Following a heated debate, Supervisor Martha McClure on Tuesday tearfully withdrew her offer to participate in a Sutter Coast Hospital study that will be funded by its parent corporation and that some local physicians believe will be biased.

County supervisors will instead send a letter to Sutter Health representatives stating that unless the corporation seeks alternative funding sources and makes the community more involved, they will not participate in the study, which will focus on the future of Crescent City's hospital and its potential downsizing to a critical access designation.

The county will also base its letter on an April 19 letter Sutter Coast Chief of Staff Dr. Gregory Duncan sent to Traci Van, Sutter Health's director of community benefit. Duncan's letter outlines the medical staff's series of concerns, including the fact that the study is being funded by Sutter and that Sutter representatives are pre-screening the consultant to conduct that study.

Sutter Health representatives have asked community members to participate in the study by helping to interview the firms it has pre-screened.

According to Duncan, outside funding for the study dissolved after Sutter Health released a memorandum in December that reads "we believe Sutter Health is the best partner for us now and in the future." Sutter Health had asked five community groups and individual members to participate, but once they discovered the study would be funded solely by the corporation, they withdrew their participation, Duncan said.

"The general consensus among the community members that were invited, but declined to participate in the study, is that Sutter Health is using them to provide a veil of legitimacy to an illegitimate process," he told supervisors, reading from a prepared statement. "The Health Care District resolved unanimously not to participate in the study under the current constraints imposed by Sutter Health."

In a presentation before the Board of Supervisors on Tuesday, Duncan asked for an explanation of the process that resulted in McClure being asked to participate in Sutter Health's study. He cited several e-mails between Van and McClure and stated that he feels there is a communication problem between local physicians and the Board of Supervisors.

"You're communicating really well with Sutter, but we're frustrated because we're not getting the same level of communication in my opinion," Duncan said. "To summarize everything I think Supervisor (Mike Sullivan) of all people, who ever opined about this issue said it best: 'Dealing with Sutter Health is like dealing with Mr. Potter on 'It's a Wonderful Life.' If supervisors can work with Mr. Potter that's great. We don't want to question that."

Sullivan said Sutter Health had initially approached him to participate, but he felt compelled to bring the matter back to the entire board. McClure had been on a subcommittee of the Board that works with the Health Care District for many years, Sullivan said.

During a closed session April 9 the rest of the supervisors, except for Roger Gitlin, agreed that McClure would be the best person to participate in the study, Sullivan said.

The issue was not on the closed session agenda for April 9, nor was there an official vote, said County Counsel Gretchen Stuhr. Sullivan said Tuesday's vote would have made that informal agreement official.

"This item on the agenda is formalizing the process," Sullivan said. "That's why it's on the consent agenda for Supervisor McClure to be on that."

McClure said after speaking with Sutter Health representatives, she agreed to participate in the study because she thought doing so would give the county better standing in a court battle to stop the hospital from downsizing. But, she said, she was surprised to find that all five community representatives that Sutter approached declined to participate in the study.

McClure said Van had sent her an e-mail stating that Sutter Health was going to ask hospital board members to participate in the study in lieu of community members.

"For me, I felt that was a giant set-up, because if the board's been included and they will be the people doing the interview, I felt that was a total conflicted response," she said prior to withdrawing her participation. "My goal for today is I think we should appoint for the study and then if we discuss it and say the study is faulty then we decline to participate. What that does is it puts us on the record that we want to have a study."

During public comment on the issue, Duncan's wife, Dr. Ann Marie Duncan, said she was also concerned that McClure was corresponding with Van, but hadn't answered her husband's e-mails. Meanwhile Dr. Mark Davis, a local neurologist, called for the county, city and Health Care District to do its own study.

Community member Aaron Funk said he was worried that a county decision to participate in Sutter Health's study would backfire.

"You know they're out to get you, you know they don't play fair, you have to know that when they make decisions, the Board of Supervisors will be part of this decision," he said. "They'll take that to court and you'll look back and say, 'gosh I wish we hadn't.' I call for a fair, unbiased, brand new study."

Dr. Kevin Caldwell, the hospital's former chief of staff, said he thinks the Board of Supervisors should write a generic letter to support an independent study, but shouldn't name McClure as being part of it.

"I tell you they will twist that around and use it," Caldwell said.

At that point, McClure said she was withdrawing her name and her participation.

"I have been working on health care in this county since we've tried to do the physicians retention project," she said. "I have been an adamant protester against critical access (hospital downsizing) to the point where I made contact with supervisors in Lake County to find out that it was not working there. I have tried to turn every stone. I have tried to ask Congressman Huffman to write legislation that's going to protect rural health care. I have worked tirelessly on this. I'm absolutely flabbergasted."

Following the board's vote, McClure left the meeting.

Sutter Health's newsletter has said the firm conducting the study will be asked to analyze the viability, advantages and disadvantages of a number of strategic options, including having Sutter Coast Hospital maintain its current governing structure, according to a hospital newsletter. Other options include having the hospital maintain its current governing structure, but pursue other business strategies such as critical access status, which would involve downsizing.

The firm will be asked to base its analysis on the hospital's ability to meet current and future community health care needs, as well as Sutter Coast's finances and operations. The firm's representatives will then present the outcome of the study to the hospital Board of Directors and will participate in an open presentation to the community, according to the newsletter.

Reach Jessica Cejnar at