Curry County commissioners plan to vote at their March 21 meeting on whether to send a letter to the Sutter Coast Hospital Board of Directors, demanding they address “extremely high health care service charges” billed to Curry County residents.

The letter, authored by Commissioner Sue Gold, was discussed at a March 7 commission meeting. Commissioners agreed by consensus to postpone a vote on the matter to allow Commissioners Court Boice and Thomas Huxley more time to consider the issue.

The issue has repeatedly been addressed at Del Norte County supervisors level. Sutter Coast officials, including Administrator Carlos Priestley, have said they were going to address what Curry County Commissioner Sue Gold calls “outrageous and unwarranted” charges to out-of-network patients with Envision Healthcare, also known as EmCare.

EmCare is the hospital’s emergency room service provider.

“We respected his request with the assurances that specific issues would be addressed and resolved by January of this year,” Gold’s letter to the hospital board approved Wednesday reads. “This has not occurred. It’s been repeatedly brought to our attention. These excessive charges on the citizens in Curry County result in severe hardships — financially, emotionally and physically.

“Unfortunately, there has been no additional communication, nor resolution of the negative impacts on the citizens of both Del Norte and Curry counties.”

Solution coming

Priestley said CEO Mitch Hanna has compared four other providers and will make a recommendation to the hospital board later this month.

“If a new provider is chosen,” Priestley said, “the hospital will have 90 days to terminate the contract with Envision Healthcare.”

Gold also wrote the board is concerned about the “total lack of transparency” in posting emergency room charges for patients.

Priestly, who started with the hospital last April, said in August he would address the concerns expressed both by the Del Norte supervisors and Curry County commissioners. It was that promise that prompted Curry County commissioners to rescind their June 2017 letter of complaint.

“Sutter Coast Hospital has diligently evaluated proposals and met with multiple different medical providers ... as our contracted provider of emergency room physician services,” said Leslie Meiring, Sutter’s communications coordinator based in Sacramento. “We have stated several times to Envision that it needs to accept local insurance plans or we will move to terminate the contract.”

The hospital gave EmCare until January to renegotiate its insurance contracts with local carriers to resolve the problem, Meiring said. A new agreement is supposed to ensure that new emergency care providers are an in-network provider for the health plans that employers have selected for their employees.

Priestley also noted the issue is not unique to Sutter Coast Hospital.

“Envision Healthcare also operates at Curry Medical Center in Gold Beach, Mad River Hospital in Arcata and St. Joseph Health in Eureka with very similar charges for emergency department care,” he said. “While healthcare charges in Oregon are historically lower than in California, Envision Healthcare’s fee structures at Gold Beach are very similar to the ones at Sutter Coast Hospital.”

Priestley also noted that, as a not-for-profit, the hospital provides care to all patients regardless of their ability to pay, and has given twice as much charity care to patients than hospitals in neighboring counties.

Curry and Del Norte counties are designated as medically underserved — both in the specialties offered and the number of physicians delivering care, Gold wrote.

“Components of these designations include our poverty levels, aged population and rural and remote location,” Gold’s letter reads. “To impede and effectively deny essential emergency care (through) your charges and agreements is in direct contradiction to the purpose of federal and state tax exemptions for hospital corporations.”

Boice refused to sign the letter.

“I wish you’d shown this kind of feistiness when I presented my letter to the forest service,” Boice said to Gold, of correspondence he wants the board to sign addressing issues at the Chetco Bar Fire last summer and how they might be overcome in the future. “You said I was attacking them. This (letter) is way too forceful, and it won’t do any good. No, I won’t sign it.”