CHARLESTOWN — For a group that started life with the goal of promoting good government in one town, the Rhode Island Statewide Coalition has come a long way.

Now a statewide organization — as its name implies — the group boasts about 4,000 members and has been a staunch advocate of property tax relief and separation of powers, while opposing any plans by the Narragansett Indians to open a casino.

Yesterday, the group’s annual meeting drew about 300 supporters to the grounds of the exclusive Shelter Harbor Golf Club, where the good-government focus manifested itself in speeches about hospitals, ticks, Indian casinos, property taxes and the need for good candidates for elected office.

“In 2006, 49 percent of the General Assembly was elected unopposed,” Harry L. Staley, the group’s chairman, said during his opening remarks. “We can do a lot better than that.”

While the group naturally focuses on issues affecting Rhode Island and its communities, one of yesterday’s talks focused on a matter that lawyers say could have nationwide implications. At issue is a case in which the U.S. Supreme Court will decide whether the Department of Interior can take 31 acres in Charlestown into trust on behalf of the Narragansett Indians.

Trust status would place the land under tribal and federal control, removing it from most state and local laws, and would, some officials fear, clear the way for the tribe to open a casino.

John Ben Carroll, a lawyer from Cazenovia, N.Y., who took up the case after coalition lawyer Bruce Goodsell died unexpectedly, said the court could, “with the strike of a pen, put an end” to the possibilities raised by the Interior Department action.

But he said people must not sit on the sidelines as the case unfolds.

“It isn’t just Rhode Island that is involved in this suit,” he said, adding that 22 states from Massachusetts to Alaska have signed on with Rhode Island, which is appealing a decision by the federal appellate court in Boston that favored the Narragansetts.

The tribe bought the land in 1991 for the purpose of developing housing for its elderly. The Interior Department later agreed to take the land into trust for the tribe, prompting the challenge from the state.

If the land case has big implications for the state, so does a topic raised by William G. McKendree, a member of the Westerly Hospital Board of Trustees.

McKendree told a story of winners and losers among the state’s hospitals, saying the eight community hospitals — Kent, Landmark, Memorial, Newport, Roger Williams, St. Joseph, South County and Westerly — are struggling because of an uneven system of reimbursements from insurers and rules favoring outpatient centers, which compete with community hospitals.

While the state’s tertiary and specialty hospitals made a combined $53.9 million last year, the eight community hospitals lost $35.7 million, McKendree said.

He said the state needs a level playing field that encourages cooperation rather than haves and have-nots. He also said the proposed merger between the hospital groups Lifespan and Care New England, which would put 70 percent of the hospital services in the state under one organization, should be delayed until underlying problems in the state’s medical system are addressed.

He said one of those issues is transparency.

“Today a hospital is not even allowed to find out what other hospitals are paid” by insurers, he said.

Thomas N. Mather, a doctor and University of Rhode Island professor who heads the URI Center for Vector-Borne Disease, focused on another medical topic — tick-borne diseases.

While ticks are a huge threat in Rhode Island, he said the state has allocated only $5,000 during the past 15 years toward prevention, not counting efforts by the state Department of Health.

Mather said the state needs to do more, and he offered advice to his listeners, telling them to check themselves and each other for ticks, carry pointy tweezers to remove ticks, kill ticks in their yard and on pets, and use permethrin repellant on their clothing.

Joe Lorenz, of Portsmouth, one of many attendees who asked questions after the talks, said that while tick experts urge people to clear away brush where ticks can flourish, the state’s Coastal Resources Management Council won’t allow that sort of clearing in areas under its jurisdiction.

“I don’t mean to be flip about it, but this is Rhode Island,” replied Staley, a Westerly resident who founded the group in 2003 to focus on government issues in that town.

The biggest name on the annual meeting program was that of Governor Carcieri, who has attended previous coalition gatherings but missed this year’s because he was attending the funeral for Newport socialite Eileen Slocum, Staley said.

Asked afterward about the push for more people to run for the General Assembly, Staley was not sure how many candidates will be unopposed this year, but published reports suggest the number will be lower than in 2006.

redgar@projo.com