Please attend meeting Wed., July 17th, 3:30 p.m. at 9th and H Streets

Please attend meeting Wed., July 17th, 3:30 p.m. at 9th and H Streets

In This Issue Meeting between County Supervisors and Healthcare District

Opportunity for input on future of Sutter Coast Hospital I just learned that County Supervisors Mike Sullivan and Martha McClure will be meeting with Healthcare District Board members Clarke Moore and Kevin Caldwell, and Sutter Coast CEO Linda Horn, regarding the possible transfer of ownership and downsizing of Sutter Coast Hospital.  The meeting will take place Wed., July 17th, at the Flynn Center on 9th and H Streets in Crescent City.  Dr. Caldwell is the former Sutter Coast Hospital Chief of Staff who voted against the transfer of hospital ownership, and is opposed to hospital downsizing.   I know Dr. Caldwell would appreciate your input at this meeting.  Public input will be allowed. Please help spread the word by forwarding this message and posting on Facebook Please try to attend this meeting.  I am sorry for the late notice, but I was not invited to the meeting.  I just learned last night that the meeting was scheduled by the Supervisors.  I am unable to attend, but I was told Sutter Coast CEO Linda Horn was invited, and is expected to attend.  A good turnout would help our elected officials understand the importance of this issue and give you a chance for input. Meeting date:  Wednesday, July 17th, at 3:30 p.m. Location:  Flynn Center, 9th and H Streets, Crescent City Room:  Suite 200 (may be moved to the first floor auditorium if turnout is high). Please try to attend this meeting.   Sincerely, Greg  Greg Duncan, M.D. Chief of Staff Sutter Coast Hospital

Gregory J. Duncan, M.D. | | drgjduncan@yahoo.com | 1200 Marshall St.
Crescent City, CA 95531

Latest News on the Future of Sutter Coast Hospital

Latest News on the Future of Sutter Coast Hospital

July 15, 3013

I write to separate facts from rhetoric concerning Sutter Health and Sutter Coast Hospital (SCH).  Currently, SCH remains locally owned, and governed by a local Board.  In 2011, the hospital Board voted to "Regionalize" SCH, which will dissolve themselves as the governing body, and transfer hospital ownership and governance to a Sutter Board in San Francisco.  Under Regionalization, decisions which are currently made locally will be made in the Bay Area. Why is Sutter Health fighting so hard to own Sutter Coast? Sutter Health originally told our hospital Board that Regionalization was needed to increase efficiency in an era of decreasing payments.  However, former hospital CEO Eugene Suksi  later reported that Sutter's strategies for improved efficiency, such as outsourcing local jobs and purchasing supplies in bulk, are already in place and do not require Regionalization.  The main force behind Regionalization appears to be control.  Now, our hospital Board has the right to negotiate with companies other than Sutter Health to manage the hospital. Under Regionalization, we lose ownership of SCH, and management will be decided by a Sutter appointed Board, which meets 350 miles away and controls 11 hospitals in the Region.  What would "Critical Access" designation mean for us? The first major decision facing SCH is whether to downsize the hospital by 50% to qualify for increased Medicare payments under the federal Critical Access program.  Sutter Health's 2012 study on Critical Access concluded with the following statement:  "we believe the Hospital should pursue the Critical Access Hospital program."  The same study estimated that under Critical Access designation, 247 patients would have required emergency transfers from Crescent City to outside hospitals in 2011. At Sutter Lakeside, a hospital of similar size to SCH, Regionalization and Critical Access designation were followed by massive job losses, closure of two clinics, and a 150% increase in emergency patient transfers. Why does a charity operate in secret? When the local hospital Board voted to dissolve themselves, they did so without looking at options, such as affiliation with Asante Health System, which operates three hospitals in southern Oregon.  Asante has publicly expressed an interest in our hospital, but to my knowledge no one on the hospital Board other than me has approached Asante.  Now, after intense public criticism of their secrecy, SCH is paying a consulting firm $170,000 to evaluate strategies, including Critical Access.  However, Sutter Health controls the study, after refusing outside funding from three charitable foundations.  The consulting firm is not permitted to audit the hospital financial records or make any recommendations--they are allowed only to list options for the hospital Board, which already voted to Regionalize SCH.   The most disturbing aspect of this process is the hospital Board's refusal to include the public, beginning with their 2011 vote to Regionalize SCH, cast in a closed Board room at the deliberate exclusion of interested parties.  Hospital Chief of Staff Kevin Caldwell, M.D. objected to the Board's Regionalization vote, noted that they did not understand the transfer of ownership, and asked for more time to study the issue.  Nevertheless, the Board voted to Regionalize over his objection.  The hospital Board meeting minutes, hospital financial data, and even the membership and discussions of the current "steering committee" on the hospital study, all remain secret.  The hospital Board has not held a single public forum since their decision 20 months ago to transfer SCH ownership to Sutter Health.   Last month, the hospital CEO and Board Chair abruptly withdrew from a Town Hall event they had committed to attend.  No observers are permitted to attend Board meetings.  The Board Chair will not allow community letters of concern to be discussed in the Board room. Last week, The Joint Commission, a national accreditation agency which certifies hospitals, validated physician concerns that the SCH Board had inappropriately excluded physicians from hospital policies, in violation of our bylaws.  SCH leadership received four Joint Commission citations for failing to address physician concerns regarding Regionalization. SCH is a locally owned public benefit charity, with a monopoly over local hospital care and the privilege of tax exemption.  Sutter Health, and the SCH Board, are making decisions which will affect the lives of 41,000 people within the hospital's service area. Given the level of public concern, is it not appropriate for Sutter to release the documents the public needs to understand this issue?  Why does Sutter continue to operate behind closed doors, hold secret meetings, and withhold critical information this community needs for our long term planning?  I applaud the County Supervisors for asking Sutter to release this information.  Let's end the secrecy.  With Sutter Health's approval, I will make all the documents available on our website at www.crescentcityhospital.blogspot.com, including a link to the audio recording where Sutter Health Regional President Mike Cohill discusses Sutter's program to outsource jobs, and confirms that SCH is still a locally owned corporation.   Printed information, and a petition opposing Sutter's plans, are available at my office on 1200 Marshall St.  To receive future newsletters, please send me an email at drgjduncan@yahoo.com. I deeply appreciate the support from everyone who has joined our effort to stop Sutter Health, and preserve a locally owned, full service hospital.   Sincerely, Greg   Gregory Duncan, M.D. Chief of Staff Sutter Coast Hospital drgjduncan@yahoo.com

Gregory J. Duncan, M.D. | | drgjduncan@yahoo.com | 1200 Marshall St.
Crescent City, CA 95531

The following letter was just sent to the Del Norte County Board of Supervisors

Latest Information on Sutter's study regarding Sutter Coast Hospital Dr. Kevin Caldwell and I just mailed the following letter to the Del Norte County Board of Supervisors, as they consider their role in the future of Sutter Coast Hospital.  Sutter Health has hired a consultant group to help the hospital Board decide whether or not to transfer hospital ownership to Sutter Health, or cut Sutter Coast by 50% to qualify for higher Medicare reimbursement under the federal Critical Access program.  Had Sutter Coast been a Critical Access facility, the hospital would have been closed to new admissions the majority of days during the past eight months.  Patients needing a hospital bed would have been flown by air ambulance, at their expense, to distant hospitals. Dear Supervisors of Del Norte County: We write with an update on the status of the Sutter Coast Hospital Strategic Options Study.  This is a study about the future of Sutter Coast Hospital (SCH), being conducted and paid for by Sutter Health, using a consultant group (The Camden Group) with ongoing business connections to Sutter Health.  As you know, the Medical Staff passed a unanimous resolution (among the physicians attending our Medical Staff meeting) that prior to participation in any study, we would like our concerns addressed with respect to  the funding, design, and rights and responsibilities of community participants.  The physicians have received no response to our concerns from Sutter Health or the Board of Directors of SCH. We have also confirmed with two community members familiar with the study that outside funding remains available, as long as the study results are not predetermined.  However, Sutter Health Regional President Mike Cohill and Sutter Health study coordinator Traci Van have rejected the outside independent funding.  Thus, although the hospital Board voted to approve a collaboratively funded and independent study, the current study is entirely Sutter funded and Sutter controlled. You may also recall that the Medical Staff has passed two unanimous resolutions asking the hospital Board to rescind their prior vote to transfer ownership of SCH to Sutter Health's West Bay Region.  The Board of Supervisors and City Council also asked the hospital Board to rescind their Regionalization vote.  In every case, the local hospital Board refused to rescind their Regionalize vote, and in fact, the Board voted on 3/7/13 to leave the process of Regionalization in place. Sutter Health claims SCH is losing money. In an attempt to verify Sutter's claims, I (GJD) have made repeated requests during the last year to meet with the hospital accountant, a meeting which is my right as a Director of SCH, and which was promised by former SCH CEO Eugene Suksi.  Mr. Suksi told me that the accountant was the appropriate person to show me SCH financial documents. Subsequently, Regional President Mike Cohill, Mr. Suksi, and current interim SCH CEO Linda Horn have all blocked this meeting, unless a Sutter Health employee is also present. Remember Sutter Health does not own Sutter Coast, but they are attempting to take hospital ownership.   In addition, Linda Horn has not responded to my requests to learn who has been invited to participate on The Camden Group's "steering committee."  The SCH Board has not even discussed the concept of a steering committee, much less discussed or approved the process by which community members would be selected to participate on the committee. However, numerous community members have told me they have received invitations to sit on a steering committee related to Sutter Health's Strategic Options Study. In light of these facts, I would ask the Supervisors, and anyone else who Sutter has invited to participate on the steering committee, to consider the following: 1.  Mandate that your participation in a hospital study be preceded by Sutter Health releasing the meeting minutes and the financial data for the hospital.  We applaud Supervisor Finigan's call for Sutter Health to release this information, but three weeks later, Sutter has released nothing.  Be aware that study of SCH financial data will require considerable time by an independent accounting group with access to detailed records, not just summary information provided  by Sutter Health. 2.  Participate in the study only as it was originally designed and approved by the hospital Board-with collaborative funding and an independent consultant.  Community participation at the outset would ensure that the consultant candidates are selected and approved by the community, not by Sutter Health, as was the case in the current study.  (Only 3 community members selected The Camden Group to perform the study, after the first six local residents initially approached by the hospital Board refused to participate, over concern the study was not legitimate). 3.  Ask Sutter Health to stop using the word "independent" to describe the current study.  As pointed out by a community member who was asked to participate on the steering committee, the current process is clearly not independent and should not be described as such. 4.  Put the Sutter hospital study on the Agenda for a special meeting of the Board of Supervisors, to be held during the evening to allow maximum community participation.  You may not be aware that some of the individuals who spoke in favor of Sutter Health during your 5/28/13 meeting, including SCH interim CEO Linda Horn, are employed by Sutter Health, the corporation which is attempting to take ownership of locally owned Sutter Coast Hospital. Finally, please consider the motivation behind the two sides of this conflict.  Sutter Health is attempting to take ownership of SCH.  It has become increasingly clear that Sutter Health wants to downsize Sutter Coast Hospital in order to receive higher payments for the treatment of Medicare patients.  If Sutter Health will allow me to release the audio recording of Mike Cohill, Sutter Health Sr. Vice President, you will hear information which supports this contention.  The local hospital Board and Sutter Health have not responded to the physicians' resolution to expand services to improve the hospital, nor to our "no confidence" vote in Critical Access designation at Sutter Coast. We believe very strongly that Critical Access designation will harm the economic development and the residents and visitors in Del Norte and Curry counties, especially the elderly, poor and chronically ill. Thank you for your consideration. Sincerely, Gregory J. Duncan, M.D.                                                                                               Chief of Staff                                                                                                                      Sutter Coast Hospital      Kevin Caldwell, M.D. Board Member Del Norte Healthcare District

Gregory J. Duncan, M.D. | | drgjduncan@yahoo.com | 1200 Marshall St.
Crescent City, CA 95531

Regionalization and Critical Access Discussed by Supervisors Today

Sutter Coast Interim CEO presents hospital update to County Supervisors

Following today's Board of Supervisors meeting, I wrote the following letter to hospital employees, volunteers, and physicians.  Please contact me with any questions or comments, as we work to preserve local ownership, and prevent downsizing, of the only acute care hospital in our region. We also need volunteers to help distribute petitions and literature, and gather email addresses of interested residents.  Your email address is stored on my home computer and is not released to anyone.  Any communication from me will come through Constant Contact, with no attachments, and is virus free.  Please contact me at drgjduncan@yahoo.com or stop by my office on 1200 Marshall St. if you would like to help.

Definition of terms for newcomers:  "Regionalization":  Sutter Health's system wide take over of once independently owned community hospitals.  The Sutter Coast Board deliberately excluded the public from their vote to Regionalize our local hospital in 2011.   "Critical Access":  A federal program initially designed to support tiny hospitals by paying higher amounts for the treatment of Medicare patients.  Sutter Health is now considering closing half of our hospital beds to "fit" the program, which would result in hundreds of patients requiring air ambulance transfers to distant hospitals every year. How are these programs related?  If we Regionalize, the decision to implement Critical Access, and every other decision affecting the future of our hospital, will be made by a 32 member Board, appointed by Sutter Health, which meets in San Francisco.

The physicians of Sutter Coast Hospital are overwhelmingly opposed to hospital downsizing and to the transfer of ownership to Sutter Health.  Our goal is to expand services where feasible.  We want the hospital to be open when you need it.

Open letter to hospital employees, volunteers, and physicians:

 

Dear Colleagues:

I appreciate the input which Linda Horn and a group of hospital employees provided to the Board of Supervisors today.  Everyone expressed the common goal of a strong local hospital.  I write with suggestions on how we may secure that goal.  

The Medical Staff has already passed several resolutions opposing Regionalization and Critical Access Hospital (CAH) designation for Sutter Coast Hospital.  In fact, five months ago, at the request of several physicians, Dr. John Tynes contacted Sutter West Bay Region President Mike Cohill seeking just those two reassurances--that we don't transfer hospital ownership to Sutter Health or move to downsize Sutter Coast to a Critical Access facility.  Mr. Cohill promised to pass our request on to Sutter Health CEO Pat Fry.  To date, we have received no reply from Mr. Cohill or Mr. Fry.

Today, Linda Horn told the Supervisors that "Critical Access is not being discussed."  In fact, Sutter Health called a special meeting of the Sutter Coast Board earlier this year to discuss Critical Access.  Sutter Lakeside executives gave a presentation on Critical Access, including a three step process by which CAH designation could be implemented here.  We are now halfway through the second step in that process.  A 2012 study on Critical Access (funded by Sutter Health) produced the following recommendation to Sutter Health (quoting directly from the report): "Based on the information presented above, we believe that the Hospital should pursue the CAH program." 

The Camden Group, which Sutter is now paying to perform a strategic options study for the hospital, has been directed by Sutter to include Critical Access designation as one of the options for Sutter Coast.  The Camden Group has longstanding and ongoing business relationships with both Sutter Health and Sutter CEO Pat Fry.  Sutter Health wrote the study proposal and conducted private conference calls with their prescreened consultants. Hospital Board Chair Ken Hall then single handedly appointed three community members to select the final consultant.  Today, Ms. Horn mentioned that a group of 15-18 community members would be involved in the study going forward.  This was news to me-no such information was ever presented or discussed in the hospital Board room.

Ms. Horn also stated today that Regionalization is indefinitely postponed.  Please note the following: if Sutter would release the minutes of the 3/7/13 Board meeting, you would read that Regionalization is only being "temporarily set aside", while "the process remains in place."  Regionalization and Critical Access were put on hold by the hospital Board only after Superior Court Judge Leonard LaCasse issued an Injunction blocking both programs.  Sutter Health attorneys are currently trying to lower the Injunction.

It is my understanding that outside funding is still available for the hospital options study--why not start the process over, with outside funding and community input from the beginning, using a company without longstanding ties to Sutter Health?  We all agree we need a study-let's make it a valid one.

Our concerns with Critical Access are twofold.  First, the program would eliminate 50% of our hospital beds, necessitating hundreds of emergency patient transfers every year to distant hospitals, at the patients' risk and expense, and without their family or local doctor at the receiving hospital. Second, Critical Access would precipitate significant layoffs at Sutter Coast.

At Sutter Lakeside, which is not as busy or as remote as Sutter Coast, the implementation of Critical Access was followed by massive job losses, and closure of two outpatient clinics. According to a March 2008 press release from Sutter Lakeside, Critical Access designation would "preserve the over 600 high quality jobs SLH provides in our community," adding that "SLH will be able to invest more in our community and expand our services--not cut them."  The reality at Sutter Lakeside has been quite different.  The "over 600 high quality jobs" have been reduced to approximately 270, including a 10% across the board cut in March 2012.  SLH also closed two outpatient clinics following Critical Access designation. 

The concern with Regionalization, which dissolves our local hospital Board and transfers ownership and governance of our locally owned hospital to a Sutter appointed Board in San Francisco, is that we lose control of all decision making, including the decision to implement Critical Access, and the decision to outsource jobs out of the community as part of Sutter Health's "Shared Services" program.  Regional President Mike Cohill told us during a recorded meeting last August that under the "Shared Services" program, only employees who touch patients can be assured their jobs will stay local.  

An ongoing frustration among the community is Sutter Health's refusal to release the financial data for the hospital or meeting minutes from the Board of Directors.  We hope Sutter will honor the Healthcare District's subpoena for the financial data (which Sutter attorneys have to date ignored), and will respect Supervisor Finigan's request today that the Sutter Coast Board release their meeting minutes. An open process would do wonders to resolve this conflict.  

Please feel free to contact me with any questions or comments.  It is only through open communication that we will resolve this issue to the benefit of the residents and visitors of our two communities, and the many talented and dedicated hospital employees and auxiliary members whom I have had the privilege of working with at Sutter Coast Hospital for the past 21 years.

Sincerely,

Greg Duncan

Gregory J. Duncan, M.D.

Chief of Staff

Sutter Coast Hospital

 

Editorial on Hazards of Regionalization

Coastal Voices: Regionalizing Sutter Coast hazardous for rural area

Written by Catherine Wiley April 10, 2013 05:36 pm

Sutter Coast Hospital provides health care services to Del Norte and Curry counties, both of which are designated by the federal government as Medically Underserved Areas by Population (MUAP) as well as Health Professional Shortage Areas (HPSA). “So what?” one might ask. Well, those designations mean that our area residents and visitors have fewer choices in medical providers and more limited access to health facilities compared to adequately served areas. However, those same area providers and facilities benefit from financial reimbursement incentives intended to expand and enhance direct service provision.  The MUAP designation is based on the percentage of the population below poverty levels; percentage of the population 65 and over; infant mortality rates; and the ratio of primary care physicians to the population. (That, by the way, does not reflect seasonal tourism influxes and their health care needs.)  Del Norte County was designated in 1991, and Curry County was designated in 2001. While the data used for establishing the designations are of interest and intended to be assistive, they are truly inadequate in assessing or measuring comprehensive, qualitative, holistic health care needs. So, we are rural, remote, poor, designated as medically underserved, and many of us are old. We also have virtually no public transportation; excessive costs for private transportation; one (and only one) north/south highway — which has failures and closures on an annual basis; one small, expensive and limited airport; dependence on life flights for emergencies (costing thousands of dollars); and, we are in a tsunami area that could be devastated/destroyed by any number of potential earthquakes. What we deserve, and need, is not just a given number of medical providers and/or facilities. We must have the right of access to local, quality, comprehensive health care provided by culturally competent individuals. The majority of residents in our communities do not have the means, public or private, to be with ill/injured family members outside of our immediate area. The significance for each of us, particularly the cultural importance, of being with family; welcoming new life and honoring elders, cannot be overstated.  The direct benefits of support from family and friends during illness/injury have been documented physically, financially, psychologically, and emotionally. The indirect benefits are immeasurable. Based on these facts, virtually every hospital now has “rooming-in,” directly in the patient’s room, or housing for family /patient support members, at very low cost, in near-by facilities. The primary issue seems apparent. None of us can afford the risk of Sutter Health’s attempt to regionalize Sutter Coast Hospital, or designate it as a Critical Access hospital.  The outcomes would include the reduction of hospital bed capacity by 50 percent, and require them to maintain an average length of hospital stay to be less than four days. It would also eliminate the current requirement to have a physician on duty in the emergency room, as well as having a general surgeon and intensive care specialist on call.  I know I am “old school,” having passed my Board exams back in the day when being in the medical profession included caring, dedication and service; and, local hospitals were involved with and cared for their communities. Now, we have “non-profit” hospital business chains where executive salaries and net profit margins exceed many of those in major, profit-making businesses. Perhaps the question that should be put to the Sutter Coast Hospital Board of Directors is, just who and/or what interests do you represent? Under their proposals for regionalization or Critical Access designation, will the Board or Sutter executives be paying for patient and family air transport and room and board? According to the Time magazine Special Report, “Why Medical Bills are Killing Us”, 3/4/13, “… outpatient emergency room care averages an operating profit margin of 15% and nonemergency outpatient care averages 35%. On the other hand, inpatient care has a margin of just 2%.” If those figures aren’t clear enough profit incentive for Sutter Health’s desire to reduce access to local care, perhaps their CEO’s salary is an answer.   According to the same comprehensive and well researched Time article, “… Sutter Health (is) a dominant nonprofit Northern California chain whose CEO made $5,241,305 in 2011. ”When health service provision and access are already determined to be inadequate, it is unconscionable to consider further limitations, especially if based on profit margins and executive salaries, rather than the essential needs and rights of those of us here in Curry and Del Norte  Counties. Please get involved with this potential threat to the health and well being of our communities. Contact your elected officials, and/or learn more on http://crescentcityhospital.blogspot.com/ . Catherine Wiley is a retired California registered nurse practioner who lives in  Curry County.

Newsletter 3/25/13

MARCH 25, 2013
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LATEST NEWS ON SUTTER HEALTH'S REGIONALIZATION AND CRITICAL ACCESS EFFORTS
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

SUTTER HEALTH ANNOUNCES RESIGNATION OF HOSPITAL CEO EUGENE SUKSI
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Summary of the past three weeks:
3/4/13:  Hospital physicians notify Board of Directors of Sutter Coast Hospital 
that the Board's purposeful exclusion of interested parties from their decision 
to transfer hospital ownership to Sutter Health violates Medicare regulations and
Joint Commission on Hospital Accreditation standards, and that Sutter's Regional
bylaws violate California law which protects patients from corporate employees 
with no medical training having authority over patient care policies.

3/5/13:  Del Norte County Board of Supervisors draft a letter to the California 
Attorney General asking for an investigation of Sutter Health's activities in our
region.

3/7/13:  Hospital Board acknowledges receipt of physicians concerns, but takes no
corrective action.  Instead, Sutter Health attorney Michael Duncheon states that
he will prepare a response for the Board.

3/25/13:  Sutter Health Sr. Vice President Mike Cohill announces resignation of 
Sutter Coast CEO Eugene Suksi.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

You may be wondering what prompted the resignation of our CEO.  Based on the timing,
I doubt the resignation had anything to do with physician input.  Local doctors,
including those employed by Sutter Health and Sutter Coast, asked Mr. Cohill to
bring in a new CEO for our hospital last year, but Mr. Cohill took no action.  
I believe it is all of us in the community standing together that makes Sutter Health
nervous. 

 Our local elected leadership deserves credit for relaying your concerns
to statewide agencies. The local response has been universally positive, but in 
particular, Kathryn Murray and Kelly Schellong have been working with the City Council,
Roger Gitlin and Martha McClure with the County Supervisors, and Dwayne Reichlin
and Kevin Caldwell with the Healthcare District. Sheriff Dean Wilson and District
Attorney Jon Alexander have both written strong letters of support, and Richard 
Enea and Mike Sullivan each submitted recent letters on behalf of city and county
leadership.  The Director of the United Indian Health Services, representing seven
local Native American tribes, wrote an excellent Declaration in support of the litigation
opposing Sutter Health.  Most of all, the more than 2500 local residents who signed
our petition to oppose Sutter Health should know your voices are being heard.  Next week, I will send a copy of the petition to state and federal representatives.

Here is the update on the litigation between the Healthcare District and Sutter 
Health:

You may recall that during the most recent hospital Board meeting, the Board
voted to "postpone" their efforts to transfer hospital ownership to Sutter Health.
But the Board did not rescind their three prior votes in favor of Regionalization,
nor did they agree to set aside litigation in the Court of Appeals, where Sutter
Health is trying to lower the Injunction that is blocking them from taking hospital
ownership or implementing Critical Access designation.

Next, some good news:  Based on letters of concern from community members, I was
contacted by the offices of State Senator Jim Nielsen, and U.S Congressman Jared
Huffman, who offered their support.  If you want to have a say in the future of 
healthcare in our region, please consider writing to Sen. Nielsen and Congressman
Huffman.  If you need help putting your thoughts on paper, send me an email at drgjduncan@yahoo.com  or call me at 707-465-1126.

Finally, the best news of all:  If we keep working together, something good will
come out of this struggle.  If we can expand and improve healthcare in our region,
every resident and visitor to our beautiful North Coast will benefit.
Thank you all again for your advice, support, and prayers.

Greg

Gregory J. Duncan, M.D.
Chief of Staff
Sutter Coast Hospital

Update on Sutter Coast Hospital 3/8/13, and upcoming Town Hall

Sutter Health Postpones Regionalization As They Advance Litigation   Last night, the Board of Directors of Sutter Coast Hospital, in the face of overwhelming community opposition, voted to put Regionalization on indefinite hold.  The Board recognized that their plan to give away hospital ownership has "bogged down," thanks to your efforts. While this is favorable news, actions speak louder than words--the Board refused to drop its legal fight to be able to implement Regionalization and Critical Access. In fact, Sutter Health and the local hospital Board expanded the legal action by filing a motion in the Court of Appeals to remove the Injunction (which blocks Regionalization and Critical Access). This  legal maneuver by Sutter Health and the local Board is costing our county Healthcare District additional legal expenses and diverting local resources away from patients and into the Appellate Court.  If not for the efforts of our Healthcare District Board, I have no doubt that Sutter Health's plan to take ownership of the hospital would have already taken place.  It is unfortunate that the local hospital Board, the majority of whom reside in our two counties, decided to support Sutter Health's decision to expand the litigation. To learn more, please join me at a Town Hall scheduled for 6 p.m. this Tuesday, March 12, at the Fairgrounds.  I will be presenting information on how Sutter Health's policies drive up your healthcare costs, and providing specific examples of "inaccurate" statements which Sutter Health executives have made to our community as they try to take ownership of our hospital. The following is a verbatim copy of a letter which I read to the Board of Directors at last night's Board meeting (bold sections emphasized during the meeting):  Dear Fellow Directors of Sutter Coast Hospital: It is clear that concern is continuing to build among the citizens of Del Norte and Curry Counties with respect to this Board's decision to Regionalize Sutter Coast Hospital.  Although this Board made a deliberate decision in September of 2011 to exclude the community and its elected leaders from the Regionalization discussion and vote, the community now understands the impact of Regionalization on our citizens.  Unless this Board reverses its prior decision, ownership and all decision making authority of Sutter Coast Hospital, including the immediate decision to reduce the hospital bed capacity by 50%, will be made by a 32 member Board in San Francisco. Over 2,500 local residents, and every elected official in Del Norte County, have provided written opposition to this Board's decision to transfer hospital ownership to Sutter Health Corporation.   Mike Cohill, the President of Sutter West Bay Region, has told this Board that Sutter Health may choose to close this hospital entirely.  Yet, and please correct me if I am wrong, none of the community appointed Board members have ever approached Asante, or any other hospital corporations, to examine other options.  It is not only our right to look at partners other than Sutter Health, I believe it is also our responsibility. This Board now faces a decision which will impact every resident of our region--whether to downsize the hospital to fit Critical Access designation.  Sutter Health has already presented, through their executives at Lakeside Hospital, their case for Critical Access.  Please be aware that following that presentation, I made three attempts to contact Siri Nelson, Sutter Lakeside CAO, with follow up questions from their presentation, including specifics on how often they have violated the Critical Access criteria.  Ms. Nelson has not responded to any of my inquiries.  In addition, we have been denied access to the data used in the 2008 and the 2012 Critical Access studies, which were commissioned by Sutter Health. However, we do know, based on census data from Sutter Coast Hospital, that had we been a Critical Access hospital, we would have been closed to all patient admissions over 50% of the days, and closed to all but maternity and pediatric patients on over 70% of the days during the four month period ending 2/1/13.  I understand Critical Access will increase profits to Sutter Health, but the cost in financial and human terms to our community is simply unacceptable, especially considering this Board has not looked at other options. In an effort to determine which healthcare model would best serve the residents of Del Norte and Curry Counties, I contacted Asante Health system, and two other potential partners, all of which expressed interest in our hospital.  As you recall, the Board Chair was critical of this action, and no follow up action was taken by this Board of Directors. This Board has also recently been notified, in the opinion of a recognized healthcare legal expert, that Regionalization violates California law.  John Harwell, the attorney who wrote this legal opinion, was mutually agreed upon by the Medical Staff and Sutter Health executives, prior to his analysis. Given the fact that it has been determined that Regionalization would implement governing documents which are illegal and which expose physicians to possible sanctions by the Medical Board of California, it is the obligation of the Medical Staff to inform the Board.  It is the hope of the Medical Staff that the Board will take immediate corrective action, as outlined in a Medical Staff resolution, passed by unanimous consent during the Medical Staff meeting of 2/28/13, and distributed to this Board on 3/4/13. While Sutter Health engages the Healthcare District in protracted litigation, and appeals the Injunction which blocks Regionalization and Critical Access designation, let us not wait for a panel of arbitrators or an appellate judge to determine the future of healthcare in this region.  Rather, let us act promptly, and in the best interest of our community, to provide the quality health care they deserve. Sincerely, Gregory J. Duncan, M.D. Chief of Staff Sutter Coast Hospital Local physicians are committed to preserve the hospital and expand services.  Here is what you can do to help: 1. Write a letter to our newspaper and our elected representatives.  Congressman Jared Huffman and State Sen. Jim Nielsen have both contacted us with interest and concern. Let them know your opinion.  If you need help getting your thoughts on paper, contact Roxie Hazard at roxiehazard@charter.net   2.  Stop by my office on 1200 Marshall St. to sign the petition opposing Sutter's plans, and pick up more information, including addresses for our local newspapers and our state, national and local elected officials, which are also available at: http://crescentcityhospital.blogspot.com/ 3.  Contact me at drgjduncan@yahoo.com with questions or comments, or if you would like to be included on our email list.  Your email address is never released to anyone. 4.  Please forward this email to anyone who may be interested!    If Sutter downsizes or closes our hospital, it will impact everyone who lives in, or travels through, our two counties. A Sutter lawyer told me last night that Sutter Health has total control over our hospital, which is simply false. Another Sutter "highly compensated employee" told me our community is not sophisticated enough to understand this issue.  Let's tell Sutter we disagree. Thank you all for your help and support. Greg