Tuesday, January 19, 2016

The Root of the Hospital Problem: A Sutter Coast Hospital Board Mired in Secrecy

In This Issue 
January 16, 2016
The Root of the Hospital Problem:  A Sutter Coast Hospital Board Mired in Secrecy
By Greg Duncan, M.D., with original email by Larry Eninger, M.D.
This article contains an internal hospital email written by my colleague Dr. Larry Eninger, providing a "behind the scenes" look at the conflict between our community and the Sutter Health appointees on our local hospital Board.  Dr. Eninger served on the Sutter Coast Hospital Conflict Resolution Committee, formed when hospital physicians opposed the Board's secret vote to transfer hospital ownership out of our community.   Local readers already know Dr. Eninger as a caring doctor with a wonderful staff in Crescent City and Brookings.  Less well known is his resume--retired Navy captain and flight surgeon, former Sutter Coast Chief of Staff and Director, and former staff physician at the Scripps clinic in La Jolla, California.  Dr. Eninger's  experience in multiple practice settings was a great asset to the committee.  For three years, he met with physicians and hospital Board members, studied the hospital bylaws changes written by a Sutter Health attorney in 2011, and offered his advice to resolve the Sutter conflict.
This week, Dr. Eninger resigned from the Conflict Resolution Committee.  His resignation email , sent to all members of the Sutter Coast Conflict Resolution Committee, follows:

(note: "Kevin" refers to Dr. Kevin Caldwell, who was advised by a hospital Board member that Dr. Caldwell could not release any committee information to anyone)
"Kevin, you don't need anybody's permission to share our communications. 
Anyone who thinks their words/actions should be kept secret should probably reconsider those words/actions.  I will certainly be perfectly candid if anyone cares enough to ask me what has transpired in our committee."
"I have been tight-lipped, but I fully understand your frustration.  All the secrecy is counterproductive.  Do some think they need to make decisions for the community without the community's knowledge because they are so much smarter than the lowly people who just wouldn't be able to understand their wisdom?  Or maybe they are ashamed of their actions and know that anyone with knowledge will recognize that those actions are indefensible?"
"I've tried for years to be understanding, but it's time to call a spade a spade.  It's convenient and comfortable to criticize Sutter Health, the big nebulous corporation in Sacramento, rather than our friends and neighbors.  But Sutter Health is not primarily responsible for the decline of Sutter Coast Hospital over the past few years.  Sure, they could have been more open and spoon-fed us with the negative aspects of their plans, but why should they?  They are a corporation whose Board is responsible for the success of that corporation.  Their primary concern is not Sutter Coast Hospital or our community.  That responsibility belongs to our local Sutter Coast Hospital Board."
"In defense of our Board, it is a tough job.  Nonetheless, it is our Board's responsibility to protect the interests of Sutter Coast Hospital, and by virtue of the hospital's charter, the local community.  Whether by ego, ignorance, ineptness, laziness, cowardice or combination thereof, our local Board has failed miserably in that responsibility."
"Some board members still believe that Sutter Coast Hospital is owned by Sutter Health.  They either don't understand their responsibility as Trustees of Sutter Coast Hospital or they choose to ignore it.  They weakened their powers, and thus their ability to meet their responsibilities, by accepting the Bylaws changes of 2011; they tried to give them away completely by voting for regionalization; and they voted for Critical Access, a designation that burdens our community.  Then when confronted with opposition they chose to spend hundreds of thousands of dollars on a carefully-orchestrated, dependent "study" carefully constructed & interpreted in the then-CEO's office to support their position before hunkering down behind a wall of secrecy.  They chose to ignore the physicians and community with whom they clearly (should) have common goals and instead listen to the lawyers of Sutter Health, a corporation whose goals are, although generally aligned with, not the same as those of Sutter Coast Hospital."
"Our Sutter Coast Hospital Board is at odds with our community - fighting us on behalf of Sutter Health.  Until the majority of our Board is once-again composed of community-focused individuals who are capable of independent thought, our efforts on the Conflict Resolution Committee are a waste of time.   I am truly sorry about the events of the past 4-5 years for all of us.  However, 4 years is enough of rehashing the facts and having them repeatedly ignored.  I had hoped to contribute to resolution of our conflict, but I hereby admit my failure to meaningfully do so and submit my resignation from this committee."
Larry Eninger, M.D.
How Can You Help?
If you support the goal of affordable, accessible healthcare, please join the more than 4,000 local residents who have signed the petition at my office on 1200 Marshall St., opposing Sutter Health's corporate plans; write a letter to the Del Norte Triplicate (P.O. Box 277, Crescent City, CA  95531) and join the statewide effort to compel Sutter Health to open its hidden books and records by asking Attorney General Kamala Harris to investigate Sutter Health's conduct and whether Sutter deserves a tax exemption:
The Honorable Kamala Harris
Attorney General of California
1300 "I" St.
Sacramento, CA  95814-2919

Gregory J. Duncan, M.D.
Diplomate, American Board of Orthopedic Surgery
Please post this letter on Facebook and forward to interested friends!
Gregory J. Duncan, M.D. | | gregoryduncan1200@gmail.com | 1200 Marshall St.
Crescent City, CA 95531

Monday, January 4, 2016


by Roxie Hazard, Certified Radiologic Technologist
Here is a brief history on California's Healthcare Districts, and why our local Healthcare District is so important to our community:
In order to address healthcare shortages in rural areas, the California legislature approved the formation of local Hospital Districts, now called "Healthcare Districts." By law, Healthcare Districts have specified statutory rights, including the right of eminent domain, in order to provide appropriate healthcare for communities.  The Del Norte Healthcare District is governed by five elected county residents who, among other contributions, built the Del Norte Community Health Center, the largest clinic in Del Norte County, providing primary care, dentistry, and mental health services.
Four years ago, as part of Sutter Health's statewide hospital merger effort, the Sutter Coast Hospital Board voted (over the objection of Chief of Staff Dr. Kevin Caldwell) to dissolve itself and transfer ownership of Sutter Coast to a San Francisco based, multi-hospital corporation, entirely controlled by Sutter Health. Sutter excluded the hospital physicians, the Del Norte Healthcare District, and our community from its decision to transfer ownership of Sutter Coast Hospital out of Del Norte County.  In spite of widespread public concern, the Sutter Coast Board Chair refused to reconsider the Board's decision, stating, "the train has left the station."
Two years ago, the Sutter Coast Board voted (over the objection of Chief of Staff Dr. Greg Duncan) to implement "Critical Access" status, which, according to hospital CEO Mitch Hanna, would allow Sutter Coast to collect an additional $5 million a year from Medicare. However, Critical Access also required Sutter Coast to close half of its beds, and would greatly increase out of pocket costs to local Medicare patients. Whenever Sutter Coast was "full" under the 25 bed cap imposed by Critical Access, patients would be shipped to outside hospitals, at their expense.
In response to Sutter Coast's decisions, the Del Norte Healthcare District led an effort to stop Sutter Health's plans to take hospital ownership and to downsize Sutter Coast to a Critical Access facility.  Now, Sutter Coast states it has ended its effort to transfer hospital ownership out of Del Norte County, and has tabled its plans to downsize to Critical Access.
The problem is, the Sutter Coast Board has not made any binding promises--they have not withdrawn their Critical Access application and have not rescinded their vote to transfer hospital ownership out of our county, despite being asked to do so by the hospital physicians. The Sutter Coast Board has also refused to release their meeting records and financial data, and they continue to hold meetings closed to the public.
Q.  How can we bring better healthcare to our community?
A.  By supporting our locally elected Del Norte Healthcare District Board. 
Over 4,000 area residents have signed the petition at Dr. Duncan's office, opposing Sutter's corporate plans for Del Norte County.  Please stop by his office on 1200 Marshall St. and add your name to this list.  Our community, together with our Healthcare District, can improve local healthcare.
Our Healthcare District generally meets at 6:30 p.m. on the 4th Tuesday of each month, but with the holidays, the next meeting is scheduled for next Tuesday,
January 5th,  2016, at 6:30 p. m.  Meetings are open to the public, and are held at the Wellness Center, 550 Washington Blvd, Crescent City, CA 95531.  The phone number is:  (707) 464-9494, Monday through Friday, 8 am to 12 noon.
Please join me on Jan. 5, and the fourth Tuesday of each month, and bring your ideas and questions.  Together, we can make better healthcare in our region a reality. 

Roxie Hazard, CRT
Crescent City, CA