Emily Jo Cureton, The Triplicate

As a fight over who calls the shots at Sutter Coast Hospital awaits a court hearing, the hospital's chief of medical staff announced last week that "in the event our management arrangement withSutter Healthis not extended,Asante Health Systemhas expressed interest in a closer alignment with our hospital."

So wrote Dr. Greg Duncan in a Sept. 27 email, one of six online newsletters he's disseminated since July making a case against the proposed dissolution of a locally based hospital Board of Directors (on which he sits) in exchange for a governing authority in the Bay Area.

Other local hospital board members and Sutter Health officials maintain that the merger is a financial imperative.

Both sides have placed future hospital access at stake.

On its website, Asante Health System is described as "the largest and most comprehensive health-care provider in southern Oregon and northern California. Comprised of Rogue Regional Medical Center in Medford, Three Rivers Medical Center in Grants Pass, and now Asante Physician Partners, which serves patients throughout our region..."

"Asante made it clear that in no way do they wish to interfere with Sutter Health, and that resolution of the Health Care District's lawsuit against Sutter Health would need to precede any substantive discussions," Duncan wrote in the email sent out to more than 800 people.

A Del Norte County Superior Court Judge is scheduled to hear the case on Oct. 17.

Sutter Coast Hospital CEO Eugene Suksi was not available for comment on Monday, nor was a representative from Asante Health System.

The Health Care District's lawsuit claims that "regionalizing" hospital governance violates terms set out in a lease agreement between Sutter Health and the district in 1986, when services were still based in a county-owned facility on A Street.

The district contends that this agreement guaranteed community-based governance for the long haul.

Sutter Health's attorney has argued otherwise.

"(The Health Care District's) application is an improper and politically motivated attempt (by the plaintiff) to interfere with Sutter Coast's right and obligation to decide how it may best operate its hospital in order to remain viable and continue to provide quality health care services to the community. Plaintiff has no existing contractual right or other legal basis which allows it to dictate how defendants may do so," Michael Duncheon wrote in documents filed with the court Aug 27.

As the hospital's business model in Crescent City remains a contentious subject, changes are afoot for Sutter Health system-wide.

The Sacramento-based corporation recently filed an application with the California Department of Managed Care for a license to form a health maintenance organization, or HMO, catering to small and midsize employers in the urban areas.

Sutter Health Vice President Mike Cohill has expressed doubts that patients in Del Norte and Curry Counties will fit into the managed care model.

"Del Norte is such a rural community I really don't see managed care playing a large role or any role up there," he said in an Aug. 13 interview with the Triplicate.

Pending approval of its HMO application, Sutter Health will continue to contract with and care for patients covered by other commercial health plans, as well as Medicare and MediCal, according to a report from Business Insurance.

Reach Emily Jo Cureton at ecureton@triplicate.com.