In response to the July 18 Coastal Voices piece by my colleague, Dr. Greg Duncan (“Secrecy imperils locally owned, full-service hospital”), I feel compelled to offer a slightly different viewpoint from a physician who has also been in this community for a long time.
Although I have agreed with my fellow physicians on some of these issues rejecting regionalization, it is solely because I believe that it is a step that will lead rather quickly to critical access application for this hospital. Based on what I know about the many ramifications of critical access, I would prefer that Sutter Health not take that step, at least not until it was absolutely necessary.
The main objection of the medical staff has been the process of the decision by the Board of Directors at Sutter Coast, in that we physicians as a group were excluded, and we do not understand, even at this late date, the need to take these steps. We want to understand the reasoning behind this process and we are also convinced that the public deserves similar understanding.
If, however, critical access were not being discussed in the same breath, I might be in favor of regionalization because the potential benefits might outweigh the numerous objections that have been raised.
I do not favor the hospital Board’s decision to “go regional” without bargaining to get a permanent seat on the regional board. But even setting that aside, if Sutter Health through the West Bay Region could assure a supply of physicians to this community by virtue of the resources of the West Bay Region physician foundation, then “going regional” might be the best solution to the main chronic medical problem in this community — lack of physicians.
In the first years I was here, in Crescent City alone, there were seven private primary care offices whose physicians had privileges at the hospital, and at their peak these offices numbered about 15 physicians between them. Now there are two such private offices in this town, with four physicians between them. I am now in my 21st year as a working physician in this community and during that time I can think of only one or two cases where physicians, after announcing their intent to leave, have actually replaced themselves, or been replaced in a timely way. All the others have retired, died, or moved away and turned their patient files over to the care of a partner or some other local office. Numerous physicians have been brought to this community to try and fill the gaps, and in most cases they left after only brief stays.
On Wednesday, I retired as the director of the Del Norte Solid Waste Management Authority.
It has been apparent for some time that the Board of Commissioners and I have fundamental disagreements about the proper direction for the agency, especially regarding the possibility of dissolving this partnership between the city and county and totally privatizing solid waste in our community. For this reason, it is in the interest of both parties to negotiate a separation.
In response to the question of “missing money” referred to in a Thursday Triplicate article, let me state unequivocally that I have done nothing illegal. Three separate auditors have investigated this issue with an indeterminate conclusion.
There is no evidence or even a suggestion of impropriety on my part. The only thing that I am being blamed for is the fact that I was the director when this problem occurred.
If I am going to be held responsible for this recent accounting issue, then I should also be given credit for my many accomplishments over the last 20 years. It is only fair that I should be evaluated on the totality of my employment here. Let me go back to the beginning.
When I first moved here in 1993, the entire system was privately operated by Del Norte Disposal, aka Recology Del Norte. It ran the collection vehicles, operated the county-owned landfill and collected the fees at the gate. After state agencies started imposing enforcement orders and fining the county for violating anti-pollution laws, the private company was able to walk away with no cost or liability.
It happens once in awhile.
And summer is the most likely time.
We have a week with no special programs to tell you about. But just because there are no special events doesn’t mean there’s nothing going on at church!
Most churches have lots of scheduled activities that occur on a regular basis. Some are well attended, some are not.
Lots of folks seem to feel that going to church on Sunday (or Saturday) morning is sufficient, electing to skip mid-week studies and things like game nights and movie nights. Some churches have various classes — sewing, crocheting, quilting — where ladies can gather and work on projects together.
Often these classes welcome the younger ladies to come and learn the various crafts. In the old days, most homes had an older aunt or grandmother to help teach young girls these skills, but as more and more women found it necessary to join the workforce, these skills dropped by the wayside.
Game night is one regular activity at my church that I thoroughly enjoy. Once a month we gather, bring snacks and our favorite games, and spend two to three hours together just having fun. It makes not only for a very enjoyable evening but allows those of us who participate the chance to get to know each other so much better.
Spending time at a recent two-by-two meeting of the Board of Supervisors and the Del Norte Health Care District Board gives me the opportunity to address concerns I heard.
The public seems eager to get the facts and we want to offer them. As a reminder, we are in the midst of the Strategic Options Study with The Camden Group because of very real financial issues. Our No. 1 goal is to ensure this community has access to health care.
The first misconception continues to be that regionalization/centralization equals Critical Access Hospital (CAH) designation. This is not true. Regionalization is strictly a governance structure. Sutter Coast Hospital will continue to have a local administrative team and input into governance matters and a local advisory board.
The regional bylaws require that the Board be representative of the communities it serves. The current West Bay Board has individuals from each of the four counties in which it has facilities. If Sutter Coast becomes part of the West Bay, I have every reason to believe there would be at least one individual from Del Norte County.
Some have speculated that if we regionalize, we impose CAH designation. We have not made that statement, or that decision. In fact, The Camden Group, as discussed in my last “Coastal Voices,” has been enlisted to guide us through the process of analysis about the best options to ensure that the hospital can meet the health care needs of our community now and in the future.
A significant focus of The Camden Group is patient safety, quality of care and the financial impact to access that care. This study is currently under way and we look forward to the evidence-based interactive process. The Steering Committee plays an active role.
In light of the recent meetings, blogs, guest opinions, letters to the editor and general public discussion regarding the plans of Sutter Health to regionalize our local hospital, I felt compelled to discuss the issue and hopefully provide some much-needed clarification as to the involvement and position of the Del Norte County Board of Supervisors.
At the request of doctors Greg Duncan and Kevin Caldwell, the Board of Supervisors has considered the potential impacts of a possible regionalization and designation of Sutter Coast Hospital as a Critical Access facility. After considering the information provided and available, the Board of Supervisors unanimously voted to support the doctors and the Health Care District in its opposition to regionalization and Critical Access designation.
The Board of Supervisors followed up with letters demanding the disclosure of information being held by Sutter Health and the local Hospital Board to allow for a full and accurate discussion of the decisions being made behind closed doors.
To reiterate, the County Board of Supervisors has from the beginning opposed any designation of Sutter Coast Hospital that would negatively impact our residents.
Recently, the Board of Supervisors and the Health Care District conducted a “two-by-two” meeting between the appointed committee members to discuss the settlement of a lawsuit brought forward against Sutter Health by the Health Care District.
It’s one thing to give undocumented immigrants an opportunity — however limited and lengthy and expensive — to gain American citizenship if they’ve lived and worked in this country for a long time while contributing and without committing any criminal offenses.
Drivers licenses for the undocumented also make some sense, especially since many law enforcement officials say that could compel those here illegally to obey laws requiring car insurance, thus cutting down the expenses of other drivers who may be involved in accidents with them.
But one bill that has passed the state Assembly and is now in the Senate simply makes no sense: Called AB 1401, this proposal would allow non-citizens to serve on juries in California’s state courts.
Never mind the longstanding American tradition of a having a jury of the defendant’s peers determine whether criminal charges are valid. That’s merely a custom, not a constitutional right.
The Sixth Amendment says only that every American is entitled to an “impartial jury” and that its members should live in the state or district where the crime under consideration took place. Courts have interpreted this to mean jury pools should contain a cross section of the population of the area, in terms of gender, race and national origin.
No one yet has specified that jurors must be U.S. citizens, perhaps because at the time the Bill of Rights — the Constitution’s first ten amendments — was written in 1789 and finally ratified by the states two years later, it could be difficult to determine who was a U.S. citizen. Birth and immigration record-keeping was far from comprehensive.
You can tell that summer has arrived and folks are going on vacation. Or perhaps taking the weekend days to relax at the beach. Or finally taking the time to do all those outside repairs or landscape changes that can’t be done when the winds are driving the rain at you sideways.
Church attendance seems to be down — at least from what I observe lately on my way to church Sunday mornings.
Between my house and my church, I pass four other churches and can see a couple others, and it sure seems like there are significantly fewer cars in the parking lots lately.
I hope summer activities are the reason for all those absences.
The Bible tells us that in the last days there will be a “great falling away” from our faith, and I sure hope we aren’t seeing the beginning of that. Some of the things happening in the world today sure make me wonder!
We have so many great churches here in Crescent City — just about every denomination, and even more than one church in some of them.
People have such varied choices in styles of worship today — it’s so different from when those of us who have reached senior citizen status were growing up. The music, too, has evolved. Often, the traditional hymns have been replaced by choruses of praise, and the piano and organ have been supplanted by praise bands with many more instruments.
I write to separate facts from rhetoric concerning Sutter Health and Sutter Coast Hospital. Currently, Sutter Coast remains locally owned and governed by a local board. In 2011, the hospital board voted to “regionalize” Sutter Coast, which will dissolve itself as the governing body and transfer hospital ownership and governance to a Sutter Health 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 the hospital, 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 the hospital is whether to downsize it 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.
Longtime Del Norte County resident Chuck Blackburn’s column appears monthly.
Recently we watched as the media covered the tragic tornadoes in the Midwest. The F-5 that hit Moore, Okla., was particularly devastating as it hit two schools. The heroism of the educators in helping save many kids’ lives brought back some memories of times past in my teaching career in Del Norte County.
I was a young teacher in October 1962 and a tremendous storm struck the Pacific Northwest and Del Norte County. Wind was the main culprit and 100-mph gusts were reported. I watched from the door of the gym at Redwood School and close to noon a wind gust hit and a TV antenna on a house next door bent over double.
A decision was made to load up the buses and try to get these kids home during a slight break in the storm, but 15 minutes later, they all returned as all roads were blocked by downed trees. Communications went out to parents to pick up their kids whenever possible. We kept kids in the classrooms and I took many into the gym. We had activities to try to keep them calm and happy. Our last kids were not picked up until 6 p.m.
My grandson just discovered we have some new neighbors.
Not welcome ones, either.
As he was mowing the lawn a couple days ago, he bumped the red rhododendron bush and was immediately introduced — to the tune of lots of buzzing wings — to little folks with striped black and yellow coats.
Closer observation revealed a huge gray papery construction in the top of the bush.