The Future of Healthcare in Our Region
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Today's
guest editorial is written by Dr. Kevin Caldwell, a local Family
Practice physician and frequent recipient of Del Norte County's
"favorite physician" award.
Please
forward this newsletter to anyone who may be interested, and post it on
social media. I also appreciate your emails with ideas on this issue,
and how to improve transparency and affordability of healthcare.
Gregory J. Duncan, M.D.
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| Our Healthcare Decisions Must be Based on Fact and Transparency by Kevin Caldwell, M.D. |
As a current Del Norte
Healthcare District Board member, three term former Chief of Staff and
Board member of Sutter Coast Hospital ("SCH"), and local physician for
the past 29 years, I would like to clarify some information published in
last week's Del Norte Triplicate which may have left readers confused
as to the ownership of SCH. As you read articles on Sutter's plans for
our community, please ask yourself if the information was written by
someone who receives money from Sutter Health. I have no financial ties
of any kind with any Sutter corporations.
First, a definition of
Regionalization: a Sutter Health statewide policy to transfer
ownership of community owned Sutter affiliated hospitals FROM local
ownership TO regional ownership. In our case, Regionalization would
transfer ownership of Sutter Coast Hospital (which has always been owned
and governed locally) FROM Del Norte County TO Sutter West Bay Region
in San Francisco.
Sutter Coast Hospital
is currently owned by the corporation of Sutter Coast Hospital, and is
governed by a Board of Directors, the majority of whom reside locally.
SCH is affiliated with, and managed by, Sutter Health. How do I know
this?
(1) The settlement agreement between Sutter Health and the Del Norte Healthcare District states, "Sutter Coast Hospital owns Sutter Coast Hospital."
In the first draft of the settlement agreement, Sutter attorneys
inserted the statement, "Sutter Health owns Sutter Coast Hospital," but
the Healthcare District made Sutter Health remove that statement,
because it was false. Nevertheless, SCH CEO Linda Horn continued to
spread the false claim that Sutter Health owns SCH.
(2) Sutter West Bay
Region President Mike Cohill, in a recorded meeting held in Del Norte
County on 8/2/12, stated that Sutter Coast Hospital is owned by Sutter
Coast Hospital.
(3) Sutter Coast
Hospital currently has its own Board of Directors, bylaws, Articles of
Incorporation, and tax I.D. number, all of which are dissolved with
Regionalization.
In last week's Del
Norte Triplicate, editor Richard Wiens quotes the following from the
Settlement Agreement between Sutter Health and the Del Norte Healthcare
District: "Sutter Health has been the sole general member of Sutter
Coast Hospital, with the right to exercise control over it, since its
inception." I suspect few readers understand the meaning of that
statement.
The "General Member"
is Sutter Health. In some corporations, the General Member is
all-powerful. In our case, the General Member is not--Sutter Coast has a number of powers over Sutter Health.
"Control," in the sense used here, is a legal term which means Sutter
Health has the power to appoint the majority of the SCH Board. "Control"
does not mean Sutter Health can do whatever they want--their powers are
limited by SCH bylaws, Sutter Health bylaws, Medicare regulations,
Joint Commission standards of hospital accreditation, and California
law. Evidence of Sutter's repeated violations of these regulations, and California law, will be detailed in future articles.
According to Mike
Cohill, Sutter Health and SCH are separate corporations, each with its
own unique powers (which Mr. Cohill calls "reserve powers"), as defined
in the bylaws of each corporation. One of SCH's reserve powers is the
authority to approve and disapprove of mergers. In other words, Sutter
Health cannot transfer ownership of Sutter Coast out of Del Norte
County (Regionalize) without the approval of the Board of Directors of
SCH.
The SCH Board did vote
to Regionalize on 11/3/11, over my objection. I advised my fellow
hospital Board members that we should not vote on something we did not
understand. The Board had not read the Regional bylaws before voting to
Regionalize, although three hospital Board members falsely stated they
had read the Regional bylaws in advance of the Regionalization vote. I
know this because the Regional bylaws were not distributed to the SCH Board until 11/8/11, five days after the vote to Regionalize. So,
the hospital Board voted on a policy they had no way of understanding.
Does a Board have a responsibility to cast an informed vote?
In 2011, Sutter
Regional executive Larry Dempsey, Esq., re-wrote the bylaws of SCH,
weakening many of the hospital's reserve powers over Sutter Health. Mr.
Dempsey did not explain this fact to the SCH Board, which had no
independent legal counsel. On 2/3/11, following minimal discussion, Mr.
Dempsey's 1300 changes to the SCH bylaws were approved by the SCH
Board.
The California State Bar is the agency which oversees attorney conduct. It is a Bar rule that one attorney cannot represent two parties without the written informed consent of both parties. Sutter
Health attorneys never obtained consent from SCH before re-writing the
SCH bylaws or asking the SCH Board to dissolve themselves and transfer
hospital ownership to San Francisco. Dr. Duncan and I filed a complaint regarding two Sutter Health attorneys to the State Bar, which is currently under review.
The fact is, despite
overwhelming community opposition to Sutter's plans for this region,
Sutter refuses to budge. Sutter Health is determined to end their 28
year relationship of managing a locally owned, Acute Care hospital in
Del Norte County. The SCH Board refused to rescind their Regionalization
vote. Regionalization remains SCH Board policy. Sutter will not
release any Board meeting minutes. Last May, SCH CEO Linda Horn
announced in a televised meeting that "Critical Access is not being
discussed," even though the SCH Board had just approved a $170,000 study
on the hospital which mandated an analysis of Critical Access. In
December, the SCH Board voted for Critical Access. Last month, they
filed the application.
The SCH Board refuses
to discuss community letters of concern in the Board room, which remains
closed to the public. Sutter Coast's ongoing secrecy and high prices
have compelled many in our community to seek care at distant hospitals,
resulting in a steady decline in our hospital census over the past year.
During our 1/28/14
meeting, the Del Norte Healthcare District voted unanimously to oppose
Critical Access and Regionalization. The Triplicate did not report on
that resolution, so the District ran the announcement as a paid
advertisement. We believe our community deserves options for their
healthcare. Three other healthcare systems have offered to provide capital to develop an affiliation with our hospital.
Please share your thoughts with me and my fellow Board members at:
The Del Norte Healthcare District, 550 E. Washington Blvd., Crescent
City, CA 95531. We want to hear from you.
Kevin J. Caldwell, M.D.
Redwood Family Practice
Crescent City, CA
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