Yes on Measure C; support for hospital affiliation

The vote on affiliation of our hospital with Adventist Health is around the corner. Mail-in ballots arrive in a few days and the polls open on Tuesday, March 3. I am writing as a local resident to urge everyone to vote in favor of this affiliation. I am also the Chief of the Medical Staff at our hospital. For full disclosure, I have not been offered any special position in the new hospital and have never been an employee of AH.

The measure will appear on the ballot as “Measure C,” hopefully that doesn’t cause confusion as this has nothing to do with the previous Measure C parcel tax and will not affect taxes. On the ballot, it is described as an affiliation with Stone Point Health, a subsidiary of Adventist. For all intents and purposes, this affiliation is with Adventist Health. It will allow the leasing of the hospital, clinics, ambulance service and home health from the health care district, which retains ownership. The lease is for 30 years.

There are several advantages to this affiliation. Being part of a hospital system brings more resources to help improve leadership, quality and safety of care. It will assist in recruiting primary care providers. It will facilitate more specialty clinics. Recruitment and retention of staff will improve. Patient and visitor experience in the hospital and clinics will also improve. Most important of all, however, is that it will help the hospital achieve financial stability without which the future of the hospital is very uncertain.

The current financial situation is tenuous at best. Despite occasional upswings, the overall picture is one of decline. As a result, many required maintenance and equipment upgrades have been delayed. We repeatedly have to dip into savings to pay bills. We recently went through a round of layoffs. It is hard to imagine how we can avoid closure given the current trends if we do not affiliate.

The problem is not one of mismanagement or failing to bill and collect. It is that the cost of providing health care is steadily rising while reimbursement is declining. This is affecting all small, rural hospitals, and over 100 have closed in the U.S. in the last decade. The principle financial advantage to joining a larger system is through better negotiating power with insurance companies, better efficiencies and savings through economy of scale. Our hospital is the largest employer on the coast with over 300 employees infusing $24 million per year into the economy through salaries. The impact of losing our hospital will be much greater than simply the loss of needed health care services.

It remains to be determined how the affiliation will impact our ability to meet the seismic standards by 2030 and whether that will involve a new hospital or simply upgrading our existing hospital. A brand new hospital building is what we would all like to have, but the cost is around $100 million. Upgrading our existing facility to seismic compliance is less expensive at about $24 million, but doesn’t give us a more modern facility. Since the health care district remains the owner of the facility, the responsibility for these upgrades remains that of the community. The affiliation is expected to help meet those goals by offloading the current losses from the district which in turn will allow it to start saving money for the eventual improvements needed.

The ambulance service on the coast will be maintained at the current level or be increased. Ambulances will not be reassigned inland at the expense of maintaining our current service levels. We expect that home health and hospice services will be improved and expanded. The hospital will come under a new board of directors appointed by AH and will be a volunteer board. This board will include local representation including members of the medical staff and one member from the district board. Some will view this change to be a positive move while others will see that as a negative. In speaking with folks who live in Willits and Ukiah, where those AH hospitals are under the same governance model, it seems to work quite well.

Many have expressed concerns about AH being faithbased. To clarify, Adventist Health is not owned by the Seventh-Day Adventist Church, but the church is its primary sponsor. AH’s mission is to serve all members of the community. Like all health care organizations licensed in California, they are required to provide equal service to all. The issue of LGBT rights often comes up in these discussions and, honestly, was an initial concern for me personally. I was able to speak with several gay and lesbian health care providers at three AH hospitals including at both Ukiah and Willits. They related to me that their experience has been of being treated fairly and with respect and that they have never been aware of any discrimination against LGBT staff or patients.

AH, like other faith-based systems, does not allow for surgical abortions to be performed in their facilities. However, unlike Catholic-based systems, they do allow for a full range of birth control and contraceptives. With respect to a provider counseling patients regarding abortion services, referring for such services and prescribing medications to terminate pregnancy for whatever reason, the official policy is “Adventist Health does not direct prescribing of mifepristone. AH does not direct physicians/providers on contraception, Plan B, hormonal therapies for any purpose, birth control or management of a post pregnancy loss situation.

All other clinical conditions not listed above are decided upon between the patient the physician/ provider as part of standard medical care.” In other words, AH does not place restrictions upon its providers with respect to these matters. Such medications are currently available through North Coast Family Health Center and that will continue.

Similarly, questions have arisen around California’s Death with Dignity law which allows physicians under some very limited situations to prescribe a life-ending medication to a patient with a terminal disease who wishes to end their life to avoid suffering. The law mandates that no health care facility shall subvert this legislation nor interfere with a person’s rights under the law. Adventist Health’s official stand on this is similar to that regarding women’s reproductive rights. AH does not get involved in the relationship between a physician/provider and the patient. The official response on this matter is, “CA state law will be followed for prescribing and administering medications.” Such medications are currently prescribed, when appropriate, through the North Coast Family Health Center and the official word from AH is that this will continue.

In summary, I strongly urge you to consider all of the advantages that this affiliation brings and vote “yes” to the current Measure C. Thank you.