Coastal Voices: Secrecy imperils locally owned, full-service hospital


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.

At Sutter Lakeside, a hospital of similar size to SCH, regionalization and Critical Access designation were followed by massive job losses, closure of two clinics and a 150% increase in emergency patient transfers.

Why does a charity operate in secret?

When the local hospital board voted to dissolve itself, it did so without looking at options, such as affiliation with Asante Health System, which operates three hospitals in southern Oregon. Asante has publicly expressed an interest in our hospital, but to my knowledge no one on the hospital board other than me has approached Asante. Now, after intense public criticism of their secrecy, Sutter Coast is paying a consulting firm $170,000 to evaluate strategies, including Critical Access. However, Sutter Health controls the study, after refusing outside funding from three charitable foundations. The consulting firm is not permitted to audit the hospital financial records or make any recommendations - they are allowed only to list options for the hospital board, which already voted to regionalize Sutter Coast.

The most disturbing aspect of this process is the hospital board's refusal to involve the public, beginning with their 2011 vote to regionalize Sutter Coast, cast in a closed board room at the deliberate exclusion of interested parties. Hospital Chief of Staff Kevin Caldwell M.D. objected to the board's regionalization vote, noted that they did not understand the transfer of ownership and asked for more time to study the issue. Nevertheless, the board voted to regionalize over his objection. The hospital board meeting minutes, hospital financial data and even the membership and discussions of the current "steering committee" on the hospital study, all remain secret.

The hospital board has not held a single public forum since their decision 20 months ago to transfer Sutter Coast ownership to Sutter Health.Last month, the hospital CEO and board chair abruptly withdrew from a Town Hall event they had committed to attend. No observers are permitted to attend board meetings. The board chair will not allow community letters of concern to be discussed in the board room.

Last week, The Joint Commission, a national accreditation agency which certifies hospitals, validated physician concerns that the hospital board had inappropriately excluded physicians from hospital policies, in violation of our bylaws. Sutter Coast Hospital leadership received four Joint Commission citations for failing to address physician concerns regarding regionalization.

Sutter Coast Hospital is a locally owned public benefit charity, with a monopoly over local hospital care and the privilege of tax exemption. Sutter Health and the hospital board are making decisions which will affect the lives of 41,000 people within the hospital's service area.

Given the level of public concern, is it not appropriate for Sutter to release the documents the public needs to understand this issue? Why does Sutter continue to operate behind closed doors, hold secret meetings, and withhold critical information this community needs for its long term planning?

I applaud the County Supervisors for asking Sutter to release this information. Let's end the secrecy. With Sutter Health's approval, I will make all the documents available on our website atwww.crescent, including a link to the audio recording where Sutter Health Regional President Mike Cohill discusses Sutter's program to outsource jobs and confirms that SCH is still a locally owned corporation. Printed information, and a petition opposing Sutter's plans, are available at my office on 1200 Marshall St. To receive future newsletters, please send me an email at .

I deeply appreciate the support from everyone who has joined our effort to stop Sutter Health, and preserve a locally-owned, full-service hospital.

Gregory Duncan M.D. is chief of staff at Sutter Coast Hospital.

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