passed.

“I take it as a real vote of confidence in the people who have run as commissioners, and an opportunity to strengthen the services that are on the island with access to tools we did not have previously,” he said.

Hilary Emmer, an island activist who wrote a statement in the voters’ guide opposing the hospital district, provided extensive comments to The Beachcomber when asked for her reaction to the passage of Proposition 1.

“My hope is that the commissioners will ensure that low-income people who have no insurance or have high deductibles will not receive bills nor be sent to collections,” she wrote. “I would encourage them to use our collective tax dollars for their benefit and peace of mind.”

Emmer continued, “I also hope that this new property tax, which ALL seniors are not exempt from and will have to pay in full, will not negatively impact them and force them to leave the island.”

“Our demographics are changing toward the wealthy, making it harder for seniors on fixed incomes,” she wrote. “Our working class will also be impacted by higher rental costs, forcing more to commute to the island for their employment.”

Emmer continued, “I look forward to seeing how the commissioners navigate the unknown and what the actual results of a needs assessment are and what changes if any occur on the island.”

Steve Nourse, an islander who has been critical of the idea of a public hospital district, wrote on Facebook shortly after the vote he sees it as his responsibility to attend as many commissioner meetings as possible “to assist in having decisions made that are best for everyone here.”

“I in no way intend to be an obstructionist, but to make sure that the plan that will be developed by quality commissioners is a good fit for everyone here,” Nourse wrote.

State statute, RCW 70.44, allows for hospital districts to be created throughout Washington. These districts can include the formation of a physical hospital, but don’t have to — the island’s commissioner-elects have said such a facility would not be established on the island. Though the board will be able to negotiate and contract with island or off-island health care entities to provide medical care here. The board also will be able to tax residents to pay for health care services by setting a levy rate and hire a superintendent, with a small staff, who will tend to administrative and legal matters concerning the district.

Statue says the elected commissioners “shall take office immediately when they are elected and qualified,” which would could be on or after Nov. 26, when the election results are certified.

“Initially, I’ve been looking at the minutes from the Orcas and Lopez districts from the early months and there’s a lot to do,” said Pryne, referring to to other islands that have hospital districts. “We’ll be, among other things, doing what’s necessary to set up a tiny government. We’ll need to figure out where we’re going to meet and lots of little details.”

Langland said the commissioner-elects were expected to meet together informally to “talk about how we begin this process in the most transparent and above-board way.”

While the commissioner-elects have researched public hospital districts extensively during the campaign, Langland said, the members “need to understand as a group getting it out of the block.”

“There’s going to be some learning curves,” Langland said.

Several commissioner-elects The Beachcomber reached out to said f the Association of Washington Public Hospital Districts would provide assistance to them in getting started.

Matthew Ellsworth, executive director of the association, told The Beachcomber in an email that his organization is excited that island voters “overwhelmingly supported an investment in keeping quality healthcare local.”

“When a new district is formed, AWPHD engages our partners at the Municipal Research & Services Center,” Ellsworth wrote. “Together, we have prepared and made available the legal manuals and essential advice necessary to begin a district in the appropriate, legal way. AWPHD wants the new district to succeed and thrive in the way the voters expect. We will be a resourse as the go down the course of standing up the district.”

The Municipal Research & Services Center did not wish to grant The Beachcomber an interview for this story.

The favorable vote on Vashon’s hospital district comes as some residents are facing increasing uncertainty as to whether a primary care clinic will remain on the island. The largest clinic, run by the Seattle-based Neighborcare Health, has admitted to being “challenged to fully support the cost of primary care operations” and that a “sustainable, predictable funding source is likely the only way to ensure primary care services can remain on Vashon into the future.”

On Nov. 7, Michael Erikson, Neighborcare Health’s CEO, released a statement to The Beachcomber commending the community for its “robust debate around sustainable funding for health care on the island.” He also congratulated the elected commissioners.

“Like everyone on Vashon, we look forward to learning of the decisions the commissioners make,” Erikson said. “In their process of gathering data and creating the systems to best determine the health care needs of the island, Neighborcare Health will engage with the commissioners to provide information and answer questions they may have. Our clinic teams are continuing their work of providing quality care to our patients.”

Correction: This story has been updated to reflect that one of the elected commissioners is Tom Langland. A previous version of this story gave an incorrect name for him.