Board would switch from local to regional
A plan to regionalize the management of Crescent City’s Sutter Coast Hospital has prominent local doctors concerned that community influence over health care will die out at the county’s only primary care facility.
Hospital CEO Eugene Suksi will talk about the plan to transfer hospital control from a home-based board of trustees to a regional one at 10:40 a.m. today during a meeting of the Del Norte County Supervisors in the Flynn Center, 981 H Street.
Since switching from county management to private nonprofit control in 1986, Sutter Coast has been overseen by a board of trustees, consisting of local volunteers, the hospital’s chief of medical staff and a corporate Sutter Health representative.
The hospital is an affiliate of Sutter Health, which in 2009 began a drastic corporate reorganization, consolidating 28 separate facilities into five regions.
The two farthest flung hospitals, one here and one in Hawaii, were the only places left out of this effort to bundle resources and cut costs, until now.
In November Sutter Coast’s board essentially approved its own dissolution when it voted 8-1 to pursue making the hospital a part of Sutter Health’s West Bay Region, a cluster with five other hospitals in Sonoma, Lake, Marin and San Francisco counties, the nearest one being 258 miles south of Crescent City.
Then-chief of medical staff Dr. Kevin Caldwell cast the dissenting vote against regionalization, raising “strenuous objections” to the potential loss of local control over health services.
Instead of a board of trustees, a regionalized Sutter Coast will have an advisory board that can make recommendations to the new decision-making body, a regional board composed of a dozen or so representatives from the other affiliates.
Del Norte is not guaranteed any spots at the board’s table right away, Suksi told the Triplicate Monday, but he’s optimistic it will reach out to local leaders.
“Why would they ask us to join West Bay and then not invite us to be part of the West Bay board?” he said.
Caldwell, who left the chief of staff post in January for reasons unrelated to the regionalization, is unsettled by this uncertainty.
“It’s a dangerous situation for the community,” he said in an interview Monday. “Basically Sutter Health has a stranglehold on health care in this county.”
Caldwell credited the board of trustees with ensuring needs were met, regardless of profitability.
As an example, he said, six years ago the hospital was seriously considering doing away with obstetrics, meaning pregnant women would have to drive 80 miles to the nearest facility.
Even though obstetrics is a “money-loser” the board of trustees stepped in to keep those services going, Caldwell said.
Suksi disagreed that a regional board would be any more likely to forgo patient needs in pursuit of a black bottom line.
“If anything, regionalization allows us the resources to do things efficiently and better support programs that don’t make money. Sutter has alway put more resources into (Sutter) Coast than they’ve drawn out,” he said, mentioning some $8 million in building improvements during 2011.
The current chief of medical staff, Dr. Greg Duncan, agreed with Caldwell that the board of trustees has been a powerful advocate for the community’s interests in the past.
“What about all these times when the community has a need and they want to expand service? We’re not involved in that anymore,” he said.
He also chafed at the administration’s lack of communication.
“There was never any attempt by Sutter Health or Sutter Coast to engage the medical staff at large in this decision,” he said in a phone interview.
He was under the impression that he might not even be allowed to attend the regional meetings.
This is not the case, said Suksi, explaining that each chief of staff from the region’s affiliate hospitals are on a panel that reports directly to the regional board.
Suksi said Sutter Health is bracing for a $1 billion decrease in revenues over the next decade as a result of dwindling reimbursements from Medicaid, Medicare and Medi-Cal.
Prices at Sutter Coast went up 3 percent last year, while costs for hospital employees’ health insurance went up by 7.5 percent, according to Suksi.
“If it’s too expensive for our patients to access care, then we’ve missed the boat,” he said. “We always got our resources from distant points to the south. Really, the geographic distance isn’t any more of an obstacle than it was before. In some ways the distance when we were one of 28 (hospitals) was a whole lot more of a challenge.”
The county’s health care district is organizationally unrelated to the hospital’s board of trustees, and is made up of elected representatives tasked with a broad mandate to improve health in Del Norte.
Caldwell serves on this district and was chair of it when fellow hospital trustees gave a presentation on the plan to regionalize last year.
“A couple of the board members did come to a health care district meeting, but it wasn’t for advice, it was just to say, ‘This is what’s happening,’” he said.
Dwayne Reichlin has been on the health care district for a quarter of a century, nearly continuously since Sutter Health acquired Seaside Hospital from the county.
“Someone needs to explain to me better how someone on a board in the Bay Area can make decisions for people in Del Norte County better than people that live and work in Del Norte County,” he said by phone Monday.