We just mailed the following letter to county 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 percent 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 its 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 its regionalization vote. In every case, the local hospital Board refused to rescind its regionalization 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 (Greg Duncan) 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 it is attempting to take hospital ownership.

In addition, Linda Horn has not responded to our 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, we 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 David 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 providedby 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.

3) Ask Sutter Health to stop using the word "independent" to describe the current study.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 May 28 meeting, including SCH interim CEO Linda Horn, are employed by Sutter Health.

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 us 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.

Dr. Gregory J. Duncan is chief of staff at Sutter Coast Hospital. Dr. Kevin Caldwell is a board member of the Del Norte Health Care District.